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9702-048 (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 # 2ptS f Q 1Lic. Class 3 j C / Exp. Date y� Q � � V A e . Date Signature of C Date 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. ( r) 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 SI -ATG !FoaP. Policy No. 2.2.`1-17 coi 5i�,45 (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 object to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forth ith comply with those provisions Date: S '%'' y Applicant— Warning: pplicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on- his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of Such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon t e above-mentioned property for inspection `purposes. Signature (Owner/Agent) Date N BUILDING PERMIT PERMIT# CONTROL# I 9702-00 5023 DATE VALUATION LOT TRACT 4122197��9�3��i�.4�fN3 7732fiF5x JOB SITE ADDRESS 47-495 VIA MONTAM APN (PL3420-04.55 OWNER CONTRACTOR/DESIGNER/ENGINEER wy it. f4itC+ n' Ii '��+F.;f rJi6: �U.A SCS^d COMPANYINC dig 'k;ANIEk DR 7_1ti7:x3 Gfri )1�'1".ld`ar CLUB DR CYPRESS CA 00630 8H"R.NIIJDA. E) UNFS CA 92204 06(045.3M C'Uff USE OF PERMIT \i=C► Si )-.t iift 'i!$ f.Ni`LtJi3 4=t f,.l'.„ S` C'1>kti� ahi vtitiI,"":. J+S SHOWN ON I,ANCD.V'„AP1? PLAN. POOL'IT) INK UNDER SEPAt2A'1:iy "!"RfiC'r CUDI4;i9'.fdUC"a' ON 3,200.00 Sir t'K:aIt.0 iLk'A"6`ttu z �;.u�+ sk I V1', WALL "kr./)Ct Lf. GAR A:.0043'ARPORT 7544A) SF EST .SJA'3 E'1 1:0. ' OF C"altrSTiol CTION 193,614-f* PE..RMIT F.AE'. SUl'1`i:Mf1Ag' ,ea 01F 0E_P0%1f 42Y).01)" - .. � A14 CHEM : �. CONS't`I7UCIN.014 k1MR 101400418-00D ift.(::t1ANti AL f j .: 101-000.421-0M SW5.0 1.3,ECT.RIC,Af, FFF 1.01440420 -ft) sm.m P11TA0,11NO FF 101400419-000 ,7'ONO M0TIt:3I'!'I*"L-2 R#;: SIT) 101-000-241-000 $19.36 o 4: RAD Nt) FElf. 101-00.423-000 vo.to Q 1� f NIKRAS1A1 r(a'fTrIZ : FIJY,; 225-00*40-342 11,'21, 12. 1 J M w. hl:l(1-'f C sr� 1, (a `nfS"i'r;T rf:; i'Tr)N E1Ni'l I'f,,A itii rli#;C f.' ," %t'i,RT1.32 1,.PS1 PRE -.1'2 .1'1.) Ff. L` `r N"fl;;;S 011NOW RECEIPT DATE BY DATE FINALED INSPECTOR "AS 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 J I Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wali Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL P ROVALS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final 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) iTV ELECTRICAL hPgROVALS 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) '. `,4,/ �•� �� Jn3�'4 LaT 773 ••P:O. BOX 1504 Building _ 78-105 CALLE ESTADO APPLICATION ONLY Address VIA A10 k1 -;o /�-4 LA QUINTA, CALIFORNIA 92253 Owner Mailing � 733 oRivT Address up!//�`%2 `� �Lcl�v City Zip Tel. .2v�✓0A/,v�r g22oi 345= 322 Contractor V14 ; SO ee tW,--4A, y Iti Address - Qt j�ip�ZzO/ j4S:• �22�rinv0N Z State Lic. City &Class if. 29g810 /3, tG 2J - 0_?6 Lic. # . Arch., Engr., Designer ��_ ��✓'�S� Ad Tel. iJ City Zip State '. Lic.�0 LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I an� licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3 o thg Busipe�s and Professio C $e, ay�of license is in full force and effect. /��1//i �isG� SIGNATURE. ��i�,I :/,L� / 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 01 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). 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. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law 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.) I: 1 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.) i } 1 am exempt under Sec. B. & P.C. for this reason 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. 3800, Labor Code.) Policy No. Company rJ 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 ($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: If, after making this Certificate of Exemption you should become Vobject to the Workers' Compensation provisions or the Labor Code, you must forthwith mply 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 validated, 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 information is correct. I 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 for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING DIVISION BUILDING: TYPE CONST:_OCC. ^ /OCC. GRP. A.P. Number L / I O � Legal Description '772A L"f 2l� S 2 9 7 273. Project Description s ' f ��� L /° c> c- C3W,4,e 0A-- _X24? O tib re Sq. Ft.No. NoDw. / Size 5-200 Stories , Units New 91' Add ❑ Alter ❑ . Repair ❑ Demolition ❑ REMARKS MAtf�-P_ IA*�_b �aY � MAIle e C aseal,E � 46-2- R410f e -n.. Pp_ CYPRESS, C,4 !Z0636 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line r S e Street Setback!from Center Line E tde Setback from Property Line FINAL DATE,. - -1 010'7 INSPECTOR Issued by: Date Permit Valida't by'li� LgNTA Validation: lislez_UDE5 W'A'l1.S fns 5µ87.,5A) oa,I L S_ pL" P � A,'e.M )T TA 9C M@Z�+.,. t G _b5_C_?A-,eAZEZ4 stimated Valuation PERMIT AMOUNT Plan Chk. Dep. ZSV O Q Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL ZSU. !!O REMARKS MAtf�-P_ IA*�_b �aY � MAIle e C aseal,E � 46-2- R410f e -n.. Pp_ CYPRESS, C,4 !Z0636 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line r S e Street Setback!from Center Line E tde Setback from Property Line FINAL DATE,. - -1 010'7 INSPECTOR Issued by: Date Permit Valida't by'li� LgNTA Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING E1 7ST FL.'— SO. FT. @ $ UNITS SLAB GRADE ROUGH PLUMB. BONDING f 2ND FL. SO. FT, @ FORMS YARD SPKLR SYSTEM POR. SO. FT. @ MOBILEHOME SVC. BAR SINK GAR. SO. FT. @ POWER OUTLET ROOF DRAINS CAR P. S0. FT. 0 OTHER APPJEOUIP. DRAINAGE PIPING WALL ' SO. FT. @ TEMP. POLE DRINKING FOUNTAIN S0. FT. @ GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES _$ WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ IA c SEWAGE DISPOSAL LATHING SO.FT.GAR @ 3/4c HOUSE SEWER MESH GAS PIPING PERMIT FEE INSULATION/SOUND PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE 1 1! MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING R AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL GARDEN WALL FINAL N5PEG7 VH'S 51GNA1 URt5/1N1 i IAL5 P Desert Sands Unified School District Notice:.82-879 Highway 111 Document Cannot Be Duplicated Indio, CA 92201 ,s 619-775-3500 CERTIFICATE OF COMPLIANCE Date 4/10/97 - APN'# 643-120-045 No. 15419 Jurisdiction La Quinta Owner Name Roy & Mary Tweedie Permit # No. 47-495 Street Via Montana Log # City La Quinta Zip 92253 Study Area 1.23 Tract # 26152 Lot # 273 Square Footage 3200 Type of Development Single Family Residence` ' t No. of Units 1 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 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: - _ .._...._ ......_ ..... _ ........ . EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.84 X 3,200 or $ 59888.00 the property listed above and that building ' permits and/or Certificates of Occupancy, for this square footage in:this proposed'projec>t may now be. issued Fees Paid By cc/Wells Fargo Bank\� ` y - Telephone x:345-3222 Name on the check By Dr. Carol McGrew Administrator in Charger. Fee collected /exempted by Pauline Pearson '. " ` Payment Received $5,888.00 Check No.. 0389001499 Signature P1 Ai a IOTICE: 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 permit for this project is sssued orbn 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-"Applicaht/Receipt Copy - Accounting CITY 0 LA 01jINTA /(01'111A R BUILDING AND y 78-495 CALLE TAMPICO LA OUINTA, CALIFORNIA 92253 ' (619) 777-7000 r; f Tvk ' FAX (619) 777-7101 March 6, 1997 Mr. Bill Watson Watson Company, Inc. 79-733 Country Club Drive, Suite 5. Bermuda Dunes, Ca. 92201 SUBJECT: Planning Commission action on Site Development Permit 97-601 Dear Mr. Watson, The Planning Commission at its meeting of February 25, 1997, approved your architectural plans for a single family residence on Via Montana in take La Quinta, subject to conditions: . Attached is a copy of the conditions of approval for your use. The final construction plans, including landscaping must be submitted to our department to verify compliance with the conditions prior to issuance of a building permit. Should you have any questions, feel free to contact me at (619) 777-7064. Very truly yours, JERRY HERMAN.. COMMUNITY DEVELOPMENT DIRECTOR STAN B. SAWA Principal Planner sbs ' C Mark Hold, building and Safety Ltrsdp97601 "A= MAILING ADDRESS P.O. BOX 1504 LA OUINTA, CALIFORNIA 92253 ®� Y' 1r ate'` PLANNING COMMISSION RESOLUTI.O.N 97-014` CONDITIONS OF APPROVAL - ADOPTED SITE DEVELOPMENT PERMIT 97-601 MR. & 'MRS. ROY TWEEDIE FEBRUARY 25, 1997 GENERAL: n 1. Approval of this Site Development Permit is for architectural plan approval of a 3,200± *Square foot single family resident"e on lot 273, Tract 26152, as noted on plans in the Community Development Department, unless amended herein. 2. All requirements. of Tentative Tract 26152 and the RL Zone District shall be met during plan check process. 3. Lawn areas for front yards shall be either Hybrid'Bermuda (Summer) orr Hybrid Bermuda/Rye- (Winter) depending upon the season when it is installed. All trees shall be double staked to prevent wind damage. All shrubs and trees shall be watered with bubblers or emitters. Landscape improvements shall be . installed before final occupancy of the house. All trees shall be a minimum 24- inch box size with 2-1/2". caliper, 18" above base of tree. 4. Ground mounted equipment (air-conditioning condensers, pool equipment, etc.) shall be located inside and rear yard areas behind screen walls or landscaping. All equipment shall be a minimum distance of -five -feet from the property line. } conaprA.700..