9609-079 (AR)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
F- Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
N W Professionals Code, and my License is in full force and effect.
dco License. ft i { �, PIC. Class Exp. Date'
W IZO r- Date -1 rl" � S�gr ature of Contractor '� .%-r
COP M OWNER -BUILDER DECLARATION/
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's
J
~ a License Law for the following reason:
Z ( ) 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).
M () I am exempt under Section , B&P.C. for this reason
LO
O N Date Signature of Owner
rn
d z WORKER'S COMPENSATION DECLARATION
C:) 2 Z I hereby affirm under penalty of perjury one of the following declarations:
Lo F- O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W �= compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
m Q U I have and will maintain workers' compensation insurance, as required by
O CJ Q Sind ion 3700 of the Labor Code, for the performance of the work for which. this
Il L Z permit is ss t��edt� My/6w
porkers' compensation insurance card fere;& po, c no. are:
Carrier Policy No.
obs
r` a
(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
3 subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date: 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 for inspection purpose .
Signature (Owner/Agent) Date
�
r�
BUILDINGS PERMIT PERMIT,014J _fJ79 CONTROL#
.zv '� 4006
DATE VALUATION LOT TRACT
JOB SITE
APN r r •v s +.err
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
i"I'V9111;:11:111;
Ir;r, :1l;l1YCUINIS zU ION
_e>•ai„ iGViis'iLA
54705A.v4L CARiUkNiiv
1A QUINTi'A VA 02253
LA QUINrA CA 92253
ffi1►>)�n-I"7�t CRF. :rifif3
USE OF PERMIT
276 Sty 1313i7R(X_1ki A1VtTI0N
W/ 1-111I NT, 00f.p' CART CtAl2Af I.,
t_113I'UA•I C%)N.STK1.3 1'iUN 276 w 14f;
(1,ARA041CARlN;rR t A00 81"
24,244.40
Ill AN('IWrnKFIJ- I{1l.()f1()-i '� 315 Y163FM
c'�:lc3sntU��r�ca.d 1�.tsls' tot-(100-alR-t10o 32S«.tom
f>fU,11ANI A1. Vt-1: i.Gl-4tifF�t21-tJ1J(i 53kc.4h►
U1.40'RI At, t�hfr till-tIE1i1 # 0 Oti(i
Ai4•ff41 NO 1:1-T, .• 101-40)-419-)M
;;,r,,4 3 MOTION FEE - RESID 101.000.241-000 32:1'2
lFEt/�[attVi:41�lifd 1014DO.123-000
�
a
SUl3-Tcn,AL comsl'RucnGN AkNtn)'VLAN CIIE'CK
4M.22
LESS PRE-11Ait) FEES
$0.00
•t-0'1 Al, I'!F>i 11T PEES Pi.1E NO'4'4'
$0611
RECEIPT
DATE
BY — .j
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
O.K to Wrap
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
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
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
v`
Desert Sands Unified School District
Notice: 82-879 Highway 111
Document Cannot Be Duplicated Indio, 92201
619-77755 -3500
CERTIFICATE OF COMPLIANCE
Date 9/9/96
APN # 761-461-084
No. 14835 Jurisdiction La Quinta
Owner Name William Strub
No.56605 Street Riviera
City La Quinta
Tract #
Type of Development
Comments
Lot #
Permit #
Log #
Zip 92253 Study Area 106
Square Footage 276
Residential Addition 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:
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 276 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 Telephone 564 ,1274
Name on the check
By Dr. Carol McGrew
Administrator in Charge,..
Fee collected /exempted by Pauline Pearson Exempt $0.00
Check No. n/a
Signature �e C4c r p,AJ P -M A )Q -04—
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
PGA WEST II RESIDENTIAL ASSOCIATION, INC.
P.O. Box 1282 • La Quinta, CA 92253
Mr. William Strub .
Landmark Partners
1515 South Victoria Road
Lilydale, MN 55118
RE: PGA WEST II RESIDENTIAL ASSOCIATION
56.605 Riveria
Dear Mr. Strub:
I am pleased to report that -the Board. -of Directors. and Architectural Committee have approved
your submittal of revision of plans for a cart garage and room addition for the above reference
residence, with the following conditions:
1.. City approval of a front yard set back variance from 20' to 15'.
2. Submittal of an irrigation and lighting plan.
3. No moraia plant material is allowed.
4. Disclosure of the general contractor with contact phone number.
5. Meeting between the Association's landscaping contractor and your irrigation installer in
the field to review irrigation plans and coordinate same.
6. Compliance with all city .codes regarding plumbing, electrical, and structural elements of
the addition.
You may have your general contractor contact John Handel, Association Manager, at (619) 360-
4161 with any questions regarding the preparation, as well as the final inspection upon
completion. Thank you for your submittal of plan revisions, and we look forward to this fine
addition to PGA WEST II Residential Association.
Sincerely,
PGA WEST II RESIDENTIAL ASSOCIATION
Don Troy
Architectural Committee Chairman
cc: Board of Directors
Unit File
\\monarch\users\cuzy\pga2\strub 7-26-96 arch vandoc
1
GO UVIS
• C A ,> L
CAUFORMIA
December 26, 1996
Integrity Construction
P.O. Box 98
La Quinta, CA 92253
Attn: Terry Smith
Re: , Strub Addition
Addition of Cart Garage Orgy
GEC Job No.: 20023
Dear Mr. Smith:
ENGINEERING
I F O R N 1 A •
Pursuant to your request regarding the above captioned project; per our phone
conversation on December 22, 1996, we submit the following:
Please see the attached framing and foundation plan for the construction of the cart garage
alone.
Note: Please verify the above with the building department prior to construction.
If you have any questions, please do not hesitate to contact this office.
Sincerely,
GOUVIS ENGINEERING
SJB:Ir
20023361.1tr
attachments: 5
9.OEESS10
J BF �"9�
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GOUVIS ENGINEERING GROUP OF COMPANIES WITH OFFICES IN:
4400 CAMPUS DRIVE, SUITE A • NEWPORT BEACH, CALIFORNIA 92660 • (714) 752-1612 • FAX (714) 752-5321
2150 EAST TAHQUITZ CANYON, SUITE 9 • PALM SPRINGS, CALIFORNIA 92262 • (619) 323-5090 • FAX (619) 325-2863
5465 MOREHOUSE DRIVE, SUITE 100 • SAN DIEGO, CALIFORNIA 92121 • (619) 623-9941 • FAX (619) 623-0278
FIELD OFFICES : LAS VEGAS (702) 597-2005 • FAX (702) 597-0905 • MILPITAS (408) 263-3016 • FAX (408) 263-3714
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Date
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GOUVIS ENGINEERING
SHEET ,E
JOB NO. 2 o 0 ,�-3
CLIENT27f�v ;•.
PLAN NO.: S�iJh ��j C _ , ')�D
DATE 12-26-1996
7 FL. CEILING BM. AT CART GARAGE
OVER-ALL LENGTH: 11.75 RCTS AT: ..00 11.75
APPLIED LOADSDO +);
.1135 AT 5.75 .��$ P �� 4 CONC LOAD #
20 5 X_ UNIF'LOAD #/LF
REACTIONS (UP +);.
LEFT: 697.1 RIGHT: 672.9
****** USE N01 DFL 6X,8 ******
A= 41.250 S= 51.563 I= 193.359
FV= 85. E=1600000. DF=1.00
CRIT SHEAR = 685. AT .63 1.5*V/(A*FV*DF) _ .29
SPAN MAX MOM = 3678. FT.LBS AT 5.75
FB=1350. M/(FB*S*DF)= .63
DEFL= -.24 AT. 5.83 L/240.= .59
1994 UNIFORM BUILDING CODE 107.3-107.6
When submittal documents are incomplete or changed so as to require additional plan review or
when the project involves deferred submittal items as defined in Section 106.3.4.2, an additional ,
plan review fee shall be charged at the rate shown in Table 1-A. ' .
107A Expiration of Plan Review. Applications for which no permit is issued within 180 days
following the date of application shall expire by limitation, and plans and other data submitted for
'review may thereafter be returned to the applicant or destroyed by the building official. The build-
ing official may extend the time for action by the applicant for a period not exceeding 180 days on
request by the applicant showing that circumstances beyond the control of the applicant have pre-
vented action from being taken. No application shall be extended more than once. In order to renew .
action on an application after expiration, the applicant shall resubmit plans and pay a new plan re-
view fee.
1075 Investigation Fees: Work without a Permit.
1075.1 Investigation. Whenever any work for which a permit is required by this code has been
commenced without first obtaining said permit. a special investigation shall be made before a per-
mit may be issued for such work.
1075.2 Fee. An investigation fee, in addition to the permit fee, shall be collected whether or not a
permit is then or subsequently issued. The investigation fee shall be equal to the amount of the per-
mit fee required by this code. The minimum investigation fee shall be the same as the minimum fee
set forth in Table l -A. The payment of such investigation fee shall not exempt any person from com-
pliance with all other provisions of this code nor from any penalty prescribed by law.
107.6 Fee Refunds. The building official may authorize refunding of any fee paid hereunder
which was erroneously paid or collected.
The building official may authorize refunding of not more than 80 percent of the permit fee paid
when no work has been done under a permit issued in accordance with this code. ' '
The building official may authorize refunding of not more than 80 percent of the plan review fee
paid when an application for a permit for which a planreview fee has been paid is withdrawn or
canceled before any plan reviewing is done.
The building official shall not authorize refunding of any fee paid except on written application
filed by the original permittee not later than 180 days after the date of fee payment.
[For SFMJ Other Fees. Pursuant to Health and Safety Code Section 13146.2, a city, county or
district which inspects a hotel, motel, lodging house, or apartment house may charge and collect a
fee for the inspection from the owner of the structurein an amount, as determined by the city, county
or district, sufficient to pay, its costs of that inspection.
Pursuant to Health and Safety Code Section 1597.46, Large Family Day-care Homes, the local
government shall process any required permit as economically as possible, and fees charged for
review shall not exceed the costs of the review and permit process.
Pursuant to Health and Safety Code Section 13217, High-rise Structure Inspection: Fees and
Costs, a local agency which inspects a high-rise structure pursuant to Health and Safety Code Sec-
tion 13217 may charge and collect a fee for the inspection from the owner of the high-rise structure
in an amount, as determined by the local agency, sufficient to pay its costs of that inspection.
Pursuant to Health and Safety Code Section 13235, Fire Clearance Preinspection, fee, upon re-
ceipt of a request from a prospective licensee of a community care facility, as defined in Section
1502, of a residential -care facilityfor the elderly, as defined in Section 1569.2, or of a child day-
carefacility, as defined in Section 1596.750, the local fire enforcing agency, as defined in Section
13244, or state fire marshal, whichever has primary jurisdiction, shall conduct a preinspection of
the facility prior to the final fire clearance approval. At the time of the preinspection, the primary
fire enforcing agency shall price consultation and interpretation of the frresafety regulations, and
shall notify the prospective licensee of the facility in writing of the specific firesafety regulations
1-10.11
T� 4
76-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 - (760) 777-7000
FAX (760) 777-7101
TDD (760) 777=1227
March 31, 1998
Integrity Construction .
54-705 Avenida Carranza
La Quinta, Ca. 92253
Attention: Mr. Terry Smith
Re: Permit 9609-079
Dear Mr. Smith:
Please find enclosed a check for $293.30 for the addition permit, 9609-079, not performed at 56-
605- Riviera in La Quinta. Also enclosed is Uniform Building Code Section 107.6 which will
justify the discrepancy between the amount of the permit fee and the refund returned to you.
Please feel free to contact us should you have any questions and we look forward to working with
you again in the future.
Sincerely,
Mark Harold
Building and Safety Manager
MAILING ADDRESS 7 P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253 -
CONTRACTOR
Terry W. Smith
P.O.Box 987 / La Quinta, CA 92253
(760) 564-1274 / Lic.# 621156
DATE March 30, 1998
TO La Quinta Building Department
RE Bill Strub
56-605 Riviera
La Quinta, CA 92253
This is notice that Mr. Strub has elected not to do the balance of the
guest house. The only part completed is the golf cart barn so I would like
a partial refund on the cost of permits.
Sincerely,
�O
4erryyS 'th, Contractor
L tNbtU Gun 1 HAG I UH UEGLAHATION
Cl) I he affirm under penalty of perjury that I am licensed under provisions of
t; • Cha: J (commencing with Section 7000) of Division 3 of the Business and
W Professionals Code, and my License is in full force and effect.
:3 ce) License, f"! I I N) Hc. Class Exp. Dalt /y 7
W
Q
Z Date�9�ature of Contractor
O�
V OWNER -BUILDER DECLARATION'
Wa I hereby affirm under penalty of-pedury that I am exempt from the Contractor's
Licens aw }nr fho fnilnuuln^ •^^^^
r sole
PER 9KI1�-079
BUILDINCpVIITVALUATION
17,k0 `%
ad for .
JOB SITE
Sv or 440�9
o a s
ADDRESS
OWNER
3
d
Ions:
kers'
r- the
W
J
�li/v
LA QUINTA CA 92253
LA QUINTA
J
Q
/
Q
d by
this
Ul)
RESIUENI'llA1., AUU1`I7UN
•
are:
coo
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ped,
the
(1IS'I'UM CONSTHU('IT.)N 276.411, SF
)me
rbOr
CIARAONC'ARPORT SF
/fJ� /f _ ✓
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and
In
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oe
24,Z44.40
PERMIT F'F:F: SUMMARY
5163.80
ety
his
PfFV JP LO -AA
PI -AN ('FfF(k FFF. 101 -W. -439-318
"Aug.
:at
_ • l0-00-18-000 2.00
CONSTRIJCrIGNFF7:
f7:
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ch
PIAINfRINO FEF 1014011.419-000 -
.10N
is
Ig
S11.)IM MUT I+E - RESID 101.000-241-000 S2.42
•
a e•mentioned property for Inspection pu fp(pe
n
GRAMNO FEE* 101-O(N1-423-000
Te
rilganature (Owner/Agent)_1102F Datep ly" V.
PER 9KI1�-079
BUILDINCpVIITVALUATION
rpu e
4 0 0ra
DATE oT ,RACT
JOB SITE
APN
-
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
WILL1;11t1..I'P.I ►(1
INTEGRTI'Y CONSTRUCTION
_X"KIVIEkA
54705 AVE. CARRANZA
LA QUINTA CA 92253
LA QUINTA
CA 92253
(619)564-1274
C'BIA 2968
USE OF PERMIT
RESIUENI'llA1., AUU1`I7UN
276 SF BEDROOM ADDITION
W/ 1.10 SF 0011.17 !-ART (1ARAOF
(1IS'I'UM CONSTHU('IT.)N 276.411, SF
CIARAONC'ARPORT SF
. f
KSTIMATED COST OF CONSTRUCTION
24,Z44.40
PERMIT F'F:F: SUMMARY
5163.80
PfFV JP LO -AA
PI -AN ('FfF(k FFF. 101 -W. -439-318
it L58't
_ • l0-00-18-000 2.00
CONSTRIJCrIGNFF7:
f7:
MECHANICAL VEL. 101-000-421-000 S38AI
u
EIX(7rRICAL FEES 101-(M-420-000
PIAINfRINO FEF 1014011.419-000 -
.10N
r
S11.)IM MUT I+E - RESID 101.000-241-000 S2.42
..��T
GRAMNO FEE* 101-O(N1-423-000
283.3
SUB-IM"AL CONSTRUCTION AND PLAN CHECK .
$456.22
LESS PRE -PAID FEES
$0.00
TO'I'AL.PERMIT FEES DUE NOW
1456.22
RECEIPI..
DATE
By
DATE FINALED
INSPECTOR