0006-344 (RER)I.
LICENSED CONTRACTOR DECLARATION
C0 I hereby affirm under penalty of perjury that I am licensed under provisions of
H
Chapter,9 (commencing with Section 7000) of Division 3 of the Business. and
04 W Professionals Code, and my License is in full force and effect.
Z; =) ch License # Lic. Class Exp. Date
pl} : 442118 B 0 0/2.f
ti LL,
oZ° -p- Dat f1 �r, l Signature of Contractor-R-�^
CIDi — tf
•� OWNER -BUILDER DECLARATION
W W c�D I herebyaffirm under penalty of perjury that I am. exempt from the Contractor's
!n License. Law for the -following reason:
Z ( ) 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.&:Prof essionals,Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
C•`) O I am exempt under Section, - , B&P.C. for this reason
�.
N Date Signature of Owner
ON
Q7
d Q WORKER'S COMPENSATION DECLARATION
OQ I hereby affirm under penalty of perjury one of the following declarations:
r H O O 1 have and will maintain a certificate of consent to self -insure for workers'
X W compensation, as provided for by Section 3700 of the Labor Code, for the
O - Q performance. of the work for which' this permit is issued.
m Q (� �. ) I have and will maintain workers' compensation insurance, as required by
. Q 0 Q Section 3700 of the Labor Code, for the performance of the work for which this
Il Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier EXEMPT Policy No.
bD Q
�a
g (This section: need not be completed if the permit valuation is for $100.00 or less).
14) 1. certify that in the performance of the work for which this permit is issued,
I'sF all not employ any person in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I sho Id become
subject to the workers' compensation provisions of Section 3700 f the .Labor
Code, I all forthwith complywith,those provisio
Date: t " Applicant
Warning: Failure to secure Workers' Compen ation cov ge 'Is unlawful and
shall subject an employer to criminal penaltie&,and civil fines up to $100,000, in
addition to the cost of compensation, damages as provide_ d for in Section 3706
of the Labor Code, interest and attorney's fees.
\ IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set. forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of .this applicator agrees to, & shall, indemnify
& hold harmless the'City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
Work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to, cancellation.
I certify that I have read'this application and state that the above information is
• correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purpose
Signature (Owner/Agent). -- /1 Date
BUILDING PERMIT PERMIT#
(=6-3 44
DAT VALUATION LOT TRACT
�IP
JOB SITE
ADDRESS 71a-234 HACII�,Iti A JAQJJJ(,1'IA.1)HIY
APN 646-JW(W4
OWNER
CONTRACTOR / DESIGNER / EN (NEER
JOHN :MARRM FOSII1 R
1`.A Kl�[1 F -D : CONST. CO.
78234 llhr`71aTTA LAA QUINTA
48-751 W PEDRO Sl M - .
LA QUINTA CA 92653
LA Qi;` NTA CA 0225..")
(760)564-4660 tM1-* 469
USE OF PERMIT
' E `' Y.'NTIAL. REM0DII.
133 S.F BATN&KITCHEN REMODEL (ENCL.O`3L:ATRIUM, RA SE ItC)OFi
i; IT01`IEN REMOUEL(CNANOR WINDOW), DEN 4VAL11 k.El 00FL (DEMQ1
FIR31,0P1 ACE ADD ENTERTAINMIDIT CE14 TM n
VALUATION 1 A900. Do L -S
ES MVIA M) u'OST:Oil' CONFFRIK7,9011
1254M.0
lE'ER C FEE SUMAIARY
PLAN CHECK FEE 101.000-439-•31$ 8412,55
CONSTRUCTION it, E 101-000-418-000 x"1.00
MECHANICAL: FEF 101-000-421.000 VX$0
XLEC TR ICA1, i;'F.E 101-000-420-000 $4g.ItG
P1.UMBINO FIDE 101.000,=41:9.000 �47.hd
11013-7tSTAi. C0NTrl2U(!rL09 AND PLAN CTU t"It
IX493 PRE-PAII),, , .."
$0.00
r"
IXYfA1: PE.IFtRt117" R+XE:S DUE NOW
x
$1;139.05
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
NSPECTMN 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
r
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
- —Zw --60
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
Final
BLOCKWALC AP ROVAI_S
POOLS - PAS
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.FA.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
0,
Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Docuinent Cannot. Be Duplicated 760471=8515
CERTIFICATE OF COMPLIANCE
Date 6/27/00
No. 20623 Jurisdiction
Owner NameJOhn Marren Foster.
No. -78-234 street Hacienda La Quetta Drive
City La Quinta Zip '92253
APN # 646-280-004
La Quinta
Permit# 0006-344
Log #
Study Area
Tract # Lot # Square. Footage 135
Type of Development Residential Addition, No. of Units_ 1
Comments
135 sq, ft. addition to the home. .
At the present time, the Desert SandsUnified School District does not collect. fees on garages/carports, covered
patios/walkways, residential additions under 500, square feet, detached accessorystructures 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:
Residential .Addition 500 Sq Feet or Less
This certifies that school facility fees imposed pursuantto Government Code 53080 in the amount of
0.00 X; 135 or $ 0:00 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 N/A - David NelsonTelephone
Name on the check-
By Dr. Doris Wilson
Superintendent
Fee collected,/eaem ted by Mary Ann L-Borja Exempt 50.00
Check No. N/A
Signature -
NOTICE: Pwr*M of AssemDlIWl 30111 (CHAP 549,15 TATS. 1988) this will,serve to notify, you that the 904ey approval period in which you may protest the fess or other payment identified
above will peOn toaun fmm the date on which'the building or Installation permit for this project Is assued or on which they, are,paid to the Distdct(s) or another public entity authorized to
collect them on.the,Distrct('s)(s) behalf, whichever is earlier,
Collector: Attach a. copy of county or city plan check application form to district,copy for all waiters.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
Villa. Ia Quinta Homeowners Associai
P. 0.. Bog 15 La Quiuta CA 92253
to.. 760/564-2177 FAX 760/5.64-4882
May 26, 2000
Planning Department
CITY OF LA QUINTA
P. 0. Box 1504
La. Quinta CA 92253.
RE: Refurbishment/78-234 Hacienda
Mr. & Mrs. John Foster
Gent l,emen :
The Architectural Committee of'v'illa La Quanta Homeowners Association has
reviewed the plans submitted by Nelson Construction for the above referenced
residence.
These plans are in compliance with our CG&Rs :and are, therefore., approved by
by our Association.
If you have any questions, please .contact the office.
Yours truly,
ca�t'-� GJ
PATRICK C. ROS 4/
President
PCR/at
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 2) CF -IR
rrgtect i cue
Project Addt
VAV►-0
cation Author
r4'�'SL
rt/oo
Gt i -j D
Building Peimit q
Telephone Plan Check / Date
Field Check / Date
or Computer) Climate Zone Enforaeetent Agency Use Only
GENERAL INFORMATION
Total Conditioned Floor Area %3 5 2 Average Ceiling Height: ft
Conditioned Slab Floor Area 13 f fe
Building Type: Single Family Addition
(check one or more) Multi -Family ,.Existing -Plus -Addition.
Front Orientation: .North. / South / East / West /All, Orientations
(input front orientation in deem fhun True Nordt and circle one)
Number of Stories
Number of Dwelling Units:
Floor Construction Type: d Floor (circle one or. both)
BUILDING SHELL INSULATION
Component
Type
FrameType-
wd = wood
stl = steel
Cavity Sheathing
Insulation Insulation
R -Value R -Value
Total`R- Assembly
Value' U -Valuer
Location/Comments
(attic, garage, typical, etc.)
wall
wpil'
-Z C
/2 -z l
? n, c .o L
Wall
Standard
Roof
/,�,
_
O
. e- s L
Roof
Standard
,Floor
S L A
n►'R_.
T #0 4 c 4 1—
Floor Floor
w 4 sJr
G c' sS
Standar
Slab Edge
ayR.,rVW%
S#,f Ltss.
V -
Standard
FENESTRATION
Shading Devices
Fenestration
#/Type/Pos.
Orien-
talion
Area.
(ft2)
Fenestration Fenestration
U -Value "SHGC
Interior Exterior Overhangs
Shading Shading Att. /Fins
Att.=
Front
Standard
Front
Standard
Left
S
6
O
Standard
Left
Standard
Rear,
-Rear ti.. P -r
Standar
Standard '
Right
w 4 sJr
G c' sS
Standar
Right -?A -tµ
ayR.,rVW%
S#,f Ltss.
V -
Standard
Skylight.
;:5 ,L,t;SS=`
Standard
Skylight.
Standard
' For prescriptive compliance, Total it -Value and Assembly U -Value arezot:required for a wood -framed wall that meets
cavity R -value insulation.requirement for the Prescriptive:Package.
2 For prescriptive compliance, there are no credits for any, interior shading except thedefault or"Standard" drapery. These
default interiorshading devices (draperies) need not be installed for compliance purposes.
Joly 1,1999
CERTIFICATE OF COMPLIANCE: RE91DENTIAL (Page 2 o£2) CF -1R
Project Title
Date
HVAC SYSTEMS
Note: Input hvl,rlionic • : c^n+!•i+::! hvd,:_. .d tr:dr. t:.: If: a! _ �rctr.a , r•.. I? _ ,Ile^ti+p•_ I nad
- w,� I�15trll`Jll�lii
Heating Fquipment Minimum Type and Duct or Heat Pump
Type (furnace: flea+ Efficiency I.ncation 'Wiping; Thermostat_ Configuration,
pump. m:.) (AWL or ll! !PF) I+i + t;. auii. tic.) R-Valuc Type (split or package)
Cooling Equipment
milliniolii
Type (airconditioner.
Ef7iciehca
heat.pump. evap. cooling)
(SEER)
Duct
Location Duct Thermostat
(attic. Cie.) R -Value' Type
WATER BEATING SYSTEMS
Heat Pump
Configuration
Energy' External
Rated, Tank . Factor or Tank
Water Hcater Distribution Number Input (IM Capacity Recovery Standby! Insulation
Type Tyre in S;N•stem r,r l3i11110 (ga!Inns) Efftciencv Loss ONO R -Value
1. For small gas storage writer ccatvrs,0med inputs o!les: than orcyual to '.8.0!'0 litu/hr). electric rc�,istance. and heat pump water heaters. list Energy
Factor. For Weegay stot:icc grater h:.-tc+s,trated itirat,ut ereatct th; n 75.0110 Htu hrl: list Rate) Input. Recovery Efficiency and.StandtiY Loss.
For instantaneous gas water hcairn. list iated input aiid tccmet% cRiciencic>.
SPECIAL FEATURES .and MODELING ASSUMPTIONS (Add extra sheets if necessary)
Including Thermal Mass (thermal mass tyl)-c-covering. thickness. and description)
COMPLIANCESTATEMENT
This certificate of cuniplianrc Bete tit: building ti uttnc:: and p.rlxmar x spccificatitins needcd to comply with Title 24, Parts 1 and 6 of
`the California t'ud.-of.Rcgulata+ns- and file admini_arativc rcuulaiil*n Io itnplctticnl'thcm: This certificate has been.signed by the
individual with overall drsipn respott<ibil'itN. Wlien this crrtific•ate of compliance is;'submitted for a single building plan to be built In
multiple oricmati+ats,. um- shadin-, fe:iune that is vari:it i; indi.;utcrt in tlr Special 1 raturc� / Rcmarlsscctign:
Designer or (rer Businesc and 1'rolessions Cade)
Name: -Tr 5v A,i'r�I� -
---I
Titic'Firm:'
Address:,7Y-23 V &Ae-/ E y0 r4 .
Q _
Telephone: 3 VI - O Vr aq
Lic.0: -
(signature),
Enforcement Agency
Name:
Title:
Agency:
Telephone: —
Documentation Author
DtQ✓i 2
Manic:
I the I irnit V C .s�
G �A9� ��► L.") 1 e�
:',ddress: q 1 - 4 e*P Tr,....J
CA' -4 'A-- &V4W
001,
0/4 1'
to urct (date),
(signature. !'slantp) Ita��-•1 -
- Jrrh 1, ]99)
:I -
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
,j,
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
O REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑
❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ OTHER
❑ REINFORCED MASONRY ❑ FIRE PROOFING
JOB L !?_^AQ
F?
REPORT SEQUENCE NO.
TYPE _� RREE
�T.L,
PEC NQS /I
DT_ I_
DAY OF WEEK
MATERIAL DESCRIPTION
ARCHITECT
C R
HRS. CHARGED
ENGINEER,
ASSISTANTS
HRS..CHARGED
INSPECTION
GATE
GENERAL l
CONTRACTOR - � N �' Q„ p'
SUB
- - - - - - --- CONTRACTOR
V A
w
v
l
6 C emo.
x V em
-
COPY SENT TO CLIENT, ❑
CON EO ON NEXT'PAGE D
PAGE,
OF
CERTIFICATION, OF COMPLIANCE
I HEREBY CERTIFY THAT 1 .HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE'ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. 'I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS, AND 40PLICABLE SECTIONS OP THE
GOVERNING BUILDING LAWS.
9/1GNAT RE OF REGISTERED IN CTOR
1, -0 ��y<
D TE O REPORT REGISTER NUMBER