0206-010 (AR)N U)
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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 A. Lic. Class Exp. Date
15 71203 T3 0513 112(
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 (See. 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.
have and will maintain workers' compensation insurance, as required by
S ction 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 Z'TATE f't flD Policy No. 1059415-2002
(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 those provisions.
Date: %7� 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 for inspection purposes.
Signature (Owner/Agent) Date ' 2
wt 1 wILIw www1111111N." PERMIT#'
DIU! WiNu rrtnnni 1 (Y-9" 4Dsa
DATE , �� v VALUATION ' �f LOT TRACTJOB
SITE
ADDRESS 2-111 D1T.N.3. ,`YZ CCPUM'
APN 769=3.62_W02
OWNER
CONTRACTOR / DESIGNER / EN (NEER
031.A R.Ll',�S 1v-M-4:t3i.'�.'Lvi•
AN1 NIAA71,'rIERCI'.i=' C()XP0R 4:fV-R7
52-? '1) M}d'Li41*121 C'OMT
'44533 DF1, ..F C"0,141:ON IT.'D
LA. QUU. TP. CA 92251
T. AL) v! 1)1 ZE iZr CA 922[ 3
(160)346-3228 QSLO 03013i
USE OF PERMIT
1:21 S!v P 1.? 1TIONiP MODEL. PER t►.3•If'l2CJt Er, PLANS.
CUSTOM COMS:'TRUC:'TI" iB1.0t► :3F
E-STll KrMI) COST OF CIONSITRUCICEt?N
1'WWI • Fla, 6IAM iill.RY
C'ONOTRUCT1014 F'LE 101 -000 -43? -000 #1.i7:ttp
PLAN CHECK FEE 1101.01W-4 39-311 8 $97,69
W0iLANIL'.t L''fiZ; IA.I4411 _tzi•000%% $19.50
hXCT91C,A1, PEZ, '10 1 •-666.§20-0C,ts $ 4. Z4
S'rPO'N4:f Ahc"lT1011 WKY - TLY910 101 e0WU1-000_ S:!9
n u u A
CITY0FLAQUIWA
FINANCEDEPT.
;lC3j'?'JTA7, COI3:T :YT(`1'l l� ANE, T7LAT7 GfIEC".K
$768.17
1X :" PRE-PPAD PFF-2
$0. 00
TOTAL FETSMT F"E]�v 13 Cf � 1�lC)V4►
RECEIPT
D �,
BY �' .�
DATE FINA D
,dZ
G - ItIl
INSPEC
/ice' v
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
6 L
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
i'—
Exhaust Fans
OX to Wrap
F.A.U.
Framing
ant
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wail Insulation
Condensate Lines
Party Wali Firewafl
Exterior Lath/l—
Drywall - Int. Lath
- d2
Final
Final U- d
BLOCKWALL APPROVALS
POOLS e SPAS
Steel
Set Backs
r .per
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
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Dain Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
_
/19/2001
t
15:00 7607777011
LA OUINTA
PAGE 01/01
bin
City of La QU111ta
AdMW ar Safety Division
Box 1304, 78.49S Cage 7`anwico
U Quina, CA 92253 - (760) 777-7012
Building Permit Application and' Tracking Sheet
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Projec Address: - aA,1LrV19 eWXrOwner's
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I urnber: ?AP 9 - 7, Do Z
Address: ,K sd? - // / F~YIE DU
Legal esctiption:
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Telephone: "�<>w:ti: •:n;<:::::;s,.•:
Project Description:
.City. Zip: V
Telep ne: X
04-1<
State
I'ic. M : j(, Vcpas
1City Lic. #:.
Arch., gr.. Designer: S
City,
. zip:
di
Telep ne: ] � (0
State. 'c. N: —
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Construction T V occupancy:3
Type-.
Project type:(cirele one): New Atld'n Alter Repair Demo
Name f contact kersott: JC �`j�jir
r '
Sq. FL: totyes 2 /
# Units:
Telcp nc # of Contact Person: JC,
Estimated Value of Project aio 421%
A(12t(
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
ubmittal
Re •d
Reed TRACVJNG PERMrr FKT3
Ian Sett
2
Plan Cbeck submitted !✓ Item
Amount
tcnetural Coles.
Z
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Revlewtd. ready for torrecdom y Plan Check Deposit
rags Cafe$.
Called Contact Ptraon 1, `�� vs. Plan Check Balance
dtlt 24 Ctics.
Plans picked up onstruetion
food plain plan
Plass resubmitted Z Mechanics,
rading play
2" Review. ready ro correct) ame 2 Electrical
abcontactor Ust
Called Contact Pers y Plumbing
rent Deed
Planspickedup ,>; y S.M.I.
.O.A. Apprvvai
Plans resabaditied (,� I - �,3 Grading
HOUSE;-
'"' Review, ready carreedaa tsar � Developer Impact Fee
l.nning Approval
Called Contact Person, ( A.I.P.P.
ab. Wks. Appr
D■te orpermic (stat
now Fees
O l 0 SSS v�
NT
ot Perrolt Fees
x--119 Sr OR 4- reef 6'w—v %o
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District 4�o
47950 Dune Palms Road EIERMUDADUNESO
, RANCHO d
Dake 7/2/02 La Quinta, CA,92253 INDIAN WELLS
LM DSEffr
�.
No. 23344 (760) 771-8515 ¢,�( P QUENTA �y
yQ INDIO ya
Owner
Charles Mechem
APN #
769-162-002
Address
52111 Dunlevie Court
Jurisdiction
La Quinta
City
La Quinta Zip 92253
Permit #
0206-010
Tract #
28612
Study Area
Type
Single Family Residence
No. of Units
1
Lot # No. Street S.F.
Lot # No.
Street S.F.
Unit 1
52111 Dunlevie Court 121
Unit,6
Unit 2
Unit 7
Unit 3
Unit 8
Unit 4
Unit 9
Unit 5
Unit 10
Comments TRADITION: addition of office space
N 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:
Residential Addition 500 Sq Feet or Less
EXEMPT
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 EtSeq.
in the amount of $0.00 X 121 S.F. or $100 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 Exempt - Bill Burgess Check No. -
Name, on the check. Telephone
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Crystal Scott $0.00
Payment Recd Overfunder
Signature
NOTICE: Pursuant to.Government Code Section,66020(d)(1), this will serve to. notify you that the 90-dayapproval,period in which you mayprotest 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 orrwhich
those amounts are paid to the District(s) or to another public entity authorized to collect them on the Districtfs) behalf,whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
Tradition
May 6, 2002
Mr. and Mrs. Cheri" Machem
Re: 62111 Dunlevie Court
Dear Mr. and Mrs. Mechem,
The Tradition Architec#ural Committee has reviewed your subrrfdial of remodel
plans for your"home on Dunlevie Court. The plans were approved as subntthed.
Thank you for your submMal and pabanoe in our review of the plans. Please call
me at 34611.01 if you would like to discuss this or any other Association matter.
Sincerely,
KV"4,1 V of "
Mindy Gutierrez, Property Manager
Tradition Con wNdy Association
ca: Bob Ritchey
PCMIr-Es>:RT RESORT PROPERTY MANAGEMENT Cok-WAvvY
POST OFFICE BCrX 4M, PALM nESFR'r, c%LrFoRNLk 92261-4772.734M ALESWMRo, 6tn71E 5, PALM DESERT, CA1:lFORNIA 92260
PHov, E: (760) 346-1161 -- FAK (760) 346-9918