9806-132 (SFD)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
CMAC
Date
Signature of Contractor
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). 't
(,),,,I'am exempt under Section B&P.C.,fe this reason
t+Date �o y' 9 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 `, i� p p . Policy No. f qYY c�4'p r
fl.'Ati'tt('K �iYf 7L 3*�A3NI •}r' i lieff}(4 lJ%'f tiff ?
(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 fo hwith comply with t os provisions.
v6ate: 9 S' Applicant—
,'Warning:
pplicant ,'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. ti '
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 f inspection
ns'ecpurposes. t sRte' r--
.,Signature (Owner/Agent) �`-�� Date & '
BUILDINGPERMIT PERMIT" CONTRCL#
DATE VALUATION 11 yy���7� LOT t 1 "1 1 i TRACT -Y ®5 s
6tV
(01 5 $82.946-6) if) 11 74, t ..
JOB SITE
APN
ADDRESS M-445,AVEL 10A HERRERA
173_11x"022
OWNER
CONTRACTOR/ DESIGNER/ ENGINEER
R))lC RDO s Rt A A VEZ
I
1t'fi CV11f,
"'4720 PAW i r RY)1: ST #66
-15-001 MONROE* S°.1` 4 F C7
lfd l.) 0 CA !?720 t
I N 1 110 CA. 92,201
CT311a
USE OF PERMIT
;`#FD (i:ffs264kc) - i'iiiLiVil Y DOL,"Sitili�i' i_r+L,I ilUks &OCi=; WALLS +:.'.%41)C1UE: .
.N. AN t";;14iA_K V(.k'1K)N 01,* F111S kI.,J,) k RD VV/o '011?V1(A;FITY:l.F ISSUANCE,,
OF S, A&W P1.A 43 I YPR.
17R skr7f CON VAUCTION 1111F
110KCfff'A'1A) f`�i�.00 SD
OARAOFiC ARPOR.T 517.00 SF
��;,+ 1n.t ♦ M p t� t�Vy ry �+r+ ptt,� o It {�/y7�t
00— 1NII EN.�.i. El D �4�A•':i.M iJ�i.l� C'O'N.Sl J.�.G�-.4-IoN
,. p .,l ,rt
if'.y°J`9 "Fw
t CaNI` RUC"TIGN1- iol-C0041.9.000 $563.00
MAN C¢iKX. f'F R1 101 _f)0ff-41,q-3€it $1'1RZ
i`���`#•ii�'1'd"1rrtlf.�� l.fJ1�007-42i�C!00 :',�Sff.50.
4slei t^�1`etIIt�AF.:t 4 % 101 -000 -420 -OW $119.41
13[.t":N113rKr_4FRE 101 -000 -419 -()(HI $121.5IL
f
STRONG MOTION F LE - RFZ D 0.14100.241-01XI $8:29
.C,Jt AL ING FEE 101.010 ;-423-000 .$24j.00
1NfRAS'1'.t< l0'iUR F E. 225-000-443-342
PMCPSE MAN 101-0A.10-441-345 $25 00
1 LESS' . "RE Pe`i1D PE"t's
$0,100
T8d4-Ai,_/ PE''RleUT YSJKS 1 Uh, NOW
RECEIPT
DATEiy j
BY f
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR'
OPERATION ' .
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
A
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
O.K. to Wrap
Z _ �' s '�
/
Exhaust Fans
F.A.U.
Framing
s S %
Compressor
Insulation
• .2.7- ?
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
-
Exterior Lath
- -.
Drywall - Int. Lath
Q /
Final
c - 3
Final
POOLS - SPAS
BLOCKWALL
APPROVALS
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
��p
Pool Cover
Sewer Connection
7700
Encapsulation
Gas Piping
Gas Test
Appliances
_ _
C
Final
COMMENTS:
'
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole 9�
_
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
1
f
Final
l7Cilty Notice (Perm)/�/
Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated 760-771-8515
CERTIFICATE OF COMPLIANCE
Date 6/29/98
APN # 773-084-022
No. 17250 Jurisdiction La Quinta
Owner NameCoachella Valley Housing Coalition
No. 51-445 Street Avenida Herrera
City La Quinta
Tract # Lot #
Permit #
Log #
Zip 92253 Study Area
Square Footage 1,302
Type of Development Single Family Residence No. of Units 1
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 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:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
1 �, t:
1.93 X 1,302 or $ 2,512.86 the property listed above and that buildings ��
permits and/or Certificates of Occupancy for this square footage in this proposed project may now,,"be issued
Fees Paid By Cashier Check/B of A/David Brudvik : '-`
TeiPphone:,'
Name on the check '= A
r.`
By Dr. Doris Wilson t
Superintendent
Fee collected /exempted by Juanita Green
Signature
Payment Received $2,512.86
Check No. 2009915354
NOTICE: Pursuant of Assfrpbly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
above will begin to run fro the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
collect them on the Distri s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
I � rg,, �$, w �)� - ri., - I pw Y., rL
June 24, 1998
Mr. Daniel Crawford - Inspector
City of La Quinta
Department of Building and Safety
78-495 Calle Tampico
La Quinta, California 92253
STRUCTURAL ENGINEERING CONSULTANT
54625 AVENIDA BERMUDAS . LA QUINTA CALIFORNIA 92253
760.564.0884 PHON E i 760.771.3606 FAX • WISH@CWIA.00M
Regarding: CVHC Plan 320 and 420 - Truss Calculations — Group 6 (Typical all La Quinta Projects)
Dear Daniel:
I have reviewed the truss calculations from Imperial Roof Truss which is to be used for the roof construction of the 3 bedroom and 4
bedroom homes in La Quinta. The truss calculations labeled "320 Plan" are for the 3 bedroom plan that is associated to the "96-051"
job number listed in the lower right comer of the architectural.plans. The "420 Plan" truss calculations correspond to the "96-052" 4
bedroom drawings.
I have reviewed the truss calculations to confirm the capacity of all design loads drags and bottom chord loaded girder trusses. I have
found each to be in compliance with the intentions of the structural design I have also verified that the roof dead loads used in the
design of the trusses exceed the design loads on the structural calculations. The truss calculations are more conservative and therefore
acceptable.
The Truss calculations will be used the self-help La Quinta Project - Groups 4, 5, 6, 7, 8 and 9. Each group will use the same plans as
those mentioned above that these truss calculations conform to. I have provided a separate letter referenced above for each group.
These are intended to simply the City's records and allow a separate approval for each block of homes. Coachella Valley Housing
Coalition can provide the addresses for each lot in each of the groups listed
Please contact me at your earliest convenience if you should have any questions or additional requirements.
Since ely,
IJ�i�IV/C�1N
De is S. Wish PE
Structural Engineering Consultant
1/O/V E;S1pt�
tv `,
��2 DEvI`1S WISH Z
0 \O. C•G31250 11
rr
s EX . X
clvc 4L
s�gTFOF CA1.IFOP�\P
STRUCTURAL ENGINEERING FOR - CUSTOM FOMES - REMODEL - COMMERCIAL - LIGHT INDUSTRIAL - SEISMIC RETROFIT 8 REPAIR - UNREINFORCED MASONRY - RETAINING WALLS 8 FOLINDATION - REPORTS:
DAMAGE ASSESSMENT - NEW ROOF - INSURANCE CLAIM - DENNIS S. WISH P.E. HAS BEEN A MEMBER OF THE STRUCTURAL ENGINEERS ASSOCIATION OF SOUTHERN CALIFORNIA SINCE 1983