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LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
e
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
533670 B , i 0613012(
tel-*/
Date Signature of Contractor
OWNER -BUILDER DECLARATION
(,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 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 OOLtgr1d F.A()LE Policy No. NWC 322374 04 k
(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 i6 any manner so as to become subject to the
worsers' compensation laws of California, and agree that if I should become
ect to the workers' compensation'provisions of Section 3,700 of the Labor
Code, (shall forthwith comply withIhoae provisions.
/Date:��/5/00 Applicant—/ �rr�--R <•�• ✓`-c-' - C'. '
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
jcgpstruction, and hereby authorize representatives of this City to enter upon
tfie above-mentioned propertyfor inspection purposes.
Signature (Owner/Agent) ;Dat
�;.
BUILDING PERMIT PERMITk
DATE VALUATION LOT 000"39 TRACT
A,6i3.2Q 26 r' 28470«2
JOB SITE
ADDRESS
APN
$2-60.22 C.AHET11J A. COURT
770-3Ei O(MI
OWNER
CONTRACTOR / DESIGNER / EN (NEER
ALACAYRD
SUNROSfE CORPO 109
52.61.2 CA�ILLA COiTRT
39'72-5 GAIWW 1,AWF-, WYM, C'
LA OjJI TA CA 92253
PALM DESEWr C'A. 02211
(760)345.7186 CB1,4 1I 7
USE OF PERMIT
MTOLE I±AIv Y IYt7 E L LWO
z
i
SPD-P.ETWIT D091S' NOT INCLUDE BLOCK WALLOP, POOL
c:
CUSTOM CONSTRUCTION 090.00 SF
PORCHIPATIO l,l.ga3.w sy
0ARAA0VCA'RP(f T (5F)
s
ri
xx ESTM ST" COST OF C0.IVT:IRVCf1ON
&41,609.20
CONSTRUCTION I<T'Ir, )01.000-418.000 $21151"
PLAN CHECK FEE 101-000-439-318 :1,744.30
FEE DEPOSIT 101.000.439-318 -$1,000.00
MECHANICAL F8t 101-0007421-000 $204.50
ELECTRICAL IEE 141.000-420-000 $324,41
PLUMBP1140 FEE 141-0,00-419-000 `)340.75
$T1 ON0 IMOTIOW FEE - R.> MD 1 Q1.Odb•241 «0,00 S53.16
03PLA> MIG FEE 141-1304-423-030 $20.00
DWELOPE R IMPACT IEE fl,907.00
ART IN PUBLIC PLAC.-M - U_$It 701-000-255--000 $823.01
UB-`i't TAL COWTIRALICr.iIdN AM PLAN (THEC'I;
S7,5W 64
7,ES0 PRE�pAU)FE S,
•$1,000,00
DUB NOW
X6,W: 6,4
/i
RECEIPT
DATE /B"Y 1
DATE FINALED
INSPECTOR -
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
AD
Underground Ducts
Forms $ Footings
4
Ducts
Slab Grade
V
Return Air
Steel
Combustion Air
Roof Deck
— - 00 S t"•
Exhaust Fans
O.K. to Wrap /LT
-00
F.A.U.
Framing
Compressor
Insulations t
Vents
Fireplace P.L.
-am $%
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final o
BLOCKWALL APPROVALS
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 LinesHeater
Final
Water Piping
7Z
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
p Qtj
Encapsulation
Gas Piping
Gas Test
p
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:
AwzS F_241.ao S -t
pP.0 wae, —,W/-?� - v
�� G,Qp
I v— L
E,•rc �v- rr- �p r..r7 r i — r`:—z ., r� *sec 7xr t•.. : v . R�*n �.�"'fr s»cl+�
µp.1 8E �IFrsp
4AweZ65 K If
P.O. BOX 1504 t� ' APPLICATION ONLY
Building ��(DZ2 CiG/` C'f, LAQUINTACCALFALLETAM
Address A92253 6 1
Mailing
Address
L4 dic-IF ! , `-R-t-' M-0 -
Contractor /� . , SL,
S���GP �nv-In_ (\
Address t I `' - )
1 a r a, n ci L� oL�r�LJ11 -rn
y ( Zipq �- I
Tel.
-3
State Lic. I City i
& Classif. Jr 3 3 r, O Lic. #
11-7
Arch., Engr.,
Designer I'i�'f • V1J1�'�1 �7r;I
Address Tel.
�,���z,
City Zip State
PILI 1 I1Csj z7' iJr `� lZ! Lic. # C-101110
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 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
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, 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 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).
IJ 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, 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.)
I 1 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 or 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 am exempt under Sec. B. 8 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
n 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 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
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.
1 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 a0plicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE'CONST.
A.P. Number
Legal -D scription L�
(Project Description
SIG .
y
OCC. GRP.
�Q S842)' 2
)G4ue SAJex,
AS 112AI
ACA00"
w
2
d
Sq. Ft.
Size 6 5 50
No.
Stories
No. Dw.
Units
New ❑ Add O
Alter ❑
Repair ❑ Demolition ❑
PRA11)
F
OF LA QUI
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Pian Chk. Bal.
✓
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
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
N _
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 5/4/00
APN # 770-300-008
No. 20391 Jurisdiction - La Quinta
Owner NameLance Alacano
No. 52-622 Street Cahuilla Court
City La Quinta zip 92253
Permit # 0005-039
Log #
Study Area
Tract # 28470-2 Lot # 26 Square Footage 6390
Type of Development Single Family Residence No. of Units 1
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered
patiostwalkways, 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:
EXEMP'T'ION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
2.05 X 6,390 or $ 13,099.50 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 CC/1st Bank/Jenny McIntire Telephone
Name on the check
By Dr. Doris Wilson ,%� ✓
Superintendent
Fee collected /exempted by Mary Ann L. Boda Payment Received I � $13,099.50
A- - -- _ .
Check No. 54330
Signature
NOTICE: Pursuant of AssembTy 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 Idem fled
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 aut horl W to
coiled 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
MAY -04-2000 12:42 TRADITION GOLF CLUB 760 564 2356
rradifion-
ARCHITECTURAL DESIGN REVIEW
April 7, 2000 Via First Cuss Maa
Mr. John Vuksic
PREST VUKSIC ARCHMC fS
74-020 Alesandro, Suite C
palm Desert, CA 92260
Re. Alaeano Residence
Lot 26, Tract 28470-2, 52-622 Cahuiila Court
Construction Documents — Conditions Review
P. 01/01
Dear John,
the above referenced
The ADRC of Tradition Golf Club met on April 5, 2000 and o ed conditions previously
submittal. All conditions have been met and approved subject Y
written.
ease provide the following information prior to brealdng ground;
pl
1, $5,000 Construction Compliance Deposit payable to Tradition ADRC.
2.
Construction site facilities plan showing location of trailer, trash port -o -let, snow
fence, etc.
3. Job site superintendent name and telephone number.
ss in the Design Guidelines for additional information
Ple
ase review the Construction Proce
regarding working in the Tradition community. -
r need additional information, Please do not hesitate to call.
If you have any questions o
Sincerely,
Christina J. Dores
Architectural Review Coordinator
W. Lance Alancmo (via,fax, 345-1451)
78505 Ota AVEWE 52 LA QuiWA " CA 92Z53.1120 - PHoNE 760/564-3355 PAX 760/564-2356
TOTAL P.01
CITY OF LA QUINTA
PLAN CHECK CORRECTION LIST
BG Structural Engineering
45-535 Via Corona
Indian Wells, CA 92210
PLAN CHECK NO.: 0002-220
JOB ADDRESS:
AREA-S.F.- :
52-622 Cahilla Ct
9177
March 14, 2000
FINAL CHECK
OCCUPANCY: R3/U1
TYPE -OF -CONST.: V -N
The submitted plans and specifications have been reviewed by VANDORPE CHou ASSOCIATES. It is
our professional opinion that the plans are in substantial conformance with the building codes and
regulations adopted by the CITY OF LA QUINTA and the State of California Amendment.
APPROVAL FOR A BUILDING PERMIT IS HEREBY RECOMMENDED SUBJECT TO OBTAINING
APPROVALS/CLEARANCES FROM ALL APPLICABLE CITY DEPARTMENTS, AGENCIES, AND
ASSOCIATIONS, AND THE FOLLOWING CONDITION.
Roof truss shop drawings to be stamped and signed by the manufacturing engineer as well
as shop stamped and signed by the engineer of record. _
Plans checked by:
Dorothy Gordon, P.E.
VANDORPE CHOU ASSOCIATES.
295 N Rampart Street, Suite A
Orange CA 92868
(714) 978-9780 VCA File No. LQ -11743
NOY-08-00 06:27—AM P.02
B.G. STRUCTURAL ENGINEERING
BRIAN GOTTLIEB - CIVIL ENGINEER - Lie. No. 033047
y 45-535 Vice Coruna
Indian WcIN, CA 92210
(760) 565-1551 (760) 565-5631 Fux .
octol , -31,2000
Mr. Mike Dtivell
Sedona Homes
3 725 Garand L.anc, Suite C:
Palm Dcsert, CA 92211
RL: The Traditions Lot 26 La Quinla, CA
Dear Mr. Duve11:
This letter is to confirm that we have completed the structural observations for
The Traditions Lot 26 residence. We observed framing, wall sheathing, drag
straps and connections for conlorntance with the. stnicturai plans and notes on
sheet S-1 and required by the 1997 UBC: Section 1702, To the best of our
knowledge and within the limitations of visual observation, all ofthe deficiencies
noted have been coiTectcd and the final construction is in substantial conformance
with the approved project structural plans.
Please call mc. at (760) 568-3553 if you have any questions or would like to
discuss this matter,
Sincerely,
Brian Gottlieb, P.L.
cc•: file
FiOFESSiO 4
m� GOTT`
d
s�, c� 1 V ►� �P
�T�ol= caL�Foa
VALID ONLY IF SIGNED
IN RED
Certificate of.0ccupancy
City of La Quintal
Building- and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification: SFO
Occupancy Group: R 3
52-622 CAHUILLA COURT
Bldg. Permit No.: 0005-039
Type of Construction: VN Land Use Zone: RL
Owner of Building: LANCE ALACANO
Building Official
Address: 52-622 CAMILLA COURT
City:' LA QUINTA, CA .92253
By: STEVE TRAXEL
Date: 04-16-01
POST IN A CONSPICUOUS PLACE
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
O REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY O
❑ POST TENSIONED CONCRETE O ASPHALT O OTHER
❑ REINFORCED MASONRY ❑ FIRE PROOFING
JOB LO 1 o _ CA.H V(*, I CT, LA . 62 ojV'%A •
REPORT SEQUENCE NO.
TYPE OF STRUCTURE
L 6T ,*
10 -PJ'
PERMIT NO.
DATE
DAY OF WEEK
MATERIAL ESiPTN 'C -b -t>
ARCHITECT
INCOFfTOR
MRS. CHARGED
ENGINEER �
ASSISTANTS
HRS. CHARGED
INSPECTION GENERAL SUB
DATE CONTRACTOR !J Ok-A t (N��CONTRACTOR RA
� 1 a-
UfB ��� e-c� i N � a o oL- � 5 A •`70
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COPY SENT TO CLIENT ❑
CONTINUED ON NEXT PAGE ❑
PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. 1 HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
T-, -- T-
SIG ATUOF REGISTERED I SPECTOR
3171
�J
DATE OF R PORT REGISTER NUMBER
- _ - t :_ - is c I: • •:+ :.__.:� c: r�
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HE1ONt •ills 7bWFil NIOMF:VT CONNECTION? THi 1011E (:OL~ -XaN I
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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
O REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY O
O POST TENSIONED CONCRETE O ASPHALT 0 OTHER
O REINFORCED MASONRY ❑ FIRE PROOFING
JOBL0�,gX ` / ^ CAv t I l A `T L 1
REPORT SEQUENCE NO.
TY PE�QF�J,LCTURE 0 ; ^
PERMIT NO.
D� I� J
DAV OF WEEK
MASTEEiRIADESCRIPTION
K! 36 -sDo179
ARCHITECT
INSPECTOR
NRS. CHARGED
1HRS.CHARGED
e ---i r --s, — ^-7 O 1
`
ENGINEER ^
ASSISTANTS I
INSPECTION GENERAL SUB
DATE - - CONTRACTOR ��N O UkeS CONTRACTOR JR L-A Z S ��
0 A N G(a. Kov'- So'S:2 s (Is -7
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COPY SENT TO CLIENT ❑
CONTINUE NEXT PAGE ❑
PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I 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 ATURE OF)REGISTERED I P TO
�8 a ''� 9
DATE bF REPORT REGISTER NUMBER
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 ❑ STRUCT. STEEL ASSEMBLY Woxy
❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ OTHER/
❑ REINFORCED MASONRY ❑ FIRE PROOFING
JOB LOCATIONREPORT
5 Z — b 22 C" %4; I � A C7- (.� �Sl �� N t
SEQUENCE NO.
TVSp C�� 0 �CA` �Ot`5 STRUCTURE
PERMIT N0.
DATE ( 'm
OAV OF WEEK
MATERIAL DESCRIPTION
so � e s z�4
ARCHITECT
PQ�s vtk
INSPECTOR
MRS. CHARGED
ENGI(N�EER
ASSISTANTS
HRS. CHARGED
INSPECTION GENERAL SUB AA'�
DATE CONTRACTOR S� �o N by CONTRACTOR (v u LO
9160
06s�e.ev,--d A -fl w
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CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I 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.
2 I � &IJ J90112 -co -
SIGNATURE OF R:GIS T ED INSPECTOR
M ;:1-6190 //// 919,
ATE OF REPORT REGISTER NUMBER