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9906-006 (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 Irofessio,nals Code, and my License is in full force and effect.$ License # Lic. Class Exp. Date 08131tza ,Date % f Signature of.Contracto j' It 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 compensatiori, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professionals Code). ( ) 1, as'owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code).. i ( ) I am exempt under Section , B&P.C. for this reason Date Signature of Owner T. 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' compensation, as provided for by Section 3700 of the Labor Code, for the 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 Policy No. FUND (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 shall forthwith comply with thos!9provisions. Date: Applicant. 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 ana for whose benefIC work Is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. �I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the bove-mentioned property for.iinspection purposes. S(gnature (Owner/Agent) Date 5- BUILDING PERMIT PERMT# "WU146 DATE VALUATION S.1l2el2R..So, LOT 62 TRACT 25429 JOB SITE ADDRESS 79-165 JACK &ASIA i• TIkUL APN 769-542-€315 OWNER CONTRACTOR / DESIGNER / ENGINEER M1NI'S" M1 ::.L1-PAiVMe,D CQVE'.ItTc- �6p,��f�"i'T:.11'�u�-S'�Ity"�'4 �� 11_"0V1 , lNC. 747851-fWY 1.11 51'13 105 747,35 HW '.1,1I S"!`E 105 INDIAN WELLS CA 92210 INDIAN WELLS CA 92210 (76()'770-441V CTIL# 3625 4 f USE OF PERMIT ;SW)LE Ftt M L Y 1.t1VE3."f .iNG . D.:PERNu'i D013S NOT MCLOWE B.LOCK WE1U OR POOL. IRA&C 03,x! s• 4tI JON 2,147,00 mol' €'OkCI-P PATTO 3W.00 SF 0ARf1GFJCJVtP0R`P 646.06 alp &S"r-fu "rED COST Or Camt,"WcT.50N, 1''2,.128..5,) C ON'srit 1lov FRE 101-{)s1()418-0) $395.A19 P),. w r'"i3-c"K 3:'1 1111-1)43 X13 - f1 �7 .Ei� MECHA1`1:C&L11m llti-0.00--4a1-000 S?fs. i0 ULM i'RYCA#.1%r-E 10 i X000.440 -#`W PLUTa B * i` H 101-000419-000 176.00 STRONc3MOTION fFS-RF*,q?V) 101 -OM -241-000 $17'23 CRADINQ rrl_ 101-00D423-000 VA00 INFRAXPRUCTURE M 2254)00-443-342 V%,763,21 ree DEP0S1'r 101-000-Q9-;315 S2�tt•Ufl 40' INN PUBLIC PLACES - #0681: 701,- IM55-AOf.) SUB-IM.AT CONSTRI M. ON A v43'Pq:AN CHECK K v),Ogo.11 LE Pf,E- ATO :FT, ,S 4250-00 •$'O AJ,r 9,°RRN3AT F1 RS1 iDUE NOW RECEIPT DATE BY f VDJ DATE FINALED INSPECTOR INSPECTION RECORD r OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR ' BUILDING Ilk APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts -Slab Grade — Return Air Steel Combustion Air Roof Deck Exhaust Fans 0. 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 Wall Firewall Exterior Lath 72 /O — / Drywall - Int. Lath — / _ g Final Final —� BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final 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 In iv Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole 5 Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G. F.I. Smoke Detectors Temp. Use of Power .74 or Final Utility Notice (Perm) COMMENTS: �� P r � ` '7�'z'+"� "t'!,r„• tom.{+" . i I Add ess 17 / (o Ar h Owner 14 n -re r'-�,-.r.r,-, fir.; -.Y+: '�w�•�7-r,..-.�......- vr..Ty�;n..,��,��++tifPr'��`�'NI��"T�'r%y�l/�i}'��•�fiK�•'. P.O. BOX 1504 APPLICATION ONLY 78-495 CALLE TAMPICO Mi r Al [ LA QUINTA, CALIFORNIA 92253 /!/K/N/STF'f It✓ r N��' rr� Mailing t/ Address%7 %�� City fip�77/0 Tel. Contractor Address f 4. Zip State Lic. City & Classif. �'%'?c� Lic. # Arch., Engr., Designer I Address Tel., CityIZip I State I 1 Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. t SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to'its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). C., 1, 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, euisness and Professions Code: The Contractor's License Caw does not apply to an owner of property who builds or improves thereon and who 'does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. It, however, the building orimprovement is sold within one year of completion, the owner -builder will have the burden Of proving that he did not build or improve for the purpose of sale.) 4 Il I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ' 0 1 am exempt urider Sec. - B. & P.C. for this reason Date Owner i WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company 17 Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i1 the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg 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. Date Owner NOTICE TO APPLICANT: Il, atter making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. r CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permil when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. I certify that I have;iead this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property lor'fnspection purposes. If I Signature of applicant Date Mailing Address City, State, Zip BUILDING: TYPE'CONST. OCC. GRP. A.P. Number ^7475--12n< Legal Description L T G `1? 9 Project Description- Z?- jjE escription 79-jjE 4aLc Sq. Ft. �/n �/M No. No. Dw. Size p( o / Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT �l AMOUNT Plan Chk. Dep. pc> Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure R p TOTAL REMARKS 1YC 1 Y u e9 IJ ZONE: BY: E Minimum Setback Distances: Front Setback from Center Line ; Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION rNotice: - f Document Cannot Be Duplicated Date 6/4/99 f� No. 18840 Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE Owner NameMinistrelli-Painted Cove, Inc. No. 79-165 Street Jack Rabbit Trail City La Quinta Tract # 25429 Lot # 62 Type of Development SFR Mitigation Comments Bran at ere - 2,847 sq. ft. APN # 769-542-015 Jurisdiction La Quinta Permit # Log # Zip 92253 Study Area Square Footage I No. of Units 1 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 or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: ' Under Mitigation Agreement EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Mitigation Agreement it the amount of 628.00 X 1 or $ 628.00 the property listed above ardAiat building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued Fees Paid By cc/1 st Community Bank/Ministrelli - Kevin Peters Te; phone 71 � 76-4450 4 Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Juanita Green Signature Payment Received $628.00 Check No. 085881 10TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) 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 peril for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to ,ollect them on the District('s)(s ) behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting PUBLIC WORKS CLEARANCE LETTER (' FOR CUSTOM HOME LOTS Dear Builder: Prior to issuance of a building permit, you will be required to obtain clearance from the Public Works Department for one, or more, of the following: 1. Verification that rough grading is complete, and the pad, elevation certifications prepared by a .licensed .surveyor, or engineer, are on file in the Public Works Department. 2. Verification that infrastructure improvements and other required tract improvements are complete, or sufficiently advanced to warrant building permit issuance. 3. Prepare an engineered grading plan that provides for on -lot storm water retention, and;have it checked and approved by the Public Works Department. • Tract 26524 (Estancias) • Tract 26769 (Mountain View Estates) 4. Prepare an engineered grading plan that provides for building pad grading in accordance with the existing soils report and tract grading plan, and have it checked and approved by the Public Works Department. • Tract 28034 (/So/uth Valley Estates),A&, rAZ10-71- P, FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT F:IPWOEPTIDOCSIFORMS%PW CLEARANCE LETTER.ss I COMMENTS: APR -21-99 WED 01:52 PM MDS CONSULTING FAX NO. 714 251 0516 P,02/02 MDS CONSULTING PLANNERS • ENGINEERS • SURVEYORS 17320 Redhill Avenue, Suits 350 19491 251-8821 Irvine, CA 92614 FAX 251-0516 April 21, 1999 Engineering Department City of La Quinta 78-495 Calle Tampico La Quinta! CA 92253 r Rough Grading Verification La Quinta -Tract 25429 I We have checked the area referenced below and find it to be in substantial conformance the approved rough grading plan. Lot # Elev. As -Built Elev. Variation 13 44.8 44.7 0.1' 115 44.0 44.1 0.1' 29 44.1 44.2 0.1' 49 47.4 47.5 0.1' 50' 47.0 47.0 None 59 47.5 47.5 None Z62D C41 -"y C4 CNone 71 50.0 50.0 None Le -q-- 4,�_ �q t� 5- � ;�V Stanley C. Mo R.C.E. 20596 Expires 9/30/01 G:1307104ker-tC13,15,29,49,50,59,62,71.doc ��OF E S S /Uti 07, No. 20596 Exp, 9-30•-01 *' MD...S STANLEY C. MORSE GARY DOKICH • SKIP SCHULTZ i' June 4th, 1999 ESI/I=ME, STRUCTURAL ENGINEERS Inc. & CONSULTANTS MINISTRELLI CONSTRUCTION CO. 50-445 Mountain Shadow La Quinta, CA 92253 ATTN: Kevan Peters t RE: Roof Truss Calculations and Layouts on "PAINTED COVE", Plan 7"C" Lot 62 to be built in 79-165 Jack Rabbit Trail, La Quinta for MINISTRELLI CONSTRUCTION CO. (ESI/FME 194-6225-122 / BBG 124-0100) , Dear Mr. Peters: We have reviewed the calculations and layouts by SPATES FABRICATORS and they appear to comply with the requirements of our calculations and plans. The review of these drawings does not relieve the contractor from compliance with the drawings and specifications. This check is only for review of general conformance with the design concept of the project and general compliance with the information given in the contract documents. Jhe contractor is responsible for confirming and correlating all quantities and dimensions, selecting fabrication process and techniques of construction, coordinating his work with that of other trades, and performing his work in a safe and satisfactory manner. { Thank you for your attention to this, matter. Please do not hesitate to contact us if we can be of further assistance to you on this project. Sincerely,, , ESI/F STRU F S By: cn eT >t Dann c(0) CV�':`� 1921 E. CARNEGIE AVE., 1 UNIT 3-J, ,SANTA ANA, CA 92705 • Ph. (949) 261-1811 / FAX (949) 261-8506