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9909-144 (SFD)LICENSED CONTRACTOR DECLARATION - .^1 hereby affirm under penalty of perjury that I am.licensed'under provisions of C�I�apter 9 -, bmmencing'with`Section 7000) of'Division 3 of the Business and P P6 sionals Code, and my License.is in full force and effect. License-"'} Lic. Class :o Exp. Date Date Signature Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am. exempt from the.Contractors 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 safe (Sec. 7044, Business.& Professionals Code). ( ) . 1, as owner,of the: property, 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. ()' 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': UNICARIF'INS CO (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 permif is issued; ]'shall not employ any personin any manner so.as to become subject to the workers' compensation laws of California, and, agree that if I should become subject to the workers' compensation provisions of ViSi kton;3700 of the Labor Code, I shall. forthwitFj comply with those.p ovlsion s” �,--� 7r -'i Date: Applicant— Warning:. pplicant ,Warning:.Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to'$100,000;, in addition to the cost of compensation, damages as provided for in Section 3706 of the I..ahnr Coft interest and attorney's.fees. IMPORTANT Application_ is hereby made to the Director of. Building and Safety for a permit subject. to the conditions and restrictions , set forth on - Pis application. .. . If 1. Each person upon whose behalf this application is made & each person at Whose request and for whose benefit work is.performed•under or pursuant to any permit issued as, a result. of this applicaton. agrees to, & shall; indemnify & hold harmless the City of La; Quinta, its officers, agents and employees. 2. Any permit issued as-aresult of this application becomes null -and -void if work is not commenced within 180 'days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation: I certify that I have read this application and. state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to ent r upon. the above mentioned property for Inspection purposes. Signature (Owner/Agent)"TMJ `� Date BUILDING PERMIT PERMIT// !909 ,144TRACT DATE VALUATION LOT' 09/212/199 4187,342.70 X31 MB JOB SITE APN p� ADDRESS. 47-690 VIA ,'MONTESSA.:3 -CONTRACTOR i OWNER' - - / DESIGNER / ENGINEER t C.MNADA.Y &C OMPA:KY CA:R'ADAY & +:;ONIPAN 1570 BR00kH01: L0-: t1_)..1'E, SurrIE 208 1570 BROOKHOLLOW DRIVE, aUME 208 SIAN"TA.AN.A .CA" 92705 SAN'CAANA., CA 92705 (7.f 1.gl�a>l. 1 i::L31A 4485 USE OF PERMIT SM-GL'E FAMILY DWEl::f,ING S`F" D - LOT 2.31, RLANRKA PEIRM.IT t DFS 614C1.I E .BLOC£•: WAtL OR.POM rt.ra3. tIZG: rtrt 0-,VIsscxA �r• AatJt,-tPt, ��.AN a :i colgTaltucT1ON � :�yCi`�;� s POR(`HiPAY10 550.0 GARAGMARPORT 65$. 4 S;✓ a • "t 110M:I9ATE'13 CUST OF C°C N.W.1'RUC3`ION 137,342.70 ;t E RMQT.YCE PitllMMA✓ Y PLAN C Cfi FEE 101-�. 00-43. —3.113 � 1�:•Ry` MECHANICAL-F-`�.E :.1pt-CDS-si21-t)a0 s:s0 JELECTRI'GAli FEE' PI..tiA03ING FFE i 1- o-4II -t3 rl; S186,50 1,;' e,,tt Ar rric9 FRE tot-:000-42'-si t;: •?w,.00 AFi'1'. td PUBUCMACSS t S[C7.1-i?Ci(i-2 -t1UiD -18-36. Ut3tici i,ti�r'! it'a LNIPACT FRU, REI DEPOSIT .1,01-0 0.439 3Ht3 W4 t ..^ ,. P.q _ 1 p!� 7_�•a�p� '�qt�y�. l�T. ��ep CHECK . Jt�Ta'il0TA'.;CC7Nia.b,�itiJt��'aVtY:.F.ivgpr;C1.!'Leey�lVyyi.��.iS.C:4vA`i.. � r[+ eg �3;115,�1i .. .. -. .' -L Ss� •T',�01r Y�,�."41) A� •�1:'�1�� •O �ai3.t:�t� ' Td'iA.1.,:1'�3'9,1%'11T FI�'RS F1fL1 PI�W $3,525.41 RECEIPT DATE BY D INSPECTOR INSPECTION RECORD d OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING •:Set Ba ks Forms & Footings APPROVALS / � ( �= fy MECHANICAL APPROVALS Underground Ducts Ducts Slab Grade . ?/ - Return Air Steel Combustion Air Roof Deck ,� — Exhaust Fans O.K. to Wrap ./Z—cra F.A.U. Framing /.�� _ Compressor Insulation _(p�C,.p Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath cai� Drywall -Int. Lath 0'b Final Z�� pry �adl BLOCKWALL APPROVALS Final �� POOL. - PAS 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 Water Piping _ C L Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans OX for Finish Plaster Sewer Lateral Sewer Connection ,� j� / `�`vv �7— Pool Cover 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 Temp. Use of Power Final Utility Notice (Perm) Building - ` . s:r . r w. �.♦�f.��,n.r-�''�+"1•c!,(''t,,'f;TLa'^..^w-:Y'k`Py'ti'<.7+aT`'^ `�,yvl • �GG��ciCu � 1 j A p ' a 3) 78-495 CALLLE TAMPICO Y o V r o i`7 ()l�' a ssta LA OUINTA, CALIFORNIA 92253 Owner '0rAV710 d , .l Mailing Address 1-1 10 G City ,,� Zip Tel. Contractor Address p State Ljc.S � I City 14 / 4 S 8 Classif. Lic. # Arch., Engr., Designer ^ `Le tJej�' Address i $6I � �r Tel City Zipq State i f)C 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, 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 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 live hundred dollars ($500). I'.' 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, Bulsness 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, provided that such improvements are not intended or offered for sale. If, however, the bullding 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. I'1 1, 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 License Law.) 1-1 1 am exempt under Sec. B. & 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 n Copy is filed with the city. O 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: If, alter making this Certificate of Exemption you should become subject to theWorkers' 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 1 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 to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip k 1 /,;P� w✓ 4ffAIAZI APPLICATION ONLY BUILDING: TYPE'CONST. . OCC. GRP. A.P. Number Legal Description—If ' Z O SJ L Gt -IJ L-31 - Sq. iz Ft. / % No. 1 Size / Sto Stories Unitss New 2r' Add ❑ Alter O Repair ❑ Demolition ❑ REMARKS 3• ZONE: BY: a Minimum,Setback-Distances" . Front SetbacE. from Center Line—' Rear Setback from Re r Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE 9 To INSPECTOR Issued by: �i'° LD) Permit Validated by: JUN i 0 1999 4 Validation: A .I.. ! r WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Estimated Valuation PERMIT r AMOUNT Plan Chk. Dep. 1p S(� Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS 3• ZONE: BY: a Minimum,Setback-Distances" . Front SetbacE. from Center Line—' Rear Setback from Re r Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE 9 To INSPECTOR Issued by: �i'° LD) Permit Validated by: JUN i 0 1999 4 Validation: A .I.. ! r WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION ` Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot,Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 9/21/99 APN # 643-120-003 No. 19352 Jurisdiction La Quinta Owner NameCanaday & Company Permit # No. 47-690 Street Via Montessa Log # City La Quinta Zip 92253 Study Area Tract # Lot # Square Footage 3079 Type of Development Single Family Residence No.'of Units 1 Comments ,ot'23 1, Plan cashier check for 6 units - $34,830.71) 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 1.93 X 3,079 or $ 5,942.47 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 cc/First Security Bank/Robert Walker-96iTelephone 760 771.6 l:'', ._ Name on the check r - By Dr. Doris WilsonIle y f } 1_ Superintendent F' Fee collected /exempted by Olivia Aguirre Payment Received $5,942.47 4<� Check,No. -0216003 Signature A/ e�x",_ NOTICE: 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 above will begin to run from the 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 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 uGV OF PUBLIC,WORKS CLEARANCE LETTER FOR g ,CUSTOM HOME LOTS 4 " 'Dear Builder: - y -Ar`.. , •,. •.Prior to issuance•of a'building permit, you will be required to obtain clearance from the " r Public Works Department for one, or more, of the following: 1. Verification that rough, grading is ,complete, and'the. pad. elevation certifications. prepared by a licensed surveyor,-'or.engineer, are on.file in the,Public Works' Department. Verification that infrastructure improvements'and other, required tract improvements'` • are complete,'or sufficiently advanced to Warrant building permit issuance. Prepare, an -engineered grading plan that provides for`on=lot -form water retention, and have it checked ,and.approved by the Public Works Department . a r. • Tract 26524 (Estahcias)• -r • Tract'26769 (Mountain,,View Estates) Prepare ran engineered grading plan that provides for building' pad grading in • accordance with the 'existing .soils report and tract grading plan, and have it checked and approved by the. Public Works Department. - ; _.•.. Tract 28034 (South Valley, Estates) - s FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT FAMDEPMOMFORMSIPW CLEARANCE LETTER.ss <, f i s• � FAMDEPMOMFORMSIPW CLEARANCE LETTER.ss <,