Loading...
9812-220 (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. Licence!- Lic. Class Exp. Date Date i r 1 Signature of Contractor y 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' 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. :i' KIM,: k`I.7i`rtD f1�I�S rt?2;:t1`JJtS4 (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 pfovisions of Section 3700 of the Labor Code, 1 shall forthwith comply with tho @ provisions. } '" C�Ate: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 and for,whose benefit 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 above-mentioned property forinspection purposes. �gnature (Owner/Agent)"r'.� ..- !-3= " Date PERMIT N I 1^ BUILDING PERMIT TRACT Z52 DATE j VALUATION S200,796.10 2M29 JOB SITE ADDRESS W040 1N. IAN QNAIP ROAD �U{�•-S'Q.R-�f�i� OWNER CONTRACTOR/DESIGNER/ENGINEER INC. MMIRT. 14PA.R;7`CD 00vT1', INC. 74 85 I -IW Yl It a M 105 747$5 HtI Y I III SIE 10.5 T4> DIAN 'WELLS CA 922:i 0 INDIAN WVLLS CA 92210 (7f?(l))770-"'50 CAL# a62S USE OF PERMIT SING .1' FAMLY WE TO SM PFMitT X' OMS NOT INCLUDE TALOCK WALLS OR POOL. r©t�C.lU1aATsi) 300.00 SF CONSTRWI'1 N 3.375M S t C0,376FCONSTtJCTm PtlNgT E (gYp7IARV _ESTIMATED 4" jONSi'T6.lIC'I'TON FIX ELECTRICALFRE 1.01-flt)1}-Q10-000 $=3.4 5 ORADINU FE8 101-000.42.3 OW MOO W, _R_ n—f tz°Iz: ,r re x Rzr 225 -WO -441 -3422 144 .t4 -- 1!/i'F,CKWCA FOI? t o i-illt(i-42 I, 4VID $1 A0.5n 'PLAN CI ?�' MMI 101-000-439-318 215.17 Pi.UN03'ING F.EF 101-000-419,-000 5+18ti. /5 .T. MONO MOTION FEE - RESID 109.000-•241.-000 ��s2.fla3 Alar TN'€+URLM MACE - PFSM T01-000-2541 ?0 'I`ION AND T(13�Aj]N� C�;HIg♦;�C� "R7,099.08 �yy��y ID 1 , a RECEIPT DATE BT� DATE FINALED INSPECTOR INSPECTION RECORD .% •OPERATION DATE INSPECTOR OPERATION I.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. Fireplace T.O. Grills Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath 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 OX for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances - Final Final — G►'U 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 Z •— Utility Notice (Perm) COMMENTS: Building /' Address J (/ U�) .L- Ownery� / Mailing Address r111 City 1`77 0 Address TA tyl 4 ����� j P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 City Zip Tel. State Lic. City & Classif. rl �! Lic. # Arch., Engr., r' Designer G Address Tel. City IZip I State 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. 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 thealleged 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 (2500). l: 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. (Sen. 7044, Buisness and Professions Code: The Contractor's License taw 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. If, however, the building or improvement 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.) r1 1, 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 contractors) licensed pursuant to the Contractor's License Law.) 1-1 I am exempt under Sec. B. & P.C. for this reason .`^ice--• Date Owner 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. 3100, Labor Code.) Policy No. Company 177 Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred -dollars 1$1001 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: 9, atter making this Certificate of ExemblioT you should become ),,subject to the Workers' Compensation provisions of the Labor Coda, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 permit when properly filled out, signed and validoed, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above i:lformation is correct. I agree to comply with all city andcounty ordinances and state laws relating to building construction, and hereby authorize representatives sof this city to enter the above- mentioned property for inspection purposes. Signature of a0plicant -Date Mailing Address City, State, Zip APPLICATION ONLY DING: TYPE'CONST. OCC. GRP. Number 10,5 ,5 �>',.2�, 2 '7 ,I Description 497' 7? %. Ict Description `J` - Sq. Ft. Size New ❑ Add ❑ k No. M No. Dw. Units Alter ❑ Repair ❑ Demolition ❑ n itlmateo valuation PERMIT AMOUNT Plan Chk. Dep. 25O ' °-0 Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: ---BY: 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 IV FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: OCT 2 9 1998 WHITE =FINANCE YELLOW =APPLICANT PINK =BUILDING DAIVISIO�ITY 0— F LA"t U a NT,� ♦' „4 Notice: Document Cannot Be Duplicated Date 1/7/99 No. 18212 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. 50-040 Street Indian Camp Road City La Quinta Tract # 25429 Lot # 73 Type of Development Single Family :Residence Comments Grandfathered, 3,375. sq. ft. APN # 769-542-027 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 pu suant to Mitigation Agreement in the amount of 628.00 X 1 or $ 628.00 the property listed above and t. at building permits and/or Certificates of Occupancy for this square footage in this proposed project �ay nov gibe issued Fees Paid By CC/1st Community Bank/Kevin Peters Tel phone -,564-?849 Name on the check +L By Dr. Doris Wilson' �1 t Superintendent Fee collected /exempted by Juanita Green Signature Payment Received $628.00 Check No. 083775 NOTICE: Pursuant at Assenl ly 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 fhe date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to tolled them on the Districl('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 v S �I f44 a CF'y OF ;I 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, o� 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. ;I • Tract 26524 (Estancias) 'i • 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. 1. • Tract 28034 (South Valley Estates) • 'i 'i FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT li TRACT: 2 LOT: PUBLIC WORKS AUTHORIZATION D E ,I F:\PWDEP'RDOCWORMS\PW CLEARANCE LETTER.ss COMMENTS: FROM : SOUTHWEST ELECTRIC CO 360-1866 PHONE NO. : 772 6998 Dec. 23 1998 10:13AM P2 Llc. #750740 LO—DALQULAT.WM SOUTHWEST ELECTRIC COMPANY DATE: 12-2398 77-734 COUNTRY CLUB DR, SUITE K PALM DESERT, CA. 92211 JOB: PLAN 1 / CHAPARRAL CONTRACTOR: MMSTRELLI 50-040 INDIAN CAMP RD. LOT #73 GEN. LIGHTING, SQ. FT. 3375 X 3 10125 2 APPLIANCE CIRCUITS @ 1500 3000 LAUNDRY CIRCUIT 1500 DRYER 4500 RANGE 0 COOK TOP 1500 OVENS 4000 TRASH COMPACTOR 1200 DISHWASHER 1200 DISPOSAL 800 MICROWAVE 1500 EXTRA KNOWN CIRCUITS (1) @ 1500 1500 POOL EQUIPMENT 6000 TOTAL LIGHTING LOAD — — TOTAL = 35325 FIRST 10 TCW AT 100 Bio 10000 REMAINDER. AT 40 % 10130 A/C 10 TONS X 2000 PER TONS 20000 40130 TOTAL LOAD / 240 VOLTS = 167 A.MP LOAD * * * * * 200 MAIN SERVICE * * * * * 77-734 Country Club Dr- Ste. K - Palm DPSPrt. rA 49911- 473 FAY 779 -Roost OCT -22-98 THU 03:14 PM MDS CONSULTING FAX NO. 714 251 0516 P.01 MDS CONSUL TING PLANNERS • ENGINEERS • SURVEYORS 17320 Redhill Avenue, Suite 350 Irvine, CA 92614 October 22, 1998 Post -it° Fax Note 7671 Orate S ply► To From CoJDw. Co. Phone s Phone 8 Fax 1^T "7W-5'V Engineering Department City of La Quinta 78-495 Calle Tampico 500�O t,P41, AJ La Quinta, CA 92253 Rough Grading Verification La QuintaC—: j ct25429 We have checked the area referenced below and find it to be in substantial conformance the approved rough grading plan. r cat Elev. As -Built Elev. Variation 54 45.0 45.1 0.1' 57 46.1 46.1 None 65 47.3 47.3 None 66 48.1 48.1 None 70- 50.5 50.4 0.1' 72 49.5 49.5 None X7.3"-"–" ----1=4.7_:3 --47.3 None 74 47.0 47.0 None 75 46.6 46.7 0.1' Stanley_ C. Mok R.C.E. 20596 Expires 9/30/01 G:\307W41cer-r154.57.66 66.70.72-75.doe V Q�pF ESS �0 C C. —, " No. 20596 Fxp. 9-30-0.1 OF CA A- V V STANLEY C: MORSE GARY DOKICH SKIP SCHULTZ F E B.-28 Cl0 MC111 14 :53 BE:G ARCHITECTS, I N1F:- _ P _ fB 1 i 1 '/CUENT/JOB Y CONTACT �< .. DATE Tib rc4t,'<1�-�,� f .. _ ... .. _ .. _ FAX TRA h` 4.117 1 o - ....... . . .. .. . x >04 Pc TRANSMI�IAl y[- • ti R12ulsf1, fp if,r� i ,- t Q /. Fc�R vrx1R ultikw 4 i' 4 TZ 1 1 ; PIFASF R av(.�TTj i ! I t 211371 Irvine: .cnnc, Suitc 120, $mita Ana Heights, CA 92707-1651 714 1434.2506 714 / 434.4885 fax catiC'hh m, 1-i1.,i1S.J1111 T 02-28-00 1 5 : 47 "rO: PA l J,Vl'ED COVE L« FRO14: 714261 1576 P01 .'1 REGISTERED INSPECTOR"S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED O REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY 9. -C.p,'&c ❑ POST TENSIONED CONCRETE ❑ ASPHALT O OTHER O REINFORCED MASONRY O FIRE PROOFING JOB LOCATION 5C -0'-i0 _ ��+�� � n KPERMIT REPORT SEQUENCE NO. TYPE OF STRUCTURE S � t^�F �3 p RI.NT4d Ct��; N0. 94x12 - ZZO DAT 919 99 DAY OF WEEK MATERIAL DESCRIPTION ,,• ARCHITECT INSPECTOR HRS. CHARGED ENGINEER 5 i j�ht ASSISTANTS HRS. CHARGED INSPECTION GENERALtt �I t SUB _ CONTRACT/OR f V � S it Z+(. L 11C CONTRACTOR GDATE o IDS e, ew k�Q PltkC L- = T - A. kA-" A i 4 k L- A 4 loe a. N. n� �" i nJ t COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE O PAGE , OF I CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. - �jj Q �) SIGNATURE OF GISTERED INSPECTOR `19 -�pcao i i l i 3z(1/ ATE OF REPORT REGISTER NUMBER N- 'OF LA 0, 1 r;;V-r.4 JON TANDY AUG 2 37630 Medjool Ave. RECD Palm Desert, CA 92211 91111DIr; Y Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 4n, REGISTERED INSPECTOR'S WEEKLY REPORT TYPE OFL'n-' INSPECTION PERFORMED REINFORCED CONCRETE O STRUCT. STEEL ASSEMBLY POST TENSIONED CONCRETE O ASPHALT REINFORCED MASONRY O FIRE PROOFING O ❑ OTHER JOB LOCATION 50- oy o ;j -/A1 Ao �� e ', L-0�' c)",'A REPORT SEQUENCE NO. TYPE OF RUCTURE s V Lo f � -73 ��a d �v� PERMIT NO. 9812- z2o DATE �b Y DAY OF WEEK MATERIAL DESCRIPTION Witi r C -1®O &K ARCHITECTINS a6- CTO /1, D, MRS. CHARGED i ENGINEER ASSISTANTS HRS. CHARGED INSPECTION DATE GENERALCONTRACTOR AJ TQ , SUB CONTRACTOR v 7p o r-/ (fiI C O 4 !� �3'CQ✓ %tv Z tA S/4" Nt C -I _ COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE 0T OF OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. t SIGNATURE OF REG ERED INSPECTOR ! 79 t t It 3z16-y� DAfTE OF REPORT REGISTER NUMBER