Loading...
9911-179 (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 ?56749 1 it 12;3U20i Date nature of Contractor;; , JA; 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). ( ) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals 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 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 - Pollcy No. rid it Irl 1`1.'713/ ii •.r.i�v i.. � (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 forthwi,": comply with those provision s D - Date: = Applicant -4 L? / 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. 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, indemnity & 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. Qom_ /,}n Signature (Owner/Agent) !IDM QA W -2n. f"fes / 2 Date � y BUILDING PERMIT PERMIT# DATE VALUATION LOT 919 1 11-179 TRACT • �2�13.31�'�`.� ��'S:B.111�.40 JOB SITE APN ADDRESS 5L-t�LM! 9.!t,l�i�VtSt:,:fi..H1�11L' /tet-aiilf•-Vb�1 OWNER CONTRACTOR / DESIGNER / ENGINEER MIN11 1`iC7ILRIS C^0&tV,%.N113S 52-820I ATROBE LA14E 43-350 SAIN LUIS REY LA;,j1. INMA CA 9225:3 PALM DESE'M' CA 92260 (700)1773-520's CRI. 2513 USE OF PERMIT izemnI F e i m I.y Tyt aT.i.fnfi ; 5FD.P0MRT DOES NOT HiCLUDE BLOCKWALLS OR POOL. C—UN ► OM s: ON _11AW— l: ON 4,075.00 :",F 110-RC1YRtVT10 917 OAKJJ,UYJCAKPt,.l;`F' t�,w .a +g[lf i.eAo ii. R•OF COi O i N"' T w v pro ! 3'l+,�t�3�S i�'r,01:�dAiti�A•8.iic�� 0.)N' 111sir 10114llf} 144-000 $i,52f.tit) tyt.AN CWC9 PTFW. ; 4V_n: 114 ki.-VIiANICAj:i-"Ei"s It?i-G00- 23 -aril; - $WI.YJ ELECTIOC:AL FEE. 10.1.000-42.0-000 Pi IfTjlr ir!4 jIrI?F •101-(((-41.9-0{1!) :►t\�iY\l j�"iV ►itOiLY w°.t1 '^1�JiJl.i� aVs-000-.Gia-=J '• .7.iea,�i. r• CRATA1NCII-`i i 1Qd-t�0i}»�i23-G00 3^u.s�is 0T»1!zti'.'.i,( PFAIMPAC"T k'k:E sow/.(10 ART Vin} P1 T91,1<3 F't,ArFR - Rf?KH', -101 S'i ';.E-1'.,t,D F,2:sS -�1 12M.00 �¢.®� AA L�.II'd '9.i V• .Cy IT l�dIA:J ��k.t:�1' 54,869.06 RECEIPT DATEf �'� / BY / jam• DATE FINALED INSPECTOR OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts QQ7 Forms & Footings Slab Grade _ Ducts J coo 5 Return Air Steel Combustion Air Roof Deck '1 • y{-� — c1.'�P"W Exhaust Fans 0. K. to Wrap 0p S-7 F.A.U. Framing - Z g .Op 'S7 Compressor Insulation '27-go S*r Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath O ' — O Drywall - Int. Lath -, c1 oa 7- 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 I 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 C,4tv Encapsulation Gas Piping Gas Test z7. al. p Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Z• _ 7 Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Q Utility Notice (Perm) .� COMMENTS: ed S evx- Q,(� �..le s 7 Z 4711 �✓.>��S7�s '°!rf e�97 �uGST K SPs PI.��StAB a�l�-� ST sxz.4., - @*-_ e--=c S7 ;�►txxr+t+i�:ca�a�a� � ..� y�-�'�'"`"`""c�"f.;�'�t�k't�a,'����'",�. ��/ raGc.S 52 8'! d LA �Qpg` TAt LAO, , P'AFQ O BOX 1504 � 78-495 CALLE TAMPICO Address APPLICATION ONLY Building % I JLA QUINTA, CALIFORNIA 92253 � (i / 4''i/ ,.,/ C' � ) C, i Owner / Mailing Address 5&C City Zip ' Tel. vvnua�ivl f\44. Address " 113—SSU �ctia Cvi � i��,y C�/� CityTel. 11111 Dl;Zipr;I %21 E O 1 -i,"0- �v;-, State Lic.I City & Classif. Lic. If Designer ` Address City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION 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 permit to construct, alter, 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 thealleged 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). I'J 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.) ^ 1'1 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 not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ` 0 1 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 Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company 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 (E100) valuation or less.) I certify that in the performance of thip 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 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 if work thereunder is suspended for 180 days. 1 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 applicant Date Mailing Address City, State, Zip r LDING: TYPE CONST. OCC. GRP. P. Number Legal Description L crT�i-J, TP-A_T SPY43I ci I Project Description S f" t -k--) -3 Sq. Ft. ` ,.. r No. No. Dw. Size y� Stories Units New ❑ Add ❑ Alter ❑ Repay,❑ Demolition ❑ I_a:JC r F� csl7 �e � 1-7 Estimated Valuation - PERMIT AMOUNT Plan Chk. Dep. 1250 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 iyP►/rl��Lii� INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT x Sy, tYi ivy`{" y� PINK= BUILDING DIVISION Y:ai4rl rst4,t".`.',?. Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 Date 12/8/99 No. 19714 Owner Name" Norris No. 52-820 City La Quinta Tract # CERTIFICATE OF COMPLIANCE Street Latrobe Lane Lot # Type of Development Single Family Residence Comments APN # 769-180-020 Jurisdiction La Quinta Permit # Log # Zip 92253 Study Area Square Footage 4075 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 4,075 or $ 7,864.75 - 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/ Palm Desert National - Steven Phillips Telephone, Name on the check By Dr. Doris Wilson `' Superintendent Fee collected /e pted by Lucy Renteria Payment Received $7",864.75_1" Signatur Check No. 75480 JOTICE: 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 identified tbove 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 Vlect 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 - Applicant/Receipt Copy - Accounting JAN -03-1900 18:44 qjradiftoon ARCHITECTURAL DESIGN REVIEW October 2S, 1999 Mr. Narendra C. Patel DESIGN DEVELOPWNT 69-730 Highway 111, Suite 118 Rancho Mirage, CA 92270-2873 - Re: Norris Residence, Lot 30, Tran 28867 Construction Documents - 2°i Submittal Dear Narendra, P.02 via l'wt C&s Mail and Paaimile The ADRC of Tradition Golf Club met on October 20, 1999 and reviewed the Construction Documents submittal for the above referenced project. This subminai has been approved to obtain a building permit from the City of La Quinta subject to the following conditions. 1. Provide details for gable end attic vents. 2. Surface mounted lighting fixtures must be specified by manufacturer cut sheets and/or design sketches. Please provide prior to installation for Committee approval. 3. . Provide specification book for complete submittal. Thank you. Sincerely, Christina I Dotes Archirectural Review Coordinator /cid PC: Mike Pedder!;::'-A..a ta-- TOTAL P.02 4 Re ordino RegWed BY First Americo Tak Company PAW CovA 'ri rae .+Ka.wrorl aEconawo Rou�eo e. AmO v -Em AEamoD NAk rp , Doc a logo --2:66408 R�enr9�d In 01f totsl J1e�sr'r� ed.tiay of JrlwsJesa 4ary L. Or" q�.aR11e., cwnty clerk & RaostQK ISIUMN1,1111 11 NO 1, TRA, Ozo - AK - P Tole d b�mern Us� ()�NTY M -S ME ACDF -D TO PRMC* ADECUMF SPACe FOR MCOAD" WOMA 1GN G53,Q0 s�ilpr,a� R�.�ns Fee Appti�J , �'GK4uwr��yn 7 3 Wood By- � TWO Unmy rt IVa P2004 NO. FVW RECO bl:!) MAIL TO: 'Goo Norris - Marilyn Itortia MAIL. TAX UTAI FiAQENM TO DOCI)M1WARY1VAK9ERrAXS 3351bu x_CwpPo% *4 t!ro m0wasaw or vake of poyeriy eosvw*: OR SAME AS ABOV E „! _Ca�u4x1 ba she coraldtradm tx amus i® liaq cr T OLMM�IUM=ie� ra� etlnine is tlrms of aw�1yy n3i�aflues�sf Di s�0d6[+su1 yr agsrte detamiaSttQ taz• Fara Naar M Awe -t - - p0 7U` �- a6GRANT Po n FCIRAVALUABLECt7it.-WFRA'nON,aruiptofwhicA herebyacYstt cdYed. TR-.DMO.'4 CLUB A=CIATES LLC, r< Drdawat! lhni* UmMlity wWwY herrayGRaAtfTS)b Line Norris afvJ Marilyn Horrta , husband anti Wife as Joint tenants ibo nn! m"" in the Qty of La Quints Casrnry of Riv=4v Sulo of Cakfaaia, dmnbW as Lcw 10 Traci 28867 (Seo F-sn;bil •A' A%Td1ad }heats,) D**&'May 7, 1999 Suft of Ca Smm ) c amu of , et a�tae%:) 54% 6e 44V -V—==— 3efete mr. PeMIRQ!r*Ppmed— permmwy town ib - O.�rt;lfiu:>ry sridearas)1n be *X 7*� -halo mmut* won MWOnbcd m dre wit. 6 iattraauest anal a0lWOW64W Is WO put h*60 hep evecraed the mm is "Wield clFad IM gut oy d4mwcvii est thm ►erwrrAOt tie per OO at Ow entry open bdt Wof whxh the pemm at w executed iLtt wn7msS41� 4C� gar rro amens. n 77-kOfP! G'.A C. t DvhLy,% )ity I3Y:. k* . ttt 4, .. �r OMWA4 t1� MIIfte00== MrCet'l�se�~Ibl.>ml 0 ri: sm for ofAeiaf ao42,61 sqm) +' k 1 . s 1 W 4 S 8 K EXHIBIT "A" Lot _ gypof Ttwt Na 28967, ¢s snows by nap on Glc in book 276 p" 69 thmgh 78otatim rmards ofRivmidc Cwmty, California. r a THIS D$ED IS BLADE AND ACaJ fED SUBJECT' TO THfi FOLLOWING: 1. nal estate taxcs and w=nwnMr 2. AU M200 Of s'c=d. incledircg without lin ilg6m iW cortain DecWra_ion of • CoTtlr, CCQ&tlnrs, RMdcttoas and Re�atioa of Ewmeats for the Trt aO�a Commu ily, r=44 on July 25, 1944 w Itsstnrmcnt No, 262477 and Ar•=ocdsd Auguot 15, 1497 as balru,nent No. 292176 both of OMcial recvrdt of " 3tivecdt Catuaty, t:a -%mia, which is incrx!pornped by ra reme burin as If fbBy cotl'oMt 11laW, Obe" Mcbrata .'rheDcclara6va includes, amongother MIU M OWL" umhkzvtuml aW deyelepnrrnt guidelines and m*ktiom which wit[ apply ;o the construction oraresiclehe: on the above-dcscsiW lot. l P r .P EXHIBIT "A" Lot _ gypof Ttwt Na 28967, ¢s snows by nap on Glc in book 276 p" 69 thmgh 78otatim rmards ofRivmidc Cwmty, California. r a THIS D$ED IS BLADE AND ACaJ fED SUBJECT' TO THfi FOLLOWING: 1. nal estate taxcs and w=nwnMr 2. AU M200 Of s'c=d. incledircg without lin ilg6m iW cortain DecWra_ion of • CoTtlr, CCQ&tlnrs, RMdcttoas and Re�atioa of Ewmeats for the Trt aO�a Commu ily, r=44 on July 25, 1944 w Itsstnrmcnt No, 262477 and Ar•=ocdsd Auguot 15, 1497 as balru,nent No. 292176 both of OMcial recvrdt of " 3tivecdt Catuaty, t:a -%mia, which is incrx!pornped by ra reme burin as If fbBy cotl'oMt 11laW, Obe" Mcbrata .'rheDcclara6va includes, amongother MIU M OWL" umhkzvtuml aW deyelepnrrnt guidelines and m*ktiom which wit[ apply ;o the construction oraresiclehe: on the above-dcscsiW lot. l P r l � 1 � i r t i i� PUBLIC ir% uIr%olec CLEARANCE LETTER FOR CUSTOM HOME LOTSz. Dear Builder:. Prior to issuance of a building permit, you will be required to obtain, clearance from the Public Works 'Department for one, or more, of -the following:. 1. Verification that- rough grading is complete, and the pad elevation certifications prepared -by a licensed surveyor, or, engineer, are on file in the Public. Works Department. 2-. Verification that infrastructure improvements and other required trad-improVements are complete, or sufficiently advanced to warrant building Permit Issuance .3. Prepare an engineered grading plan that provides for on -lot storm water ret'e tio and approved by the Public Works Depairtmen and have it checkedYr • Tract 26524 (Estancias) • Tract 26769 (Mountain View Estates)' 4. Prepare an engineered grading plan that provides for building 'pad grading accordance with the existing soils report and tract gradingplan, and. have it checked and approved by the Public Works Department. • Tract 28034 (South Valley Estates). . . . . . 20 L-ATkOSE FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT TRACT: 2SS LO ELIC WORKS A13THORIZATION DATE F.IPWDEPT%DOCS%FORMS%PW CLEARANCE LETTEP-ss - 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 ADDRESS: Use Classification: SFD Occupancy Group: R 3 Owner of Building: M/M NORRIS �drt"'L 52-820 LATROBE LANE Type of Construction: Building Official Bldg. Permit No.: 9911-179 VN Land Use Zone: RL Address: 52-820 LATROBE LANE City: LA QUINTA, CA 92253 By: STEVE TRAXEL Date: 05-18-01 POST IN A CONSPICUOUS PLACE YOUNG ENGINEERING SERVICES 47-159 Youngs Lane, Indio, Ca. 92201 (760) 342-9214 (760) 342-6164 June 8, 2000 ' Tom Hartung Building Official City of La Quints Re: Norris Residence —Lot 30 Latrobe Lane, The Traditions, La Quinta Dear Tom, We have reviewed the framing for the above referenced project and find it to be in general conformance with the approved structural plans. ` "If you have any questions please call. Sincerely, Q®ESSf®q Jeffrey B. Young S.E. �® �`� B. %)Y(.P •3.�r09/' OF c�a. •- \ ` r r •- \ REGISTERED INSPECTOR'S WEEKLY REPORT .�t JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ ❑ POST TENSIONED CONCRETE ❑ ASPHALT OTHER ^�A� ❑ REINFORCED MASONRY ❑ FIRE PROOFING ��V'�/ JOB LOCAT ' ^ N^ - / �� �� J O Q�]A f ,� V�r/-Dt./���1��J LO REPORT SEQUENCE N0. TYPE 0 TBYLyILRE �1 -iL✓V N �1 )�.a^CV• J� 1 D E U D DAY OF WEEK MATE IAL DES IJIPTI w �� PA ARCHITECT Ij-Tu HqS. CHARGED II ENGINEER o ASSISTANTS HRS. CHARGED INSPECTION CONTRAGENECTOR �� QyC, 1 r CONTRACTORL SUB DATE owl w It S T S. "r- ? x S g-e� --k-b II, -j I (., yc,;-b cod. , S- SAGS" cz � K 2 S x ((d C v ave"z- WeA,I4 to ' 4k tis �� • s cam. 8wt .. Cis cleUQI S, COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I 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 APPLICABLE SECTIONS OF THE '�.r�rrrrr.nvFRNIN,G18UILDING LAWS. S N TURE OF REGISTERED UOSPECTOR DATE OF REPORT REGISTER NUMBER ..r 4177 YOUNG ENGINEERING SERVICES �d-352 47-159 Youngs Lane, Indio, Ca. 92201 (760) 342-9214 (760) 342-6164 February 23, 2000 i om Hartung uilding & Safety ity of La Quin Re: Addendum #2, Norris Residence -Lot -30, Tradition, La Quinta Dear Tom, The following Addendum #2 calculations reflect the lengthening of the moment frame along line 9, area 3 and the omitting of beam # 10. The Structural plans and details have been revised to reflect this change. Addendum #2 plans have been dated with a revision date of 2/22/2000. If you have any questions please call. Sincerely, Jeffrey B. Young S.E. f. FESSI No.4�2 Exp.y3. OF LICENSED CONTRACTOR DECLARATION ;hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (coonencing with Section 7000) of Division 3 of the Business and Professionals Code,'and my License is in full force and effect. License # Lic. Class 4 �' i Exp. Date 1539 89/.r✓ �. --��yy � pjtt grate ILI ' �-% "_Signature of Contractor I 0 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 am exempt under Section , B&RC. 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.. (4 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance 6f the work for which this permit is issued. My workers' compensation insurance. carrier & policy no. are: Cartier 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 be"ome subject to. the workers'' -°compensation laws of Califo nia, and agree tha If I should become subject to the workers' compensatio prc6ions of Seeti • n 3 f0 of the Labor Code, I shall forthwith comply with those provisions. r y bate:Applicant Ir " 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 +rand 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. r I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and Stat laws relating to the building construction, and hereby authorize representatiives of this City to enter upon the bove-mentioned property insp4 ction,pu�poses. ` ignature (Owner/Agent) f Date i . t' BUILDING PERMIT PERMIT# DATE VALUATION LOT 44�.lr TRACT JOB SITE v APN ADDRESJ OWNER CONTRACTOR/DESIGNER/ENGINEER 14~x'31€3: NORRM A' 014 Y.1TWFX? i PORTOLES1 2.•Z' Q A,7 t 1? 7 44v830 LM PALIM2 Old LA. Q INA CA 922 :E?td;M DESHRT CA 92260 (7,W)R 36-9197 CBM. ;1113 USE OF PERMIT ACk07110N,AL11, PIMMIT TO �iHO",V �T,l� ANUE OF C(71°3`I'.�-1ZTOR AS F�YJ - , 11911LTLIAIWU11 107-ff -423.009 Wo i - k IMS I'Fig-PAID FEM $G%00 11MIALTIMAff DIMS DUE NOW $4,f* RECEIPT DATE BY•` DATE FINALED 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 Combustion Air Roof Deck Exhaust Fans O.K. to Wrap -F.A.U. Framing Compressor Insulation Vents Fireplace P.L. - Grills Fireplace T.O. Fans & Controls Party Wail Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. 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.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: Gene and Marilyn Norris 80155 Merion La Quinta, CA 92253 September 21, 2000 Gregg Butler - City of Building and Safety 78-495 Calle Tampico La Quinta, CA 92253' Re: 52-820 La Trobe Lane Lot 30 @ Traditions FAX: 760-777-7011 Tele: 760-777-7012 Dear Mr. Butler, This is to inform the City of La Quinta, as of September 12, 2000, Fedderly Companies is no longer representing us as our General Contractor. We have decided to hire A. J. Portolesi Construction to complete the construction of our home on La Trobe Lane. His mailing address is P. O. Boz 1802, Palm Desert, CA 92260. Cell # 760-409-9198. Lynn Mills was our representative monitoring the accounting through Fedderly and will continue to work with Joe Portolesi in an Administrative/Accounting position on our behalf on a daily basis to complete our residence in a timely and efficient manner. If you have any questions regarding any Administrative/Accounting problems that may arise, please call her at 760-837-3610. Lynn's mailing address is 73-880 Shadow Mountain, #104, Palm Desert, CA 92260. This letter was requested by the City in'order to complete our inspections through La Quinta in a timely manner. Sincerely, M rilyn Norris . ene Norris