CGAR (9707-081)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
/DateTPJ/ Signature of Contractor �""� ���°v
9 { w ;,
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.- (X, 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:
Carrier Policy No. ,
sf'
s3 �J, F J.. 3Jp'!'lYf�}!tT•.fc!
(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 Sectior}.3,700 of1he' Labor
Code, I,„sha I forthwith comply with those provisions.
✓Date: Applicant %" `.�Fi tf �? �JA� i 1�`• a �✓ `�
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 is 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 offithis City to enter upon '
the above-mentioned property foruinspection purposes. A
/Signature (Owner/Agent) j°' �gDaterf"
PERMIT # CONTROL• # '
BUILDING PERMIT 97074*41 5561,:
DATE '71'0 19%1 VALUATION 1��ay?d� atj LOT TRACT.
JOB SITE
ADDRESS 577 157 MR:)0-XI
APN 76#4514)11
OWNER
CONTRACTOR / DESIGNER / ENGINEER
l -S ',
{:,7;rlt"��.(kY.,�. .fitiJ:11:'�'t7M;,�:f�.tL��'�,{
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USE OF�PERMIT
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REQ PT�
DATEz %� f,.
BY rLV
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms &Footings fjDucts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
InsulationVents
Fireplace P.L. All—Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROV S
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:
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ti, . i• Building & Safety Division . `.
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.. - P O Box 1504
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Permit # <:>;:::::
s 78-495 Calle:Tampico . _
-
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La Quinta, CA'.92253 , ' • , .`
Building -Permit Application and Tracking Sheet w
Project Address: —. �� .%
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%Owner's Name: 6 •
A. P. Number: '.
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Address: aS
Legal Description: .,
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0City,ST, Zip:,M— � � N " 9-& 00 /
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n ractor. -
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Tel' hone:.
ep
Address: .� Yds •�- d.
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Project Description: .�• •, , , _ Q ' ,
City.ST,-Zip: � (.t/ C % 2 2: S -3 • .
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Tele hone:
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State Lic. # : &4p I S
City Lic. #
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Arch:. Engr.• Designer: -
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Address: - •. 1- .
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City. ST. Zip: .' ti.
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Tele hone: '
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State L'�c. #: _ .
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Pro'ect act cle one : New Add n• Al `
ter. R au Demo .
J tyP . ) ep
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•Name of Contact Person: �� �• ,_ rn.� �1. "�
'Sq. Ft.: - 15 -
-
#Stories: �'' _
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#Units: s
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Telephone # of Contact Person: , � 64—' a 7 L/
Estimated Value of Project: l% D U C� �_
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CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. o "A
L�;�AQING FEES
IST F!_. SO FT ,r f
2ND FL. S0 Fr. .a
POR_ SO. FT
GAR. SO. FT. ,0
CAR P 50. FT 4
WALL SO Ft R
50 cT. A
ESTIMATED CONSTRUCTION VALUATION S
UNITS
MOSILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to Ca :.Seo as procany :as ra:uatlon
BONOING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVARCOOL :4000
SIGN
WASHER(AUTO)t01SH1
APPLIANCE DRYER
GAS (ROUGM
GARBAGE DISPOSAL
FURNACE UNIT 'MALL FLOOR SUSPENDED
OTHER APPJEOUM.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP, POLE
KITCHEN SINK
ABSORPTION SYSTEM B.T U
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE. TEWPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. 0 c
IBATH TUB
SO. FT. a c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SU. FT. RESIO A Ila a
SEWAGE DISPOSAL
SO.FT.GAR 0'AcHOUSE
SEWER
REMARRBt
GAS PIPWKI•
PERMIT FEE
PERMIT FEEm
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
NST. FEE
r
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATMIGAAIRCOND SOLAR
SETBACK
GROUND PLUMBING
UROERGROUNO
A G UNIT
COLL AREA
SLAB GRADE
ROUGH PLUMS,
BONOING
HEATING (ROU"
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRWIO
DUCT WORK
ROCK STORAGE
FOUND. REINF,
GAS (ROUGM
METER LOOP
HEATING (FINAL&
OTHER APPJEOUM.
REINF. STEEL
GAS (FINAQ
TEMP, POLE
GROUT
WATER HEATER
SERVICE
FINAL low
BOND BEAM
WATER SYSTON
GRAORM
CLL Y&
_ 01111111
LUMBER GR.
FINAL INS/.
FRAMING
FINAL INV.
ROOFING
REMARRBt
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR FIREWALL
LATHING
MESH
INBULATK WSOUNO
FINISH GRADING
FINAL INSPECTION
CERT. OCC,
FENCE FINAL
I/q/R/VR�i/1M�A1V��Yw�
GARDEN WALL FINAL '
Y PGA WEST II RESIDENTIAL ASSOCIATION, INC.
%
P.O. BOX 1282, LA QUINTA, CA 92253
(619)77'6-5100 FAX(619)776-51111
PGA WESTTM
June 24, 1997
Mr. Joseph Finley
625 Raintree Road
Mankato'MN 56001 "
Re: Architectural Variance - 57-157 Merion, La Quinta CA
Dear Mr. Finley:
I am: pleased to report the PGA. WEST II Residential 'Association Board of Directors and
Architectural Committee have approved your plans submitted to construct a golf cart. garage at
the above -referenced residence, with the ,following ,conditions:
1) Need' clarification from. your architect/builder.as to what is affect of cart garage on,
common wall between properties.
2) Need Neighbor Murphy's approval on sketch to be faxed to him (see attached
application documentation.
3) Show the -wall location on page 14 of -the plans and the wall to structure interface
detail.
4) Need six inch square reveal detail on each side of cart door per the Highlands
models. "
S) The separation between the cart. garage and main building is only 8 feet. Obtain
permission from the City of La Quinta for this narrow of a separation between
buildings.
6) Provide .structural plans prior to commencement of construction.
Thank you for providing the above requested items. Should you or your builder have any
questions, please do not hesitate to contact me or my assistant John Monahan at (760) 776-5100.
Sincerely,
PGA WEST II RESIDENTIAL ASSOCIATION
For the Architectural Committee
By cc: Board, John Monahan, Unit File
JOHN HANDEI , ASSOCIATION MANAGER
JU JUN 10 '97 01:09PM CRADDICK,CANDLAND,& CONTI
PGA WEST II RESIDENU4,L ASSOCIATION INC.
ADJACENT NEIGHBORS' APPROVAL
For Architectural Change Application
Applicant's;Name: -J d a \1��� - •: •��e
Address of Pro
Posed C!>arsg+e.
Proposed Change:
Dear. Neighbors of the Applicant,
Your next door neighbors, as listed above, have applied to the Architectural Committee for
approval to make a modification, addition or change to the exterior of their residence. In uses where
there could possibly be any infringement on a neigltboes view or privacy, as they will be looking at the
rooru addition, cart garage, awning or golf ball protection screen, the Committee requires that the
appli= obtain the written consent of adjacent neighbors,
The Architectural Committee will take into account all comments from neighbors before malting
its final detenni,natiou on approval or.denial of the application submitted Now is the time to be. heard if Y:
you have any objections. We appreciate your input Thank you for cooperating in granting'apptoval that
will not be unreasonably withheld.
`Architectural Committee
Adjacent Neighbor's Navane and Address (Please Print): '
t- Approval Disapproval (Please Check One)
Comments: D E s A N ;-n d 5- Re u % 6w 4-Z)
Signature: Date: /lo :2
Other Adjacent Neighbor's Nance and Address (Please Print);
CA
Approval Disapproval, (Please Check One)
Comments:
Signature: Date:
page 9
TOTAL P.01
A _:
Building
Addressss57x'25, Herion
Owner
Sunrise Coma
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
maning
Address 42-600 Cook St. Suite 200
City Zip Tel.
Palen Deseri 9226th 568-2028
-Hational HDrtaaae &fund
Address Sam I
Tel.:
State Lic. I City
& Classif. � $ Lic. # 39s
Arch.; Engr.,
Designer
Address Tel.
City IZip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of hrtsion 3 of the Business and Professions Code, and my license is in full force and
SIGNATURE DATE
OWNEWBUILDER DECLARATION
I hereby aff un that 1 am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,11usiress and Professions Code: Any city or county which reQuires a
permit to constiruct. aller, kWmve, demofsh, or repair any structure, prior to its issuance also
therequires the applicant for such permit to We a
is licensed
suant to
provisions Contractors Licensee Law, �Chapter�9 (commencinent that g with Section 7000) of,
Division 3 of the Business and Professions Code, of tthat.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 rove hundred dollars (8500). -
❑ 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, Suisness and
Professions Code. The Cantractors 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 rrprovements are not intended or offered for sale. fl, however, the building
or improvements 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 card actors) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec B. & P.C. for this reason
Date owner
WORKERS' COMPENSATION DECLARATION
Workle by affirm that I have a certificate of consent to self -insure, or a certificate of
pensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Cbmpany
❑ Copy is filed with the city.. ❑ Certified copy is hereby furnished. . .
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed N the pemdt 'is for one hundred dollars ($100) valuation
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
Date Owner
N077CE TO APPLICANT: d, after making this Certificate of Exemption you should become
subject to the fybrkers' Compensation provisions of the labor Code, you must forthwith
comply wilt? such Provisions or this pemnit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.) "
Lenders Name
Lenders 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 certity that I have read this applicationand state that the above information is correct.
agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof this city to enter the above-.
mentioned property for inspection purposes.'
Signature of applicant Date
Mailing
City.. State. State, Zip
No. 07234
s
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number PGA
Legal Description Tract 24841
Project Description Phase 5N a Plan H?A
Sq. Ft. 2645
Size
No.
Stories. -Units
No. Dw.
New ❑ Add
- Alter ❑ .. Repair ❑ Demolition ❑
Estimated Valuation
$191,449
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ 17d+44)
Const.
vollbu
Mech.
15.
Electrical
A2J. A
Plumbing
1b4l bu
S.M.I.
Grading
Driveway Enc.
Infrastructures.
•fit%
5 Uredif
Z11544dusw
n
11.111 -a WUCCgi"
�(7C0
TOTAL
REMARKS
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
2/28/90
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL SQ. FT.
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. Sp, FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
OTHER APPJEQUIP.
DRAINAGE PIPING
WALL SQ. FT.
TEMP. POLE
DRINKING FOUNTAIN.
SQ FT ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
=$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® IVi c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3Vic
HOUSE SEWER
MESH
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
PLUMBI �GUNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
VSEWER OR SEPT
ROUGH WIRING
DUCT WORK
ROCK STORAGE
LOUND. REINF�'---"r
GAS (ROUGH
"
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 GFL
NNSP./6C26-fa INSP./66-fa
�y
FRAMING {/��
[
FINAL INSP.
ROOFING
a // r7 — 2-0— qlio lklli<
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
J1//ATHING —4?,
MESH
INSULATION/SOUND'
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1