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0107-115 (SFD)LICENSED CONTRACTOR DECLARATION ereby affirm under penalty of perjury Ila, 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 61/17103 m� /,1_7Xignature of Contractor Date I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 1, 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). ( ) 1, 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 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. PREMONT COMPE142 X1350-060040320 (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 37.00 of the Labor Code, I sVall foqhwith comply with thosel.:Pro Sion ms _XY Warnihg: Fdilure to secure Workers' Comp6nsation coverage is unlawful and shall subjectan employer to criminal penghies and civil fines up to $100,000, in addition to the cost of compensation, cla'mages 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 wh6se benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnity & 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 .11 f the above-mentioned property for -inspection �Ypqses. Signature (Own BUILDING PERMIT PERMIT # DATE VALUATION LOT 01107.4 1.S TRACT JOB SITY ADDRESS APN 1 '170-' .470-4318 OWNER CONTRACTOR / DESIGNER / EN61NEER MADTA014 MIMA"OCIAT a -St ANIMW 1-WRCE CORPM)MON 1 76-505 OLD MMUE52, 4 4 8 357 DW C"i YON:RD LA QUIDTM CA 92253 11DAUA r/FMT CA 92261 (760)346-322S MIN 03011 USE OF PERMIT MfCL1Li.71)JH0'TH2 "a1WA140qR_tr) SPECIES ACT OF 1973 (16 O.S.C. CUSTOM CONSTRUCTION 311IM100 sp UARAQ WCARPORT 70.00 Si? POR.CMIA110 3512.00 15F 99ZE"TED Cogir OF C0.124SMUCTIOM 267=4M 00ma &UY FSE DEPONT 1011-000-439-M 43rkop PIAN CHWE.'",F, $254.34 CONFrItUCTION FOR 101-0W-416�00 $1,227." MECHANWAL FEW 101-000-421-0-tv. 91ZCTPJCAI,'M­X 101 -000-4?,0-000 PLUMBRi a IFFIE 1101-000-419-000 MONOMOTION ME - RMD 101-000-241-000 S20.72 WtAf) NO KUKC191 PLAN -AltT DI PUBLIC PLA 5-.--00o , '"no JUL 19 2001 Ruen �ax' C ­bm -01T Alpp $4, 1 a. 33 A MOS PR. -+PaD M?M 4333.00 POW RECEIPT DATE 1BY D T FINJAD ( - 0 Z..,* I INSPECTOR _ INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION I DATE TINSPECTOR BUILbING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap E, F.A.U. Framing Insulation )7 T Compressor Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall Int. Lath - 2 - Final Final POOLS -SPAS BLOCKWALL AP 'ROVALS 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 ShowerPans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test ;'S 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 W 4 Utility Notice (Perm) 7 - 77 V P.O. BOX 1504 Building 78-495 CALLE TAMPICO Address -7 3 - N 'P; k? n a -a e LA QUINTA, CALIFORNIA 92253 Owner I malting Address'I-A City lZip [Te_1 Contractor Address A.4 — City Zip Tel. State Lic. City Lic. 4 & Classif. 6_,-712-63 Lic. # Arch., Engr., Designer Address Tel. City Zip State 7 Lic. # LICENSED CONTRACTOR'S DECLARATION I hereMeffirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of 1vision 3 of the Business and Professions Code, and my license is in full force and effect . SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the follow ing reason: (Sec. 7031.5,gusiness 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 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 th rfi qe alleged exemption. Any violation of Section 7031.5 by 'any applicant for a p subjects the applicant to a civil penalty of not more than five hundred dollars ($560). 1-11 1 as o net of the property, or my employees with wages as theirsole compensation, will do ihe wpr , and the structure is not intended or offered for sale., (Sec.�7044, Buisness and Pro'..ions,116de: 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 0, 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.) I I I 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 [71 Copy is filed with the city. 0 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 thp work- for which this permit is issued, I shall not empi oy 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 con s truction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Signature of a0plicant —Date— Mailing Address City, State. Zip APPLICATION ONLY LDING: TYPE'CONST. OCC. GRP. . Number 77()-37o_ opl� al Description T 2_ 9,16 7 40--r- 179 1--6 Project Description S Ft No No. Dw. s9iz'e , 3, 11 -4 —stories Units I Newv Add 0 Alter 0 Repair 0 Demolition 0 Estimated Valuation PERMIT Plan Chk. Dep. Plan Chk. Bal. AMOUNT Const. Mech. Electrical Plumbing U] S.M.I. Grading 1AAV 1) 0 On"'11 Driveway Enc. 1 4- V -U I Infrastructure L CITY OF LA QUINTA PINANCE DEPT 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 Issued by: Date— Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert 'Sands'Unified School District 47-950 Dune Palms Road' Notice: iinta, CA -02253 LA u Document Cannot Be Duplicated � 7'60-771.;'8515 CERTIFICATE OF�COMPLIANCE Date 7/13/01 No. 22248 'Jurisdicti n �o Owner NameAndr'ew Pierce Corp. No. 78-198 Street Pinnacle Point" city La Quinta zip 92253 APN# 770-370-017 La Quirita Permit#0107-115 Tract # 28867 Lot # 6 Square Footage Type of Development Single. Family Residence Comments Log # Study Area V 3174 No. of Units I ived a cashier's check in the amount 'of $19,520. 10 for3 SFD. At the present time,.,the Desert Sands Unified School District' doe's not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehornes. It has been determined'the above-�'n-:amed owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to GovernmOt Code 53080 in the amount of 2.05 .'* X 3J74 or$ 6,506.70, the'property listed.above and that.buildin 9 permits and/or Certificates of Occupancy f6r.this square footage Mi- this proposed project may now be issued Fees,Paid By CC/Palm Desert, Nat'l Bk -Autumn Sim's -346-3228 Tele0hone 7.60 Name on the check By Dr. Doris Wilson Superintendent Fee collected /exem ted by Annette Barlow Signature Payment Received $6,506.70 Check No., 0823.45 40TICE: Pursuant ot Assembly Bill 3081 (CHAP 549, STAT I S.11 . 996) this will' 'erve to notify you that the 90 -day approval period in which you ma I y protest the fees or other payrn ant i . dentified r lbove 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�autlhorized to :ollect them on the DistrictCs)(s') behalf, whichever is earlier. Collector: Attach a copy of -county or citiplan checkapplication form to' , district copy forall waivers. Embossed Original- Building Dept./Applicant Copy - Applicarit/Receipt Copy - Accounting -0? -2001 18:21 TRADITI'ON GOLF CLUB ?60 564 2356 P.01 qradifton. ARCHITECTURAL'NSION REViEw June 6, 2001 Via First Cl= Maff Mr. David C ' hap�nan TRADMON CW8 ASSOCIATES 78-505.,Ola Avenue �52 La Quinta, CA 92253 Re: Old ' Califibmia Village construcdon Documents .21 Submittal Dear David, The ADRC of TraAition Golf Club reviJew'e'd and approved the, construction documents for The Old California Village. The Committee has asked that you*consider using solid wood mechanical doors. If you need any addiddhW"informatio'll, please do not.hesitateto call. Thank you. Sincerely, Christina J., Dores Architectural Review Coordinator cc: Gary Lohman,- APC j6 dy Jq nes, APC Rob Parker, RGA 78505 OLD AVENUF-32 7 LAQUhNTA —CA92253� I IN — NoNE760/564-335.5 — FAx 760/564-2356 Certificate of Occup'ancy .City of La Quinta B ilding and Safety Departme'nt This Certificate issued pursuant to the requirements. of Section 109 of the Uhifofm Building . Code, certifying - tha t, a t the i . time of.issuance, this structure was in compliance with the various ordinances of the City regulating -building con'. struction'bruse. Forthe.follow,ing: BUILDING ADDRESS: 78-198 PINNACLE POINT Use Classification: SINGLE FAMILY DWELLING Occupancy Group: R-3 Type of Construction: Owner of Building: TRADITION CLUB ASSOCIATES Building Official Bldg. Permit No.: 0107-115 VN Land Use Zone: RL - Address: 78-505 OLD AVENUE 52 City: LA QUINTA, CA 92253 By: RICHARD KIRKLAND Date: 05-17-02 POST IN A CONSPICUOUS PLACE �SPECIAL INSPECTION SERVICE, 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 0 REINFORCED CONCRETE 0 STRUCT. STEEL ASSEMBLY 0 POST TENSIONED CONCRETE 0 ASPHALT 0 REINFORCED MASONRY 0 FIRE PROOFING 0 je OTHER JOB LOCATION 'I 1 1 1(96c) —LA REPORT SEOUENCE NO. TYP �FJSURE y DATE OF'REPORT PERMIT -NO- 6�q-7 —k kz-;7 DA 13 DAY OF WEEK -roe-S MATERIAL DESCRIPTION or(�_ja& '2� ARCHITECT V\\Ja f INSPECTOR HRS.CHARGED E ENGINEER �-k Ks ASSISTANTS I HRS.CHARGED INSPECTION GENERAL DATE CONTRACTOR SUB CONTRACTOR 4er ck 7& A WIr --o.A s3a i& �o' A�\ Q ow"(x SA r,,I?S 6 c\ Z7'�e)r 4 COPY SENT TO CLIENT 0 CONTINUED ON NEXT PAGE 0 PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CER71FY THAT I HAVE INSPECTED TO THE BEST OF MV 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. C& S16WURr OF REGISjEjtD V'M M INSPECTOR 'I 1 1 1(96c) :;707-77 1'7-8(/ DATE OF'REPORT REGISTER NUMBFIR 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 0 REINFORCED CONCRETE 0 STRUCT. STEEL ASSEMBLY 0 POST TENSIONED CONCRETE 0 ASPHALT 0 REINFORCED MASONRY 0 FIRE PROOFING d- J410 X 0 OTHER JOB LOCATION "784%9 'LojAJOA CI -e poi Aj 7 LA i REPORT SEOUENCE NO. TYPE OF STRUCTURE : i:, 5 _b We - IRM Ljio t -)S PERMIT NO. 0 1 (0 DAT itlills( DAY OF WEEK MATE6AL DESCRIPTION e"(jApj 0 tj 54e. geow ARCHITECT 0(Z5AVM fAA-91e- INSFFECTOR HAS.CHARGED ENGINEER u �ASSISTANTS HRS.CHARGED INSPECTION DATE GENERAL SUB CONTRACTOR 16VIJe�jWCA3 F' -e CONTRACTOR Lt 5 INI-� 5 ox -P-4 Z,T Pot -os bW54--p-al bk"oJ C ta C' e—, oeRIOP— 7V COPY SENT TO CLIENT 0 CONTINUED ON NEXT PAGE 0 PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV 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. to - ) !��" SIGNATURE OF REGIAERED INSPECTOR it & I - --rz& (it 13V -V? "DATE OF REPORT REGISTER NUMBFR 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 0 REINFORCED CONCRETE 0 STRUCT. STEEL ASSEMBLY 0 POST TENSIONED CONCRETE 0 ASPHALT 0 REINFORCED MASONRY 0 FIRE PROOFING 0 OTHER 9p C11w- 0 'X I JOB LOCATION�L(,/7-=-j-q'-.g--- p- REPORT SEOUENCE NO. TYPE OF ST TURE SM & PE RM61. 7_ /JS, DATE DAY OF WEEK - MATERIAL DESCRIPTION ARCHIT CT C HRS. CHARGED ENGINEE�, ASSISTANT� HRS. CHARGED INSPECTION DATE GENERAL t SUB lei p CONTRACTOR f�tOQL 'e le -Ce _CONTRACTOR If + 6" VI - r V4., - COPY SENT TO CLIENT 0 CONTI E)N NEXT PAG:,2f PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV 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. �G I kTUj OF REGIS�nS61ECfOp - --)- -;Z-A 1,oL ki TE Ok REPORT REGISTER NUMFIFR 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 0 REINFORCED CONCRETE 0 STRUCT. STEEL ASSEMBLY w- F-?o`ILq 0 POST TENSIONED CONCRETE 0 ASPHALT 0 OTHER 0 REINFORCED MASONRY 0 FIRE PROOFING JOB %114- C14V Q -%Z, N --r- ;N. REPORT SEOUENCE NO. TYPE OF STRUCTURE TV-4wl % PERMITNO. :A E, '& 'I ' t j DAY OF WEEK MATERIAL DESCRIPTION 51 o to --;e- 9AP-4- ARCHITECT _ja%j INSPECTOA 'T! 6 71 HRS.CHARGED S I. -7<17 ENGINEER ASSISTANTS HAS.CHARGED INSPECTION GENERAL SUB DATE CONTRACTOR r -t-' a n',:' T-(LcV. r-oNTRAcToR %k %t- 'S Ou'r Be -AW -00 '!�'Ioj C" 'S'% &A 5 C3 ,I 5,e --T- C -pd )C-*-( Elp-t+ W6 1' 6 f- T -0 COPY SENT TO CLIENT 0 CONTINUED ON NEXT PAGE 0 PAGE 'Of CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV 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. SIGNATURE OF REGI�TMD INSPECTOR %k 31�o It =60 I t I I 31,b - 4 4`1 1 DATE OF REPORT REGISTER NUMBFR