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0002-078 (SFD)
LICENSED CONTRACTOR DECLARATION l hereby affirm under penalty of perjury that I am licensed under provisions of',' ,V# gptei,9 (commencing with Section 7000) of Division 3 of the Business and .,IP,rofessio6ai , i Code, and my License is in full force and effect. yF IC�ns6 #;. Lic. Class Exp. Date .67,407 Date `. U7�31l2C Date ,Signature of Contractor fj�t OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that l am exempt from the Contractor's License Law fpr 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 salc (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 STATE, FUND Policy No.' 046 -00"339 (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 mann%so as to become subject to the workers' compensation laws of,Cal fornia, ang agree tthat it'l shobld become subject to the wo kers' compensation provisips•of-Section 370?of the Labor Code, I shall fo fw4h comply with those provisions. Date: ! zv rr Applinant—. -- Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at. whose request and fog"whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby uthldr'za representatives of this City to enter upon the above-mentioned�pro>erty fc ins�ct' �n purpos Signature (Owner/A!aent) Date :..BUILDING PERMIT PERMIT# VALUATION LOT ��9�yr� (� �p2TRACT r\/ ..y C4" 01,21 A0 a 23 - bV .6+`�'•vv,. [�!DDATE [j yJ�� JOB SITE ADDRESSJSI%C�()�% ''' 4,.,7 APN tr>'-�8, Q a i t OWNER CONTRACTOR / DESIGNER,/ EN (NEER LA QiU N rA. ORCHARD PARTAE'R S SPAIRM.5 CONgrrt'I C 1©19 POBOX 1316 75'-295 RANCHO LA QVICITEAjrXR.. Q1i1NTACA 92253 LAQilll+l'1:A. C:A 92Za3 (760)771-1941 CLO 2996 ✓� a / ' USE OF PERMIT SINGU 1? Y DVMJ, �1G / t Stffl .< PERMIT DOHS N0T jNC1,U1) .13I OC'K WALLS Ct.. POO TihCT CC)348TAUCT10N 098.00 O Q1�cK(PATIO OtARAGiZlc;;.;fiRP U ($F) 79,487,60 ]laVIMAT.H.D COST OF CQNbM% C--11.0ff 4591,272AD FERA T Ti'1'vR SUMMARY CONSTRUCTION FEE 101.000-418.000 si'O.06.50" P"14 Cfitcr, ne 101-000-439-318 $1,94I. -W FELE DEPOSIT 301.000-439.318 4250.00 11 AI'.,CN"IC.AI, FEE 101-000-421-060 ELECTRICAL T172 101.000.420"001 $377.05 PLUMBING FEE 101-000-439-000 li`.f96.2 VRO.iC3 MOT.101 FRE - RES]D 101.000.7,41.000 $40.13 G i.? 0FFY 101.000-423.000 $20.00 DEVELOPER -IMPACT FEE $1,94"f,118 ART iN Punic PLE3Cs - R.Esir. 101-000-2ss-000 V53.19 SUB -TOTAL. CaC N'.911`ALiMOR AKD PLAN CF: t C $'i5y"632.t5L' LESS MR—PATID na!Z 4250,00 TOTAL i' '�:�'MIT F S 1113:j?. OW Ksnm RECEIPT DATEB' DATE FINALED INSPECTOR iu - INSPECTION RECORD • OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR 2 _ BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade �j p���y�..— Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation 2—+rJ/ 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 A ROVALS 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 r.*?i 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 / ��C/ err Final�M� CQN,.�,�,b,�, Final/0 Utility Notice (Gas) ELECTRICAL A PROVALS 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) �. ,. ,,,.._.� _ : � .�sc,--• •-'r�.'•� �•rr.F•�.a..r fj t'f� �iiFSS:+�IM^'�'.+�r:%v° • �y,��}.,r:'v'�.�1� . . � •°3 . �-' +nt �f t .�+,.. -�'T -c:l � y P.O. BOX 1504 APPLICATION ONLY Building 78-495 CALLE TAMPICO Address /5'o 3& O t� 000 A_(,r PF— LA OUINTA, CALIFORNIA 92253 Owner n Vf`// /�1�. o%�C i'1!!/!"GL. � (�S Mailing Vt ] BUILDING: TYPE CONST. OCC. GRP. ,t� Address Pr D f .50 1/ /6 A.P. Number / -7-7-72 " o-1 /�.V " of City 4 01W i,� JZiplaa.5, � ITO�•/%f/ Legal Description �i1 41� Contractor Project DescriptioneG/,7"Ell JF4Q J &_% 1��6/, Address a JQS 10 A U `.I ('JIG! // City/ _ u 1 1� Zip �a 53 Tel.. l XACSS y '791 /9 '�/ State Lic, ^ City / & Classif. Lic. # p2� 9(C/ Sq. Ft./_ �/ yam, -',,No. No. Dw. , Size (!! I c1 Stories Units Arch., Engr. Designer r Ne Adder❑ Alter ❑ Repair ❑ Demolition ❑ AddressTel 77 – 3 rl� , ity % Zip State + • " ti 75/� © < PS$�4.�/,U/2o �T� G 7 —�D Lic. u 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 -.k,-„ ' effect. ^ ///yyy SIGNATURE DATE �� . 1 1 I2 4 OWNER -BUILDER DECLARATION Estimated Valuation IV I hereby affirm that I am exempt from the Contractofs License.Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or,county"Vwhich requires a permit to construct, alter, improve, demolish, or repair any structure, prior fo'Its issuance also AMOUNT requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT 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 .c jV for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Plan Chk. Dep. '7 C-.1 subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I:! I;as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 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, Mech. Provided that such improvements are not intended or offered for Sale. If, however, the building orimprovement is sold within one year of 'completion, the owner -builder will have the burden Electrical of proving that he did not build or improve for the purpose of sale.) I 1 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 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 S.M.I. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading I'] I am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. Date Owner Infrastructure 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 M Copy is filed with the city. O Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS 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., It, after making this Certificate of Exemption you should become ZONE: BY: subject fo the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: comply with Such provisions or this permit shall be deemed revoked. Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY y `'4 Side Street Setback f-om Center Line Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Pr3perty Line Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to -FINAL DATE ^ •`• - INSP=CTOR expiration if work thereunder is suspended for 180 days.. s ' ` •'v "' I certify that I have read this application and state that the above information is correct. Issued by: - Date - Permit I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives sof this city to enter the above- mentioned property for inspection purposes. Validated by: r - r` '• •� r Signature of a0plicant �. Date '"'�' _ • 1 .,. Mailing Address Validation: + r City, State, Zip WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands Unified School.District " `47-950 Dune Palms Road Notice:,La Quinta, CA 92253 , Document Cannot Be Duplicated 760-771-8515 4 CERTIFICATE OF COMPLIANCE •. Date 6/13/00 APN # 772-040-011 No. 20543 Jurisdiction La Quints Owner lvameLa,Quinta Orchard Partners ` Permit #0002-078 No. 50=360 Street Woodmere Log # city La Quinta zip 92253 ,f Study Ara Tract # 26524 Lot # 23 Square Footage 6598,4" Type of Development . ' Single Family Residence . s 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 fee's 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 2.05 X 6,598 or $ 13,525.90 the property listed above and that bu.1ding permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued Fees Paid By ,Check/Eldorado Bank/Judy Halpairi Telephone X760-771-1941 ' Name on the check By Dr. Doris Wilson .. A - y 4� yr .'v"• •,-. � Superintendent Fee collected /exempted by Mary Ann'L. Boda - Payment Received't,'' $1;3.525:90 ` Check No.'. 070676826 w Signature , [No TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to not"rfy you that the 90 -day approval period in which you may protest.thetees or other payment identified bove will begin to run from the date on which the building or installation permit forthis project is sssued or on which they are paid to the District(s) or to another public entity authorized toollect 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;waiver. z Embossed Original- Building Dept./Applicant Copy=Applicant/Receipt Copy - Accounting CITY OF LA QUINTA PLAN CHECK CORRECTION'LIST 4 . G . • June 5; 2000 y Gouvis Engineering 4400 Campus Drive Suite A Newport Beach, CA 92660 PLAN CHECK NO.: 0002-078 FINAL CHECK JOB, ADDRESS:. 50=360 Woodmere OCCUPANCY: RMA • AREA-S.F.- : 9177 TYPE -OF -CONST.: V -N The submitted plans and specifications have been reviewed by VANDORPE CHOu ASSOCIATES. It is,- our s,our professional opinion that the plans are in substantial conformance with the building codes and regulations adopted by the CITY OF LA QUINTAand the State of California Amendment. APPROVAL FOR A BUILDING PERMIT IS HEREBY RECOMMENDED SUBJECT TO OBTAINING APPROVALS/CLEARANCES FROM ALL APPLICABLE"CITY DEPARTMENTS, AGENCIES, AND " ASSOCIATIONS. T Plans checked by: �— Dorothy Gordon, P.E. ` VANDORPE CHOU ASSOCIATES. 295 N Rampart Street, Suite A Orange CA 92868' ` (714) 978-9780 VCA File No. LQ -11658 I - L-KC-110 CALIFORNIA February 8, 2001 GOUVIS ENGINEERING • C A L I F O R N I A • E-MAIL TO • SCIPPORT@GOUVISGROUP.COM • SALES@GOUVISGROUP.COM Stormy Dayton La Quinta Orchard Partners c/o Sparks Construction 79295 Rancho La Quinta La Quinta, CA 92253 Re: ' The Estancias Custom Lot #23 GEC Job No.: 20915 Dear Mr. Dayton: This letter advises that we have observed the structural requirements that are visible during construction at the time of our site visit. Gouvis Engineering believes that the as -built construction at the time of our visit is in general conformance with our structural plans and relevant correspondence issued by our office relating to the above referenced dwelling. This report is understood to be an expression of professional opinion by this office, which is based on our best knowledge, information and beliefs. As such it consists of a report for only structural elements (as above outlined) and is neither a guarantee nor a warranty, expressed or implied for other trades or requirements of subject dwelling. Respectfully Su UV Saeed NG a a Saeed J. l President SJB:HV:cb Certif. 20915 C 3 8 2 7 6 EXP. 3-31-01 � CIVIC' �� OF CAVW Hanie Vinoya Project Engineer GOUVIS ENGINEERING GROUP OF COMPANIES WITH OFFICES IN. WEB -SITE: WWW.GOUVISGROUP.COM 4400 CAMPUSDRIm, SUITEA * NEWPORTBEACH, CALIFORNIA 92660 * (949) 752-1612 * FAX (949) 752-5321 2150 EAST TAHQUITZ CANYON, SUITE 9 * PALM SPRINGS, CALIFORNIA 92262 * (760) 323-5090 * FAX (760) 325-2863 FIELD OFFICES * SAN DIEGO * PLEASANTON * INTERNATIONAL OFFICE: VIETNAM