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9604-124 (SFD)U) N U) W O0M, r� 0 L0 W Cr r O H o� W W C° I— D_ Z M LO N ON U °) Q T Cr Q O W X W — mUU O Il rn H coo �O a J 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 AAN999 C -.3/31/%, Date Signature of Contractor I 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 (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 Afi-lj,1Wf'&i:I 4J)U8'6' Policy No. .old; is7- (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: 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 BUILDING PERMIT PERMIT# CONTROL// y��-� 24 3260 DATE 5/ 796 VALUATION �Z�D Z.� LOT �S TRA;GTj.129 JOB SITE ADDRESS '79.20U !'d x RUN APN 769,.542,412 OWNER CONTRACTOR / DESIGNER / ENGINEER 50443 NIOUNIAIN SHADOWSRE) 30,143 MOUNTA,;N .SaA SOWS RD LA ('?ULWfA. CA, 9225:4 LA QUINCA. CA 92253 (619)561,1&49 Q i,'L'If 36.15 . USE OF PERMIT �1:(ViiLlz 1,'}LAilisl° I)'41ff;l...l�iiVi`i PFRX11'f DOPS N011' tNCLUI)E BLOCK U IVLI, OR F'1 -S3 PtEF'1,'ECt A' t i..t56 C'ti-w1.'1' FoR �lt'I'f; !� l�if�LFC:.IA1,A;:"F3 f'tft AC'i.17.Fsr;l�(H"j�r r�l�C"1'fF t,;'�, COR�II�9_iJt�'1`1'1'9JisVFt.�Jlsl�i"alsi' Faf:3''i, Ci3;,T31'.KIIC't'ION 3.*400) 3F 0ARA0I•JC AR(•0 PT Sr. 1v.STI[eiAT.E%COST OF f` a* WNS"w''RUCTION 2U.661.40 c {Ji�ui'Ft:tTG4'LC`NFM' idJ O -Ali -f3U0 f,0ai,€;U OLt>NCIff:C.K7=EC 101-{) O -4.39 -:fix?' $9.21.W fk,4_-' NA.NI A:Lr F1;J- 10J.-000421-000 ili.tnf °LfLL141G;NO r1_-Tj 10140-419-000 5243-25. rift 6�IV« t1,1.t"r f'i:0N 11;.E -12 411:1 1()1-000-2=1.6 -11110 $21'4'7 t':{(tA0I'N(_1 FL -1; 10,143131,-423.000 $26.ir# fRr 'tt.r?S`1'ftl l+.af t IRE1'61't5d 00 -X64'`; -;fid? .85,(1.1."_ _+,,•, "', tj l�'�[�.7 I�x`Uw {.-VlW iS '4tJN !' D PLAN tfs, 1.Ei..+.LR. 1099.59 LESS PRE -PAID REES 42`0,4 o TOTAL PERMIT1 E'ES 1!'.)llii'NOW j S7,449-59 RECEIPT DATE r; BY f DATE FINALED INSPECTOR T_11 '_-t'- -- - INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings ( Ducts Slab Grade gr Return Air Steel Combustion Air Roof Deck (p Exhaust Fans O.K to Wrap F.A.U. Framing - L Compressor Insulation II!:—:� Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath - Drywall - Int. Lath FinalI Zo G Final 2 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 (� ^ 6_ 1465 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 Piaster Sewer Lateral Pool Cover Sewer Connection /S Encapsulation Gas Piping' Gas Test - Appliances. Final Final 16 -22 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 Final (, • ,Z [ Utility Notice (Perm) LGC COMMENTS: - Z, P.O. BOX 1504 APPLICATION ONLY `Bui din /7 / 7&105 CALLE ESTADO Address -ZOO ,-jx zee,/LA QUINTA, CALIFORNIA 92253 Mailing J� /� BUILDING: TYPE CONST. �t"' ,/� OCC. GRP. Address 5O "Y � A / %^�� __=� 'Y�//Z /1/. ,�l . C'!'LC� A.P. Number 6 .� Cit Zip Tel. / �_� %�� ar�C`4429 {�� f �� ���j�— 70 Legal Description ,G1� .-, � / Ik'/�GV� �) i Contractor � ,[ � � Project Description Address City lZip Tel. State Lic. City & Classif. Lic. # Sq. Ft. No. No. Dw. Arch., Engr.Size Stories Units , Designer c"C.At��A New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. 74/111 <-<- Aeo�. 7 7/_ - SP417 Ciyty� �j' Zi State T;4 /l1 �S�/41 �k �L� Lic. If 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 effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to 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 the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). [; 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, Buisness and Professions 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, provided that suchimprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) I 11, as owner of the property, am exclusively contracting with licensed contractors to con- 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 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) I 1 I am exempt under Sec. B. & P.C. for this reason Date Owner 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 F1 Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE (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: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address - This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. 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. Signature of applicant Date Mailing Address City, State, Zip BUILDING DIVISION .2 uat PERMIT AMOUNT Plan Chk. Dep. p. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street -Setback from Center Line Side Setbackf=rom Prope� y -Lime FINAL DATE INSPECTOR 1lam! Issued by:�Daate 1 1 in. _ Perniit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IR 1ST FL.SO. FT. @ $ UNITS SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) YARD SPKLR SYSTEM FORMS 2ND FL. SO. FT. ROUGH WIRING DUCT WORK ROCK STORAGE POR. SO. FT. MOBILEHOME SVC. BAR SINK HEATING (FINAL) GAR. SO. FT. @ POWER OUTLET ROOF DRAINS TEMP. POLE DRAINAGE PIPING WATER HEATER CAR P. SO. FT. 0 FINAL INSP. BOND BEAM WALL SO. FT. @ DRINKING FOUNTAIN =$ SO. FT. ¢ - URINAL FRAMING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER -- VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED SPARK ARRESTOR LAUNDRYTRAY AIR HANDLING UNIT CFM KITCHEN SINK LATHING ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY INSULATION/SOUND HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB FINAL INSPECTION SO. FT. cns c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID Cid 1I c SEWAGE DISPOSAL INSPECTOR'S SIGNATURES/INITIALS SO.FT.GAR @ 14c HOUSE SEWER GARDEN WALL FINAL GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND, REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP, FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION -- FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL Notice: Document Cannot Be Duplicated Date 5/1/96 Desert Sands Unified School District 82-879 Highway 111 Indio, CA 92201 619 775-3500 CERTIFICATE OF COMPLIANCE No. 14410 Jurisdiction Owner Name Ministrelli Construction No. 79200 Street Fox Run City La Quinta Zip 92253 Tract # Type of Development Comments Lot # Single Family Residence Uirandfathered 3840 sq. ft. APN # 769-542-012 La Quinta Permit # Log # Study Area 125• Square Footage I 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: Under Mitigation Agreement EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Mitigation Agreement in the amount of 628.00 X 1 or $ 628.00 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 Ministrelli-Painted Cove, Inc. Name on the check By Dolores A. Ballesteros Superintendent Fee collected /exempted by Pauline Pearson Signature a LA J , AA n � 0 N1 AA IC26nLL Telephone' X564-1849 Payment Received $628.00 Check No. 2507 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 , o' 16 PAINTE D'COV.E ' ` LA QUINTA • , � April 26, 1996 .- .. • • ' - .; : , • _ " `-•• ,. City. of•La Quinta 78-495 Calle Tampico La Quinta, Ca: 92253 Re: Architectural Committee Approval Lot 55 Tract 25429• ` 79=200 Fox Run - Dear Sirs, This letter will confirm -the Architectural Committee approval of.drawings to.be .constructed on- Lot. 55 tract 25429, as prepared by Stanford & Leon hard.'Architects: - Should you,'e quire any additional information,. please contact.our office. Sincerely, Ken •Sch.male,.-President Architectural Control Committee, Painted Cove " < KS.: rm A.;im 0W -01-b l ' 50-445 MCiUNTAIN SHADOWS LA'QUINTA, CALIFORNIA 92253 ` TELEPHONE: 619.564.1849 FACSIMILE: 619.564:5530 ' i BUILDING &SAFETY DEPARTMENT 777-7012 ' INSPECTION REQUEST LINE 777-7153 Owner AWaSTRELLI-PAINTED COVE Contractor STRELLI-FAINTED COVE Permit' Number 9604-124 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 79-200 FOX RUN SFD-PERMIT DOES NOT INCLUDE BLOCK WALJ OR POOL TYPE OF INSPECTION FOUNDATION & SETBACK MAIN GROUND SYSTEM GROUND PLUMBING PRE-GUNITE DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB JOISTS & GIRDERS ELECTRICAL GROUND WORK DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH PLUMBING ROUGH GAS & GAS TEST HEATING & VENT -A/C BOND BEAM O.K. TO WRAP GROUT ❑ 4' ❑ 8' INSULATION PRE -ROOF COVER NO WORK UNTIL DRYWALL INTERIOR EXTERIOR LATH . i POOL PRE PLASTER J POOL FENCE & GATE EWER EPTIC TANK ELECTRICAL PLUMBING FINAL GAS TEST HEATING - A/C HOUSE NUMBERS JOB COMPLETED TEMP POWER S BEEN SIG ABOVE APPROVALS DO NOT INCLUDE RIGHT TO 196 TURN ON UTILITIES OR OCCUPY BUILDING Cerfilicale ol Occupancy City of ta Quinla Building and Safely Deparlment This Certificate issued pusuant 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: Use Classification: SINGLE FAMILY DWELLING Group: R31 Type Construction: VN Owner of Building: MINISTRELLI CONSTRUCTION Building Official 79-200 FOX RUN Address: City: By: Date': POST IN A CONSPICUOUS PLACE Bldg. Permit No.: 9604-124 Use Zone: RL 50-445 MOUNTAIN SHADOW LA QUINTA, CA 92253 KIRK KIRKLAND 10-22-96