0304-222 (AR)LICENSED CONTRACTOR DECLARATION
I herby affirm under penalty of perjury that I am licensed under.provis ions 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 # tic. Class / Exp. Date
f, 7431.77 B,ZIT. 0— l i 2/3.1/2C
,, atep Signature of Co....
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
cont'ra'ctors 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 STA -1 S FUND Policy No. 2%904 024699
(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 Califor�la, jn/d agree that if I should become
subject to the workers' compensation ptrllovlsions of Section 3700.of the Labor.
Code, I shall forthwith comply with..those.JprofFisions.
Dater., / P / - Applicant 1
y� — r/,.17. N\,./ VIA
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 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.
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 tb
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 authorize6presentatives of this City to enter upon
the above-mentioned property for ilspection purposes.
;,Signature (Owner/Agent) `'() a /" { Dater �-
BUILDING PERMIT PERMIT#
ticl�-int`' -
DATE VALUATION' LOT ''TRACT
JOB Sit& r
ADDRESS
78"7V V1A S'01VXC '.. a...
APN
CfQr&MAW
OWNER
CONTRACTOR / DESIGNER / EN (NEER
1vtiCTi'AES. iU.i�.F, PIt F.
PIMM Of'Y1 S'C`I. UCTION
78-734 VXASONATL,,
7226.3 DE5foMT:D3R.
LA QC31RV, CA 9'22,53
RANalC) . :tlt.A(FE CA 92270
(760)340,6888 t"' Y114 2811
USE OF PERMIT
RE 31.IaXa'.,MIAL ADDY110N ,
(ilfEST RODM fiDDIT1014 (2856 S.F.) 2001 c8
9 ADAC T C'-OWST12UCT1014 %Ily.f?if V,
Es'1Civu co iur of .("oNnh"Ui"1%C)n
l s 3.sf343
CONSTRUCTION FEE '10i.mG00-418.000- $171.00
PIAN CHECK PEE 101-000-4W-318 aI Q9.3fl
MECHANIC AL,FEE 1010000-421-000
El_-ECTRICA I., FEE L00-4.24-000 $25.01
i
1yWMBYNf FEE $24.00
STR.ONCl MCJT1014 I;FE • kt.ESID 101 000-241
(9ItAL ING RM ..1-017000-425 i 400 MAO
`W
03JB=. °��eleL C61 I ANT PI -AN t.,,J• ECI:
TZSS PRE -PAM NEWS
MOO
KAY 98 3
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�3�>55AS
ill#r 3 ., �71- b1U� �C�?Y4r r
CITY 0 LA ouINTA`
F4N ,' CE Or -PT.:,
i
RECEIPT'
DATEf /r
BY
e �—
DATE FINA
—
INSPECTOR
•w.
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
n
Ducts
Slab Grade
Return Air
Steel
— y -.3 S
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
-/
F.A.U.
Framing
i 7 -3
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 o
Final — 3
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
Appliances
Final - -
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)
COMMENTS:
_
CERTIFICATE OF COMPLIANCE �FLEDsc
Desert Sands Unified School District
47950 Dune Palms Road zc
Q. BERMUDA DUNES
Date 5/27/03 La Qumta, CA 92253 - U) RANCHO MIRAGE I=
No. 24462 (760) 771'8515 INDIAN WELLS �.
PALM OE,y
r! LA OUINTA
vTA
.JO INDIO �^
Y O J
Owner Michael & Rhonda Perez- APN # 646-050-009
Address 7,8730 Via Sonata as Jurisdiction.` La Quinta
City La Quinta� _ Zi jT92253 Permit # 0304-222
Tract # 21555-3 Study Area
Type Residential Addition No. of Units 1
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 17 78730 Via Sonata '286 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
At the present time, the Desert Sands Unified School District does not collect fees on grages/carports, covered patios/walkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
Residential Addition 500 Sq Feet or Less
EXEMPT
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $0.00 X 286 S.F. or $0.00 have been paid for -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 Exempt - Robert' Perri Check No.
Name on the check Telephone 760/340-5888
Funding Exempt
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sh cGihrrey
Payment Recd Over/Under
Signature
NOTICE: Pursuant to Government Code Section 66020(d)(1), this wl erve 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 issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the Distnct('s) behalf, whichever is earlier,
NOTICE: This Document NOT VALID if Duplicated
c�
Embossed Original - Building Department/Applicant Copy,- Applicant/Receipt Copy - Accounting
r a •
AVAIL PROPERTY -'MANAGEMENT
r P.O: BOX 1032
` x PALM DESERT, CA 92261
_ (760) 568-2717
i
ar-Ic la guihta I y '
•. ' . March 11, •2003 4 • ,_'
' Mr 'Michael Perez
78-7.30'Via Sonata
' La Quinta, CA .92253 T
RE:(., Architectural Review Request,
-Dear Mr. Perez: ,
.r Your plans for ,theconstructi0IV-of a room,jaddit ori on the side
of your house was -reviewed by the ARC and the Board.. ,
The plans were approved as submitted'_, Please send a check in
the amount of $250.00 to this office as;a 'refundable' security ;
deposit.; Make the check payable to Parc La'Quinta HOA. ,
All necessary -plans must be obtained from the City of La Quinta.
• prior to the start of your construction. Any damage to.the
common.,areasI or any 'other property in the complex, will be ,
.your responsible to repair or replace as.a resultof your- con.
-
struction_
Please contact this office if 'you have questions.
Sincerely,
l '
Cam Anderson A
Project; Manager