BLCK (04-7558)55420 Medallist Dr
04-7558
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760).777-7012
78-495 CALLE TAMPICO. FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . . 04T0-0007-55-8 Date 12/.02/04
Property Address . . . 55420 MEDALLIST DR
APN: 767-510-020- -
Application description . . . WALL/FENCE
Property Zoning . . . . LOW DENSITY RESIDENTIAL
Application valuation . . . . 3275
Owner Contractor
.,MEDALLIST DEVELOPMENT EHLINE COMPANY
1070 INDIANTOWN RD 55375 MEDALLIST DR
JUPITER FL 33477 LA-QUINTA 'CA 92253
(760) 771-8130
WCC: STATE FUND
WC: 2290006783 01/01/05
CSLB: 482086 11/30/05
CCC: B
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Permit . . . . . . WALL/FENCE PERMIT
Additional desc
..Permit Fee . . 6.3.00 Plan Check Fee .00
Issue Date . . . . Valuation 3275
Qty Unit Charge Per Extension
BASE FEE 45.00
2.00 9.0000 THOU BLDG 2,001-25,000 18.00
i
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Special Notes and Comments
131 L.F. 6' GARDEN WALL, CITY STANDARD
Fee summary Charged Paid Credited Due
------------------ ---------- ---------- ---------- ----------
.Permit Fee Total 63.00 .00 .00 .63.00
Plan Check Total .00 .00 .00 .00
Grand Total 63.00 .00 .00 63.00
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P.O. Box 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: Date:
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Address:
a
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby 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 in full force and effect. ,, //
,,--'License Class nse No. a— 44P2 Ds -k
,,--Date12/V O 17 -tor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
U 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 and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work
himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.).
U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions code: The Contractors'
State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. , BA P.C. for this reason
Date
WORKERS' 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 forwhich this permit is issued.
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 orkers' compensation iAs nce carrier andpolicy number arg:
er -S%/ !p c/•v -,Policy Number 72,5 4000(o % j-3
_ 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.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application..
1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work.is performedunder or pursuant to any permit
issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemtftfy an6h31d haat ILgSstherl 4jr'of La Quinta, its
officers, agents and employees for any act or omission related to the work being performed under or following issuance of this pennW -
2. Any permit issued as a result of this application becomes null and void if work is n mmenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject per ancellation.
I certify that I have read this application and state that th above i fo is correct. a r e to Comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of is county t nter u n the ov m ntioned property for inspection purposes.
ate Si re (Applicant or Agent):
ti'ov 08 04 10:5?a RF STRUU f UKHL&5HM lHMHKlH 'rbU IdJb UtS*b,
R F STRUCTURAL CON8ULTAN"+S, tNC.•
— 75.153 MEFLLE DRIVE, STE. B, PALM DESERT., CA 92211
PHONE (760) 836-1000 FAX (760) 836-0856
E- MAIL RAYMOND@RPSI UCrURAL.COM
NOVEMBER 8, 2004
EHI,INE COMPANY
81-480 NATIONAL DRIVE
LA QUNTA, CA. 92253
Attit.: MR. GILBERT LEYVA
Re:: THE NORMAN ESTATES AT PGA WEST
LOT S57,j, LAN 1B
LA QUINTA, CA, 92253
FOLLOW-UP TO WALK -THROUGH
JOB NO. ; 4082
DEAR PHIL,
THIS LETTER ADVISES TIi.AT WE HAVE OBSERVED THE STRUCTURAL
REQUIREMENTS THAT ARE VISIBLE DURING CONSTRUCTION AT THE TIi iE OF
OUR SITE VISIT.
WE BELIEVE THAT THE AS -BUILT CONSTRUCTION AT THE TIME OF OUR VISIT IS
IN GENERAL CONFORMANCE WITH OUR STRUCTURAL PLANS ANIS RELEVANT
CORRESPONDENCE ISSUED BY OUR OFFICE. ,
WE OBSERVED THE BUILDNG IN ITS FRAUED CONDITION PRIOR TO
INSTALLATION OF DRYWALL AND STUCCO. WE OBSERVED THE VISUAL AND
ACCESSIBLE STRUCTURAL REQUIREMENTS. ( EXCLUSIONS ARE ITEMS SUCH Aa: .
FOOTING SIZE AND RENFORCEMENT, TOP PLATE SPLICES, ROOF SHEATHING,
AND ANY STRAPS ABOVE THE ROOF SHEATHINO.).
RESPECTFULLY SUBMITTED
Essran,,
gyp_
C N\
ZEYAD FAQIH, PE sT' TE OF 0p 1F
Mov 08 04 10:57a -:RF STRUCTURAL&SANTAMARIA.,. 760'836 0856 ,+ p I
R F STRUCTURAL CONSULTANTS INC.,
— ` — — — — — — — — — — — — — — - — — — — - 75-153 MERLE DRIVE, STE. B. PALM DESERT. CA 92211
' PHONE (760) 836-1000 FAX (760) 836-0856
E- MARAYMOND @RFSTRUCTUI2AL.COM
IL
NOVEMBER 8, 2004
EHLINE COMPANY '
81-480 NATIONAL DRIVE
LA QUINTA, CA. 92253
At n.: MR- GILBERT LEYVA
Re.: THE NORMAN ESTATES AT PGA WEST
LOT # 57,. PLAN I B r
55-420 MEDALLIST DRIVE
LA QUINTA, CA, 92253
FOLLOW-UP TO WALK THROUGH '
JOB NO. 4052
DEAR PHIL '
THIS LETTER ADVISES THAT WE HAVE OBSERVED THE STRUCTURAL
REQUIREMENTS THAT ARE VISIBLE DURING CONSTRUCTION AT THE TIME OF '
OUR SITE VISIT. .
WE BELIEVE THAT THE AS -BUILT CONSTRUCTION AT THE TIME OF OUR VISIT IS
IN GENERAL CONFORMANCE WITH OUR STRUCTURAL PLANS AND RELEVANT
CORRESPONDENCE ISSUED BY OUR OFFICE•
WE OBSERVED THE BUILDING IN ITS FRAMED CONDITION PRIOR TO
INSTALLATION OF DRYWALL AND STUCCO. WE OBSERVED TIE VISUAL AND
ACCESSIBLE STRUCTURAL REQUIREMENTS. (EXCLUSIONS ARE ITEN S SUCH AS:
FOOTING SIZE AND REINFORCEMENT, TOP PLATE SPLICES, ROOF. SHEATHING,
AND ANY STRAPS ABOVE THE ROOF SHEATHING).
RESPECTFULLY SUBMITTED
A. QUO Es to i
• mak, -1 y , . , •
a No• 57955 '
W.06-30-0
q C IVii-, 0¢ 3 *.
OF Cpl
ZEYAD FAQIH, P$ T
l k
Nov 08 04 10:57a --,.:.RF STRUCTURRL&SRNTRMRRIR 760 836 0856 p'`2
STRUCTURAL CONSULTANTS, INC.
75-153 MERLE DRIVE, STE. B, PALM -DESERT, CA 92211
PHONE (760) 836-1000. FAX (760) 836-0856
E- MAM RAYMON D@RFSTRUCWRAL.COM
NOVEMBER 8, 2004 "
EHLINE COMPANY
81-480 NATIONAL DRIVE t;e
LA QUINTA, CA 92253 .
r
Attn.: MR. GILBERT LEYVA
Re.: THE NORMAN ESTATES AT PGA WEST
LOT # 56, PLAN 2CR ;r
55-460 MEDALLIST DRIVE
LA QUINTA, CA, 92253 y
FOLLOW-UP TO WALK THROUGH
JOB NO.: 4082
DEAR PHIL.
THIS LETTER ADVISES THAT WE HAVE OBSERVED THE STRUCTURAL '
REQUIREMENTS THAT ARE VISIBLE DURING CONSTRUCTION AT THE TIlVIE OF
OUR SITE VISIT.
WE BELIEVE THAT THE AS -BUILT CONSTRUCTION AT THE TIME OF OUR VISIT IS ._
IN GENERAL CONFORMANCE WITH OUR STRUCTURAL PLANS AND RELEVANT
CORRESPONDENCE ISSUED BY OUR OFFICE.
WE OBSERVED THE BUILDING IN ITS FRAMED CONDITION PRIOR TO
INSTALLATION OF DRYWALL AND STUCCO. WE OBSERVED THE VISUAL AND
ACCESSIBLE STRUCTURAL REQUIREMENTS. ( EXCLUSIONS ARE ITEMS SUCH AS: ,
FOOTING SIZE AND REINFORCEMENT, TOP PLATE SPLICES, ROOF SHEATHING, ;
AND ANY STRAPS ROOF SHEATIENG.).
RnFEa
RESPEC
CIO
No. 57958 ..
r 4 Dcp.06-340
C f NV c0 \Q
OF CALF w
ZEYAD FAQIR, PE + .
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