9705-035, 9803-010, 9809-258 (SFD)R LICENSED CONTRACTOR DECLARATION
. hereby affirm under penalty of perjury'that lam licensed under provisions of
1, Chapter 9.(Commencing with Section 7000) of Division 3 of the Business and
NIi�J f Professionals Code, and my License is in full force and effect.
_M License # Lic. Class Exp. Date
W ;3142
ZO r a,e �" 2 Signature of Contracto Y
CO O)
� U (0OWNER-BUILDER DECLARATION ,
W1 hereby affirm under penalty of perjury that I am exempt from the Contractor's
CL
U) 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).
co O I am exempt under Section °�B&P.C.Ifor this reason
N Date Signature of Owner
Orn
CL Q WORKER'S COMPENSATION DECLARATION
r
o crI hereby affirm under. penalty -ofperjury one of the following -declarations:
HO () 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 -J k` rf rmance of the workfor which this permit is issued. ,
CO a U I have and will maintain workers' compensation insurance, as required by
�s • O, Q S ction 3700 of the Labor Code, for the performance of the work for which this
CL Z permit is issued. My.workers' compensation insurance carrier & policy no. are ��,
Cartier Policy No.
coo. d:�.t.KICI•f�i'kANIS. r-(,1. 1 c 6i.��1i3`:db_°.05'
J (This section need not be completed if the permit valuation is for $100.00 or less);
O 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 io become subject to the '
workers' compensation laws of California, and agree that if I should become
subject to the workers' compertisatlonprovisions of Section 3700 of the Labor
Code,.l�s all fo -With 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
• V 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.buijding
construction, and hereby -authorize 4representatives of this City to e'nter.upon
.the above-mentioned, property for inspection purposes.'
�1+ >t`• c q
i Signa(Owner/Agent) '{'- Date 2, �7
•L S '
1"6�•4".N s � F ..>" _ ' a:. - . ' t_ .. ...xaa✓."ifi F-5.+i4.+e. _ .. ...... , YYY .. _ - ..
PERMIT# CONTROr#<,K
BUILDING_ PERMIT e��
..SIP3.3
DATE �pp �' /���jy VALUATION w.. �]y yj� �f� LOT' �f�j� TRACT y {� t
JOB SITE t " I
ADDRESS"
APN
OWNER +
CONTRACTOR/DESIGNER/ENGINEER
V'SL .AND �-i'���ii.�� .
KS�,i16:+�iFr�.,�l.d l�iYl i13,�i�.9`;�`4J�\�}
at) 40 A;A B 4'T,
56140 PGA 8L VD'
:i i1`;t! 11TJ t'f1. if k" A. 9'i
I.,p1l fll�f'CA C'61 92253
(700 42. C.'•81L.9 . 4670
USE OF PERMIT
if t;) -' t .631iw pu%x .Sclt
t I,r TiJ Ct` r`t<. flt?l7t1t.131] 7 '�oF i2fbiU1,T.T.F%l.I lSSUA;NCEOP SAME
PLM4
um ur rl cowrgvurlrN A;141.00 S
1-,0Ra1(P t°f.10 3.14.00 Sl'!
iifylKll� 1J(;A)tl'i l2%�t` 5:3100 5F
C911,1NIATEM M81 OF CONSTRUcTION,
F CY, 101 d)iK_ 41 8-0m
14'.± G`kIAN'lc t1.L7d . ;'itt-t3fif)<4xY-flOf3 $174.t?(1
C
F X.CrIf W CALI_-V`E lfrl-iii-4241-t?Qi3 �:tEt�:�E;
�
P r. t:NO �u 1Q1-tNm.41+�400 ��1�.23
rn
S7`!tof4a', mar 1 c it -0 -R-111 ts') 10 ()4^^ �?! fl4i() ��,n�t
�
� • .., � �..
-GRADING FEE 101-000423-000 �?[.Ut3
rv.; ssw
�" C%2 <Zx
it�l stet 1TkC3� " �Itl i l t 22 >-00-443 1422 .feiw.tsU
°'
Aii't'tN f'IJBi:IC N�.A #2 rC:'%A1-00n 2 54M $465 96
I ?-
`SUR-`rt?MGCONS"IRtlCfl(]N AND.p1. c lIEt K , ...
" g�DSg�a;�R•
x:.,
Li SS F�E:Id-P:UD FE64.
. t �TA 9,..4T�.Y`YlYt. br.bMiS 001,'.ilfOW
'." 9.68
RECEIPTDATE
BY
DATE FINALED
INSPECTOR
_;refs
C,
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 7
Compressor
Insulation / y 7 ,
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
D ll - IM. 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 41
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test ? ,2 S- r
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)
_.... ,,.� {...�..._ r4. ... • .� YT- r-.^ -....: - -'.,,: ref .-.r„ -^t .. _ .. _... _... _ ... _ .. .
J®N TANDY
35e80 Condalia Ave.
� �c c6Walley, CA 92284
(6191365-5045
REGISTERED INSPECTOR'S WEEKLYREPORT`���,
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL AS 1�MEILY ❑
❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ OTHER
❑ REINFORCED MASONRY ❑ FIRE PROOFING
JOB L T}9�1_ ^ �.� -/� 1 ( ^ ,� ` in
0 L)TYP ll //PP
V v
REPORT SEOUENCE NO.
URE L-16
PERMIT NO.
= � - q�
DAV OF WEEK
MATERf7QL DE RIPTION ..�`
',
ARCHITECT
IN R
HRS. CHARGED
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPEDATE CTION ^ ' CONTRACTOR K. �• L' F-�.�(, GENERAL SUB -IJ�C�J
CONTRACTOR
-a -
dP -Pten w -e -L6 N & o -F 6 A S -e (ams
Coo (jeeiz o� � (A,S c� �S
UAW
COPY SENT TO CLIEN
'- CONTINUED ON NEXT PAGE ❑
PAGE OF
I
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
XTURE OF REGISTERED INACTOR CC�-
6. � �J
DATE OF REPORT REGISTER NUMBER
� Summit Structural Engineering
2283 Fifth Street
La Verne, CA 91750
(909) 596-0842
September 18, 1998
Gail Soderling/Danny Armor
53313 Avinata Navaro
La Quinta, CA 92253
Attn: Danny Armor
Subject: Guest House Addition
57422 Riviera
La Quinta, CA
Dear Mr.' Armor,
The roof truss drawings by Yuma Truss and Edias Engineering for the subject
project were received by our office on September 8, 1998, and are approved.
The submittal has been reviewed for general conformance to the design concept
of the project structural . plans. The fabrication processes, techniques of
construction, dimensions, and quantities are not a part of this review. Since the
shop drawings were reviewed only for general conformance with the structural
plans,'unless variations from the.structural plans have been clearly indicated, we
'may not have listed them. Our review of these drawings "does not relieve the
truss engineer and .the framing contractor from complying with the structural
plans. -
Please add plywood sheathing to the truss above the #12 shear wall with nailing
to match the shear wall below. ' The reason for this is that the drag calculation for
this truss was not provided. Also, please provide one copy of the truss
calculations for our office for our records.
If you have any questions, please call Benjamin Herbst of our office.
Yours truly,
OQPOFESS ,\
SUMMIT STRUCTURAL ENGINEERING
All 10 a No. C054193 m !II
* Exp. 12/31/99 x/
�
Benjamin Herbst, P.E. of C/V11-
vik-
ALIV
CC: Gail Soderlirig
Attachments: 2 -sets wet stamped truss drawings
BH d:\98jobfiles\CD-36\36_truss2.doc
Residential, Commercial, Industrial, Land Development
i
City of La -Quinta
BuildingnSafetyDepartment.
andoh
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 constructionor use. - For the following:
r
BUILDING ADDRESS: r 57-411 RIVIERA
Use Classification: SFD HOUSE ONLY, [NO GUEST HOUSE] Bldg. Permit No.: 9705-015
Occupancy Group: R 1 Type .of Construction: VN Land Use Zone: RL
Owner`of Building: KSL LAND II Address: 56-140 PGA BLVD.
City: LA QUINTA, CA 92253 '
By: STEVE TRAXEL
Date: 3-27-98
Building Official
POST IN A CONSPICUOUS PLACE
�M=
s II
+ 11
d
P.O Box 1504
78-495 CALLE TAMPICO
1.A `QUINTA, CALIFORNIA 92253
July 13, 2001
v
(760).777-7000
.FAX (760) 777-7101
Mr. Bruce Lindell
57-395 Riviera
La Quinta, CA 92253
Dear Mr. Lindell:
Please be advised of address changes for the following structures. The structures
formerly "addressed as: �a7=395-Riviera, 'Lot 18-APN#761-560-010
57-411 Riviera, Lot 17-APN#761-560-01.1
57-427 Riviera, Lot 16-APN#761-560-012
57-443 Riviera, Lot 15-APN#761-560-013
67-459 Riviera, Lot 14-APN#761-560-014, the construction for..
which building permits 9705-016, 9710-168, 9705-015, 9804-098, 9803-010, 9809-258,
9902-101, 9705-014,:9712-068,.9811-134, 9705-013, 9711-075, 9712-025,'9708-072
and 9712-017 were .issued, will now, be addressed as follows;
(80=425 -Riviera, Lot 18 - Lindell
.80-455 Riviera, Lot 17 - Soderling
80-475 Riviera, Lot 16 - Gould.
80-485 Riviera, Lot 15 - Westergaard
80-505 Riviera, Lot 14 - Schweizer
Please note this change and contact me directly at (760) 777-7019 if I.may be of further
assistance.
Thank you.
Sincerely;
Diane Aaker ,
Senior Secretary
Building & Safety -Department
J
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LICENSED CONTRACTOR DECLARATION
%M;?q)reby i0lrm under penalty of perjury that I am licensed under provisions of
�_'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 # r Lic. Class Exp. Date
Date 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).
VI, as owner of the property, am exclusively contracting with licensed
ntractors to construct the project (Sec. 7044, Business & Professionals
Code)'. 1 k' ,
O I am exempt under Section B&PC..fohis reason
ate �. r- Signature of Owner'
WORKER'S COMPENSATION -DECLARATION. Gam(
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 IPolicy 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 hall 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
sub.ect to the workers' compensation•provisions of Section 3700 of the Labor
Code, I shall forthwith comply with'those provisions. t
VI
Date: Applicant
Warning: Failure to secure Work0Compatibn=coverage is ufilawful 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 autK6ri2e representatives of this,City to enter upon
the above-mentioned property fi�i`nspection purposes.
V�ignature (Owner/Agent)L ' ' Y Date—,-? Imo'
BUILDINGPERMIT PERMIT#
CONTROL#
DATE r VALUATION LOT TRACT �, �i
/�
JOB SITE'
ADDRESS
f: 9(
OWNER
CONTRACTOR/DESIGNER/ENGINEER
�i;,�.����',;�: s ;:°�lla ti;f�t�,t.l:i^a�`=
fa,. ?;:,1: ; ►gig °,3:a'A�:i�
14'`l t4La'k_iM.S41I X ' x04
USE OF PERMIT
�li J��/�u�
•^ `
gyp.
aEp3ae`"11MLWUtL t0 Pfikioi r: rr y%ti-t'ttS. tm7e 3.r -t V ', a t.c!.h,,S'f
Hol QSK UNIOFid CY. VS11 W;t 51 N,
MIA
_
I n
0
'J"3T �iiii.'%3"�i: i'tiis "'
r�,44 894,64 MAE
6 ILIK 111IM01
2*6 1998
01 ® t+(UdFVT�'1
.)11�RIN"T• Or CG+, ly.,M ICHR 113
r r 1�4Nl"FJ1X*1(+;)PV'i"171' 1(114tt1l1•-=tlk'w601) `.igS%#1
.t "fl�lt'fl3, i f:l. E()IMO.
I11.1)MBING 1141.
`+ IV,(- ),N(11 k4l''A`t N 1,F , • lam:_SIV 101.4AA) ' 31.4 10
ra•r,�fi��fr°ckr �aa�t: ifia-.tilltl-iii 00:�ttl
r1:NO M<1NCHP(T.
RECEIPT
DATE
BY >
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs G
-Z
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
tIzinal
utility Notice (Perm)
Coachella Valley Unified School District
P.O. Box 847, Thermal, CA ' 92274
(760) 399-5137, Ext. 235
This Bos For District Ilse Only
CERTIFICATE OF COMPLIANCE
(Government Code 53080)
Project Name: Date:
March 19, 1998
Owner's Name: Ronald & Gail Soderl i ng. Phone No. (
Address: 57-411 Riviera, La Quinta, CA 92253
Project Description: Room Addition
APN: 761-560-011
Tract #:
Lot #:
Type of Developmrr Residenti Commercial Industrial.
Total Square Feet of Building Area: 594 Sq. Ft.
Certifieation.of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement
under penalty of perjury and further represents that he/she is autorhized to sign on behalf oMle owner/developer.
Dated: March 19, 1998
SCHOOL DISTRICT REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE
SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING (CIRCLE ONE):
Gov. Code Gov. Code
53080/6599 65970
Number of Sq./Ft.
Amount per Sq/Ft.
Amount Collected
Project Agreement Existing
Approval prior to 1/1/87
594. Sq. Ft.
$ 1.84
$ 1,092.96
Note:
Not subject to fee
requirement.
By: Foch "Tut" Pensis Assistant Superintendent Administrative Services
Administrator in Charge
Certificate issued by: Elsa F. Esqueda Signatur .
"- -- —
aci i ies Analyst
NOTICE: Section 66020 of tie Govenuuent Code enacted as Asseubly Bill 3081, set forth as Chapter 549, Statutes of tlhe State of California, 1996 effective Jan. 1, 1997, requires that this school district provide a written notice to
to project applicant at the time of payment of school fees, ndtigation payment or other exactions. Ms notice is to advise you tut any protest ser regard to such arnounts or the validity tliereof bh accordance with Section 66020
of the Govenmhent Code end other applicable haw, conunences with such payment or performance of any other requirement as described bh Section 66020 of the Govemnhent Code. Additionally, this notice advises tut the
protest thereof nest occurwit hin 90 calendar days thereafter.
Note: AB 2926 and SB 201 fees are capped at $1.84 per square foot for all residential construction, and at $0.30
per square foot for commercial/industrial projects.
Dev. Fees Disk: Misc\Cert-ComSam (REV. 1/97)
� t ,
- - PGA WEST II RESIDENTIAL ASSOCIATION, INC.
P.O. BOX 1282, LA QUINTA, CA 92253
(760) 776-5100 FAX(760)776-5111
PGAIVEST - - - -
February 28, 1998
-Mr. Ronald Soderling _ -
57-411 Riviera -
La Quinta, CA 92253
Re: Request for room addition at 57-411-Riviera
Dear,Mr. Soderling: _
The Architectural Committee has reviewed the plans submitted for a room
addition at your new PGA .WEST home. I am please to inform you that the
committee has approved your room addition. Please note that this approval is
good for a period of six months, ending August 24, 1998. If the work has not
begun by that date a new application will be required.
Please contact me upon completion of room addition so that the committee may
inspect the job and return your deposit.
Sincerely, - _ -
For the Brec
John J. Monahan _
Association Manager +
z
CC: Architectural Committee Board of Directors John Handel, TMG
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/ Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer,and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations underFederal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing 'their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle
La Quin 92253 -
(760) 77X-701
2
FAK-176 7-7011
OWNEK'S.$IGNATURE/ DATE
PROPERTY ADDRESS
9603-010
PERMIT NUMBER(s)
'-:
n
1.:1 I Y Ur LH UU1IV I A
-S UB-11ST
CONTRACTOR
/1F:;1wti29-- ADDRESS 57-411 V,yIcQA
OWNER ga?uw ,k Gn11,
JOB ADDRESS 57-411 '-tdtr A
1
This form shall be posted
on the job with the Building Insaection Card at all timmous olact.
It is the responsibility of
the General Contractor or the Owner/Builder-to monitor the sub -contractors that
are on this list are the same persons performing the work. Any changes to this list must be approved the
City of La Quinta Department
of Building. &' Safety puQL to work being performed by a changed sub-
contractor. Failure to comply will result in a stoppage of work and/or the voidance of building_ permit.
::.
CITY
SUB -CONTRACTORS.
TYPE OF
STATE
:WORKER'S' -
,
:BUSINESS
TRADE
NAMELLCENSE
`CONTRACTOR'S
'COMP:NAME/ „
LICENSE
'
;:LICENSE
NUMBER ON•FILE,
NUMBER/
1
:'NUMBER',EXP:".DATE
GRADE/:::::._:::..:.,:
A/C -12
.EXCAVATE
PIPELINES
C-34
CUNCRETEI
C-8
;FOUNDATIONS i.:
AS?HALT,,. ,. „ ,
A
FRAMING w ` .
B
STEELh,
C-51
STRUCTURAL
MASONRY
C-29
PLUMBING
C 36
LATHING
C-26
'
DRYWALL ...
C-9
PLASTERING
C-36
HVAC :
C-20
ELECTRICAL
C-10
(Generel►
•
ROOFING
C-39
SHEET:.METAL
C-43
FLOORING
C-15
GLASS(
C-17
'INSULATION
C-2
SEWAGE DISP
C-42
PAINTING/
C 33
DECORATING F
TILE. ',
C-54
-
CABINETS/ ,.
C-6
INSTALLATION
FENCING
C-13
LANDSCAPING `:-
C-27
POOLS
C-53
OTHER .
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RECREATION CORPORATION
October 24, 1997
Mr. Mark Harold _
Building and Safety
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92253
Re: Parcel 17 Tract 28118, 57-411 Riviera, Permit #9705-015
Dear Mark:
This letter is written to clarify the conditions for finaling the home at the above referenced address.
The buyers, Mr. and Mrs. Ron Soderling, are currently designing an expansion to the guest house that
is framed (no framing inspection as of this date). Their desire is for KSL to finish, final and close the
main house on or before December 31, 1997, and leave the guest house in its current unfinished
state. They would then finish the guest house concurrently with the construction of the expansion,
which is scheduled to occur immediately after the close of escrow. Construction of the guest house
expansion will not be done by KSL Development Corporation, and KSL disassociates itself from that
portion of the permit.
It is hereby agreed that the City of La Quinta final sign-off/Certificate of Occupancy is dependent upon
and shall not be granted unless the guest house expansion plans have been plan checked and
.permits issued. Issuance of said building permit shall not occur I an November 30, 1997.
s
aul W. Dooley Mr. an s. Ron oderling
Project Director
KSL Development Corporation -
Thank you for your consideration and time. Please call me.if you have any questions or comments.
Sincerely,
Paul W: Dooley -
Project Director
KSL Development Corp.
cc: File
America's Leader In Distinctive Lifestyle and Recreation -
56-140 PGA Boulevard • La Quinta, California 92253 • (619) 564-1088 • Fax (619) 564-4880.
t/1 ti LICENSED CONTRACTOR DECLARATION
%ereby 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
Date 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).
( X) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code)'.fs
( )/I am exempt under Section B&P.C.. for this reason
'-(Sate , Signature of Owner i ✓%�
(U—
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.
(This section need not be completed if the permit valuation is for $100.00 or less).
(K). 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,prov'sions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
vDate: it) Applicant ��11
r
Warning: Failure to secure Worker C mpensation 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 ; urpoes.
� 0
/Signature (Owner/Agent) Date t;? -1 ^ r
BUILDING PERMIT PERMITv809'2K8 CONTROL#
DATE VALUATION S.00 LOT TRACT 8345
nn nn
JOB SITE
ADDRESS '—-jtAVtEj2�i
APN 76:8.56E� ilY9
OWNER
CONTRACTOR/DESIGNER/ENGINEER
It0.N1NLID &CA11, S0DERt.ING
OWPJf?RISU11,DER
1221 WEST COAST IMY 504
NEWPOWr B ::ACC CA 92M3
c j - CBIX
USE OF PERMIT
y , 7
fVS.VS'L I
SUPPILFA.I[ENl.AL TO13fiMf1t 9803-010, R.ECONF'XG3bRi` OGUES HOUSE.
PCRMIT FBE SUMMARY
PL&X CW -CK F9E 101-000-439-3113
PLIr1.1pt1`(JFEY 1Cl1-( t} i4:.fJ f1 s7a q
ro
a
S F fi 3
PAID
OCT 0 8 1998
IIT Y OF LA CSUINT
ict
"ON ANO PLAN MIECK
1
LESS P1Zxs`d=. D FEES
W.00
'j'lYj.Aj.VERNI1, V. ji,% 1)l1F ;dflW
$94..410
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
O.K to Wrap
F.A.U.
Framing
it IT
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
Finale
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
,LQ
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
t
c
Final
Utility Notice (Perm)
Jl CITY OF LA QUINTA SUB-CONTR CTUK L.151
JOB ADDRESS
-5")J '7 1 f �� V(E �— % PERMIT NUMBER OWNER �12 h � �1—���' BUILDER
This form shall be posted on thejob With the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of
building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
:.::..
Trade / Classification Contractor
State.:Contractor: sLicense; ::::::..::.:; W0
4"P
ensation l.risurance;; ::;;::::;>>: :; :':Cit Business License
IF
Company Name Classification License Number Exp. Date Carrier Name Policy Number Exp. Date License Number Exp. Date
le.g. A, B, C -B) (xxxxxx) (xx/xx/xx) (e.g. State Fund, CalComp) (Format Varies) (ux/xx/xx) Ixxxx) (xx/xx/xx)
EARTHWORK IC -12)
CONCRETE (C-8)
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