9907-183 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chzpfer 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
Date Q !Ci �� Signature of Contractor'
OWNER -BUILDER DE ARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 1, 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).
O 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.
`(/1 I have and will maintain workers' compensation insurance, as required by
Sec ion 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 /r tt y^ rt� f 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 provisions of Section 3700 of the Labor
Code, hall forthwith comply wit those provisions.
Date: Applicant I to
Warning: Failure to secure Worker 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) x t\ Date k I`,
1
BUILDING PERMIT PERMIT#
Si+.}li?- k S:r
DATE/,, f� VALUATION LOT TRACT
:�s�7�SS1;2U 7t: 131,KC3Lt
`//,
ADDRESS r z�'+.2.-470 t�l'�`�r�IIDA VI.�:+�:RliRA
PN 77a 3,254N
OWNER 3
CONTRACTOR / DESIGNER / ENGINEER
r
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' TAI i1 Im'sER-T CA 92211
W.-IMUDA DUNE'S . CA 92201
{'t Ql �f•4)-tY 118 CIAL# 3002
US i.OF PERMIT
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SIM • PEid;rit31' (XiI S 1tiC:T 1NOMUD E t>ViCk WALL Oil POOL. 7FU P _K
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RECEIPT
DATE
BY rj�j
DATE FINALED
INSPECTOR
.I
INSPECTION 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
3 4zidQD
Exhaust Fans
0. K. to Wrap
3 - Y — 00 <1t_
F.A.U.
Framing
y - 'i - o0 %,I--
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
y - a ov0 Cyq_
Drywall - Int. Lath
y - ao - 00
Final
Final
POOLS - SPAS
BLOCKWALL
AP ROVALS
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
p 2
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection�g
S
Encapsulation
Gas Piping
Gas Test
517
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole — Q57
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)
qqllj Q)T4tyl 4
�Cv
P.O. BOX 1504
BuildingS� $ 70 rf1�C��A- 78-495 CALLE TAMPICO
Address LA QUINTA, CALIFORNIA 92253
Mailing
Addressy/;L(-010 G.4v/L S 7%
PC' ty ^r Zip Tel %
ftm/✓ C
ContractoX. 5 1
00 CODr- S i . 5 Fr-, /_> n
�in.l✓1 t��SC�'• ZIP � a � �)
Tel y7�rg
State Lic. City
& Classif. 3.i �L„f 3 Lic. #
Designers 5MIP/OC-d fOn"C,S
Addrgffss0 Tel.
City /� Zi State
t�l/1-IMC'n; 1 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby.affirrrS'lhat I am licensed under provl ons of Chapter 9 (commencing with Section
7000) of aviso37� nd('PiofesQons Code, and my license rc nd
effect. )/� f�0;,.y
SIGNATURE
DATE
OWNER -BUILDER DECLARATION
I hereby affirm hat I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Susiness and Professions Code: Any city or county which requires a
permit to construct, atter, 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).
l-! 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 such improvements 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 I I, 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 nor apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
I 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 Com en & it on Insuranc ar a certifie Ory thereof. S c. 3800, Labor Code.
Polis No.. i p —I-7 'Aj{iir�% f 2! 1e%� A"T p)
n Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(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 thV work for�hich to is permit is issued, I shall not
empl y ny p so`n'-fn'anymanrier-sdas to ecoine subject to the-. orkers' Compensation
Al
Date /- /Owner I
NOT CE TO APPLICANT:iIL aR r mak 'his Certificate of Exemption you should become
subject to the Workers Co ensation provisions of the Labor Code, you must forthwith
comply with such provisions -00 is 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 -of this city to enter the above.
mentioned property for inspection purposes.
Signature of a0plicant Date
Mailing Address
City; State, Zip
WHITE = FINANCE
! ..
APPLI0 NLY
BUILDING: TYPE'CONST. `� '" OCC. GRP.
A.P. Number 7 7 3-- — po l�
Legal Description Xy72 / 3LO'-4- ALO r �`��'i c �� �t�rr✓T�!
Project Description's
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date ) t _
Validated by:
Validation: Juri
PINK = BUILDING DIVISION
YELLOW = APPLICANT
Sq. Ft. S -7
Size
No. No. Dw.
Stories Units
NeJ6 Add ❑
Alter ❑ Repair ❑ Demolition ❑
f�
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
7- Q 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 Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date ) t _
Validated by:
Validation: Juri
PINK = BUILDING DIVISION
YELLOW = APPLICANT
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant 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
ollowing.
BUILDING ADDRESS:
Use Classification: SFD
Occupancy Group: R 3
52-870 AVENIDA HERRERA
Type of Construction:
Owner of Building: BUILDING HORIZONS
Building Official
Bldg. Permit No.
VN Land Use Zone
9907-183
RC
Address:
42-600 COOK ST.
STE
120
City:
PALM DESERT,
CA
92211
By: STEVE TRAXEL
Date: 07-14-00
POST IN A CONSPICUOUS PLACE
0#%f 1 E Q &
i o
OADUNES r
RANCHO YIRADE � Desert Sands Unified School District
RANCH
6 INDIAN WELLS a 47-950 Dune Palms Road • La Quinta. California 92253 (760) 777-4200
PALM DESERT `► 9 •
• LA OUINTA �a
v1Q INDIO
August 2, 1999
Joseph R. Sitko, Executive Director
Building Horizon's
42-600 Cook Street, Suite 120
Palm Desert, CA 92211
Dear Mr. Sitko:
Desert Sands Unified School District hereby waives the payment of Developer . ,
Fees for the Building Horizons Project located at:
52-870 Avenida Herrera, La Quinta, CA 92253
52-890 Avenida Herrera, La Quinta, CA 92253.
If you have any. questions and/or concerns, please don't hesitateto contact me
at (760) 771-8516.
Sincerely,
Peggy Reyes
Director of Facilities Services
PR/j9
RC District. - P/annina Review Form
This form is to be used by CDD staff for review of single family dwellings in the RC (Cove
Residential) District, in order to determine the applicability of compatibility issues or need
to require the filing of Master Design Guidelines by the applicant. It shall be transmitted to
Building & Safety as your correction list. Please attach additional explanations as necessary.
APPLICANT: Building Horizons
PROJECT
ADDRESS: 52-870 Avenida Herrera
APN: 773-325-00.6
LEGAL: LOT" 21 , BLOCK 16Q , UNIT. 140 , S.C. @ V.L.Q.
CVD BY: Stan Sawa
BIN NO:. CASE NO. 99-87 ..CHECK DATE:
Inform the assigned Building plan checker upon your assignment to this case. The CDD
Executive Secretary maintains a .log book to track applications and assign case numbers.
REQUIRED ITEM 1-Y-1 N I
COMMENT/CORRECTION
aR"•. \ v}., v a •'\l v, `{.:. n 2$::tl~•'{n:i\\j `}�{\ ♦ OM� a
y.... :., may' �G w •.. {..; �,x . ��`':�
:�iJ•3s.6��'�:i�R'�`:7�i`v��'.`.�..°.:�:�}':�+�`4•.•:,�k.���. .�`:\.,• °'4�,.u`�•:...�,~a\Y,{:'4:;C yg•. ;` �x•�1
a v CiY�k.:"�v... a:.:.,\..:?3?�`� o..•:•:.x•.....:�?,�«..::..•.....•a.«:..'�k:•.,ta•::??a;:��:.
ani`{:jCt '. �C``"{>:�+k.r�i••'v. �y#a�`"''ti.{a
�'
•r���\� a •.4'n^�•`�`"t�• .2. #' C'�
�a•aa a ..
Case logged and number assigned
Verify legal and APN information
Consistent with MDG on file las applicable)
MDG filing required (5 + filings since 9/3/98)
Cbh" istericy-with-street/surrounding area:.
`
• colors �
Materials
Architecture
bND cotaiG 5an�p �
dam A 4V%O-je- y ,v
e
OTHER REQUIREMENTS:
- Sq o i-lerre+^a
The zoning code, architectural and landscaping manuals, and/or assigned inspector should
be consulted where uncertainties arise. The, completed checklist shall be maintained in the
Building .& Safety address file.
axe. aee'�4"b3e �. Yr � ^'va+v«r� •. �n •Fw..xc. L:w':+�,.. •,,. ,.,.., �1....,
July 30, 1999
Daniel Crawford
City of La Quinta
Department of Building and Safety
78495 Calle Tampico
La Quinta, California 92253
STRUCTURAL ENGINEERING CONSULTANT
54-625 AVENIDA BERMUDAS. LA QUINTA CALIFORNIA 92253
760.564.0884 PHONE 9 760.771.3606 FAX 0
SECONSLTNT@AOL.COM
Regarding: Truss Calculations for Building Horizons — Including Revised Calculations From AC Houston, Las Vegas
Dear Danny:
I received the revised truss calculations for the Building Horizons project. The trusses were found to be missing the calculations for
the drag truss at the rear of the garage, which were shown on the structural drawings. I have contacted AC Houston in Las Vegas and
they faked me the revised calculations and promised to follow up with the hard copies. I have not received them as yet and have
included the faxed copies that I received to represent the changes in their package. .
I have reviewed the calculations for required drag truss connections and for compliance with local and code live and dead loads. The
truss'calculations issued comply with the intention of the structural drawings for the Building Horizon project and appear to be in
compliance with the Uniform Building Code (1997) provisions for Live Loads based on various roof slopes. Appropriate
consideration has been given in the structural details to provide resistance wherever uplift may occur at the eave.
Therefore, please accept this letter as my acceptance of the truss package with the noted revisions as being in compliance with the
intentions of the structural drawings. ,
Sincerely,
Dennis S. Wish PE
Structural Engineering Consultant
`, yiESS/pA/.
DENNIS S. WISH
I NO.C•041250
EX .3
Rc�IL e
CAI�F�
STRUCTURAL ENGINEERINGFOR! CUSTOM HOMES! REMODEL 1 COTYERCIAL T LIGHT INDUSTRIAL r SEISMIC RETROFIT 8 REPAIR • UNREINFORCED MASONRY T RETAINING WALLS 8 FOUNDATION I 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 ,
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Certificate of Insuiation
Your Home has ben insutated with CedainTcvd Nberghm IosutaOon products, which are designed
for today's safety standards and tomorrow's energy requirements.
Fiberglass is inorganic and therefore permanently noncombustible, so it docs not have to be treated
,with fire -retardant chemicWs that will Idmly lose their effect4vaeess Over limn. It has not been treated
with chemicals dwi = corrode wiring or acetal. Fib ss will not absorb a$oisl nor will it
settle over time as may other insulation rnaterrals.
'ۥleis also cert&es that CertmaTeed Frber Glass Insulation has been pzoft*wonaltr installed in this horse
to provide the €ollowing thermal perfosrminaz-
Job Nam, SPS 'Tract: Plan #: _ Phase:
Lot No,: ,fob Addre;i: 52870 Avcnjda Herrera
Ceiling Area: R-38 Unlaced
Eat. Walls: R-23 Blown
hterier Walls:
Garage Cealiug
With IaviBg Above
With Living Above
Sub Floor:
Non Aects:
& Sloping Areas
Accem At4ie:
Knee Wiallsr- R-19 Kraft
o -
tT Subcontractor. OJ .lnsule&n Co. Jim
(.0Vias, C509r7 (b2 t i�setit6li7tJ9
Z
Signed
Conclpites Ortiz, Serre4aj r 'reamrer —or Scott Jenkins, Preoident--or—
Lais Merold, Director of Oiler ftOns Officey
It- means resistarue w heat flaw. The higher the R-valuc, the &rester the insutatwg power.
Ash your budder for the fats stweet on R- values. XcP this ccfticate with yarn other
valued yrs. If you ever sell this home, this certificate should be messed on to the IgWer
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