0107-098 (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 Signature of Contracto 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 •ot the property, am exclusively contracting with lidensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
O I am exempt ander 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 haye,3nd,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.
$,41 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 �31d9' +tet?1 w 1Pro Policy No `-3,P,I10000-141 P
(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 bec me}�subject to the
workers' compensation laws of California, aAdragre� ° if I.- hould become
subject to the workers' compensation pro' Ions�o S ct ori+3'700 of the Labor"'
Code, Iski Ifo w�tt5 comply with tho a prov�islo
Date. /I.,� t.'' Applicant—
Warning:
pplicant }� f
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $1,00 OOO :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
fora 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 applicator 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 tete jaws relating to the building
construction, and hereby authorize/repres n�tativ44s of this City to enter upon
the above-mentioned property for'inspecti Mpur6oses.
Signature (Owner/Agent) °�r�i`,� `r Date
BUILDING PERMIT PERMTk
DATE VALUATION LOT 007-M TRACT
1,IA Aa(X
JOB SITE
APN
ADDRESS �'p;{��!.J�rle�i�n.�-•��.I
OWNER
CONTRACTOR/DESIGNER/EN INEER
CARA AY A; C;'C7A t'aMIY
C AN ADA` & C;fQIv1.PAI-pC
1 48 .CP, #106
17 4)3 R I Tff3 J1,. 0=106
` LIaaTI'N1 CIA 02790
;Mllu CA P..^Ic`'0
(V14)-508-4440 Cti lfi 4.485
USE OF PERMIT
q J
PINfZ PA IL•'1f` 1IMU.1NG.
N1.M it}1,0414 30APZ-P1Z..1R.AAIT DOES N1".ai' MICIXOX 81.00K WAAUZ OR Pa701.1
VOILANCHa CK. PIFR:UDUCr` IOW FOR
!"LAN TYPE1.
x`11 04.E 7 CONSTRUCTION 21433.06 By
P0R.CFYPAT10,' 3';'fl.0 BF
ci�t,��dCA1r;l�ca1•c� �i3Q.�iJ ��
COST OF C<ONWMji..".rIC3.N
1-15,146AD
}p�.ar•� y],q, ( �r�4'�' ,('{vy /��' ,yMA'17_10D
N-d'AiVdU.3•��, .[9 .Ei.`A+ li i,.i.I•YA•�3L
. �
CORZITRUCTION ITMI 101-000-438-000 $933.00
PLAN CHECK FRE 101-000-439-318 $194.04
FKF DEPOUI 101-TJO-4 39.318 41,50.00
;N0e,C1',AN1CA1,.PEP, #'M -000 -421 -WO $105,01
1%FC i'111r'r , RX 101.000-4 G1.000 31161479
1-%'1.1MV1Nu T°'kug 101-Citi`Yl3-09-0.00 $192.50
Y
,51-t.OT:Ci Mcg 3'►(X91�i R ., RESI 3 101 -000-241 -000 V8.09
!r0$1AX)=FLM
. 4 15EIVELOPERiMPAC'd YZ
..� -C' :':�5
q���¢WW��TT.»(3 IF\NYiPpeaL4.
,`.
$3,S26.91
NOV 13 Wl MV91?,'n-PIAM MIS
4250-CrO
O9'y OF LA QUINT. V1311R.M1'.r riMS XXTE, .1fOW
S%2-76
RECEIPT
DAj�
BY
DATE �INAL'��
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
_' _ �?jj l� 1
Underground Ducts
Forms & Footings
Slab Grade
_ (
Ducts
Retum
-�? �/
Air
Steel
_
Combustion Air
Roof Deck
—�j' z /
Exhaust Fans
O.K. to Wrap
F.A.U,
Framing
Compressor
Insulation
/_ 2S -per -.
Vents
Fireplace P.L.
_
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
_
Condensate Lines
Party Wall Firewall
Exterior Lath
_2 -5 -,5;,
Drywall - Int. Lath
2 ^ % - o
Final
2 9_3 -`
Final
'�=®�
POOLS -SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
:5 20 �Z ��
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg, Test
Final I
Gas Piping
PLUMBING APPROVALS
Gas Test
Waste Lines
Electric Final
Heater Final
Water Piping
_�i—'9 oL r�o�
-
Plumbing Final
Plumbing Top Out
�_Z yam-
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral ,
/
Pool Cover
Sewer Connection
_
��d%
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
r
Temp. Use of Power
Final
Utility Notice (Perm)
-
Cof Occupancy
ertificate
Cityp f LaQuinta.-_
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109- of the Uniform Bui/ding 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:
47-690 VIA FLORENCE
Use .Classification:
SINGLE FAMILY DWELLING
Bldg. Permit No.: 0107-098
Occupancy Group:
R-3. Type of Construction: VN .
Land Use Zone: RL
Owner of Building:
CANADAY AND COMPANY
Address:
17480 EAST 17T" ST. #106
City:
TUSTIN CA 92780
By:
STEVE TRAXEL*
Date:
07-23-2002. i
(r •
{ I AND
DEVELOPMENT
D ESIGN ,
/E November 20, 2001-
V 0, 00 CATION JN3065
City of La Quinta
Building & Safety Dept:
RE: Lots 114,115,116,148,149,150,151&214
Phase 7C
TR 26152
Rough Grade Certification
Dear Sir
This letter certifies that the above mentioned site has been graded in substantial
conformance with line and grade as shown on the approved grading plans.
The forms have been verified in the field. The pad elevation is listed below For each lot.
Lot 114: 60.12
Lot 115: 60.59
Lot 116: 59.51
Lot 148: 61.30
Lot 149:. 60.92
Lot 150: 60.63
Lot 151: 59.43
Lot 214: 59.82
Sincerely,
C y
Dennis C. Farnsworth
%11'x•
RCE 31653, Lic. Exp. 12/31/04 \ 12131S -:may
r ^
PLANNING CIVIL SURVEYING
2313 E. PHILADELPHIA ST. UNIT F • ONTARIO, CA 91761 • BUS (909) 930-14466 FAX (909) 930-1468
9
ESI/FME, Inc...
StructuralEngineers Date Jan. 5th, 2002. By: R.R.W.
1800 East 16th Street N .
Santa Ana, California 92705 ? `
Company CANADAY AND CO. Arch't / Designer : Len Nobel
Address 47650 Via Antibes, Project Name: "REGATTA
La Quinta, CA. 92253 ESI / F M E Job No.: 9323 - 7 .
Contact : Bob Walker cell (760) 275-8731 'Project Eng.-: - R.R.W.
Phone : (760) 771-9636 FAX (760)771-0564,"..' PH.; (714) 835-2800 /Fax 835-2819
Phone Conversation Field Meet'g �r Meet'g @ Client's In=House Meeting
MEMS Page 3 of 3
Field observation on the following lots Tract 26152, Phase 7C
Lot 1115 PI_an 30AR 400 Vi 1.Fj1orence '
Dining 'Room: MOVE 31/2' x 11-7/8" PSL to „the front of the room.
NOOK: ADD (2) 2x4 trimmer at each side of rear wall Parallam ' r
Fireplace: ADD Simp. ST -22 at each corner. of fire -stack.
Kitchen/BA4/Laundry: SHIM bottom of trusses to develop bearing. f
'BED3/BA2: SHIM bottom of G.T. to develop bearing.
BED3/Gar.:.ADD shear panel, above • top plates.
Garage: ADD edge nailing of r shear panel .on bottom , of garage door, header. .
ADD
2) 2x4
NAIL ( strap t lfront wall at lgh as per' detaiend of ls. C1/D3 `.
5I ,
Entry: ADD shear panel SW11, 4 -ft at each.* side of . tower. s
BED2: ADD Simp..CS16 at exterior wall, as. per El/D3.
ie: FRO1052c.WK4
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