8208-017 (SFD)r
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
"j• "Z l's ��{.c 1110 t W-2( „
/ Dafe Signature of Contractor j
y # V v
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason: r
( ) 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 contracti*with licensed
contractors -to construct the project (Sec. 7044 Business 8yProfessionals
Code).
(') I am exempt under Section B&P.C. for this reasoh
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 -in ' re for workers'
compensation, as provided for' by Section 3700 of the Labo Code, for the
performance of the work for which'this permit is issued.
(.) 1 have and"will maintain workers' compensation insurance, as required by
Se�fion 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 STATS FUND Policy No. 130gWr,.99
(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 .riot employ any person in any manner so as .o becom '%subject to the
Workers' compensation laws of California and�agrBe�tF�at if I s' ould become
subject to the. workers' compensation ,erov44lslo s of Section 3 00• of the Labor
Code, I shall (ort with comply with those plovi lois
Date: � { ja : 0 Applicant t .:/ _ :tti t I I ,�'�. Ot
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 -,1Q0 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 r ity, and State laws relating to the building _•
construction, and hereby- au horiz '�eprest ntati les of this City to enter upon
the above-mentioned propert for I pur
spectlo poses.
Signature (Owner/Agent) % Date
f �
- BUILDING PERMIT V= - PERMTk
132•(1:4 7
DATE VALUATION LOT TRACT
^ . � $103 ;xP IFS RIX 205 U -Z
JOB SITE y��y+�+.
ADDRESS . ,5b 140 AAT34 j.M!1•r.� VTIZ b
APN
774-054-005
OWNER
CONTRACTOR/ DESIGNER / EN (NEER
M. U,1+! u AIN COVU % EV. YNR°.
JIMP M:i I'ERPRIKC43;
P101 BONI 41578
45.260 PALM w'3..
TAL•M DY_ 1311' , CA 92261
WD10 CA P2201
4.7.T89 13CBVW 4'99
�J
USE OF PERMIT
5M. 4691 ��%F. IDEMIT P DOES WO T I:NCI,UDk, 8- C)* W..A.L." POOL, OR
TRACT CM19TRUCTION
�
Y=Oh�C£•it4'+a4.Ts�l . 1a2:4��!�r+11'
.
I'.F]t3E ATM) C0.7f OF "CONTiy"�'RUMON
CONN IM1 tC TION IVE 101 IS -000 I .
PLAN CliiICK ME
MICk1AR'"" L FEE 1411-000.421.000 $66.so
ELECTRICA 1.0 MIR $4.17.77
i`if,L1MTHO 7ev 101-000-419-000 $4 V.t,'Q
S7'TfM0MOTION, x'6;'1:: a RV11D 101-C3►00-241 -000
101-000-4Z3-000 �1 IN "
O{R!`�(�PW,'tT'l'Ftiitt�'pFt.1��a
�{ /m tv
DEV'ALOPE:.iw :F1JPF'_j�clP. UZI.�'
PRECISE PLAN '`' 101 -00064,41-,345
&`CID,-�"OTAI. r�MUC I;QNAND�rl �;ls:`k1 ;C '►
?,Q3t�. `7
1=3 PRE-Pfim =13
$0100
6
)TAE, PISMARTI)TWaS, TMO WAY
AUG .0 F 2no2
C FINANCEDE6rP
RECEIPT
DATE
l
:BY
yy11 s
D FINAL D
/1`
IINSPECTO
� •JF.
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
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
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 -- C/
BLOCKWALL APPROVALS
Final
POOLS - SPAS
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
O p 2 %
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
�,p/�_
Encapsulation
Gas Piping
Gas Test
Appliances
Final
.Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole 7- Q Z
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) y
COMMENTS:
�� L v — ;21,;21,Z U
�3 �y / G
`
,
CERTIFICATE OF COMPLIANCE �F>
} Desert Sands Unified 'School District z4�cso
47950 Dune Palms Road r
Q BERMUDA DUNES r
Date 8/5/02 La Quetta CA 92253 rn RANCHO MIRAGE d
INDIAN WELLS ti
PALM DESERT
No. 23453 (760 ) 771-8516 LA OUINTA
- �INDIO
e Yl
Owner Mountain Cove Development- APN #
Address t. Jurisdiction La Quinta -
City La Quinta Zip 92253 Permit # 0208-01788 ^
Tract # Study Area
Type Single Family Residence No. of Units 2
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 8 54385 Avenida Ramirez 1691 Unit 6
Unit 2 18 53140 Avenida Villa 1691 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9 ._
Unit 5 ., Unit 10
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 (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 $2.14 X 3,382 S.F. or $7,237.48 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 CC Canyon National - Larry Shields Check No. 10949
Name on the check Telephone 771-1670 s
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Crystal Scott $7,237.48. 0.00`
Payment Recd Over/Under
Signature
•
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or
other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
t, NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
RC DISTRICT'- PLANNING REVIEW FO
This form is.to be used. by CDD staff for review of single fam' w Ii s ' the RC (Cove
Residential) District per Section 9.50.090 of the Zoning Co I p p is to determine:
1) that the proposed house design does not duplicate f sam a of any
house within 200 feet of the applicant, and/or 2) if there a nee r pplica o file for
Master Design Guidelines. If the applicant does need to file a Mast Gu' ine, please
transmitted this information -lo the Building and Safety Departmen of your correction
list.: Please attach additional explanations as necessary..
APPLICANT. Mountain Cove Development
SITE.ADDRESS .53-140 Villa:,.
APN 774 "- 064 - 006 CASE NO. 2002-677'
LEGAL. LOT 18 BLOCK 205 UNIT" S.C.@V.L.Q.
CHECK AND APPROVED BY: Greg Trousdell DATE: .
Inform the assigned Building plan checker upon your assignment to,this case. The CDD
Executive Secretary maintains a log book,to track applications and assign case numbers.
REQUIRED ITEM
Y
N
COMMENMORRECTION
Verify legal and APN .information .
Consistent with MDG on file (as
applicable
MDG filing required (5 filings since
9/3/98)
So 1
Architectural variety within 200'feet.of
ke
the surrounding area.
o�
Colors
ab
m1ss�
P
Materials
Go
—$.ITy OP r n-
Architectural design features�t\�
e5��
JUN 1:3 RECD
Other Requirements:
E
.rah`
"\c
G010Will
Sl�LC7�w.
koo
Certificate of Occupancy
City of La Quinta
-,Building and Safety Department
This Certificate issued pursuant to the requirements _of Section 109 of- the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction 'or use. For the following:
BUILDING ADDRESS:. 53-140 AVENIDA VILLA
Use Classification: SFD, Bldg. Permit No.: 0206-017
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC
Owner of Building: JNP ENTERPRISES Address: 45-260 PALM ST
Cily: INDO CA 92201
By: KIRK KIRKLAND
Date: 11-14-02
Building Of4cial
POST IN A CONSPICUOUS PLACE