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9612-160 (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# Lie. Class; Exp.'Date ib1 f: 3134 ` ate f, ignatw6 of Contractor OWNER-BUILDEWDECLARATION I hereby affirm under penalty of perjury that.l 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 (See. 7044, Business & Professionals Code). y O I 'am exempt under Section r �', 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, d'ecla'rations: O` I have and.will maintain a certificate of, consent to self -insure for woikers' compensation,• as provided for by Section 3700' of the:Labo( Code, for .the performance of the work for which this permit is issued. K I have and will maintain workers' compensation insurance; as required by Section3700 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, 11241Ct 2 C 'E7 $ co ig 11'19614 J.'79 .(This section need not be completed if. the permit valuationis for $100.00 or less). . I certify that in the performance of the work for which this permit is,issued, I shall not employ any person in: any manner so as to become subject to the workers' compensation laws of Califor ia, and agree .that if I should become in subject to 1he workers' compensa Provisions of, ction 370 f the Labor G`otle, 81 ort with comply Wit thpo '.prov'sions ;Date: 1Apolicant f Warning: Failure to secure Workers' Compensation coverage is'unl ul and shall subject an employer to criminal penalties and civil fines up•to'$t 00,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorneys 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 v whose request'and for,whose benefit work is perform6d'under or•pursuant to `�`L 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 notcommenced within 180 days,from:date of issuan ,bf such permit,. or cessation'of work f6i:'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 autho ize represen atives of t is City to.'enter upon the above-mentioned prope, r inspect/ion urposest Signature (Owne A-npntl IN ( 'Date •�M% PERMIT # CONTROL # BUILDING PERMIT.. �i�x�j�f►6J X30. DATE 4 r��. VALUATION $15 4 �1.f)f) LOT; . '• TRACT ADDRESS ' ' 47r54)s VIA jUrJS-4 i ZtV JOB SITE APN -OWNER DESIGNER ENGINEER qCONT.RACTOR 1 ,; MIPSA)t84ANADAf& C10, (4yAY COMPANY. UAa1110: 1510 ,1312OOKe 14OLLO i d3M'1 E, SIJITE 20g. SANT.A.ANA, CA .927A5 AM.'A. AxN'A . CA. 92705 r ' (1A 4)"711-915t � ��1a • 4495 USE OF PERMIT till aro .•Vk`}21a bUS'NO'i`. A3CJr3D':8i C'°dlAi F dJtfi`Jil . POACTIF( A 11, -01 sw­ kAOErC'A.►OIOR'!' £+li1 CiA.Al3 I �,e).�; ars . :> • 1...a$1 -CONISTRUCTION 157.44311 �.$y.�IfV,I�:. 'f� :9���'JA.i 64T,�AY�.�t@��'.4 . � •r ` .. •C;.`f�Id4`!'it.f3t'�t'"ft�Nd�.f� '!4?1-l'149f)-�tlt�=•flt}C) �fi�12,�9 , . t�,��,��G`�►a ')l1t•t3ilt?�a.3'��d,F.d �fi)�z..t1 13LA1m CIMIX i7 PCi'II 3' 4"0100 ALf"i" iANiCiti: L s� 10.1060�421-000 M00 F LPr UK! C„At AFEfi35E7561 tai tt�13i�,d� sn„1��� - •. 1t1I��0'�d.1� tu!{i .; �t��,�? -CI°td':ONt PMO.°! 3�414iZla3) }i}tt)t31� 2.41-000' : �it2 F� Ifo 101 -OW -423-000 225-tN 0 443 Q m 3.k �ili!';tV!'t3.1'ita?f rf Artu�t 1 f t1©0-2555. . ., l¢ 7!-81 c t L �[�(�"'CO}.' `yq^7�t �y )►y }fit.-� 'fit /"T1 + ` ' r r ti(�4{) .s TO IAL i.r�✓I,t 1l<.1,1'l 1, ii.`�t `1 .:715?.lk.(/ L'. f.. �yY��1.L,. +'✓Jym.�F,..e•l? $5,595.96 YN..,lij�,n: 1997�� TAR 19 frXa PERMI IFE s 6UT x J S5 344. RECEIPT,. 71 DATE• '.' .. BY ; . q X d 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 O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Griffis Fireplace T.O. Fans & Controls Party Wail Insulation Condensate Lines Party Wail Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL PP OVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final I 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 Appliances Final Final Utility Notice (Gas) ELECTRICAL PP OVALS 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: Building ����• Psi �'1:��2 x.60 P.O. Box 1504 APPLICATION ONLY t I /1�� N 7&105 CALLE ESTADO v INTA, CALIFORNIA 92253 Owner Gha Gy d �o Mailing Address City Zip 0 S� ,,— d.0%y S Contracto/!, 7J I/ Address 5— ./ 7013 v� City zip h r BUILDING: TYPE CONST. OCC. GRP. A.P. Number �n17 Tel. C / S Legal, Description �C..D t Alo Project Description F v //n)/nJ r vt" 17,0897— 575 Vl/ „ram/ U 7�,G� L, �� 1"7-4 State Lic.nO f I City & Classif. (71e. SS .6 5 7 W Lic. # Arch., Engr., Designer Address Tel. CityI Zip I State 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, after. 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 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). 17 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, 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, prgyided 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.) 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 Lioense Law.) 1-1 1 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 ❑ Copy is filed with the city. 0 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: U, 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 I 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 toibuilding construction, and hereby authorize representatives -of this ci[y to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING DIVISION A., C+ Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ ��>>3 nTt►JG Af��utP�t_. �Ee(��r� ��--TZ �y-w-►S 3 f LR X1,7 Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. d°SU. 00 Plan Chk. Bal. Const. Mech. Electrical sine Setback from Property Line Plumbing INSPECTOR S.M.I. i9c I Grading Date Permit Driveway Enc. Infrastructure TOTAL a5 by REMARKS ?�64N Gly DELbSiT r r ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line sine Setback from Property Line FINAL DATE INSPECTOR 2 i9c I Issued JQEC Date Permit Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FFA 1ST FL. SO. FT. $ 2ND FL. S0. FT. @ POR. S0. FT. Cal GAR. $0. FT. @ CAR P. S0. FT. @ WALL SO. FT. @ SO. FT. @ ESTIMATED CONSTRUCTION VALUATION $ UNITS ' MOBILEHOME SVC. POWER OUTLET { YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN ' URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM. B.T,U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 11A c SEWAGE DISPOSAL SO.FT.GAR @ lAc HOUSE SEWER REMARKS: VENTILATION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING d AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING CU. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL GARDEN WALL FINAL 1 VM J 01UNA I V MCJ/11Y1 11ALA Notice: Document Cannot.Be Duplicated, Desert Sands Unified.School District 82=879 Highway 111 Indio, CA 92201 619-775-3500. CERTIFICATE OF COMPLIANCE Date 3/19/97 APN # 643-120-029 No. 15352 Jurisdiction La Quinta Owner Name Canady & Company Permit # No. 47595 • Street Via Montigo Log # City La Quinta Zip 92253 Study Area 123 Tract # 26152 Lot # 257 ; ' 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 $ 4780.32 the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may, nowcbe issued Fees Paid By cc/Pacific National Bank/Canada & ComPpanY Tele pho714-751-9151 n Name on the check ` * '?� " _r4 By Dr. Carol McGrew Administrator, in Charge s� f Fee collected /exempted by Pauline ?earson Payment Received $4;780.32 Check No. 66911 Signature k AlLad- 2 - 10TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS1.1996) 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 i,mstallation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to ollect 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/keceip"t Copy - Accounting 2 ARZyHITECTURAL COMMITTEE LAKE LA Q UINTA HOMED WNERS 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 Gentlennen: The renderings of the lake front South Shore Homes submitted to the Architectural Committee on October 12, 1996 and the detailed plans submit- ted to us on December'. --,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 arey,compatible with the surrounding homes at Lake La Ouinta. 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. rank Tasso, Chairman Ann T Madison, Co -Chairman i 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: Thi's letter 'concerns th'e. re.sidence to be constructed at 47-575 Via Montigo, La Quinta, California. The design of the roof.trusses by Houston Lumber. Company is in substantial conformance with the structural.frarning plan. Very truly yours, Carlos. Elias CE: j Certificate of Occqpancy- City of La Quianta Buildin Department OFetYand. Saf, do This Certificate issued pursuant to the requirements of Section 109 of the Uniform Bu4ding 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: 47-595 VIA MONTIGO Use Classification: SINGLE FAMILY DWELLING Bldg. Pe rnit'No.: 9612-160 Occupancy' Group: R-3 Type of Construction: VN Land Use Zone: RL Owner of Building: CANADAY AND COMPANY Address: .17480 EAST 17T.1 ST. #106 City: TUSTIN CA .92780 By: STEVE TRAXEL Date: 09=22-1997 Building Official