9709-032 (AR)79754 Arnold Palmer
LICENSED CONTRACTOR DECLARATION BUILDING PERMIT PERMIT# CONTROL#
I hereby affirm under penalty of perjury that I am licensed under provisions of " 9701.03Z 5868'Q
H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and DATE VALUATION + LOT TRACT Q O
N W Professionals Code,and my License is in full force and effect. " !
License# Lic.Class Exp.Date b ;o
JOB SITE APN
O .>i'I :tu R ^A/3I R ADDRESS 79-754ARNOLD PALF4'l.i R 7t► . ,I -t3
0 Z /Date N Q Ito < ignature of Contractor S` -•"` ' • ^' ; '' OWNER CONTRACTOR/DESIGNER/ENGINEER
Oo OWNER-BUILDER DECLARATION ` 'I✓4' u . r."iK"r`x; t (; (j►r, pc
J v ,t►Ji.t ARNOLD F't1l Ai'r:F2 27 t iil,t ti(:i:1
W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason: (»
NJI-ITVA CA 022.51 LA QUINTA CA 922 3
Z_ ( ) I, as owner of the property, or my employees with wages as their sole ( Ci(),) CAL# 41.42
compensation,will do the work,and the structure is not intended or offered for
sale(Sec.7044,Business&Professionals Code). USE OF PERMIT
( ) 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals t1. D14
Code). ars •O,_ - t }
() I am exempt under Section , B&P.C.for this reason c ,,fz tti:0 >•t"•fl%tii i
u'
O N Date Signature of Owner
rn
Li Z WORKER'S COMPENSATION DECLARATION
C:) :2 Z I hereby affirm'under,penalty of perjury one of the following declarations:
Lo O O 1 have and will maintain a certificate of consent to self-insure for workers' :i i :// 4 L lid a'i+ai!{:i'i'i r,3 i.{its 101l1 1
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.
ED < J
I have and will maintain workers'compensation insurance,as required by
O CJ Q Section 3700 of the Labor Code, for the performance of the work for which this
t Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
ob j •; ; ;',1,iT 71.41 I 'f'; F", '} {y ' t '3•i ` t 1814
11013.201
(This section need not be completed if the permit valuation is for$100.00 or less). 111411RINIJIT PEE sCj MARY
( ) I certify that in the performance of the work for which this permit is issued, MAN C.'f$f:'(.K l=HF: 1()1-000-4P-1IS
I shall not employ any person in any.manner so as to become subject to the VONR'1*11tlir'"VION,!. V 101.00-1 tX-MO 1N1:-
workers' compensation laws of California, and agree that if I should become ;, i t t3t? il-€'t' 1 ,,..
r r,d: 11i1:"+iia 4 .1w.Sif }, 2 ., i.(9)
3 • sybject to the workers'compensation provisions of Section 3700 of the Labor
Code,I sh II forthwith comply with thoseouisions: , if)i-00110.rx (►-a) $1,83:3
/Date: 1 10 Applicant a ✓f"' • :J ) /l4. kms, S`!'iC0NCFf VY1,K)h FHE ZkF-1411) 101-000-1.4fk-OW ;5xi
f _.k .
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 t + t
' whose request and for whose benefit work is performed under or pursuant to ) \PLAN
r/ y1_T[
Aj Il t.'j.JAN\, IJECK y!5✓3,94
any permit issued as a result of this applicaton agrees to,&shall, indemnify < j
& hold harmless the City of La Quinta, its officers, agents and employees. GF"NS' S Itf; AID I-VTS $0.00
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. ." ' , C
I certify that I have read this application and state that the above information is r' !n•
• correct. I agree to comply with all City, and State laws relating to the building
1111 11111111111111111 III 17
construction, and hereby authorize representatives of this City to enter upon(,". IE
t e above-mentioned property for inspection purposes,
j (" RECEIPT DATE 3 BY r DATE FINALED INSPECTOR
Signature (Owner/Agent) /, , % ` Date -1
Ry.
INSPECTION RECORD
OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR
BUILDING APPROVALS MECHANICAL APPROVALS
Set Backs n Underground Ducts
Forms&Footings J 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 Stedt
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 Heater Final
Water Piping Plumbing Final
Plumbing Top Out Equipment Enclosure
.Shower Pans OX 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 s
r _
Final
,Utility Notice(Perm) >
F
Desert Sands Unified School District 18
Notice:
•,1,
Notice: 82-879 Highway 111 + (E
Document Cannot Be Duplicated Indio, CA 92201 -
619-775-3500
CERTIFICATE OF COMPLIANCE
Date 10/10/97 APN # 769-411-032
No. 16159 Jurisdiction La Quinta
Owner Name Jeff Silveira Permit#
No. 79754 Street Arnold Palmer Log#
City La Quinta Zip 92253 Study Area 106
Tract# Lot# Square Footage 108
Type of Development Residential Addition No. of Units 1
Comments Enclose atnum
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 108 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 564-1309
Name on the check
By Dr. Doris Wilson - -
Superintendent `
Fee collected/exempted by Pauline Pearson Exempt $0.001
Check No. n/a
Signature POAAA_nly�_
r
TICE: Pursuant of Assembly Bill 3081(CHAP 549,STATS.1996)this will serve to not fy you that the 90 day approval period in which you may protest the fees or other payment identified
ve will begin to run from the dale on which the building or installation permit for this project is sssued or on which they are paid to the District(s)or to anotherpublic entity authorized to
ect them on the District('s)(s')behalf,whichever is earlier.
1
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
4
t.
ELECTRICAL LOAD CALCULATIONS
Silveria Residence
79-754- Arnold Palmer
La Quinta, CA 92253
Original plus addition:
2400 sq'. ft. V-3 watts . . . . . .. ., 7, 200
. GD. . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . 1 , 500
DW. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 ,500
Sub Zero ( 2) . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . .3,000
Small Appliance ( 2) . . . . . . . . . . . . . . . . . . . . . . . . . .3, 000
Washer. - . . . . . . . . . . . . . . 1 , 500
Dryer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5,000
Cooktop. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 , 500
Oven. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8, 000
Landscape, . . . . . . . . . . : . . : . . : . . . . : : : :3, 000
TOTAL 35, 200
1st 10KW @ 1.00%. . . : . . . . . . . . . . . . . . . . . . . . . . . . .10, 000
Remainder .@ 40%. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9, 68.0. . .
A/C Load @ 100%. . . . . . . . . . . . . . . . . . . . . . . . . . . .22, 000
Wine cooler condensor. . . . . . . . . . . . . . . . . . . . . 1 , 680.
TOTAL LOAD 43, 360w
43, 360w divide by 240v 180 .666 amps
.. 200 •AMP SERVICE IS SUFFICIENT
n
PGA WEST
RESIDENTIAL ASSOCIATION, INC.
September 2, 1997
Jeff Silveira
12 Fawn Run
Bloomsbury,NJ 08804
RE: Architectural Variance for 79-754 Arnold Palmer.
Dear Mr. Silveira:
Your request for an architectural variance has been approved by Mr. Dan Shepardson,Architectural
Committee Member. Specifically, you have the approval to proceed with the conversion of the
atrium into a wine cellar at your 79-754 Arnold Palmer residence. Upon completion of converting
the atrium into a wine cellar, please submit the enclosed Notice of Completion form to this office.
We reserve the right to make a final inspection of this change to make sure that it matches the
original request. An approval is based only on the aesthetics of your proposed plan and should not
be taken as any certification as to the construction worthiness or structural integrity of the proposed
plan.
We appreciate your cooperation in submitting this request for approval. If I may be of further
assistance, please contact me at the HOA office (760) 771-1234.
Sincerely,
1yycGalliard
Operations Manager
cc: Architectural Committee
Enclosure(1)
P.O. Box 1060, La Quinta, California 92253,Telephone 760-771-1234 FAX 760-771-5125
IIIIIIIIIIIIIIillllllllll ,� DAVE STEAVENS Page_�of
IE
Inspection Services
0*7
PROJECT 6& trJ E S1- G -� v OS PROJECT # y7 vd @7 - 0 4 . ..-
ADDRESSIR-1!S 14L. "1'S4 17` 3 CLIENT - CGA t,J t.-'-r V-10 c* _ ;
Ati004.0 71ACa",.,2 @G•%It s DATE 1.3 ;f-ixogg: .'aya,'!.
BLDG.PERMIT# ARCHITECT �?-.t1 A tzc t4 ,
ENGINEER -i u 4 0 S A JCONTRACTOR CL m A c2 r.�c��•�
INSPECTION TYPE
INSPECTION REPORT `
" ltL� �•. i1 S'1 �1u..-�r+ siac -• hat%f��
ULIii Sq. 14A + .T
i
� L�t.w • r+ T tr �
i
r J�� t'1 t t.. Qf '� • 7 f��+M +►J t- 1�L a Gil!a�G , � •.I S S �-� ?d 5 �a.ry,.J�� TL's`'' 4
Ar .20
i
s
i
ZTrt 7 y ? r rc'r�wt LtK�e/af 4• 3 S (-vwt &C- r c;
d
f �
�. D'a'r. - / 5- ? — •3 y �M
CERTIFICATION OF COMPLIANCE:To the best of our knowledge,all of the reporteJ work,unless otherwise noted,
0;:ubs�lantiqiopplies with.approved plans,specifications and applicable sections of the building codes.This report covers
work inspected only and does not constitute engineering opinion or project control.
CERT NO. Silo '.SLS INSPECTOR NAME t A J 6 S fE f1 V C,
lave..
DATE J�� G a GW INSPECTOR SIGNATL R Q�
!k
P
Jr