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0006-276 (RER)LICENSED CONTRACTOR DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of ­9h�!pter 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. ClassExp. Date Date i 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). ( ) 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 ' m Date Signature of Owner ` WORKER'S'COMPENSATIONDECLARATION 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 •01TAT1s FUND Policy No. 2291869600 (This section need not be completed if the permit valuation is for $100.0d, 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, 1,shall forthwith comply with,t%A provisio s. ete: ` % d Lk* 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 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, 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. tS gnature (OwnedAgent) �' �-�' "-Date- • BUILDING PERMIT PERMIT# DATEdlt J VALUATION LOT 0006-276 TRACT JOB SITE APN ADDRESS .3-50 a- ir7 OWNER CONTRACTOR/ DESIGNER/ EN (NEER JAWS PAID Y 0. L �;qR V S1 COMM.CTION 49-657 AMMIDA VIF'ABONTI A 61400 YUCCA ROAD 42.60 L&QiTiAlrA CA 92253 MOLTSTA19CEMM CA 92561 (760)831-^7439 CB1X X484 USE ��O��FFyPERMIT go u. F. AD 01 TI©'N (AT PJUM EN'CLOS UP-Pl AS PER AI7PROV &D RLAN S ONLY 'VALUATION 21,000.001A .A.TED COST OF CC�.N 7MITC"T:ION 21low.00, , - y'pZ y�7,�* pay; �fy' f T��gy���y1F,�S7. P.R.'d[,Wdlyd- D�.n {76J.1E2!.Ltlli3A�4.A. PLAN CHECK FLIS, 101.000.439.318 $140.40 CONS3 2UCT1014 ME 101-000.418-000 $21$.00 , y ELEC'•TAICAL. PH, 101.000.420-000 A 3TR6NQ naO ION F&1. - PES1D 10-00CMI-Ooo 'l0 4, . • ah:a .;.,. d SUB-TOTALCON�'"i1 CiC.�Mg�,N PLAN iCa'Fi�C.f; $31Eits x=S PRE -PAW . S $0.00 " 011AL,rXTR1 'FEE SWE -Now tai RECEIPT DATE BY DATE FINALED INSPECTOR c INSPECTION RECORD - OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings i Underground Ducts Ducts Slab Grade � Return Air Steel Combustion Air Roof Deck O. K. to Wrap C Exhaust Fans F.A.U. Framing 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 — — o D Final Final BLOCKWAL A ROVALS 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: ` Desert Sands Unified School District jc 47-950 Dune Palms Road - _ Notice: rLa Quinta, CA 92253 t , 'Document Cannot Be Duplicated ,760-771-8515. 'CERTIFICATE OF COM_ PLIANCE Date 6/26/00 . �` ' h APN # 773-350-056 No.. 20617 Jurisdiction La Quinta: , Owner NameJames Patty Permit #' No. 49-657 Street .Avenida Vista Bonita - Log.# City La''Quinta Zip 92253 Study Area. Tract # Lot #' ° Square Footage s"80 'Type of Development' Single, Family Residence R' 4 No. of Units 1, . At, the present =time, , the Desert Sands Unified School District does not collect fees on garages/carports,'covered. patios/walkways,•residefitial additions under 500 square feet, detached accessory structures or replacement rriobilehomes." 'It.'' has been determined the above-named owner is exempt from paying school fees at this time'due to the followi reason:,Vit' Residential Addition 500 Sq Feet or Less EXEMPT•• This.certifies that school facility fees imposed pursuant to Government Code 53080 n the'amount- K' 0.00 X 80 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 exempt/GL Setiyens Telephone 760 349-3327 Name on the check x' By Dr. Doris Wilson ' Superintendent s. ° Fee collected /exempted by Olivia Aguirre Exempt 130.00' u - -Check No. N/A' f Signature NOTICE: Pursuant of Lsembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90-day approval period in which, you may orotest the fees, or other paymentidenfrfied' 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 Districl(s or to another ublic entity authorized_ to collect them on the District('s)(s') behalf, whichever is earlier., Collector: Attach a coPY, of countyor city Pl_an check application form to district coPYfor'all waivers. - Embossed Original- Building Dept./Applicant Copy Applicant/Receipt . Copy - Accounting { , May 1, 2000 James & Sonya parry 800 Merriman Road Akron, Ohio 44303-1748 Re: 49-07 Avenida Vista Honite Dear Mr. Mrs. Parry' Your architectural variance dated April 12 removing and replacing windows and / or doors on the backside of the unit, raise the patio ceiling soffit, roof over the interior atrium, remove and replace the back patio, install flagstone at the patio, and install a 18" wail at set becks has been approved under the following stipulations(s): • Actual- modification must conform to the plans and. specifications 6ubmitted'and appiovQ. -_., • The hardware for the windows and / or doors must match the existing hardware in color. • Competent and licensed professionals shall do all work in a workmanlike manner. • All work is to be in compliance with local building codes and ordinances. • All electrical wiring, if applicable. must be contained within approved conduit painted to match the surface it ooritam. • Any damage to the common area resulting from this modification arid its construction shall be repaired at the Owner's expense. If a construction bin is rented through Waste Management it must be beige in color and stared, if possible, in the garage.. All construction debris is to be removed from the site by the close of enh do to maintain oder and retain the aesthetics of the Santa Rnsa Cove_ • Prior to the commencement of any work the contractor and., their subcontractor(s) must provide the Association - proof of worker's comp., liability and auto insurance; natrning the Association as additionally insured. • Prior to the commencement of any work you or your contractor must provide the names of the scheduled warlaaen to the security guards at the Mazatlan gate, (564-5414). • Prior to the commencement of any work your contractor must read and sign the Association's Contractor Rules, which have been faxed to their attention _ • Prior 10 the commencement of any work you are required to pay a 5500 refundable deposit for the roottt ' addition and patio extension. 6. Prior to the commencement of any work you are required to pay a one-time fee of $5 per square foot for the new roof area, as well as provide a five-year written guarantee covering the new roof area. `Prior to the commencement of any work you are required to pay a one-time fee of $1 per square foot for the new wall space. Please contact the Association office once your modifications are complete for a final inspection. A copy of the approved variance will be mailed to you after the inspection along with the refltndable deposit. if you have any questions, please call. Very truly y6ys, Pamela S. Salinas Association Manager 49-991 Eisenhower On Behalf of the Architectural Committee La Quints, California THE SANTA ROSA COVE ASSOCIATION ( 760) 777- 7621 Greg Scrivens Constructian F= (760) 777-76'.2 Mailing Address: SANTA ROSA COVE ASSOCIATIONPost OMCe Box 12710 Palm Desert, California 92255 L0 39tid h.dddS3WVf ELTZ9E80EE 02:ET 000Z/t�0 /90