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0003-282 (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 678677 13 WC 10/3012( Date All l Signature of Contractor Y !/ 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 & Professiorfals 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 pe ormance of the work for which this permit -is issued. ,R I have and will maintain workers' compensation insurance, as required by ction 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 CIMIPT 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, I shall forthwith comply with thoseCr visions. Date: Applicant— Warning: Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of tho Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for' spection purposes. Signature (Owner/Agent) Date `>] f 56-1-0" BUILDING PERMIT PERMIT# DATE VALUATION LOT TRACT JOB SITE APN ADDRESS '� 7.4W0 4-yF. k'iID.A. MDALOO 773-I0 4 0?:i OWNER CONTRACTOR / DESIGNER / ENGINEER IuM®RD :0 L Kl, FARM14M CON° .TrRU'MON 53183 AVL I:3IM14211:I AS 41.463 JAIti4AT A. SANDS r'I 1,AQUWTf+, CA 9.2253 IlnMI,U CA 92201, .. (760)345"799'% CBL4 . 1 USE OF PERMIT 2%G1-1; FA.IMI Y DWHT.:UWG SFrJ- PERMIT DOESS. NOT INCLUDE BLOCK WALLS OR POOL TRACT CONSTRUCTION 2439.00 SF PORCH/PATIO 6.31.00 Sir CARACMCAR.PORT 552,00 IF 5 FT. WOOD PENCR 11F I ATED COSH' 0.1 CiJMIr`.!`lt.'E7C'i101f 'yy Cq�•��.�. '�Yy1'� ��j'"/$y'(�'j �I&ST,! K�`Jd.i1'1.i,3 J).LwiS {7 FilYj,IVUYrICi CONSTRUCTION FEZ 101.000.418.000 $8181" PLAN CHECK VIM 101-000-439-338 $688.48 IviF, HANICAL PEE 101-000-421-000 S 72,Sb 1?,f„ IXTRICA1, PLVE 101-000-420-000 $165.91 PLUM13INO FFIF 1011.000-419-000 5148;00 , STP,0N0 MOTION FEE , RE`JID 1031-000-241-000 SI5-34, GRADING FLEE 1, 001.000-423.000 $20ioo DLNFi,OPFR 1hl"XT iri`Z? $1,90.0D PRECISE PLAN 101.1100.441-345 $100M PP's T➢FX- OSIT 101-000-4.39.318 .$2%00 M,TB-TMAL COATMU'CTTOM AND PILAAf I CK $3,946.23 USS M -PAW:PMS 4251100 'f (.?'!AL P MMT n.. ES DILIF. MW RECEIPT DATE B.Y, DAT F ALE a INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings � Ducts Slab Grade Return Air Steel Coml5ustion Air Roof Deck Exhaust Fans O.K to Wrap I c1��-p 5 F.A.U. Framing ! / 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 y��0 S� 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 (p' CY 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 COMMENTS: Final 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 Utility Notice (Perm) 0003-C�8,;)_, 1. R �O Building Q Address -7 -7 Qy VG 4 P.O. BOX 1504 78-495 CALLE TAMPICO C 4, /,-It, LA QUINTA, CALIFORNIA 92253 APPLICATIONfON Y » if I I� r �`� TtZZr BUILDING: TYPE'CONST.MailinOCC. GRP. 1 7 d A.P. Number� .i ��el W "T/�T G73-��7'� Legal Description L6 S 1 2 (.'SCK ! 31 ¢ Project Descriptionl� . ��^^ Address �' 1 p3 AVd g3rooVJ.�f`IS City Z' rC ZZ✓ Tel. � Contractorcc f /' n Address ` //�^^- f� �I/7V _ Por thealleged exemption. Any violation of Section 7031.5 by any applicant for a permit City` �- Zip T Plan Chk. Bal. State Lic. �L 8 Classif. 6743 -7 City Lic. # Sq. Ft. �f _Ng. I No. Dw. Size Z+ �� Stories 1 Units Arch., Eng.,�� _ l Designer (�J New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Z/ J I V ))A Tel. ';&VV ✓L Professions Code: The Contractor's License Law does not apply to an owner of property who City ^ ZLi�� ( State Lic. # Mech. ICEfISED CONTRACTOR'S DECLARATION I hereby affirm that I m licensed un er provisions of Chapter 9 (commencing with Section 7000) of Division 3 of jpey'�6t? i e a rofessions Code, and my licensed 'n ull forc and effect. 11110 provided that such improvements are not intended or offered for sale. If, however, the building SIGNATUIDATE OWNER -BUILDER DECLARATIONEStlmated 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" luation permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also for to file that he is licensed to PERMIT 3 �� requires the applicant such permit a signed statement pursuant the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of AMOUNT Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis Por thealleged exemption. Any violation of Section 7031.5 by any applicant for a permit Plan Chk. Dep. subjects the applicant to a civil penalty of not more than five hundred dollars (5500). Plan Chk. Bal. 1.2 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 Const. 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, Mech. provided that such improvements are not intended or offered for sale. If, however, the building orimprovement is sold within one year of completion, the owner -builder will have the burden Electrical of proving that he did not build or improve for the purpose of sale.) III, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who builds or improves thereon, and who contracts for S.M.I. such projects with a contractors) licensed pursuant to the Contractor's License Law.) Grading tl I am exempt under Sec. B. R 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 [l Copy is filed with the city. ❑ 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 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. 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 Ihereby 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 cut, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and slate 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 representat ves of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Driveway Enc. Infrastructure TOTAL REMARKS r 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 I . FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Mailing Address I Validation: City, State, Zip ' �a WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION W ♦ - FJ Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 Date 8/1/00 No. 20826 CERTIFICATE OF COMPLIANCE APN # Jurisdiction La Quinta 773-104-038 Owner NameRichard Hill Permit # No. 77-890 Street Avenida Hidalgo Log # City La Quinta Tract # Lot # Type of Development Single Family Residence Comments Zip 92253 Study Area Square Footage 2439 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 2.05 X 2,439 or $ 4,999.95 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 CC/Bank of America - Kevin Farmer Telepbehi -• Name on the check By Dr. Doris Wilson = Superintendent Ve collected /exempted by Ellen Patino Payment Received $4;999:95 Check No. 401327771 Signature NOTICE: Pursuant of Assembly 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 ide,plified above will begin to nun 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 aythori�ed to collect them on the District('s)(s') behalf, whichever is earlier. I i 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 ' RC DISTRICT - PLANNING 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 the Building and Safety Department as your correction list. Please attach additional explanations as necessary. APPLICANT KFC CONSTRUCTION qo SITE ADDRESS 77- Avenida Hildigo . APN 773 - 104- 0.3E'BINNO.: ��/ CASE NO.: 2000-269 LEGAL: LOT 11 & 12 BLOCK 134 UNIT 14 S.C.@V.L.Q. CHECKED BY: Greg Trousde ll 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 Y N COMMENT/CORRECTION Compatibility Review Case logged and number assigned OF,QZ Verify legal and APN information �VF�OQ Consistent with MDG on file (as.applicable 0 P MDG filing required (5 filings since 9/3/98) 0 QO 0 Consistency with street/surrounding area: Colors aterials tnnJ i lutecture 0`l Icy C 0�Z F- Other Requirements: 'Du'wi CHARLES D. GARLAND "' Architecture, Interiors, Space and Land Planning Structural Calculations 29 June 2000 City of La Quinta Department of Building and Safety 78-495 Calle Tampico . La Quinta, CA 92253 Project: Single Family Residence "for: Mr. and Mrs. ;Hill '81077venida Hidalgo La Quinta, California Re: Review of Truss Manufacturer's calculations To Whom It May Concern, I have been supplied with a copy of the truss manufacturer's calculations prepared by A. C. Houston of North Las Vegas Nevada, for the project noted above. Upon review of these calculations I find them to be in substantial conformance with the design intent of the construction documents. If you have any other comments or questions regarding this or any other matter pertaining to the project noted above please do not hesitate in contacting me. D. GA Sincerely, .0 v No. r1►99 EXP DA, E harles D. Garland, \��. Architect 0;L 35-325 Date Palm Drive, Suite 151-J - Cathedral City, CA 92234 - Phone/Fax: (760) 324-7146