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9806-227 (SFD)r r LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions. of Chapter 9 (corrimencing with Section•7000) of 'Division 3 of the Business and -Professionals Code, and my License is in full force and effect. License # x' ` Lic. Class Exp. Date r. 3/311001 V0ate 0 17 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 am exclusively contracting with" licensed contractors to construct the project (Sec. 7044, Business &' 'Professionals Code). O 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. (1) 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: CarrierPolicy No. � . ttt jd (This sectionlneec° otlbe completed if the permit valuation sfor)$100 00 0V(This ss). () 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 , gree that if I should become subject to the w�6rkers' compensation pro sion's of Section 3700 of the Labor Code, I sh II fo . ith comply with those,p ovisions. '4 yDate: _ Applicant—, Warn g �, ilure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 Of.the Labor Code, interest and attorney's fees.. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to •the conditions and restrictions Set forth on his application. , I 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit Work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify &'hold harmless the City of La Quinta, its officers, agents and employees. '?.,Any permit issued as a result of.this application becomes null and'void,if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the'above information is correct. I agree to comply with all City, and State laws relating to the buildirLg construction, and hereby authorize representatives of this City to enter upon the,above mentioned property for in purposes. ,,Signature (Owner/Agent) -BUILDING PERMIT PERMT# . r' DATE t VALUATION LOT TRACT 9806_227 JOB SITE _- -2 AP _ ... ADDRESS. 47=60q i A ! i 3_. I 0-.fk'VA OWNER CONTRACTOR/DESIGNER/ENGINEER ' CrANA:DAY & COMPANY C"psNADAY & CONIPfANY ' 1570 t R,00Ii.1'iOT.,1.OW 13R1'VE, SUrfF, 208 1570 BR001;'HO1.1.(:)W DRWEy SURT 2108 'ANTA—AUNAA; CA 92705 SANTA ANA CA 92705 1 (7191751-9151 OW 4485 USE OF PERMITDW�LSt , .l • Ll 51 Ls. 1 V SrD PLAN 352 1 irI2M1T DOES NOT dI22oi 1XDE BLOCK WAu1 I.S OR POOL. r ' -MACT CONSTRUCTION 2,628.00 S1: POi2.(,'IHfPA.i iO 330.00 SF OARAGWC.AR.PO'Wr 542.00 SF TeS TIMI f T is CQN T OF CONSTRUCTION I PERMIT FEE SUMMARY VEE i'. EPOS.TT 101-000-439-318 4250.00 r~CizJ3't'kiifF ['ialt+f F'wzlt)1,;f1f113.�118.0011). SR.tJ,50 ri s r•iIGI;C 143C i.()i tl00 `I ly s1Ss �"i t7: Pvffi!L'1_iA.NI:CALh"(H l/Uf �)yt�ftgl�i'_}fgfi�l}i►(l�l;, @$ti.i�l! W 1�..,1RICAL bl.l:' 101 b i+� tFAlFtlt t;xk'trF' itnnjl t 1{i 1l9-(0) Xma ��Jyilk_�)VV iVlil,l j ..4.4Y f'�.+L.� �r✓Jli% �l V.t `1lVt/'aNJ-'VV6iiJ.g/ _ t KAJI)IN W_h i4�1 tl4fl142.3-11JOU $2t),Ull tNF'RA,'ITRUC'i URE FEF' x,15.000,.4:13-312 S:3,491", kti ART I3V'.FUBL'IC PI:ACE.8 - Rf"31 '701-0004255.000 31'15.13 UI 4 fa(tH iY)°�s�f°tT��aN 1`dl t(sj__ AV0Pl„,;nja�r�f-ECK_ Fi 15{iK 1j AUiG,j2 61998 t� SS PRE->aA f,'LTE 4250.W TOTAL P.EIWIT FELS DUE NONIT ,5.,05.39 j 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 0. K. to Wrap F.A.U. Framing ,(is Compressor Insulation -2 _ Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath 4- -6-- Drywall - Int. Lath 112 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 Encapsulation Gas Piping Gas Test 3 Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fbdures Main Service Sub Panels Exterior Receptacles G. F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) i COMMENTS: Desert Sands Unified School District , 47-950 Dune Palms Road Notice: E La Quinta, CA 92253 Document Cannot Be�Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 8/26/98APN # 543-110-026 No. ' 17587Jurisdiction La Quinta Owner NameCanaday & Company Permit # No. 47-695 Street Via Florence Log # City La Quinta zip 92253 Study Area Tract # Lot # Square Footage 2,628 1 i Type of Development E Single Family Residence No. of Units 1 Comments 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 replF-cemegt mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: , y EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in..rhe amount of 1.93 X 2,628 or $ 5,072.04 the property listed above and that ildmg� w} d uu permits and/or Certificates of Occupancy for this square footage in this proposed project max;nnw tje issued, Fees Paid By CC/City National Bank/Cariaday & Company TiPphione :714-751-915I� � Name on the check 1,;:, ? t, r-� By Dr. Doris Wilson Superintendent �x {' Fee collected /exempted by Juanita Green Payment Received $5,072:04 Check No. 01058611 Signature ' NOTICE: Pursuant of Assemb Bill 3081 (CHAP 549, STATS: 1996) this will serve to notify you that the 90 -day approval period in which you may prote-t the fees or other payment identified above will begin to run from th4 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 collect them on the Districl('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 ` gip} �y,,. �. a .wr— ��,,� 3A`� yi ,.,"+t• '.c"` AM�`ry1 $444.01111.11D+n: ;s". T �+r 1 • ��IY��'� r w twl ildinq�' P.O. BOX 1504 APPLICATION ONLY l �� `` 78-495.CALLE TAMPICO i Addrress "'4%¢695 Via Florence LA QUINTA; CALIFORNIA 92253 r% Canaday & Company/LLQ, LLC BUILDING: TYPE'CONST. OCC. GRP. Address 1570 Brookhollow Dr., #208 643-110-026 A.P. Number Tract 26152, :.ot 225 City zip 1914/751-9151 Santa Ana 92705 l Legal Description Single Family Detached Residence Contractor It Canaday & Company Project Description Address 1570 Brookhollow Dr., 0208 Santa Ana Z�2705 ' /114/751-9151 State Lic. & Classif. 591561 City Lic. # 4485 Sq. Ft. 2,628 No. Size Stories : No. Dw. 1 Units Arch., Engr., Designer Len Nobel Company New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ VV:s BOX 16606 T2,14/559-4305 cit ryine Z�2713 State Lic. # f� 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. Estimated Valuation `' t 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.Susiness 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 PERMIT .AMOUNT 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 Any Section 7031.5 'any i Plan Chk. Dep. exemption. violation of by applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500). Plan Chk. Bal. a V.. 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 Const. 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 Mech. . 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.) Electrical I'1 I, as owner of the property, am exclusively contracting with licensed contractors to corn Plumbing 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 S.M.1. Such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading I'! I am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. Infrastructure Date Owner WORKERS' COMPENSATION DECLARATION 'I hereby affirm that have a certificate of consent to self -insure, or a certificate of Worker's C"i e y''r �r f@gC� l�bf�a4litied copy thereoJR?f1V&0,0&b1ff5e,, Policy No. Company r] Copy is filed with the city. ❑ Certified copy is hereby furnished. I TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (5100) valuation or less.)' I certify that in the performance of lhp 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., It, 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. r 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 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 representatives -of this city to enter the above• mentioned property for inspection purposes. Signature of aliplicant Date Mailing Address City, State, Zip REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Fear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: PAI U Validation: MY 0 1 i998 WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVI OJ—N ®F Lia QUINT' ` -ES I/FME., Inc. Structural Engineers Date : 5-8-98 By: R.R.W. 1921, East Carnegie Ave., St. 3 J Santa Ana, California 92705, p y _CO.Project Name: S " outh Shore Company CANADAY AND CO --- ..............------...._ - :_.._ .. _ On .,:... . . Address : 1570_Brookhollow_ Drive, St. 208 Lake La Quinta Santa Ana, CA_ 92705 _ _ _ _ ESI / F M E Job No.: 298-8436 Contact : Steve Sante _ Project Eng.: R.R.W. Phone : -(7114)--751-..9.1.51- FAX: (714).751'9152 PH.: (704)261-1811 /Fax 261-8506 X Phone Conversation Field Meet'g Meet'g @ Client's In -House Meeting City. of La Quinta Department of Building and Safety 78495 Calle Tampico La Quinta, CA. 92253 RE: South Shore On Lake La Quinta PlanWR2,/.LQT ..225.,.:.i, 4 695 ,_Via Florence To Whom It May Concern We have reviewed the truss drawings and calculations by Truss Works for the above reference project and find' them in substantial conformance with the structural framing plans prepared for submittal 'to the City Of La Quinta . TrussWorks P. O. Box 626 Thousand Palms, CA. 92276 Ph. ( 760) 343-3461 Fax ( 760) 343-3491 ' Qa0FE5s�pN Ramon R. Wong, II, S.E.2345 �; x W No $2345 rn °C Exo ( 2.31-8j c.c.: Steve Sante78-095 >k ste La Quinta CA. 92253 � OFCT UF�`��� , CA ie: . Y Certificate of'.0ccupancy City.of LaQuinta, Building and Safety Pe 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: 47-695 VIA FLORENCE Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9806 -227 - 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 Dater 08-06-1999 Building Official POST IN A CONSPICUOUS PLACE ' now u..