9811-0045 (SFD)49201 Avenida Anselmo
LICENSED CONTRACTOR DECLARATION
I hireby-affirm under penalty of perjury that I am licensed under provisions of
F.ghap,-*; 9 (commencing with Section 7000) of Division 3 of the Business and
Profes*s*-Jnals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
1 '
Date r `
f*` Signature of Contractor '''! rft r+
- a...r • • t . .-,.J
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.
( ) 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.
L"°,'Et4tPTION ON f+"11;1
(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
C cle, I shall forthwith comply with those provisions.
,Acte: ; °► ' Applicant`'
r, br.✓ tr.• tk.
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.
r t
,Signature (Owner/Agent) -. Ef r d 1 , -,,Date r ?
BUILDING PERMIT PERMIT 9811.041
DATE VALUATION S3.11t,t44,40 LOT TRACT
t 1 Z 161
JOB SITE 4q , 261 AVEN UM ASNISELN10
APN 631-342-00
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
i
rn1R. C_ A4 x,fi(1NIACA Cl- r ?C'
fl\dw Lt lir 4•'IVtV •,i •1lJi.rlwf
r e rYv r_r,"i?V f.'*i[; ty n i Cell t T Y Af -iY1i)
I[..4ri . ,,./• !\l?l.IJwly l,.slll•.. .di•• llllr i4••♦
PO BOX 1944
54-350 tl V NIDA HI. RF ERA.
1.A QU1N I A. CA 92253
LA QUI9.1-A CA 92253
'
(760)504-3511 G-`ffIft. It 15
USE OF PERMIT
8F - Hifi W414 1Du-1iS NOT 11ir"ivt.ii E BLOC K WALL OIi P00i,
CONSTId.L'CTION 3,75112M S
hJltl;lil'.r Yf) tow 00 SF
(3A n(fk:!(.t RP(.).K'1' 64.LIAO SF
VS TMUTIE .OST Of,"
i." )f40rRU(_'I f0N FEE 101 -000 -408 -Ufa 1:4qu.t tf
t r,nnT f'rTt:l"`k, uI?I; 1111-dlflfi- 1;i4_-;(9 St r f, f z1 €
1 ' .t 4:f'r. N1'k' t •'t?IiU-:9 )-? t:t-al,iKttt fNi
hUft' t1ANICAL FISH IGI-000.4214000 Sto.4,i)
1 C1(, 1,R1C:AL 108k, 101-00)-120-11180 $216.64
r)I,; lmyttr o ti`rr. 10,1 -(W)-4114111410 t IH3 :Zs
i°":'ttONG N40T10N, LTM RESID 101 -0(H) -2 -111 -WO $31,181
ORAt)1t+i01 FEE lt7l-Oii0 iJ.'3-000 1:6,,l,int
INiRAi1*1 JC"1't!Rk,'F E 22_S -(X* -443-342 Yti,tltnt.rk.t
ART 1M 1Yt TfA[,(.° Rt,nr' S - RFSrt^'/0I.f3f?dl-..755-!if)t1 $54536
:z6
S( 41:17f -YE -Al , (,' OMFI'fi.t.lc;710N AND Pf,AN C-14ECK
LESS' "R11" -PAID E'A3'3
-ssall,ow oso7
TO i'AL #'EtdNI t° V l.,EN IMP, W
$8,639.57
IIIIIII VIII III VIII IIII 12
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,RECEIPT { v ti 1
\\ Fr
DATE
DATE
BY
D E NALE
INSPECTOR
\"
f
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
nderground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
—
Exhaust Fans
O.K to Wrap
.. _
F.A.U.
Framing
Compressor
Insulation
Fireplace P.L.
Vents
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
S
-ice
Final
Final
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
.2
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
Sepr, C
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)
COM ENTS:
Q
MAY 07, 1999
MR. HAMID_SHENASI ( SHENASI DESIGN )
P. 0. BOX 2771 ( 46045 OCOTILLO DR. # 5 )
PALM DESERT, CA. 92260 TEL: (760) 7.79-5996
Dear Hamid:
SUBJECT_: STRUCTURAL OBSERVATION FOR�MR._& MRS.__SOLIS .LOCATED AT__49?01__AVENIDA]
(ANSELMO� IN THE CITY OF LA QUINTA.
Based on your request and the requirement of city of La Quinta Building
& Safety Department, per requirements of Uniform Building Code (UBC), 1994
Edition, I have conducted an inspection on the job site on Saturday May 1, 99.
The inspection was limited to the framing and connectors. The purpose
of this inspection was to see if the structural requirements of the building
was compiled according to the relevent building codes and approved plans and
calculations. The requirements include shear wall nailing, structural
connections, and shear transfer details, straps, anchor bolts sizes, spacing
and holdowns.
Some deficiencies were noted which were brought to your attention.
A follow up inspection of the site was also conducted and previously
observed structural deficiencies have been corrected to conform with the
approved plans and calculations.
Please feel free to contact me if there are any concerns or questions
regarding the above information. Once again,
opportunity to work with you.
thank you for giving me the
i• r l r �' �J
SincereYQ
HOSSEIN ZAND ASSOCIATES
5175 Chapala Drive, Riverside, CA 92507. (go9)784-2424. FAX (9o9)784-0706.
IIIIIII
VIII
III
VIII III
13
IE
MAY 07, 1999
MR. HAMID_SHENASI ( SHENASI DESIGN )
P. 0. BOX 2771 ( 46045 OCOTILLO DR. # 5 )
PALM DESERT, CA. 92260 TEL: (760) 7.79-5996
Dear Hamid:
SUBJECT_: STRUCTURAL OBSERVATION FOR�MR._& MRS.__SOLIS .LOCATED AT__49?01__AVENIDA]
(ANSELMO� IN THE CITY OF LA QUINTA.
Based on your request and the requirement of city of La Quinta Building
& Safety Department, per requirements of Uniform Building Code (UBC), 1994
Edition, I have conducted an inspection on the job site on Saturday May 1, 99.
The inspection was limited to the framing and connectors. The purpose
of this inspection was to see if the structural requirements of the building
was compiled according to the relevent building codes and approved plans and
calculations. The requirements include shear wall nailing, structural
connections, and shear transfer details, straps, anchor bolts sizes, spacing
and holdowns.
Some deficiencies were noted which were brought to your attention.
A follow up inspection of the site was also conducted and previously
observed structural deficiencies have been corrected to conform with the
approved plans and calculations.
Please feel free to contact me if there are any concerns or questions
regarding the above information. Once again,
opportunity to work with you.
thank you for giving me the
i• r l r �' �J
SincereYQ
HOSSEIN ZAND ASSOCIATES
5175 Chapala Drive, Riverside, CA 92507. (go9)784-2424. FAX (9o9)784-0706.
Certificate of Occupancy'
City of La Quinta
Building and Safety Department
IIIIIIIIIIIIIIIIIIIIIIIII 14
IE
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:
Use Classification:
Occupancy Group:
SFD
49-201 AVENIDA ANSSELMO
R3 Type of Construction: VN
Owner of Building.: GREG & MONICA SOLIS
Building Official
Bldg. Permit .No.
Land Use Zone
9811-045
RL
Address: PO BOX 1944
City: "LA QUINTA , CA. 92253
By: GARY HARTMAN
Date: 9-17-99
I POST IN A CONSPICUOUS PLACE I
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 1/22/99
No. 18273
Owner NameGreg & Monica Solis
No. 49-201
City La Quinta
APN # 631-342-009
Jurisdiction La Quinta
Permit #
Street Avenida Anselmo Log #
Zip 92253 Study Area
Tract # LQGE1 Lot # 129 Square Footage 3,752
Type of Development Single Family Residence
Comments
No. of Units 1
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 3,752 or $ 7,241.36 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed projectm.ay now b-, issued
LS
Fees Paid By CC/Canyon National BarWGreg & Monica Solis Telephone 776-50'44
Name
44
Name on the check '
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by
Signature ('1//1u
Juanita Green Payment Received
Check No. 01422
$7,241.36
NOTICE: Pursuant otfiftembly 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
IN
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