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0003-270 (RER)„"1�y 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 ate '4 - Y ` 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: ( ) 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. J �) I have and will maintain workers' compensation insurance, as required by SXction 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). ( ) 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. �”; ��: )Applicant 5 ` 4.. 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 for inspection purposes. Sitoure (Owner/Agent) ( �+ *+% Date ' 2'" -'' �) BUILDING PERMIT PERMIT# UT}f}3-270 DATE VALUATION S505�� LOT TRACT JOB SITE S 19-56:5 s�.�.�.e� ETA D Ei ADDRESS APN 664^144-012 OWNER CONTRACTOR DESIGNER (L ( } �Y ]77[� { �/ �) �Y Tilt 'ir-RRd )'i& IA itL.11iD- 41 C Si1.11°E�1 p/t9/EENGINEER ED"Al6V.Y �..A-�'G:R.S 785 65 VILLF.TA :ISR 79-3411 VIL}.ETA 1:3I i r E LA QUIN 'A CA 92253% LA QUINTA. CA 92253 f USE OF PERMIT CONVERT 111iRD BAY Or GAi`. &G.r INTO 160 ,,r. 0M1tCiSR ROOM . (ROOM SHALL i CYF BE _USE; a FOR SLhf:.P1N(J PURPOSES) tsUYviTa i2i�i�;�I `i ;4.1)!6 ;>r ESTFIAIAgE� U.n. TO CON�'�'RUC�'RON .tlit PE RMUT FEESUMMAR: PLAN CHECK ME 101 -OW -439-3111 +:.GNq, TR,l1 f'!0N Fi- I(iT--(.T00-aIR-000 �Rt iift W..i:CU14T.CAL F01 1G4.�Cx1G-�2t3-i?VU �tt.tisj S°' RCYNI M,.OTIOlN F13E - 32CSID 101-000-241-000 ^iIIF3-i"Cts"'A 1,00'?J tf!'I'TCiA3 e\N iPT.A14rt°ij (."h' 9;67 11 TT ca,S'r��� c•. a.trtc.Y 4.,i. Al rl f l�.fr'�;"9.lAA l I.ii.i.Y n! �Rr U.! '€' YFA11 PUR_041I.:+C F.d! ES x.)(11.+: NO4fir'' $474.3) RECEIPT DATE BY %� 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 OX to Wrap F.A.U. Framing ''j -3,p -od, Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 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 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: 3 Notice: 4 Document Cannot Be Duplicated Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE Date 3/23/00 APN # 604-144-012 No. 20214 Jurisdiction La Quinta Owner NameTerry R & Kathleen C Hunt Permit # 0003-270 No. 78-565 Street Villeta Drive Log # City La Quinta . zip 92253 Study Area Tract # Lot # Square Footage, 160 Type of Development Residential Addition No. of Units 1 Comments third Bay of Garage into 160 sq. ft. Exercise Room. 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: Residential Addition 500 Sq Feet or Less EXEMPT This certifies that school facility fees imposed pursuant•to Government Code 53080 in the amount of 0.00 X 160 or $ 0.00, 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 N/A - Michael Caron Telephone ; 769--3160-8219 Name on the check By Dr. Doris Wilson ` ry -y �^ Superintendent Fee collected /exempted by Mary Ann L. Borja Exempt x$0,00 • r , ' Check No. N/A . err,..` s= `• Signature wA, INOTICE: 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 Z-/, DY eo Va.JT� U, CTION HOURS April 30 .m. to 5 a.M. to 5:00 p n j. 1 04..A WAS cp is .IV G4a.o� :airs: bone 3400 wew7A4La-o7%,p . .. •, r � G ts�e TyP.� p ;s 00, w,e! 2X�i✓ —�✓G � % ; CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE 3 ti�i gv "Y a /i a f*s a Nsl Zj*jLTovTIt,T 40• G va!►�o e ho :21e74 4041'5 u0% AS A A RE -INSPECTION FEE OF $30 WILL BE CHARGED IF THE APPROVED PLANS AND JOB CARD ARE NOT ON THE SITE FOR. A SCHEDULED INSPECTION. NO EXCEPTIONS! / rt0.?0- A71 'm..s.... a .Z . • T'�. Z. �/ lam; u w� -% .Ir vt'L1 rrA 7nAa.7 c•a �. AA 'Aa 4 1 D au -0 G44lsE loot 01, AvST . H4WE 06ATii,5 T C,48461"7-1' f- fIm4L, I a dOZZ Su,6'w&iI Z. w/ y' 60"'WeAvati wy 6 x �,'' •�,,,,nAys CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 2) CF -1R 'r �aAP1�-COY �,Crnl ✓i�P.h'!e� �oys � ��ec�sc) 23 bC� Proiect Title Building Permit # Plan Check / Date PA 46Field Check / Date. Compliance Method (Package or Computer) Climate Zone Enforcement Agency Use only GENERAL INFORMATION Total Conditioned Floor Area lk ft, Average Ceiling Height: ft Conditioned Slab Floor Area I �jD ft2 Building Type: Single Family G Addition (check one or more) Multi -Family Existing -Plus -Addition Front Orientation:© orth / South / East / West / All Orientations ut front orientation in degrees from True North and circle one) Number of Stories Z Number of Dwelling Units: ' Floor Construction Type: �Iabised Floor (circle one or both) BUILDING SHELL INSULATION Component Type Frame Type Cavity Sheathing wd = wood Insulation Insulation stl = steel R -Value R -Value Total.R- Assembly Value' U -Value' Location/Comments (attic, garage, typical, etc.) Wall W 1? -13 Left Cit_ L2 At.t, Wall Standard Rear Standard Roof A Right L d1t;1G 5 Gt �! t Roof Standard Skylight Standard Floor Standard Floor Slab Edge FENESTRATION Shading Devices Fenestration Orien- Area 4/Type/Pos. tation (ft) Fenestration Fenestration Interior Exterior Overhangs U -Value SHGC Shading Shading Att. /Fins Att.2 Front _ �� Standard Front - Standard Left Standard Left Standard Rear Standard Rear Standard Right Standard Right Standard Skylight Standard Skylight Standard For prescriptive compliance, Total R=Value and Assembly U -Value are not required for a wood -framed wall that meets cavity R -value insulation requirement for the Prescriptive Package. 2 For prescriptive compliance, there are no credits for any interior shading except the default or Standard" drapery. These default interior shading'devices (draperies) need not be installed for compliance purposes. July 1, 1999 CERTIFICATE OF COMI'Ll AN CE:..RE.SI DEN TIAL (Page 2 of 2) CF -IR AP Tn f -3m,\0- QOC*k- k��' _A(,�, 5 Project Title Date HVAC SYSTEMS Note: Input livdionic u: lwdlolli;.din:! kimic! \Vitwl I Sym -.-vi,. e.,Xici,i heSign I lc:iiing Load. Distribution Heating.Equipmem. Minimum Type and Duct or Heat Pump Type (furnace. heal Efficiency Location Piping Thennostat Configuration P11111P. ck:.) (AFUI: m 11SIT) (ducls: altic. c1c.) R -Value Type (split or package) Cooling Equipment Minimills Duct Heat Pump Type (air conditioner. Elficiertcv Location Duct Thermostat Configuration heat purnp, evap. cooling) (attic. Cie.) R -Value Type (split o' r. package) eVA�U ni JL WATER HEATING SYSTEMS Energy', External Rated! Tank- Factor Or Tank Water Heater Distribution NUinber Input (lAV Capacity Recovery Insulation Type Typc i - in S\.slcnl of Blu"110 (gallons) EfTiciency Loss (%) R -V aluie 1. For small gas storage W.'ller heaters (Fated inputs o!'Ics.; 1han or equal to 75.0Q,0 Mono. electric resistance, and heat pump-watcrh i eaters. list Energy Factor. For large gas storage waict livnicis (rated ilipul of greater than 75.001) Muth!).- list Raied Input. Recovery Efficiency and Standby Loss. For instaritallCOLIS gas Water killt:[S. list iated input and rcco\:cl\ efficiencies. SPECIAL FEATURESand A10I)ELING ASSUMPTIONS (Add extra sheets if necessary) Including Thermal Mass (thermal mass typtc, covering, thickness. and.description) STATLA117INT This-certificatc of I complial*ICC IiSIS Ill,.- bUildillL1 I'cLMJICF and proforma icc specifications necdcd to comply with Title 24, Paris I and 6 of the California Codc of RcgulL!fi( I ns. and the adminktrativc repulations to implemcni them. This certificate has been signed by the individual with ovctall design responsibility. When this certificate of compliance is ';Libniiited for a single building plan to be built in' multiple oricu-tatiLmis—am; shadim-, fLN111KC thill is \ali'-'d iS indicated in Ill,.- Spvcial Features / Remarks section. Designer or Owner (per Busincss and Professions Code) Documentation Author Name Namc: -_TAII,; AS 720SIC,06 Aj -41. '1 illoTimil: >r- Address: At► !,%ddressl K' Te I e p It u! i e: 0_34,0. A7.1T 'I X Lic. P: .71 (s i -n at u i e) (date) E n fo tre e n i c i i t - A e n c v .1111N. 1 1999