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9809-027 (AR)LICENSED CONTRACTOR DECLARATION Y 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 a d effect. License # Lic. Class Exp. Date 11875€ 4 .,BC -10 2/29/00 tiDateJL-Signature of Contractor OWNER -BUILDER DECLARArIbN.i I hereby affirm under penalty of perjury that I am exempf 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. Se( ) I. have and will maintain workers' compensation insurance, as required by 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 Policy No. a VID CLIN17L'R 31N.S. C M1 J3:24-93 (This section need not be completed if the permit valuation is for $100.00 or less). () I certify that in the performance of the w rk for which this'permit is issued, I shall not employ any person in any mann r so as to become subject to the workers' compensation laws of California and agree that if I should become subject to the workers' compensation pr• isions of Sectirsn 3700 of the Labor Code, I shall f rthwit comply with thos rov�isions. Date: Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT. Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby au nze representatives of this City to enter upon ,the above mentioned grope for i nspection,purposes. 1' t /Si -- ./Signature (Owner/Agent) ""`6—�__<=-�'wr Date PERMIT* CONTROL # BUILDING PERMIfid►�_�>~ ( qq,, q DATE �4 1Lt�;� VALUATIONi�q�+� �� LOT TRACT 'q A23 ADDRESS :?��. 60 �JOB SITE . �i�1 1 �:�: wA APN % %�t� -�yy %i' OWNER CONTRACTOR / DESIGNER / ENGINEER MIM v ASERION A & M CONSIRUr_TCON, r 63.160 AVEN"IDA.1/fLLA -79-070 c t,,i LE CADIZ: LA: QUIN",.,CA. CA 922~3 X..A (3UIxTA, CA ±32253 (3617)564.4832 626 .. USE OF PERMIT MW 158 S.F'..TLOOM ADD[ i it?N r RAC1 C034STRWT10N 183.00 V 1'.I r'a�i.t'.:H$�Ct�:F'�fr• 1€11-dll){1-A��-�3b� SSI;.�i1 CONS TRf?CTION FEE 9.O Z -(?Q7-4 9.8-(l00 $ ll,26, 3i) 'WVC IA1QCAL r.=T-'E got tbo-4'l1-000 s?�.so 1:•.�,EC'°i'O.T�;AT. `1� E.�� I � �--�12o-T�0 rb2 9: w?. • - STRONG 10T10NTF1X. '0LEST1a 101-000-241-000 CMADIMFER 101-000-421-000 SUB-'C(A'A.L• GENS`[' UIC- 10N AND PLAN C HIRC',• LESS* .PILE -,PAID FEES $0.00 NOW . Sz72.00 R CEIPT ©A E BY1 TE FINALED INSPECTOR OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms& Footings Eq _. Ducts Slab Grade Return Air Steel Combustion Air Roof Deck O.K. to Wrar Exhaust Fans F.A.U. Framing RZ/p%9 _ Insulation // ZQ P L. — /it/�j Compressor 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 BLOCKWALL APPROVALS - 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 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 Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power t Final Utility Notice (Perm) COMMENTS: Desert Sands Unified School District 47-950 Dune Palms Road N Notice: -La Quinta, CA 92253 Document Cannot Be Duplicated 760-771;.8515' CERTIFICATE OF COMPLIANCE Date 8/10/98 ? APN # 774-064-007 No.' 17474 Jurisdiction La Quinta Owner IvameJacqueline Ashton Permit # 53-160 Avenida Villa • No. Street i - . Log # City La Quinta Zip 92253 Study Area Tract # Lot # Square Footage 188 J Type of Development Residential Addition No. of Units 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 mobile'homes.' It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: f Residential Addition 500 Sq Feet or Less EXEMPT. ' 4, This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 0.00 X 188 or $ 0.00; the property listed above and that�bu ldiiig J permits and/or Certificates of Occupancy for this square footage in this proposed project:may now be issued 4,g , Fees Paid By N/A - Rick Morris F r j e16phone. 342 55551 . Name on the check By Dr: Doris Wilson Superintendent" •� Fee collected /exempted by Juanita Green Exempt $0.00 Check No. N/A . Signature . 4.. y NOTICE: Pursuant o ssembly 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 rum 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 Distnct('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; X z .. T���c�1� ff i- ;,..4-"1 f'.t 1 784951CALLECTAMP;•ICO • -, ! AK QUINTA CALIFORNIA"92263- '(4760) 777-7000 FAX; . (760)`177-7101 July 6,1998 TDD (760) 777-1227 Mr. Stephen Nieto 82723 Dr. Carreon Drive ,Indio, Ca,' 92201 SUBJECT: Minor Adjustment 98-458 (53-.160 Avenida Villa) Dear Mr. Nieto',, The Community Development Department has approved your request per the attached exhibit, for a minor adjustment allowing a one foot encroachment into the required 10 foot rear yard setback to allow a room addition, based on the following: 1 This minor adjustment is consistent with the General Plan in that :the single family use ,is• permitted -.in the Low _Density, Residential land use designation of the Land Use Element of the General Plan. 2'. This minor adjustment is consist with the Zoning Code in that it .is a permitted use in the Low Density Residential District and complies with other -applicable Zoning Code requirements. 3. Minor adjustments are categorically Exempt from the requirements of the California Environmental Quality Act, per Class 15303 (a.' and c.). Therefore, e no further environ mental review is deemed necessary. 4. The uses surrounding this use are single family 'residential: uses or vacant' Tots proposed for single family residential. The encroachment of a portion of •a room addition is necessary due to the substandard small size of the lot. Approval is subject to the following conditions: . 1 .. A 'building permit shall be obtained. 2: Approval is as'shown on attached plan, with'the-exception that as required by. . Zoning Code Section 9.60.070 B:1 patio post shall be a minimum 4 feet from swimming .pool :water.line. Shouldyou have any questions, please call me at (760) 777-7064. c:\Itr app ma 98-458 MAILING ADDRESS P.O. BOX 1504 — LA QUINTA, CALIFORNIA 92253 -_. 1• •4 ' • •Ks.� .. K r' .. , � . • s�^i • �t iia, � • .. r • �� )�/� /7/Jj�j,a _ �. 9-4 v . Y-, 44 -77 .�. r' _ • + V 'r ' ^rte J -J. .• . . Q. � , f 14I .r J• 7 -4 h' I ,V A i . 1 4 1 i .