9607-0040 (POOL) + 9404 (AR)49350 Avenida Anselmo
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjurythat 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
441672 C53 C:61 C3i9K
_13 sate < < " r Signature of Contractor i
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:
Cartier Policy No.
STAU ,IF UM 142.36.13-96
(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.
'Date: '% .7 %! Applican .J4 -
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnity
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void.if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection pu poses.
Signature (Owner/Agent)f _Ant.- c-"^ — Date ^
BUILDINGPERMIT PERMT# CONTROL#
9M)7-040 3703
DATE VALUATION LOT TRACT
JOB SITE
ADDRESS 49-350Ai/CN10A.ANSSBLIWO
APN
G31-3a1-iIUY
OWNE
CONTRACTOR/DESIGNER/ENGINEER
AESTVI ITC:SUNLIMITED
2193 AV 'NIDA ANSELI\'1c3131100
WN. RE1LL-1)ESEtz l' HOT :` }>RiN .r5
COACHELLAC'A. 92236
RiXNCHO:WI .NGE CA 92270
610-2251-0350 CRU, 4328
USE OF PERMIT
POW. AN NOR SPA,
POOL 10.7140DU -ADD NEW 1.1001t, SPA,, .
WAWR F"EA.71jt2PS, T)ECORATTVE W)CK,
ALL NEW PT.M f1IW__1 fir Ti1.1'~C`I'.RICAL
P001. ANDICk 511A -;11,000.00 LS
F NT 1N1,rA T 1%yD (:`()ST OF CONSTdt13M. 41ON
20,000.00
! FAMIT ME SUMMARY
C.ClNS'i'I"i:d.CTION FET., 101-OW-418-bOO 32011 200
PLAN C1,I1X FEE- 101-000-439-,31.$ $134.55
ibtl?C'#iA:N1CAL ,144 — POOL 101-0004-2140
1511 t i[ZtC4ii.rTME r ! U(J2, 101-000-120-001) $45MO
PLUMBING FEE -- 0001. 101 -000 -414 -ow 327.)1)
SUl3- C0TAL CUt I,rs"i'EpC.ii;:I" ON .At D PLAN Cad%C Tr.
$4 7.55
LESS WE-PAH)HES
WOO ..:
III II VIII III VIII IIII 62
IE
RECEIPT
DATE
BY
I DQT FI ALED /
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
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final L
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 e'x,� ,
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
/ 6
Gas Test
Appliances
Final
COMMENTS:
'
,
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)
IIIIIIIIIIIIIIIIIIIIIl 63
Building .3sa .
Owner
Martin Sanborn
Mailing
Address 6a me
City
La Outtnta
Address
54-520 Ramirez
92253
La Quinta 92253
State Lic.
& Classif. B1 358739
Arcn., tngr.,
Designer
J Address
P!O. BOX 1504T
NQ.
7&105 CALLE ESTADOLA QUINTA, CALIFORNIA 92253
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
\ 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the. alleged exemption. Any violation or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than Ove hundred dollars.($500). r
�O I, as owner of the property, or my employees with wages as their sole compensation, will
`do the work, and the structure isnot intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner,of propehy who
builds or bnproves thereon and who does such work himself or through his own employees,
provided that such improvements are not Intended or offered for sale. If, however, the building
or Improvement is sold within one' year of completion, the owner -builder wiM have the burden
of proving that he did not build or knprove for the purpose of sale.)
O I, as owner of the property; am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property* who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. B. 8'P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insu�¢nce, or a certified copy thereof. (Sec. 3800, Labor Colg.)
Policy No. �%r1C.)�r^�F'Company `�Ai t1` ft.3 11<fi" i1"i i/
0;,Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars ($100).valuation
or less.)
I certify that in the performance of thg 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
Date Owner
NOTICE TO APPLICANT., If, alter making this Certificate or Exemption you should become
subject to the Workers' Compensation - provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. ,
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and stale that the above information is correct.
1 agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof. this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
fi3JV.�U
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description
Laundry Room Addition and =tis ft
Tel.
554-4890
AMOUNT
Plan Chk. Dep.
parapet wall around
the house. Stucco
Tel.:
564-4690
exisC-ing wood siding
and parapet wall
City
Lic. # 1787
Sq. Ft. 161 No.
Size Stories
No. Dw.
Units
18.00
New O' Add ❑ Alter ❑
Repair'❑ Demolition ❑
Tel.
°
Grading
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
\ 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the. alleged exemption. Any violation or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than Ove hundred dollars.($500). r
�O I, as owner of the property, or my employees with wages as their sole compensation, will
`do the work, and the structure isnot intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner,of propehy who
builds or bnproves thereon and who does such work himself or through his own employees,
provided that such improvements are not Intended or offered for sale. If, however, the building
or Improvement is sold within one' year of completion, the owner -builder wiM have the burden
of proving that he did not build or knprove for the purpose of sale.)
O I, as owner of the property; am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property* who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. B. 8'P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insu�¢nce, or a certified copy thereof. (Sec. 3800, Labor Colg.)
Policy No. �%r1C.)�r^�F'Company `�Ai t1` ft.3 11<fi" i1"i i/
0;,Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars ($100).valuation
or less.)
I certify that in the performance of thg 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
Date Owner
NOTICE TO APPLICANT., If, alter making this Certificate or Exemption you should become
subject to the Workers' Compensation - provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. ,
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and stale that the above information is correct.
1 agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof. this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
fi3JV.�U
PERMIT"'
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.--
64.35
Const...
99.00
Mech. , °
6.50
Electrical
18.00
Plumbing
S.M.I.
.56
Grading
Driveway' Enc.
Infrastructure
TOTAL
18U. 41
REMARKS
i o
f. 4° YrY1S:Y i YuthL A YOQ1.VA,
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center. Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
-
YARD SPKLR'SYSTEM •`
2ND FL SQ. FT. ®
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER OR SEPTIC TANK
ROUGH WIRING.
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.'
DRAINAGE PIPING
CAR P. Q. FT.
HEATING (FINAL)
WALL SO. FT.
REINF. STEEL
DRINKING FOUNTAIN.
SO FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER HEATER
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM. FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LUMBER GR.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FINAL INSP.
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
.WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SPARK ARRESTOR
SQ.FT.GAR ® 3/<c
HOUSE SEWER
GAR. FIREWALL
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE I PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB./
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
75 ,L
v�
DUCT WORK
ROCK STORAGE
FOUND. REINF.'
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-x$-=$
LUMBER GR.
FINAL INSP R
FRAMING ✓�j� %
FINAL INSP.
�- n/
ROOFING `
Z
��
frre� (/� U/_ _ /A�
IY
�I Q� ` • T �'�/��
/��` �•/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
HING C -P
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
T H E C I T Y 0 F
Wr
La pinta
1982 - 1992 Ten Carat Decade
4
February 3, 1992
Mike Whitley
54-520 Ramirez
La Quinta, CA 92253,
Dear.Mr. Whitley:
Due to the fact that no response was received from our letter
January 7, 1992, your permit #9404 for a laundry room addition
and parapet wall located at 49-350 Anselmo has expired.
Once a permit has expired a new permit must be obtained prior to
any further work. or inspections to take place. The fees for a
new permit would be as listed in Section 303(d).
If you have any questions, please do not hesitate to contact the
Building and Safety Department.
Sincerely,
BUILDING AND SAFETY DEPARTMENT
-
Tom Hartung
4jO Director of Building an Safety
TH/lc ,
f
City of La Quinta
Post Office Box 1504 ♦ 78-105 Calle Estado
„;. La Quinta, California 92253
Phone (619) 564-2246, Fax (619) 564-561.7
Design 8 Production: Mark Palmer Design, 619.346-0772
78-105 CALLE ESTADO
January 7, 1992
Mike Whitley
54-520 Ramirez
La Quirita, CA 92253
Dear Mr. Whitley:
n
LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
FAX (619) 564-5617
It has come to the attention of the City of La Quinta Department
of. Building and Safety that your building permit # 94.04 for a
laundry room addition and parapet wall located at 49-350 Anselmo
has expired.
According to the Uniform Building Code, Section 303(d), no further
work shall be performed on the above permitted job -site until a
new permit has been issued -or an.extension granted.
Should you wish an.extension of this 'permit you must request, in
writing, for an extension within 30 days of the. date of this
letter.
Once a permit has expired a new permit must be obtained prior to
any further work or inspections to take place. The fees for a new
permit would be as listed in Section 303(d).
We -appreciate your immediate attention to this matter.
Sincerely,
BUILDING AND SAFETY DEPARTMENT.
Tom Hartung
Director of Building and Safety
TH/lc
cc: Martin Sanborn
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253