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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
CVE4c
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).
(
)/I I am exempt nder Section B&P. . for this reason
Ate Signature of Owner
_
ORKER'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.
()C) 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 Policy No.
(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 visions of Section 3700 of the Labor
C�OdlV:Fail'ul;
nObeto
th,comply With th • se pr vlslo
VDate:pplicant`
Warnsecure Workers'SCompensation 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 hove -mentioned property for'ir p cion purposes. ;
Zature (Owner/Agent) ' ! " Date
BUILDING PERMIT PERMIT#
94N074114DATE
VALUATION LOT TRACT
43hn, t r�
82,v4fi,.. 0 10JOB
SITE
APN
ADDRESS s.1- 45 i����ul�l l�f.� f.�EUZI,R
OWNER
CONTRACTOR / DESIGNER / ENGINEER
3ftSEPZOGAZIGO,` RA1Vt*!Ti
L' WIL-M." B Jif,ID1~t'.•.V1'd'!`O1CVRIC
82•-133 LEMON ROM)
45- iOt MONROE V1' S.rV tis
MEMO CA 9U01
INDIO CA. 9.2201.
USE OF PERMIT
`a#iJ-.�i.A.PI taidff�lL. Z'�.KtVli'!' 4�1��3 NGai` Ihlt.`,'.Li.t33'4s' I:fLe_:rC;l� b1rAi.f.� (;)tC �
Pool,. PLAN r. kHKW.'I^!^ t. "KF"sDt1�71Li 75% F(Jpt M rLTIP L9 I SSUANCIL. O
�
Ailfl YPR.
TRW -7 00NSIRUCIION ;,3101.00 SF
wy
!'OAl` W!"A'140 09.00 8
0A1 Arii•J4."A10'1cW+.16,' 517.00 ;SY
C-014S'4°ftt xC" ION FOE i 01-)(1*4 d 9-000 ' s5rO.00
r .•�Ni'clw("x. t. tip 3tlt-rjOn.l,)a
1014100 -411 -OW S,1,0,9)
ii},t;CTMUC'AL tAiL,' iOB-000-4204AX) K1P0.41
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Ilku18.12
P P3CISE'PLA'V $2:5.(3(1
i:? '►�C ;1. f;C NS`,"?i,C.i r?`10,N AND P'(,AN• r.'!A iCK,
TOTAL PRitM 11' F ERS 01 F NOW'
• I
RECEIPT
DATE
BY •.,
DATE FINALED
INSPECTOR
INSkCTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
IMECHANICAL APPROVALS
Set Backs
Main Drain
Underground Ducts
Forms & Footings
Approval to Cover
Ducts
Slab Grade
Equipment Location
Return Air
Steel
Underground Electric
Combustion Air
Roof Deck
- 3- Q
Exhaust Fans
OX to Wrap
_ 6 _ IT
F.A.U.
Framing
S _f3 - QQ
Compressor
Insulation
Heater Final
Vents
Fireplace P.L.
Plumbing Final
Grills
Fireplace T.O.
Equipment Enclosure
Fans & Controls
Party Wall Insulation
O.K. for Finish.Plaster
Condensate Lines
Party Wall Firewall
Pool Cover
Sewer Connection
Exterior Lath
I EncaDsulation
Drywall - Int. Lath
-11/94
Final
COMMENTS:
Final
Utility Notice (Gas) Y
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
Utility. Notice (Perm)
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
- (re -Q Q
I EncaDsulation
Final
COMMENTS:
Final
Utility Notice (Gas) Y
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
Utility. 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 7/28/98
No. 17401
Owner NameCoachella Valley Housing Coalition
APN # 773-173-022
Jurisdiction La Quinta
Permit #9807-104
No. 51-945 Street Avenida Herrera
city La Quinta zip 92253
Tract #
Lot #
Type of Development Single Family Residence
Comments
Log #
Study Area
Square Footage 1,302
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:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
1.93 X 1,302 or $ 2,512.86 the property listed above and.that build ag
permits and/or Certificates of Occupancy for this square footage in this proposed project may npw be issued
Fees Paid By CC/Bank of America/David Brudvik Telephone
Name on the check r
By Dr. Doris Wilson P� t
Superintendent
Fee collected /exempted by Juanita Green
Signature
Payment Received $2,512.86
Check No. 7404 avo9Rl Grl.(�3
NOTICE: Pursuant of Assembly Sill 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 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 District('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 - ApplicantlReceipt Copy - Accounting
Coachella Valley Housing Coalition i
Plaza 1, 45-701 Monroe Street, Suite G., Indio, CA 92201
TEL: (760) 347-31 S7 FAX: (760) 342-6466
ATTORNEY-IN-FACT AGREEMENT
I/We hereby appoint COACHELLA VALLEY HOUSING COALITION,
and/or any of its authorized agents as my/our attorney -in fact for the
purpose of executing any notices of completion, waiver, of liens and/or
executing contracts with subcontractors, and/or release of liens and/or
handling building permits relating to that certain real property
described below.
All that certain land located and being in the County of Riverside, State
of California, described as follows:
LOT 10 OF BLOCK 60 OF UNIT 5 OF SANTA CARMELITA AT VALE LA
QUINTA, AS SHOWN BY MAP RECORDED IN BOOK 18, PAGE 63 OF
MAPS, RIVERSIDE COUNTY RECORDS.
;7-16 -913
Date
fAsfam i ly\anna\m i scfor\attnyfa
JOSE RODRIGO ARMENTA
M
All
June 24, 1998
Mr. Daniel Crawford - Inspector
City of La Quinta
Department of Building and Safety
J
78-495 Calle Tampico
La Quinta, California 92253
STRUCTURAL ENGINEERING CONSULTANT
54625 AVENIDA BERMUDAS. LA QUINTA CALIFORNIA 92253
760b64LW4PHONE V76D.771.36D6FAX 9 WISH@CWIA.00M
Regarding. CVHC Plan 320 and 420 - Truss Calculations — Group 7 (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 corner of the architectural plans. The "420 Plan" truss calculations correspond to the 1196-052" 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.
Sincerel
De is S. Wish PE
Structural Engineering Consultant
Evs,�t�
�1:0 DENNIS S. WISH
0 N'0. C-041259
UJI
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CAL -1i
STRUCTURAL ENGINEERING FOR - CUSTOM HOMES - REMODEL - COMMERCIAL - LIGHT INDUSTRIAL - SEISMIC RETROFIT 8 REPAIR - UNREINFORCED MASONRY - RETAINING WALLS & FOUNDATION - 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