GRES (0202-050)LICENSED CONTRACTOR DECLARATION bl
I hereby affirm under penalty of perjury that I am licensed under provisions o,Jj--
Chapter 9 (commekoing with Section 7000) of Division 3 of the Business and
ProfessionalsCode;' and my License is in full force and effect.
License # yt"" Lic. Class Exp. Date #
t
�` ^ 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).
( ) 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:
O 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
r%permit is issued. My workers' compensation insurance carrier & policy no. are:.
Carrier L&C1014114S CO. ' Policy No. WC3441'M
(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 to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with, hc6e,pr6v s'ions.
Date. E h 11 1 'r Applicant ! ( t
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, ,damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his .
application.
1.'Each person upon whose behalf this application is made & each persgn.'at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees. .r
2. Any permit issued as a result of this application becomes null and void if M!
work is not commenced within 180 days from date of issuance of such .
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent)•f� .^. Datell"; -�
r
BUILDING PERMITNt- PERMIT#
DATE ! VALUATION LOT TRACT
'J /4,i e-
APN
ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
M & 1A MAND VNN
BOTS MWt1RDS CCSNMMi: CTICM
S6 9O PRION
19-920:[It�.��':A�DJi U
Lf%(JUTcJ"a: •. C A 0225.'4
X. s, `� INTA, CA 92253
'aU
:3212
USE OF PERMIT
CI1;8LF ICA1RT KSf1.f ACIR AMMON. 0100 V, If.)
Sy
P .,'9►� 70 Col", Ca+: r t;4�'d�s°;�`��`f,7`C.:`.$: ON
}j .q'9 �t gg�y';g;}�,�'?
y �'�g•�g,,yam p' y7•�'$v'SUMMARY
F*
PLAN CDECK TiFIE, 103 -00"- 39-1131 r� S40,0
C 0NS'b'R,UCTT0,W PIKE 101-000-418-000 so`, 00
MEC`•TRICiAL M-3 2O�-eit�Q +�a.Q�£hiir $dSasfi
S'f`RCYNG M011014 IMS113 1,0 -000,241-000
ifTte`!�'3�t'r� }�S lt3� �C<3�3a�2:�-CiUt� a�it,ilit
i� 3=x'C)AIS,I i`t�A) '9° tt9 CCi +t Al, i3'1'1f;Y1 CREq
$149.95
11114 1. PIZE-PADD T-1101
MOO
p.
0,1 - .A444
.0S
APS 0 4 7o0z
CoTY0E—
RECEIPT-:1SDA#E-•-
Bye
DAT�,FI
/fes
INSPEC O
!,
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 j
Exhaust Fans
0. 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 4
Drywall - Int. Lath
Final
Final 0
BLOCKWALL APPROVALS1
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
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated 760-771-8515
CERTIFICATE OF COMPLIANCE
Date 3/26/02
No. 23077
Owner NameM & M Grandove ,
No. 56-790 Street Merion Street
APN # 762-032-008
Jurisdiction La Quinta
Permit # 0202-050
Log #
city La Quinta Zip 92253 Study Area
Tract # Lot # Square Footage 200
Type of Development Residential Addition No. of Units 1
Comments
Cart - Carport
r
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 200 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 - Donna Ricketson Telephone' 760 775-7933
Name on the check
By Dr. Doris Wilson �= `
Superintendent �f
Fee collected /exempted by Paula Ruiz
Signature
s
Exempt
Check No.
i,
(NOTICE: Pursuant to Assembly Bill 3081 (CHAP 549, STATS. K96) 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 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
mar V1 uZ ua:iup
..
PGA ST.
February 25, 2002
Mr. Christopher Grandov
1000 Paloma Ave.
Budingamcy CA 94010
PGA WEST 11 RESIDENTIAL ASSOCIATION, INC.
P_O. BOX 1282, LA QUINTA, CA 92253
(760) 776-5100 FAX (760) 776-5111
Reference: 56-790 Mcrion, La Quinta
- Architectural Change Request — Addition of Golf Cart Garage
Dear Mr. Grandov: 0
The Architectural Committee unanimously approved your plans for the installation of a golf cart
garage. Please reference page 5 ofthe Architectural Rules, that state: "In homes originally built
with sectional mill up garage doors, the golf cart garage door must be a sectional roll up. in
homes with one-piece lift up garage doors, garage and golf cart garage doors may be replaced
individually, if the owner chooses, with a sectional roll up door. In all instances, the new and
replacement doors must retain as closely as possible the original design fagade." If you do not
have a sectional roll up garage door and decide to rcplace it later, the golf cart garage will need to
be changed to match
Review by the -Committee is obly for general conformance with the Architectural Rules. Itis the -
responsibility of the owner to 611y understand and conforin to the Architectural Rules criteria
Kfiethcar or not all deficiencies are noted during review. It is also the owner's full responsibility
to field verify all existing conditions. The Committee's decision with regard to project design
will be final. Please refer to the Architectural Rules and Application for Architectural Change for
all required submittals.
Following are the concerns of the landscape committee.
• Existing landscape must be brought back to its original condition upon completion of the
construction.
• The relocated Mediterranean fan palm must be, warranted for six months and replaced
should it die within that time period.
Please note:
1) Calliandra and Japanese boxwood do better in shade than in sun; would you consider
changing?
2) Bougainvillea does well in the sun but not in the sha(k; would you consider changing?
3) Are these Nandina Domestica trees? They look very large on tate draKin. The Nandina
Domestica on the Recommended Plant Palette are shrubs.
Please contact Javier Contreras, supervisor lbr Valley Gardening Service at 760/399-1844 and
Carol Fuller, the Association Manager, prior to any irrigation modifications associated with this
change. Damage to the landscaping, i.e., shrubs, trees, flowers and turf is the responsibilit-
y of the
contractor. The landscaping must be brought back to its original condition when the project is
completed.
Mar 01 02 05:19p r
I
Mr. Christopher Grandov
Fcbruary 25, 2002
Page 2.
Approvals given by the Archiwzmral Committec are good for only six months from the date on
the approval letter. After that time a new application must be submitted.
Upon completion of your project„ please complete and return The Notice of Completion of
Architectural Change.
If you have any additional questions or concerns, please do not hesitate to contact Carol Fuller.
Association Manager, at 760/776-5100, Ext. 20.
Sincerely,
s
PGA WEST 11 RESIDENTIAL ASSOCIATION
For the Architectural Committee
For the Landscape Committee
Carol Fuller
Association Manager
cc: Board of Directors
Unit File
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE O STRUCT. STEEL ASSEMBLY 0
❑ POST TENSIONED CONCRETE ❑ ASPHALTQ7 OTHER
❑ REINFORCED MASONRY ❑ FIRE PROOFING
JOB LOCATION=--� -� -' - - •O (
REPORT SEOUENCE NO.
TYPE_ OF STRUCTURE
I _
EQ v 1&
PERM T N0.
J �K � �(��
(D W K!
DAT DAV OF WEEK
-
MATERIAL DESCRIPTION
S �
INS ECTOR HRS. CHARGED
t�,ao 2 o
ENGINEER
I(:;V) G
ASSISTANTf HRS. CHARGED
INSPECTION GENERAL J SUB
DATE CONTRACTOR;& CONTRACTOR n
y- 5
b � 1 r ;o
(1 8 z�I n �
'dg-
o S �� S a
COPY SENT TO CLIENT ❑
CONTINUED ON NEXT PAGE ❑ PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT 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
I d2t��-4��
5 N TUBE OF REGIST ED INSPECTOR 4
DATE OF REPORT EGISTERRNUMRFR
Twyl 4 4 a"
Building
Address S6 -M "on
Owner
Sunrse env
AddressO- f
itie
City I Zip ITel.
Contractor
Address-'--------
SM
ddress---------- SM
Zip I Tel.
State Lic.I City
& Classif. _ _ _ _ _ _ Lic. #
Arch., Engr.,
Designer
Address Tel.
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
CityI Zip I State I
Lic. #
LICENSEDCONTRACTOR'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
e!IW4 , '• r.1 1 / - .4,- '71! / 4./)
d r
SIGNATURE' "UNTE
y OWNER. BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors 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 thathe 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 (8500).
0 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, Bussness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds .'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.)
❑ I, 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.)
0 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
❑ Copy is filed with the city. O 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 (8100) 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 it 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
BUILDING: TYPE CONST
A.P. Number
No. 07545
14''? kI
_OCC. GRP.-
Legal
RP.
Legal Description T"Ct: 2449-I
Project Description PhA4t4+ fiR Plant MRR
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 4/23/90 Permit
Validated
Validation:
Sq. Ft.
Size 28"
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
$214,923
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
838- 8
Const.
Mech.
Electrical
Plumbing
S.M.I.
ICAS
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
UJR7.73 41/1 ( -7, �
1141f!_,{1.Fi"�.+^14-e?`3~�t
R.tlJitt'
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 4/23/90 Permit
Validated
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO, FT, ®
CAR P. I SQ. 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
AS (ROUGH) F MVV
Z
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,TEMIPERM
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 ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
VENTILATION
GAS PIPING
PERMIT FEE
MIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEECONST.
FPL.CK.FEEE
FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING .
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
ER OR SE tV
��/S�
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF. /. Of
(vi
AS (ROUGH) F MVV
Z
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.
ANAL INSP/0 -
FRAMING rr/�
FINAL INSP.
ROOFING —!
ej
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
/ THING %
MESH
6INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL