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0002-330 (AR)79794 Arnold Palmer LICENSED CONTRACTOR DECLARATION PERMIT# • I hereby affirm under penalty of perjury that I am licensed under provisions of BUILDING PERMIT 19z-este H Chapter 9(commencing with Section 7000) of Division 3 of the Business and DAT 3 )) ( VALUATION ; 44)J 18.`0 LOT TRACT N W `"Professionals Code,and m License is in full force and effect. / fj )6 it► License# Lic.Class Exp.Date r- v U-) 684937 13 "\ tiJd_+ai t/{ JOB ADDRSITE ESS 79-794 t itt '0LD PALMERPALMERAPN76!"01_00276!"01_0022 / 1 (J (// 0 Z Date a7 Signature of Contractor h" `"— OWNER CONTRACTOR/DESIGNER/ENGINEER NIM r;1 tD O T&3o! 11 ROFMI?!N ROB EDWARD'S D'S f_ON-STi,C1MION J UOWNER-BUILDER DECLARATION 79794 ARNOLD PALMER 7)-320 I I&STfi.DX(V E W WW I hereby affirm under penalty of perjury that I am exempt from the Contractor's !aA UfJlN 1 A (,A 92253 LA t U#'N`!A CA 32253 U) License Law for the following reason: Z ( ) I, as owner of the property, or my employees with wages as their sole (160)77,5-793.1 if' ('t 2 compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,Business&Professionals Code). USE OF PERMIT _ ( ) I, as owner of the property, am exclusively contracting with licensed 1U,SI ICW1 iAL ADIATION contractors to construct the project (Sec. 7044, Business & Professionals Code). iiS .i C+TTisS".i Hi:rUSFi AA7U7110N cO () I am exempt under Section B&P.C.for.this reason LO N Date Signature of Owner ON CD d Q WORKER'S COMPENSATION DECLARATION p2 Z I hereby affirm under penalty of perjury one of the following declarations: ,.r ,n , Q 011 a om t.vi+I:;Tc .iJ ;F'is72W SUM M SF r H O ( ) I 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 CJ (\)41 have and will maintain workers'compensation insurance,as required by O U Q Section 3700 of the Labor Code, for the performance of the work for which this C L L H permit is issued. My workers' compensation insurance carrier & policy no. are:NT F ? Carrier ., Policy No. "4805^2":°,I; ;5!''►1B% " '9' ',: ' 1)^i" tZ1 C ' ' '.°r'.$JC' ? ! t Ml3,' 1` .5ti ob 5 CA s, sN*NTAN Mrd.. i . r- C) PER'NUT FEE SUNiMARA7 J (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'll AN cN C;K r,Er; 101-61D1?-`I3g-3114 $23L.40 1 shall not employ any person in any manner so as to become subject to the ('0N8`fR(Y%YK)N FEET QI• -`fit 'Q B ° 5 ' workers' compensation laws of California,and agree that if I should become in"itf li 1Pli r'.i.i"i ? QC 1}CQ-";' 1 Cats $•1..1.50 subject to the workers'compensation provisions of Section 3700 of the Labor f LE+r:'i T1:AL FEE Q 1-tftIQ-42Q QQ 33.ir3 ` ' Codejf shall forthwith comply with those provisions./ ( Date: '2:tct-o1— ApplicantVKA/1 -•L 1 c rs ^` I'LUNIBI.NuFJP_I 101-Ut?0419-000 $39.00 STRON[;4><NOTMN I -RR810 101-00MA t-ON .Ot : r W ening: Failure to secure Workers'Compensation coverage is unlawful and Y J r shall subject an employer to criminal penalties and civil fines up to$100,000,in 5 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. i r 1.Each person upon whose behalf this application is made&each person at tt whose request and for whose benefit work is performed under or pursuant to T+1 _ 'MAN'1 any permit issued as a result of this applicaton agrees to, &shall, indemnify STT - ti Tt-NL CO} T5""j' '(,J ") f(' '( 'AN ' AN(''r ECY. $704,01 & hold harmless the City of La Quinta, its officers, agents and employees. '°SS nR -PAID FIE-ES 30-(IT s.i. u i .i x 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 TOTAi.:1.'FAMIT FEESff2@1:lI'.NOW $7tW.94 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 I IIIIIIIIIIIIIIIIIIIIIIIII 79 I • 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 IE the above-mentioned property/for'in pecton purposes/ / .fir' RECEIPT DATE BY\;{` ) DA'jE NALE D INSPECTOR T, signature"(Owner/Agent) t-' - = ` Dated (( - 1i 1 L IL 3 C i 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 jjd 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 Wali Firewall Exterior Lath Drywall-Int.Lath Final Final Q/ T 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 f 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) ` Desert Sands Unified School District 4 d Notice: La Quinta, CA 92253 IIIIIIII�III�IIIIIIIIIIII gp Document Cannot Be Duplicated 760-771-8515 )E CERTIFICATE OF COMPLIANCE Date 3/6/00 APN# 769-401-002 No. 20118 Jurisdiction La Quinta Owner NameNelson&Joan Hoffman Permit#0002-330 No. 79-794 Street Arnold Palmer Log# City La Quinta Zip 92253 Study Area Tract# Lot# Square Footage 515 Type of Development Single Family Residence No.of Units 1 Comments 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 515 or$ 993.95 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 CC/1st Bank/Bob Edwards Telephone 760-775-7933 Name on the check , By Dr. Doris Wilson a Superintendent - Fee collected/exempted by Mary Ann L. Bora Payment Received :', $993.95' Check No. 53165 Signature NOTICE: Pursuant of Assembly Bill 3081(CHAP 549,STATS.1998)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 tolled 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 I. PGA WEST RES ID ENTIAL'ASSOCIATION, INC. March 7, 2000 J. Nelson & Joan D. Hoffman P.O. Box 7000 Snow M. Village, CO 81615 Dear Mr. and Mrs. Hoffman: Your request for an architectural variance has been approved by Mr. Don Adolph, Architectural Committee Chairman. Specifically, you have the approval to proceed with the construction of a casita in the front courtyard of your 79-794 Arnold Palmer residence. Upon completion, 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 constriction worthiness or structural integrity of the proposed change.. We apprepiate your cooperation in submitting this request for approval. If I may be of further assistance, please contact me at the I40A office, (760) 771-1234 extension 15. Sincerel , Kel cGalliard Operations Manager cc: Architectural Committee enclosure (1) P.O. Box 1060, La Quinla, California 92253,Telephone 760-;,.-1�3� FAA' 730- -- IIIIIIIIIIIIIIIIIIIIIIIII 01 Page of DAVE STEAVENS �. � IE Inspection Services PROJECT�PGa -- L E:r oC� 0'5 PROJECT # " o O o7 -109 I ADDRESS"140 10,1116,qQ0.'IQ4 CLIENT 1�' GA DATE , ,R Z%A.0Z 1,o0 2. BLDG.PERMIT# ARCHITECT GOLAA p ar to ENGINEERAQWIC tr3t CONTRACTOR__Ns-E-L MAA. Nc;ctc JN'S$.F.CTION TYPE ' s INSPECTION REPORT { ~� t As1D T LM i� � �•>]G. -^ �t.c I A 5 Pc Y Ah lI- Ale- CERTIFICATION leCERTIFICATION OF COMPLIANCE:To the best of our knowledge,all of the reported work, unless otherwise noted,0 I substantially;omphes.with approved plans,specifications and applicable sections of the building codes.This report covers I mwws OM6 work-inspected only and does not constitute engineering opinion or project control. �fa� CERT.NO. o�-F� • e �� INSPECTOR NAME P 1.) .J A 11 <, DATE 07420 Z- PA a..ry) INSPECTOR SIGNATURE +•yt..+ t r •H Page of IIIIIIIIIIIIIIIIIIIIIIIII 02 DAVE STEAVENS IE I 01*-;.,ti....:. -� Inspection Services PROJECT kGA 6Jt-S-T- L.CG440 s PROJECT # c7a 02 ••O 9 I ADDRESS '1 ?7�,%1( r!$fr•7�y CLIENT�4P` v��- aT' brio et �dye� dc.a�,"ate Pr��L � DATE BLDG. PERNUT# ARCHITECT fpd1.8 A A s G4 ENGINEERI"fJ4 JAJ o#or -T^jC. CONTRACTOR ZCL IPA It INSPECTION TYPE INSPECTION REPORT If--t A -'� � &ouv -►G -A -3 y•*j — Cg-v% ,)#.t.-•Qr I � , afl, Li 4t . �'+ !3 �S • �• L - 7u1-4 �+t�c lti�/c� y4 OV; ZVA c.417 C V 1.-60--,e f n3 �E-v LS • 7• 1. • lv �� 11• : u•'-, ,A ,flSi [.Pr•Y , >r + J9 � JG. 5�i:.+�� ! ��A��S — l� •!7. 7 " I��/1 w+i JG ��,!lC.LI�[a 51/t,.N/T �IRfL r�lC. ~ C.G'�Yt.��►Tt' , 4 �C"CA+L, i•7�g• � - Cy�1�1�c't u.J �v�G� �4sr — �o� a4�r� l3Z1At%. Gy p'/S•7 'St4CAX A/AWJ& Adt �LY ,✓A�c.���, l.S •�,�" � �r �4 _!� 1T /7,j�• �c��, 1410"M 12 17A 4T Aab PLV M. AIA i CERTIFICATION OF COMK ANCE:To the best of our knowledge,all of the reported work, unless otherwise noted, substantial cod�1�es�n M approved plans,specifications and applicable sections of the building codes.This report covers {/\y��\����`���gTffleVwork inspected only and does not constitute engineering opinion or project control. . 1J tiw..yam. Q P.3 2 71)k CERT NO. © �T JNSPECTOR NAME V I 5+" j crO c' 7 DATE ..J Li .t.J e d Z,, INSPECTOR SIGNATURE i