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ADDN (9709-080)LICENSED CONTRACTOR 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 is in full force and effect. License # Lic. Class Exp. Date 684857 Bj Y31/yti ,Date"' Signature of Contractor r� •`t - f 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). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section , B&P.C. for this reason Date Signature of Owner 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 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: Carriert'Policy No. ",'ttn 171 1�ft.l 22997 (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 subject t the workers' compensation provisions of Section 3700 of the Labor ode, Il ort with comply with tho rQ visions. Date:f'� 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 prope4for inspection purposes. /Signature (Owner/Agent) � Date kZ-7v, BUILDINGPERMIT PERMIT 71 CONTROLIf DATE / / I `^ VALUATION SS..W LOT .TRACT r� / JOB SITE ADDRESS �i 1 APN 741431 01 OWNER CONTRACTOR / DESIGNER / ENGINEER M W & S MCVALI_.1 IM PXY8 iiDWARDS CO>`SSi RI_N''i10N 16090 tiEUN 7-920 I t£St'ri 1 DRIVE LA W1 ('A 9225:1 LA Q tINTA ('A 42253 l7 �75.T9'ri MIN 3712 USE OF PERMIT At.)UI'S U00i V.cvt 4t,fl�'1 Y iS^..Ml1IV PIKXMIT P1.AN("HW.'K f'FY. 1111 -Otto -4I 1AX318 SS� bti (Y94.6rr'RIW1T10N FTF 1!}I..V}(}fi..d{ft 4f{H� fRf.flit I4Ei 0 LkNTIC A1 t'r`, i lot -000-4214" S 15.t}4 4�f��:<"1ii1c.�A1. rte. 101-(Mitt-�,2t?••-tltiii Ei;.t�? �tiRf )t+K) A* rr10N Fht, - RESIL) 141411th) -241-W) 1.47 - O Strt�-Icrlgt.r•rfNsrlttl(:�i'1trNANDVI.AN011FUT S1671ro' LESS PRE,PAID FEES ;0.00 TC3•fAL FXRMIT YM DIIF:NOW r RECEIPT DATEBY f of DATE FINALED INSPECTOR " ,. OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab GradeReturnAir IV 14, 41J4 Steel Combustion Air Exhaust Fans o 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 S Drywall - Int. Lath Final Final t'/' BLOCKWALL AP ROVALS POOLS - SPAS 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 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) COMMENTS: Desert Sands Unified School District Notice: 82-879 Highway 111 Document Cannot Be Duplicated Indio, CA 92201619-775-3500 CERTIFICATE OF COMPLIANCE Date 11/21/97 No. 16311 Owner NameM. & S McCallum No. 56690 City La Quinta Tract # Street Merion Lot # Type of Development Residential Addition Comments .00m a itio mmng room APN # 761-451-023 Jurisdiction La Quinta zip 92253 Permit # 9709-080 Log i'# Study Area Square Footage 88 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 88 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 exempt Telephone 775-7933 Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Olivia Aguirre Signature Exempt $0.00 Check No. N/A NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) 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 collect them on the Dislricl('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. r Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting 4!_ �' `. 1C''\` �`� PGA WEST II RESIDENTIAL ASSOCIATION, INC. 1 : P.O. BOX 1282, LA QUINTA, CA 92253 ' (619) 776-5100 FAX(619)7'76-5111 WEST ak April 29, 1997 Mac McCallum 56 690 Merion. La Quinta, CA 92253 RE:. PGA WESI" ll Residential Association Architectural Variance - Dining Room Extension i 56 690 Merion Dear Mr. McCallum' c! -Thank you for your submittal of preliminary plans on the above -referenced residence regarding a dining room extension. Please he advised that the Architectural Committee of GA WEST 11 Residential Association, in conjunction with the Board of Directors, has tentatively approved your preliminary plans with the following conditions: 1) Please submit flour final irchitec(ural drawings. Thank you for your submittal, and should you have any questions, please do not hesitate to contact me or my assistant, ;lohn Monahan, at 776-5100. Sincerely, 6t F � .. a c. ,aa. , n n a r . � •P.'I1 • r l or Che Ardhitectural C oWIT ittIN? By.: 60' john H. Handel, Assoc iML Z MIanager cc: Don Troy, Chairrnan John Monahan, Assistant Manager Unit File 4 P.O. BOX 1504 No. 15689 Buildi"tog 78-495 CALLE TAMPICO ; Address 56-'690 1.l' Brion LA QUINTA, CALIFORNIA 92253 Owner Mac and Sheila McCallum aMailing BUILDING: TYPE CONST. OCC. GRP. Address same as above A.P. Number City. Zip Tel. La Quint? 92253 Legal Description Contractor Project Description Golf Cart Garage Addition Bob Edwards Construction Address 79-920 Fiesta Drive City Zip Tela La Quina 92253 775-7333 State Lic. City & Classif. 684857 Lic. # 3212 Sq. Ft. 213 No. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add IN Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following $4,175.00 reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a Permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to PERMIT AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. subjects the applicant to a civil penalty of not more than five hundred dollars ($500). - ❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 46.80 do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. A Professions Code: The Contractor's License Law does not apply to an owner of property who t. 72. 00 builds or Improves thereon and who does such work himself or through his own employees, Mech. provided that such 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 Electrical of proving that he did not build or improve for the purpose of sale.) O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for S. M.1. . 5 such projects with a contractor(s) ycensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec B. 8 P.C. for this reason Grading Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy Is filed with the city. O Certified copy is hereby furnished. TOTAL 119.30 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS'COMPENSATIONINSURANCE (This section need not be completed N the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg 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. Date Owner NOTICE TO APPLICANT: d, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback from Center Line 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, Side Setback from Property Line DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. This is a building permit when property filled out, signed and validated, and is subject to FINAL DATE INSPECTOR expiration it work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct: Issued by: Date Perro(Y;N 11 I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for inspection purposes. Validated by: Signature of applicant -Date-1[� SEP r �� Mailing Address Validation: 7 C r I City, State, ZiLVp IV t CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING. FEES 1ST FL. SO. FT. @ $ 2ND FL. SO. FT. @ POR. SO. FT. @ GAR. SO. FT. @ CARP. SQ. FT. @ WALL SQ. FT. @ SO. FT. @ ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK }. ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 1+/4 c SEWAGE DISPOSAL SQ.FT.GAR @ 3/ac HOUSE SEWER REMARKS: VENTILATION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA 9i 13 GRADE ` S ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF �` _� GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATUREWINITIALS GARDEN WALL FINAL T4tV1 4 4 a" Building 56-590 Perim Mailing Address ,S2.6W Coolt St. SUI goo City I Zip ITel. Contractor P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Address SM Zip ITel. State Lic. City & Classif. _ __ _ _ _ I Lic. # Arch., Engr., Designer Address I Tel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 17000) of Division 3 of the Business and Professions Code, and my license is in full force and effect./Or SIGNATURE r _ ---,rr�v -i'•.r - .• ••.� --r� DYNE OWNER -BUILDER DECLARATION I hereby affirm that I "am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he 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). ❑ 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such 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 did not build or improve for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company 0 Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg 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. Date Owner. NOTICE TO APPLICANT. If,after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. ©?642 14 1_3 BUILDING: TYPE CONST. OCC. GRP. A.P. Number Legal Description TnCt 25499*= Project Description Phase 6H P1 an MAR ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date 4J23!' hermit Validated by: Validation: Sq. Ft. Size 2M No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation ;214* PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. 19042-00 Mech. 73.10 Electrical 132.71 Plumbing 168.50 S.M.I. Grading Driveway Enc. Infrastructure Low n Credit 2 V417 __89 TOTAL REMARKS to ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date 4J23!' hermit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. @ WALL SO. FT. ® SO FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER O<G�AS (ROUGH) Q /f�A, v G V GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SO. FT. ® c BATH TUB FINAL INSP d—il SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® V4c HOUSE SEWER VENTILATION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK �6ROUND PLUMBIN �� UNDERGROUND A.C. UNIT COLL, AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS EWER OR SE ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF.5 9 O<G�AS (ROUGH) Q /f�A, v G V METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP d—il RAMING � FINAL INSP. OFING e✓ _ �--G —� ,� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL V/4fHING MESH NSULATION/SOUND7�. FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL