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0205-251 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of:the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date 6 42f A BICC � lit`? ] /2 Date �� r l� Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 'License Law for the following reason: ( ) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: () I have and will maintain a certificate of consent to self -insure for workers'af compensation, as provided for by Section 3700 of the Labor Code, for tRe performance of the work for which this permit is issued. ( ) I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier EXEMPT Policy No (This section need not be completed if the permit valuation is for $100.00 or less). ( ) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation,provisions of Section 3700 of the Labor Code I shajl'forthWth comply with those 6r'ovisions. Dae' . a Applicant � - I' �- Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on. his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursua any permit issued as a result of this applicaton agrees to, & shall, inde ify & hold harmless the City of La Quinta, its officers, agents and employ els'. 2. Any permit issued as a result of this application becomes null and v I If work is not commenced within 180 days from date of issuance ofLdin permit, or cessation of work for 180 days will subject permit to cancell I certify that I have read this application and state that the above informat correct. I agree to comply with all City, and• State laws relating to the bu construction, and hereby authorize, representatives of this City to enter upon the above-mentioned property for/inspection purposes. A/11 Signature (Owner/Agent) �>%� '� "`-' Date BUI.LD,IING PERMIT'' PERMI " DATE—VALUATION LOT' TRACT 44.9425.30 20 28470.2 JOB SITE �yry�+Ar�•i�T` ADDRESS �di d�iAdlite94 Ito APN OWNER CONTRACTOR/DESIGNER/EN (NEER C-H",� oxrlol r�msc��rcONSTRzf��1O1� 99 BRIARWO01) ap.t:1~ t ` ` 77.62.2 COU14x12YCLXM- DK 0AII'12Z00K ,s•.. IL 'i'\ 6052 , 13JV Wi DE3W. kT CA. 92211 " (760)34.5.5154 CSL4 5285, USE OF PERMIT MWOLE FA 41L.Y DWRf 1 WG ._ t 3FT31 ILCI'.UC3l�.S'E+TAI I S/.FO©UD1Z3'd1r17TAY APIsRC�AG}1t'U7J1P1.IAtdClrV1T33 .ALL FEDERAL &STAT'E LA1V2J14CbUU1N0 THF ENW.NGERED SPECIE , ACT OF 1973 IF APPLIC.&ULF :0S REQUIPLED CUSTOM CONSTRUCTION 108 .00 SF PORCH/PATIO 1,60:2.00 ."slr 0ARAGEICARPORT 907.00 3F ESTUVUTED C•:0W)" OF CONSTRUC. '�Off �91,9,Cs2:5.�fD PYRMT FW. f,2'Iffii!i[4A CONSTRUCTION FEB 101.000-418-000 SIM9.S0 PLAN CHEA.K TWEE 101-000-439-318 $1,r1aT n FEEDEP031T 1071-000-439-318 -51,000.00 k4EX iANICAi. MEM .101-000-4 I -0010 $163.50 " ELECTRICAL FEE 1011.000420.000 $271,62 PLUMBIWO M, 101-000-419-000 $213.00 STRONG MOTION FEE - R.ES1D 101400.241-000. $41,96 (F3I.&DINO"IF, 101-000-423-0200 $15.009 •� ` DEVELOPER IMPACT FEE. 52,403,00 ART IN PUBLIC PLACES . RESIE 270 -MI -445•-000 $549.04 . iil� •1� cAAY: (,Y tNS"!'12.LTCiT�J1�1 AF3D 1 L,I 1' �G"K. . -$(3,849.96- . LESS PJE R-PAI:"C FEES S l 41.,000,(0�0 r 1 dQTAJ/ A i4 M.1CP" 8 .M QX d• V A"�1i8 j Yi yZP �edFJ MAY 1 9 2003 ITY OF LA QUI.tVTA FINANCE SEPT. ' RECEIPT DATE ws 5- BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wail Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces'that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14X 4,885 S.F. or $10,453.90 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By CC/Banco Popular -Ken Hudson Check No. 798817 Name on the check . Telephone 760/345-5154 Funding Residential By Dr. Doris_ Wilson Superintendent Fee collected /exempted by Signature ilvrey $10,453.90 Payment Recd Over/Under NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated . 'Embossed Original - Building Department/Applicant Copy- Applicant/Receipt Copy - Accounting . y CERTIFICATE OF COMPLIANCE 7 �Fsc Desert Sands Unified School District 47950 Dune Palms Road . zo-0.7 o ¢ BERMUDA DUNES r Date 5/15/03 La Quintaf CA 92253 Cn RANCHO MIRAGE d INDIAN WELLS �+ No. 24426 760 771-8515 LM DESERT d PALA QUINTA ,�y . J'�RINDIOr�, JJ V O Owner Charles Saporito APN # 770-300-002 Address 99 Briarwood Circle Jurisdiction La Quinta city Oakbrook Zip 60523 Permit # 0205-251 Tract # 28470-2 Study Area Type Single Family Residence No. of Units 1• Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 20 78362 Talking Rock Turn 4885 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments ^ At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces'that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14X 4,885 S.F. or $10,453.90 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By CC/Banco Popular -Ken Hudson Check No. 798817 Name on the check . Telephone 760/345-5154 Funding Residential By Dr. Doris_ Wilson Superintendent Fee collected /exempted by Signature ilvrey $10,453.90 Payment Recd Over/Under NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated . 'Embossed Original - Building Department/Applicant Copy- Applicant/Receipt Copy - Accounting . y