0403-291 (AR)I•�-
W
N
� W
Ouch
r` C f u7
W
•1` � �
.C:) Z
� o
�(0
~ate
U)
Z
M
LIDN
ON
U °)
�a
It Z
`,oQCC
O
LL
0 J J
mUU
O
d rn H
`* Z_
w Z5
r- ()
J
".- 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
Date 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).
U ,r®m exempt under Section , B&P.C. for this reason
�D"ate 1 --5._ n ' Signature of Owner e4 _ J rz�.y.-�
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.
(This section need not be completed if the permit valuation is for $100.00 or less).
(V,),1 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 forth, with comply withNi6se provisions. y�
Date:�/'�ndr�rgpplicant.✓"�,�/.�+`�.cf rff-�_/
Warning: Failure to secure Workers' Compensation cbverage 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 authorizeerepresentati es of this City to enter= upon
the above-mentioned property for`inspecti purposes. r ; #r
I,8lgnature (Owner/Agent��' _ Da(ftee"�
BUILDING PERMIT PERMIT#
'6403•• i! sal 1
DATE VALUATION S2 ,10.20 LOT 20 TRACT
JOB SITE S 79_81R1?s: 0]?S.MC0J. to"
ADDRESS
APN
OWNER
CONTRACTOR/DESIGNER/EN (NEER
RDilJMW HApnaA
Bi7R.tZIR.
79.8801.10ROMHOE ROA13
LA QUINTA CA 922:53
rt 033
USE OF PERMIT
READ&VEW, ON
514 S.I+ fiXIX`f IOW OF HUNT HED OOM & 8 A`}.'HROOM. 2001 C:8C
TRACT CONSTRUCTIO14 514M SF
4
MWIMATIM COST OF CONSMETC11014
L''Eil'[1 T r FRAP. IMAJ'Yt'&R Y
CONST RUC`a IOX FSE 101.000»418-000 SM.50
sPl, .14 CHECK 17u.Z 1011--000-439-318 M.75
MiCdHAM1CAL FRE 101.000.421-000 $33.00
ZI CTRICJ11, FM 101-000-420-000 $ 0:,49
PLUM804C, FK9 101-000.415.000 $45,00
S'TRIONO M OT.It-IN PFz , PYSJ J 101-000-241-000 $3.179
SUB -Ta AT, C0148°i:RiiMON NSD PLAN CBFZX
X51 x.53
LESU PRE -PAW FEES
$0.00
D r
PX0419 F1138 DUE Now
01204 ;
CITY OF LA OWNTA
FINANCE DEPT.
RECEIPT
DATE/
�/�. ,
BY /
, t
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
_
_ _
_
Ducts
B
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
L/
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
- l 5 , 8Pi g
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall 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
Gas Piping
PLUMBING APPROVALS
Gas Test
_ e
Electric Final
Waste Lines
Heater Final
Water PipingJam-
_
2=
Plumbing Final
Plumbing Top Out
t�- �?
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
(/S'105 ''R_QMt T
iy- 7"Ztv&J . CERA►` cD A.C,
Final
CCI�QtRE's
8`{ f bs,
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)
\
Jan 31 05-08:50a ted & robin hanna 7603473892 p.2
oZ
CITY OF LA QUINTA
oFo��� BUILDING & SAFETY DEPARTMENT
777-7012
INSPECTION REQUEST LINE
777-7153
Owner EDWARD HANNA
Contractor OWNER - BUILDER
Permit Number 0403-291
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-880 HORSESHOE ROAD
514 S.F. ADDITION OF GUEST BEDROOM &
BATHROOM
TYPE OF INSPECTION1 DATE INSP.
TEMPORARY POWER
SETBACKS
U/G PLUMBING / WASTE
U/G ELECTRICAL/ GROUNDING
FOOTINGS / STEEL
CONCRETE SLAB
DO NOT POUR CONCRETE UNTIL ABOVE SIGNED
ROOF NAIL/ PRE -ROOF 'ti
OKAY TO WRAP
FRAMING COMBINATION
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH MECHANICAL
COVER NO WORK UNTIL ABOVE
\ INTERIOR GYP. BD. DRYWALL
EXTERIOR LATH
GAS TEST
SEPTIC ABANDONMENT
SEWER CONNECTION
SEPTIC / GREASE INTERCEPTOR
MASONRY INSPECTIONS
FOOTINGS / STEEL
BOND BEAM
POOL /SPA /WATER FEATURE INSPECTIONS
PRE-GUNITE / SETBACKS
U/G PLUMBING
U/G GAS
U/G ELECTRICAL
PRE -PLASTER (ALARMS/ BARRIERS
FINAL INSPECTIONS
TEMP. USE OF PERMANENT POWER
ELECTRICAL
PLUMBING
MECHANICAL
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT.
FINAL / JOB COMPLETED
J
d'y
P.O. Box 1504
!,A QUINTA; CALIFORNIA.0247-1504 BUILDING & SAFETY DEPARTMENT -
78 -495 CALLE TAMPICO.' (760) 777-7012*
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
January 31, 2005
Mr. & Mrs. Ted Hanna
79880 Horseshoe Road
LaQuinta, CA 92253
:RE: Building Permit Extension Request'—.79880 Horseshoe Rd.
Dear Mr. & Mrs. Hanna:
.1 have received your letter dated 1/27/05, requesting an *extension for the
residential addition being constructed at the above address under Building Permit
#0403-291.'
Inspection status:
Exterior Lath: 8/3/04
180 -day expiration date: 1/31/05
180 -day extension date: 8/1/05
Under the provisions of California Building Code Section 106.4.4, your. request
is hereby granted.
Because the. Building Code specifies that "no permit shall be extended more than
once," please be advised vised th . at unless the. project passes its next -required
inspection on or before Monday, August 1,-2005, your building- permit will expire
automatically.
Yours truly,
Greg By ' tler
Building &. Safety Manager
r
January 27, 2005
To City of La Quinta
Building & Safety Department ?
Cc: Ed Randall
This is a written request to ask for an extension on Permit'# 0403-291.
Last inspection was 8-3-04
Ted & Robin Hanna
79880 Horseshoe Rd.
La Quinta, CA 92253
We are very, near. completion of the addition, however we are requesting an
extension of 180 days time to finish. The reason for the delay was because
we were required to attend family business down in Australia.
Home # or Cell#
Thank you for your time,
7
Comments Guest Bedroom & Bathroom
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, 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 $2.24 X 514 S.F. or $1,151.36 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 Cash - Ted Hanna Check No.
Name on the check Telephone 760/485-2191
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted Sharon Gilvre Payment Recd $0.00
$1,151.36 Over/Under
Signature ('
NOTICE: Pursua 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
I
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
ZoG'cas�2�0
47950 Dune Palms Road
Q BERMUDA DUNES r
Date
3/31/04
La Quinta f CA 92253
HO
RAN AN WELLS LSMIRAGCJ
� 'ter
INDIAN WE
No.
25753
(760) 771-8515
PALM �y
�,�
�QINDIO
Owner
Edward Hanna
APN #
649-061-019
Address
79880 Horseshoe Road
Jurisdiction
La Quinta
City
La Quinta Zip 92253
Permit #
0403-291
Tract #
Study Area
Type
Single Family Residence
No. of Units
1
Lot # No. Street
S.F. Lot # No.
Street S.F.
Unit 1 20
79880 Horseshoe Road 514 Unit 6
Unit 2
Unit 7
Unit 3
Unit 8
Unit 4
Unit 9
Unit 5
Unit 10
Comments Guest Bedroom & Bathroom
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, 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 $2.24 X 514 S.F. or $1,151.36 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 Cash - Ted Hanna Check No.
Name on the check Telephone 760/485-2191
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted Sharon Gilvre Payment Recd $0.00
$1,151.36 Over/Under
Signature ('
NOTICE: Pursua 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
I