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0304-341 (SFD)' LICENSED CONTRACTOR DECLARATION 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 a 'd effect. License # Lic. Class Exp. Date 7461 SrS �/Date X01 "�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 am exempt under Section,— B&P.C. for this reason Date Signature, of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty, ofperjury 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' ,81,A,rE p T�I.i) Policy No. U+l •UI t!i1fiP23: -42 . (This section need not be completed if the permit valuation is for $100.00 or less): ( ) I certify that in the performance of the work for -which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California;',and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, Idshall f rthw� comply with tho$e�provisions. Date: �• 1 Applicant 7 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, 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 fCity, and State laws relating to the building construction, and hereby autho,% representatives of this City to enter upon the above-mentioned property,for inspection l5G?poses. Signature (Owner/Agent) - • Date n .. Yn� b BUILDING PERMIT PERMIT# DATE VALUATION LOT TRACT 7 - ;, - :• r JOB SITE' �'' APN ADDRESS OWNER CONTRACTOR/ DESIGNER/ EN ]NEER A& M MA 311tucnoYlt, '��•X23"a/l��'E'].aP►t<Ati`',•-'"""•.,.� LA QiM-TMA CA 922193 tA. ftmli, — CA _92213 (160)5644832. MIX 11526 USE OF PERMIT .1631 S. Y. SPO I,-URMAT OT iNG°c UG?. T.4L0CX R?A,1J, P00 4SPA 0R DRIVE'WAY AC'F'ix.CTrt.K'K ?Mto IkEDUC:"P'D PL,A.14 CHECK. FZZ F :fR'bfifIMP%,r, PLANS Ole St 4 hE TYPE / PGRIC IPATTO ua, 0 Sr EviMUTWOD COST VJ` gf�,�ty�,ypr�. �• p;1•�f 1C Z".RLiar�'67�J. A'rL�. /i'W.tN9J.r':lJ4F�� . PLAN +z'liF'PCF 54 Uw $1391.0:; FEE, DEPOSIT 144. KAIIMCA IL YR K $59 Ula R12,C"TR:ICa,/#I; iF9K 7` ] 61U*14201<000 . l�I:UlbfgiNL`idrit:L 1011-()()li-�•1B•�t� �13D..�? IURONf31 OTION ITZERESID [p?=0>114.24.1 <X0 OEMOPER t iPACT Ips 4£D1-(.1(�iJ-hdi &SSS SS1iJFJ,�ii k4REA_ESEiy,:..&HLEM9 RK1.1-PAID1 MIN 4250M JUL2 L 2003 . . cfr.• Q+. L, f •,. RECEI t BY DATE INALED INS ECTOR 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 O Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wail Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final — BLOCKWALL APPROVALS Steel POOLS - SPAS 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 _ Encapsulation Gas Piping Gas Test Y0 Appliances Final Final Tll�l _63 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 Pourer 3 Final 14 Utility Notice (Perm) COMMENTS: ,. 4P.O. BOX 1504 �,' �� 78-495 CALLE TAMPICO APPLICATION ONLY Building Address Yerc: AO (r &k?-- LA QUINTA, CALIFORNIA 92253 �%✓j✓ Owner - Mailing BUILDING: TYPE'CONST. OCC. GRP. Address A.P. Number Z& —a"Qzo City Zip Tel. 1: Legal Description e Contr cto Al s�� Q Project Descriptions- Address lk� t City zip el. State Lic. City 8 Classif. Lic. q Sq. Ft/fl . //// ,, rr�� No. / No. Dw. Arch., Engr Size ,3 2 Stories ! Units ., Designe S` New Add O Alter ❑ Repair ❑ Demolition O Address /C Tel. n _ ��] 2Z 3 �77 �%� 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 rile 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). I[-] 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, 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 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.) I'! I am exempt under Sec. B. 8 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 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. I certify that 1 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 LEstimated Valuation ` 96 -mo PERMIT AMOUNT Plan Chk. Dep. 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 Prop bine FINAL DATE INS Issued by: Validated by: Validation: �� WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE Type Single Family Residence No. of Units 1 Lot # No. Street Unit 1 8 51685 Eisenhower Drive Unit 2 Unit 3 Unit 4 Unit 5 Comments Newgate Plaza S.F. Lot # No. 1632 Unit 6 Unit 7 Unit 8 Unit 9 Unit 10 Street S.F. 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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that 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 Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14 X 1,632 S.F. or $3,492.48 have been paid for 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 OC/EI Paseo Bank - John Clapinski Check No. 851657329 Name on the check Telephone Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Sha r M Gilvrey $3,492.48 0.00 Payment Recd Over/Under Signature C NOTICE: Pursuant to Government Code Section 66020(d)(1), 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 issued, or from the date on which those amounts are paid to the District(s) or to another public entity authored to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting CONCORDE CONSULTING GROUP, INC 3505 CAMINO DEL RIO SOUTH; # 350 SAN DIEGO, CALIFORNIA 921.08 PHONE: 619/516-337 FAX: 619/516-3388 May 18, 2003 To: Antonio Santa Maria Santa Maria and Associates 44-100 Monterey Ave, # 201 B Palm Desert, CA 92260 Re: Lots 20/22/23/19/21, La Quinta, California Dear Antonio: DOPY N This note is to confirm that the following substitutions can be made for shear walls with panels on both sides. Please note that this will affect studs, top plates and sill plates. Item # 1 — Use Type 9 shear wall instead of two sided Type 1 shear wall Item # 2 — Use Type 12 shear wall instead of two sided Type 2 shear wall Please call me if you have any questions Thanks Kripanarayanan No. 52654 Fxp. &l03 �r y 's\a:�F CAL1�i� CONCORDE CONSULTING GROUP, INC. ENGINEEERING & CONSTRUCTION MANAGEMENT 3505 CAMINO DEL RIO SOUTH, # 350 SAN DIEGO, CA 92108 PH: (619) 516-3377 FAX: (619) 516-3388 MEMORANDUM/FAX COVER SHEET TO: FROM: A & M CONSTRUCTION KRIPA COMPANY: DATE: 09/02/03 FAX NUMBER: TOTAL NO. OF PAGES INCLUDING COVER: 760/564-0406 1 PHONE NUMBER: SENDER'S REFERENCE NUMBER: YOUR REFERENCE NUMBER: RE: SITE VISIT 8/27/03 X URGENT X FOR REVIEW X PLEASE COMMENT X PLEASE REPLY ❑ PLEASE RECYCLE notes/Comments PROJECT SITE ADDRESS: Lot # 8 — 51-685 Eisenhower Drive, La Quinta, California THIS NOTE IS TO CONFIRM THAT SUBJECT TO THE CORRECTION OF THE FOLLOWING ITEMS, THE FRAMING IS IN GENERAL CONFORMANCE WITH CONSTRUCTION DOCUMENTS: 1. HOLDDOWNS APPEAR TO BE MISSING FROM THE SOUTH WALL OF EACH OF THE HOUSES AT THE INTERIOR LOCATIONS. IF THESE ARE CALLED OUT, PLEASE USE 5/*" DIA EPDXYED THREADED BARS WITH MINIMUM EMBEDMENT OF 6". PROVIDE SPECIAL INSPECTION FOR THIS WORK 2. THE GABLE TRUSSES OVER THE GARAGE ON THE EAST SIDE DOES NOT HAVE CONNECTORS AT THE BEAM> PLEASE PROVIDE A35 AT 12" ON CENTER 3. THERE ARE SEVERAL AREAS WHERE THE TRUSSES HAVE NOT BEEN BLOCKED AT THE TOP PLATE LINE. PLEASE ENSURE THAT THE BLOCKING IS COMPLETED AND THERE A35 CONNECTORS (MINIMUM OF 1/BLOCK EXCEPT FOR THE ABOVE, FRAMING IS IN GENERAL C INTENT THANKS r No. S2.6.54 E0 '0' .F; , 6130107 _ Certificate of Occupancy0 HI C OFT9� Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 51-685 EISENHOWER DRIVE Use classification: SINGLE FAMILY DWELLING Building Permit No.: 0304-341 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RC Owner of Building: CHRISTOPHER LLOYD Address: 79-025 VIA SAN CLARA City, ST, ZIP: LA QUINTA, CA 92253 By: KIRK KIRKLAND Date: November 3, 2003 Building Official POST IN A CONSPICUOUS PLACE /