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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 and effect.
License # Lic. Class
vExp. Date
Date ' E 0 Signature of Contractor
f
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 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 S ' 'i`I d� ivi3 Policy No. 4;;,,I�{�JI f)Qt'r 1;2.02
(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 rpt inner so as to become subject to the
workers' compensation laws of Califo��tia, and agree that if I should become
subject to the workers' compensatio,°iprovisions of Section 3700 of the Labor
Code, Mal�f6ct I "comply with t °6se provisions.
Date: ,G Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety"
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued asla result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with alltity, and State laws relating to the building
construction, and hereby authof: a representatives of this City to enter upon
the above-mentioned property, Wr inspection purposes.,
./Signature (Owner/Agent) Dated' d�
BUILDING PERMIT PERMIT#
DATE VALUATION ����
LOT TRACT
`7 2 ��j_2,$.i� do ? x+� 1 c�
JOB SITE APN
ADDRESS I_%.' .i Q4 7�E�l i 77_:y-154.020,
OWNER CONTRACTOR/DESIGNER/EN (NEER
CIMMOF ; LLOT) . , A 1% 11+6 L"O3d19"i'Y+? ICTIVAN
79.011 IIIA SAINT CLAYA
LA QuIr'-fi. CA V2.23 3 LN QUIN TAk CIA 92253
t'?60)5164-4KS,22; CSilAl 626
USE OF PERMIT
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PLAN CHECK FILM
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RECEIPT DATE_, BY DATE
$3,6 1.2.256
5N.7,w+9.12-s
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 Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
00
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
2 p
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:
-
_
Date 6/23/03
No. 24599
Owner Christopher Lloyd
Address 79025 Via San Clara
City La Quinta Zip 92253
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515
APN #
"q�J�Ft�scyo
Q BERMUDA DUNES r
Cn RANCHO MIRAGE d
INDIAN WELLS
PALM DESERT,
LA QUINTA
��IN0 y�
O
773-134-022
Jurisdiction La Quinta
Permit # 0304-342
Tract # Study Area
Type Single Family Residence No. of Units 1
Lot # No. Street S.F.
Unit 1 10 51725 Eisenhower Drive 1632 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
Lot # No. Street S.F.
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, 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. 851657320
Name on the check Telephone
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sharon MCGilvrey $3,492.48 0.00
t Payment Recd Over/Under
Signature
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 authorized 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
1
CONCORDE CONSULTING GROUP, INC
3505 CAMINO DEL RIO SOUTH, # 350
SAN DIEGO, CALIFORNIA 92108
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:
COPYC)II
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
�oQFOfESS ��.
A�
S26!a
[�Xp. 6:03
,I
QT CAL\ ®i��a
~ 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 # 10 — 51-725 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)
F�S5�QhG�[
EXCEPT FOR THE ABOVE, FRAMING IS IN GENERAL CONIF10 CE + DESIGN
INTENT tC'`ci�Q4�NAI441g9
THANKS 4
* tc No. 7