0301-396 (AR)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
Date 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:
(q) 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
Datey ;e a 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.
(This section need not be completed if the permit valuation is for $100.00 or less).
Q 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 agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
,Patel s' Applicant
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 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 authorize representatives of this City to enter upon
the above-mentioned property dr inspection purposes.
��S gnature (Owner/Agen't) f /✓' �.% °� Dates` %Mr W7�4
BUILDING PERMIT PERMIT#
(MI -396
DATE /j` VALUATION LOTTRACT
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JOB SITE
ADDRESS
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OWNER
CONTRACTOR/DESIGNER/ENGINEER
MAE 19TADE
48445 VIRA-EXTIVEJA
LA C r?.TMIA CA M133
i asz f
USE OF PERMIT
3�5 S.l�. k10Ot'E'IOT�
Cl3sr"9'OM CONISuTFt'UC`j IOH 383.00 9F
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2°9"I..549
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CON10 's UCTION FSE 1014)00-418-000 $2 KSO
Pi.°w 4:1IWX "I's. 1x31-tJ(30-4n- -318 $715.41 .
MUCH"1(%1L IL FER 101.000,421-00 ; Sit%
KLEC RIC.°AI' ME, 401-000-420.000
STRONG M( i`609.PEE ^'r3 lD 101-0 00-241,000 SIM
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CITY OF LA QUINTA
42
110119 PRE-;WDFM
$0.00
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RECEIPT
DATE/f`
BY<'
D I A D
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
—Z -
Combustion Air
Roof Deck
/Z —
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wail Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS '
BLOCKWALL
APPROVALS
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
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring—— 3
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
_
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
CERTIFICATE OF COMPLIANCE ��Sc
Desert Sands Unified School District zQ�c�o
47950 Dune Palms Road
Q BERMUDA DUNES r
Date 4/14/04 La, Quintal CA 92253 E RANCHO MIRAGE
No. 25795 (760) 771-8515 INDIAN WELLS
�.� PALM DESERT y
LA QUINTA r�
•QINDIO y�i .
O
Owner Herb Stade APN # 649-100-009
Address 48745 Vista Estrella Jurisdiction La Quinta
City La Quinta Zip 92253 Permit #
Tract # _ Study Area
Type Residential Addition No.'of Units 1
Lot # Nm Street S.F. Lot# No.. Street S.F.
Unit 1 48745 Vista Estrella 190 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 garages/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 190 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 - Herb Stade Check No.
Name on the check Telephone 760/771-4424
Funding Exempt
By Dr. Doris Wilson
Superintendent
Fee collected /exempted Aron M ilvrey Payment Recd $o.00
Over/Under
Signature.:..
NOTICE: Pursuant to Government Code Section 66 0(d)(1), 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 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 District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy = Accounting
x
X
A
A
X
B'°#
City of La Quinta
Building at Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 48-745 Vista Estrella
4 Ouener'sName: Herb Stade
A. P. Number:
Address: 48-745 Vista Estrella
Leeal Description:
City. ST, Zip: La Qu i nt a, CA 92253
Contractor: self
F Telephone: 771-4424
741 X
Address:
XProicctDescription: One room addition
City, ST, Zip:
to main house
Telephone:
" +'
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
.�, .�� :fit::•
State Lic. #:'
Name of Contact Person: Herb Stade
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: 18 8 # Stories: 1 T# Units:
Telephone # of Contact Person: 771-4424
stimated Value of Proiect:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
R'ec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
y D
Item
Amount
Structural Cala.
Reviewed, ready for corrections
449104.
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs
Plans picked up
i 4
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'' Review, ready for correctionsrssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Call c .c
A.1.P.P.
Pub. Wks. Appr
Date of permit issue
L,
School Fees
Total Permit Fees
Certificate of Occupancy � � o
City of La Quinta
Building and Safety* Department OFTM
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: 48-745
Use Classification: VISTA ESTRELLA Bldg. Permit No.: 0301-396
Occupancy Group: S.F.D. Type of Construction: NV Land Use Zone: RL
Owner of Building: HERB STADE Address: 48-745 VISTA-ESTRELLA
City: LA QUINTA CA.92253
By: GARY SHOWALTER
b' Date: 04/01/03
Building Official 1
POST IN A CONSPICUOUS PLACE,