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0201-208 (AR)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 :541336 Bloc �� ' M4 0/2C eDate)k &-1iv", 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: ` ( ) 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, Business&Professionals Code). �y ( ) I, as `owner;of,the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business &: Professionals Code). rr f () I am exempt under Section', B&P.C. for this reason Date Stature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty) of perjury one of the following declarations: () 1'have'and will maintain a certificate of consent to self-insur)e for workers' .,- - J-* compensation, astprovided� for by Section 3700 of the Lab'or�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 STATE YUND 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, 1_,hall f, rthwi'th comply with th�o�e provisions. ,Date: °f '' Applicant d Warning: Failure to secure Workers' Com ensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT (Application is$reby made to the Director of Building and Safety for a permit subject to the 1condit6ns and restrictions 'set forth on his application. ( j 1. Each person upon who e'behalf;this application is mader& each person at whose requitsst and for whose -b At work is performed under or pursuar t to t 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 ofissuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I'h`ave 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 -for inspection purposes. c Y -g Signature (Owner/Agent)x r Date2)EE�If� ",' or BUILDING PERMIT PERMIT# DATE VALUATION LOT 0201•` 09 TRACT .rlsj a 815 .00 V840 JOB SITE r ADDRESS 473 -0.,; mchmo Lif APN W-340-007 7 OWNER CONTRACTOR / DESIGNER / ENGINEER R(DWALD SA 0Z COINSTRUCH014 75-6$5 x?ESCAY113( LANs 78-a:,5 AVWUB :fit Q?"To"A CA 97258 BF -R !ifJ1:tA DUDS CA 9224? ("M)200d!'S93 C IIB 3287 USE OF PERMIT l4dUi�LJL'6O iLfll., tt'Ar,�ffL "J�VAJ S!#Ji/�`�`.1L/1'O (lvVd '��/IMi1 Y'A`%iw F+i"L14L© CHER (240 .. , CUSTOM CQNSTRUCTION r 169,00 SF �f�Cif9Pdi`t it3 �"+ ��.r30 SP' f `✓ 1.0 . ldATMD C OSIS' 69F COMSTRUMION � . 15.6s'4 .00 , it"AN, CHECK FEE 101-040439-313' SMAS COId' 'i'R.Lf(;'FION -17M, 101••Cl(1aO.41€-000. i11.Ei0 PacHA-HICA1,FEE 101-000-4�1»000 V,J.f:'t RICA1, le fK 101- -420-000 X21.73 MONQ MOTIO-W FIFE PYAMP 101.010.241.4,001 $1,57 ';31;,€td DiD 1�` yk' 101-4f1t 413-000 $.20.00 HIM •.tfS'!AL COMM UC TIOR AND PLiV?3 .f5M'_,1 TAW P-IRR-:PINDFrI.B3 $0,00 J,y-wir rim! Dit now 14 2002 ti CITYOFLAQUIRFA ,f �' RE Ell T �Blr DATE FINALED INSPECT INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs21-15-021 Underground Ducts Forms 8 Footings Ducts - Slab Grade Return Air Steel - 2 Combustion Air Roof Deck 3 O 20 2 Exhaust Fans O.K. to Wrap x9 5 F.A.U. Framing 3 - p- .92- Compressor Insulation = Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath _ —Z Drywall - Int. Lath „E Z Final Final BLOCKWALL APPROVALS steel POOLS - SPAS 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 z O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final 02 Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring _ Low Voltage Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G. F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: N Bin # City of La Quin ta Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: S(p &4ve Owner's Name: A. P. Number: 0 Address: )c78. 8s- L')Lz�(sz--) D Description: 1,r 7 Cin •. Ciy. ST. Zip: K LA CA qaZo-z;� Contractor: X—RUA (()N%" (M Cy,) Telephone: r, - - Address: )( 44 Project Description: X Rrpq City. ST. Zip: Y_ Ch qzz6l 13' UV -0 156IS77AI(4 Telephone: y State Lic. )c. G44 336 City Lic. #: Arch.. Engr.. Designer: Address: City. ST. Zip: Telephone: .... . . ..... ............... Construction Type: Occupancy: State Lic. Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person:x 3M 0a. Ntcme "Sq. Ft.: N'D #Stories: F Units: Telephone# of Contact Person: )C Estimated Value of Project: X 110, Q)M 216 APPLICANT: DO NOT WRITE BELOW THIS LINE Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets '2 M*J J lvk=� Plan Check submitted % , 02- h/ Item Amount Structural Coles. 0 'e*f) Reviewed. ready for corrections dPlan Check Deposit Truss Coles. Called Contact Person IXA/'01111 Plan Check Balance • Title 24 Coles. Plans picked up L Construction a Flood plain plan Plans resubmitted Mechanical e 2" Review. read), for corrcctir(s/.ssue4 Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. 0 H.O.A. Approval Plans resubmitted Grading 8 IN HOUSE:- " Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees J:�iSiA 524� 6W A] lit-- Total Permit Fees -.Mw cr- yell 1 45 P- bow -c T,,, hot/-5iff I &/07" MP by A454 Lot C Pw ser -f rr Itsert ttsort I nage,Ment December 7, 2001 Mr. and Mrs. Wolrige 78-685 Descanso Lane La Quinta, CA 92253 Dear Mr. and Mrs. Wolrige: The Rancho La Quinta Architectural Committee has reviewed and approved your submittal of plans for a room addition and trellis at your home at 78-685 Descanso Lane, with the following conditions: -All work is to be done in accordance with all applicable requirements of governmental entities, including the City of La Quinta; and inaccordance with all Homeowners Association architectural guidelines and governing documents. -All construction must access your lot via the street (and not the golf course). -All materials and colors to matchexisting house. - Especially note that trellis shall be rough sawn wood. When the above conditions have.been met, and the work begun is finished, please fill out and • return to me the enclosed Notice of Completion. The consultant will perform a final inspection after receipt of that notice to verify installation according to `the approved plan, and then your deposit can be processed for a refund. Si cerely, Gary roy, Prope Manager Rancho La Quinta Master Association Professional Community Management / Desert Resort Management - i Post Office Box 4772 - Palm Desert, CA 92261-4772 73-550 Alessandro, Suite 5 - Palm Desert, California - (760) 346-1161- FAX (760) 346-9918 Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 Date 2/14/02 No. 22947 Owner NameW & Ml's Wolrige CERTIFICATE OF COMPLIANCE APN # 646-340-007 Jurisdiction La Ouinta No. 78-685 Street Descanso Lane City La Quinta Zip 92253 Tract # 27840 Lot # 7 Type of Development Residential Addition Comments Room Addition 160 s.f. Permit # Log # Study Area Square Footage 160 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: Residential Addition 500 Sq Feet or Less EXEMPT This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 0.00 X 160 or $ 0.00 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 Exempt - Michele Sawyer Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Nicola Wong Signature -L�0� �i M, Telephone Exempt W.'00 Check No. - NOTICE: Pursuant to Assembly Bill 3081 (CHAP 549, STATS. j99(ij 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 or on which they are paid to the District(s) or to another public entity authorized to collect 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 IMPORTAi'7`6a:s _ riot asd«rey.ltis merely furnished as a comrenierto to locate the land in relation' to streets and other lands and not to any dimensions, distances, bearft" ®r wmmge. IN TOE HT N U QUOTE, COOa9Y OF F"ERSID, 51&TE OF CALEFG;MZA . 5 OF 9 TRACT�A PAP RTI ar 27840- NECOROS OF flI EASIDE COUNTY, NITHE9HE 114 OF SECTYONN3 8 NW J/4 95 OF SECTION 32. TSS. RX. WK SANBORN/WWB SCALE 1"=60' JANUARY 1994 ffIATA SAT rwa••r. �w.Ltw o.n s a i upyk .lA ' w e> aD.O fTY1YL � A 4 M I W Y•aa PLA -.Wei nVr 6A e•In • r -•—' pw .i•e r S ' i�+i.•a.. an s r+ry ir. . i CALSO HAY YOM SEE SHEET 2 FOP. r HAS1.S OF 8RMN'`G AND " w :: w Irp'ar. a. ,r s' a Nswf r,Farsne ne Aplia gpRVMWS NOTES. Ylaa+'nT } Intal M'n A refq-y.'. !�• r fI.D �us.r.7 faai�/bD-lY . va-.c •+.ate r.r •as•e // VEE E 48 74MAU. a a a K� ■ ss�` Ialt a2� �as�o e�� aclr.a�a ns..si ie.. f - a a5 si•�L Yeusn a r uoL a+L LOT "g Tl)7 B9 154 AC. - - - - - - - ;CZ ZMAIN or8185CAN50 UrcE «.A IAT "Y' 1.10 AC. t•L . a_ aL / ��.�� ,u m ae.m a�.va o :iAe s - � Q . i e ci $ 2+ m y ► Y 7 8 8 to E,[YC -L6• R COURW t 4- E— rad C7 r x ;: L~ i P w PARCEL a a "" 1 « co It ` pa IT IAT -Lr 7..22 ILC. h 80 i gg 86 SEE S1499T 2. (cap p 1 as i i e� t� 085 84 83 0 0ffi SHeT 7 4 - 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 ❑ REINFORCED CONCRETE ❑ POST TENSIONED CONCRETE ❑ REINFORCED MASONRY ❑ STRUCT. STEEL ASSEMBLY ❑ ASPHALT ❑ FIRE PROOFING ❑ HER 'b JOB OC T i �` � � t) (X� � � REPORT SEQUENCE NO. TVP CTURE I PERMIT NO. -y k D DAV OF WEEK MATERIAL DESCRIPTION ARCHITECT 1 ` HRS. CHARGED ENGINEER ASSISTANTS HRS. CHARGED INSPECTION DATE GENERAL CONTRACTORS"' SUB CONTRACTOR 8AS QUADL COPY SENT TO CLIENTO C TINU DON NEXT PAGE PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV 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. SIGN' TOURE OF REGISTERED E TOjt � II� (�'/, ATr F REPORT REGISTER NUMRFR