9612-161 (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
f 3r' � 1't
/Date - ' Signature of Contracto
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.
�Ky 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 Policy No.
1113501
(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 �C li ornia, and agree that if I hould become
subject to the workers' compensa,o iprovisior)s of Section 3�/ 0 of the Labor
lode,�l al'I f 'rt th comply wit tliols pl vision
`Date: Applicant
Warning: Failure to secure Workers' Compensation coverage is u awful 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. t
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 City, and State laws relating to the building
construction, and hereby brize re res tatives of is City to enter upon
the above-mentioned pro erty r inspectio urposesr
Jae(Owner/Agent) / ate _ V
M �
BUILDINGPERMIT PERMIT#. 4 -CONTROL#
61 4831
DATE 31,�,`�� VALUATION LOT r�Cl� TRACT
JOB SITE 1�
ADDRESS 47-745 VIA t, ON TWU
APN
"3410-034
OWNER
CONTRACTOR / DESIGNER /ENGINEER
laIVINA'PiXtt it (XJ APr%v
("All U-DAIGt0.rlMPAN
-Y
1. 70 WR+:X)KHOUXAV t}i<i L, SME 206
1570 BY, i(ihJ40(..t UW DRIVE, SUITE 208
SANT) ANA f 'A 9270!
;;AWA ANA CA 92705
(71 X6,)75 t -9 i 51 t.'t3 X .V485
USE OF PERMIT
SA -1)
SPD - 081WIi I: i is ks NL1�'s ) N4CLUDE. isU)CK WALL OR 1000
N ills Al N I L I I
.y.. 9yy3.�GuuOSt."
`ypYi Ayyt'.'rY,E°fiNS'gr'RE3+"%'ION S
SF
0AkA(AA,'.AitPt.JWF 61000 Vii•' °
ri.ST1:A;'fi.'ITED COST 011F CONSTRUCHO N
157,443.00
PERMIT .lilck, SUMMARY
CON;iTRUC"t'If.1N FEEt 101 -000 -419 -{?t71)
MAK C7fECK, Frl:, J0141IM-134- 3 18
P1. IV C.6.1WK
MECAANICAL V£:tiS 101:400-421-000 a9w.tx1
M EC"i'€2tCAL FRES 101 -000 -42(l -1M $175,63
t?€.t7td�t}}� } Fi:+T':> t ii t-(lti0--S i �-fN)t► 31.5.''•5
M-RONG i'1$(YT ON (RES) 101 -WO -2.41 --OW ia`.74
(IRAOING 141 -000 -X123 -OW
PvFR.A.`I`tt-K"Ti RF 225-000-443-342 $3.443.12
MT N POMP' P1•. r1. T-,3 (H4' `+A.
Yf'ft.l., "{ }N '1"lti>rC"IIc)Rt ,AND KAN CHECK
pQ
' LESS PRE -PAID FEES
4250.00 ,
MAR 19 1997 X-11 � �e n is ' : � t�rrti; t� 1V
S5,30.96
RECEIPT
DATE
5By" k e
DATEFINALED
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 Wall 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
rApproval
to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
i
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)
ELECTRIC
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
FbQures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
17
A PROVALS
/
COMMENTS:
Desert Sands Unified School District
Notice:' - 82-879 Highway 111
Document Cannot Be Duplicated Indio, CA'92201 ,
619-775-3500
CERTIFICATE OF COMPLIANCE-,
Date 3/19/97 APN # , 643-120-034
No. 15353 Jurisdiction iLa Quinta
Owner Name Canady & Company Permit #
t
No. 47745 Street Via Montigo Log #
City La Quinta Zip 92253 Study Area 123
I.
Tract # 26152 Lot# 262 Square Footage 2598
Type of Development 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 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
1.84 X 2,598 or $ 4,780.32 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
e
Fees Paid By cc/Pacific National Bank/Canaday & Company 'Telephone 7714-751. 9151
Name on the check
By Dr. Carol McGrew.
Administrator in Charge
Fee collected /exempted by Pauline Pearson Payment Received " $4,780.32
' Check No. 66911 ,
Signature Qn, 'A A
An . Q9 AAA_&4A,_
10TICE: 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
bove will begin to run from the dale 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
.Ilett 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
4
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
1.84 X 2,598 or $ 4,780.32 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
e
Fees Paid By cc/Pacific National Bank/Canaday & Company 'Telephone 7714-751. 9151
Name on the check
By Dr. Carol McGrew.
Administrator in Charge
Fee collected /exempted by Pauline Pearson Payment Received " $4,780.32
' Check No. 66911 ,
Signature Qn, 'A A
An . Q9 AAA_&4A,_
10TICE: 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
bove will begin to run from the dale 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
.Ilett 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
CARLOS E'LIAS
REGISTERED CIVIL ENGINEER
38825 CHARLESWORTH DRIVE
CATHEDRAL CITY, CA. 92234
TELEPHONE (760).328-7271
LICENCE No. 16839
EXP. DATE. JUNEP97
MAY 05-'97
CITY OF LA QUINTA
P.O. BOX 1504
LA QUINTA, CA. 92253
RE: -LOT # 262
47-73, , VIA MONTIGO
LADE LA QUINTA, LA QUTNTA.
GENTLEMEN:
PLEASE BE ADVISED THAT I AUTHORIZE MR. MIKE MENDOZA TO
INSPECT AND APPROVE THE STRUCTURAL COSNTRUCTION PUT IN PLACE
BY CANADAY & COMPANY CONSTRUCTION, IN ACCORDANCE WITH U.B.C.
CODE 307 ON ANY OF THE SINGLE FAMILY DWELLINGS LOCATED ON
TRACT No. 26152, LAKE LA QUINTA, CALIFORNIA.
CARLOS ELIAS
ENGINEER
ARCHITECTURAL COMMITTEE
LAKE LA QUINTA HOMEOWNERS.ASSOCIATION
Lake -La Quinta; 'California:
December 3,° 1996
City of La Quinta
La Quinta, California
Re: Lake Front South Shore Homes at Lake La Quinta,
Gentlemen:
The renderings o the lake- ront South Shore Homes- submitted to the
g .f f
Architectural Committee on October 12, 1996 and the detailed plans submit-
ted to us on December 3, -1996 by'Jim LaLoggia, Project Manager of Wilma,
L. P., met with unanimous approval by our committee.
The committee is especially impressed with the' efforts. being made by
Wilma to maintain the overall -integrity.,of the area by, implementing plans
and designs that are'Sompatible with the surrounding homes at Lake:La
Quinta.
As homeowners,. as well as committee members, we are grateful that
Wilma is. still concerned with the long range affect. of any; development pro-
posed for the area and we think the proposed plans for the South Shore
Homes are steps in the right direction.
r. Arank Tasso, Chairman
Ann T. Madison, Co -Chairman
CARLOS ELIAS
REGISTERED CIVIL ENGINEER`
38825 Charlesworth Drive '
Cathedral City, California 92234
Telephone (619) 328-7271
December, 19, 1996
City of La Quinta
Department of Building & Safety
78495 Calle Tampico
La Quinta, Calif. 92253
Gentlemen:
This letter concerns the residence to be constructed at
47-735 Via Montigo,.La Quinta, California.
The design of the roof trusses by Houston Lumber Company
is in substantial, conformance with the -.structural framing plan.
Very truly .yours,
WCertificate of Occupancy
0
City,of La Quinta �4 �
Building and Safety Department �°eMo.TM `¢
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: 47-745 VIA MONTIGO
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.:. 9612-161
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: CANADAY AND COMPANY
Building Official
Address:
17480 EAST 17T" ST. #106
City:
TUSTIN CA 92780
By:
STEVE TRAXEL
Date:
09-11-1997