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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
764224 E 09113W204
i"
Date t' I J g
Si nature of Contractors-�
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 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:
l�
Carrier TATE U114,� Policy No. 713 1385.991
(,This section, need not be completed if the permit valuation is for $100.00 or less).
f(,� 1' 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 those provisignsl.
.Date:-?�1 —Trt Applicantvo 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 a permit subject to the conditions and restrictions set forth on his •
application.
1. Each person upon whose behalftthis 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 property for'ins pection-purposes.
Signature (Owner/Agent) P� )1 • ,',� F Date
-.i , 77 1 gay
�t
-1 Y/,�- BUILDING PERMIT PERM'002-224)
ATE VALUATION �¢3�s��,LOT TRACT
,JOB SITE
ADDRESS 52_642 C4%.RU1'J,I.eA. ' CU(IrR
ti
APN _ -
OWNER{
CONTRACTOR / DESIGNER /ENGINEER
7 Atc �� t 1;aL LUQ �O3.V ly i �l�i iOAti CO.
ttuERS CON' iRILKTION Col.
78-060 CALLE MADO, SUITE 1.1
78-060 CALL E EXI! 09, aL,l1'1 a 11
LA. t UMo CA. 42253
LA QLI)N-1-t1 CA 42253
,564-778-11 CIR 11987
USE OF PERMIT
SiNOLUAIN Y DWELLING
s
SF% - DOE4; 14O111 1"ttiCLUDE BLOCk WALLS OR POOL.
y
d I
CUU1O*%4 C",ONSI'11UC"eiO1V 5,896.00 S)F
pi- rndI 1,20 :i� 3t`
0ARAt3WCAt(k-) r 0416.0 SF
EMAIATI'M COST OF COINISrRUCTION'
495,
CONSTRUCTIOrN Mme; 101-000-41MOO s�,t)2s.su
K j1'N CFECK P° T__F -t1fK)»4;i�-3 i R �+F1,rrr+�.RrJ
%,F.� 97ByC� �;:T !n. •OOi?-:t3�•_'•:;-Y2r;.t)i1
Ivo. CHANICAL F TI 101-000-421-000 $137.00
LrLECTRICAL NEE 101-000-420-000 ��2tq.Z3
pr s ftiturn) rrH. 101 (K)
STRVNIO 1rl0'I.1:ON, f' - - RESID 101-000-241-000
GRADIM T,ITI. 101-000-4413-000 �40.iit►
i.e\11.; 011ER.ft1IPA-crkEE $1.90'0.CN1
A.RT TN (NAVAL PACT& - RESID 701-000-255-000 $989.81
-TOTAL o n?NNSTRUCT1ON AND Plfa`N CfI�C'i�
LESS RE -PAID FIrl E S
-$230.00
TOTAL PERIM-Ef FEFSOVENG-W
S7,08307
RECEIPT
DATE
By, /'�
DATE FINALED
INSPECTOR
ti i
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
O
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
�� / - Old S7
F.A.U.
Framing
_� p-C=� -T
Compressor
Insulation
Oo 4b;1
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
o
Drywall - Int. Lath -;:p
Final
Final z- 3 0 <
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
I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plu 'ng Top Out
3
Plumbing Final
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
g _
Encapsulation
Gas Piping
pt
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) O
COMMENTS' 57
IsOFSq ,`(csJC�6�^Q-?-c`� ark s%
7- 17—
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PevVe
P.O. BOX 1504 p� APPLICATION ONLY
78-495 CALLS TAMPICO
esg - `> -' ` Com` i �L\\`�'. LA OUINTA, CALIFORNIA 92253
j,rf ((f , f wner , 'j; • S �j / t� f 1 7 / .,`7 ,c
('.. !' : i_':•:•s;:. �brr / '
_ BUILDING: TYPE'CONST. OCC: GRP.
Mailing
Address J S- )-C) 1 A.P. Number -
Pty 11 Zip Tel. �/(I7e"
Legal Description
'Contra fnr_ Project Description
Address
l CUiI-S7nVLT1 J 7 �, �f�/1 f✓/ �1 c.� .
City Zip Tel.
State Lic. rr__ City
& Classif. V 11,2A Lic• N Sq Ft �Jj
Siz.10
/ �o Stories itl =F r"k`•
Arch. Engr., _ Y
..-Designer _•: New „ , ?/1dd D + , fJ ' Alter O R ; Repair O -- ;,DfemotiUon 1] '+
Address = ,..�. F:. Tel. -
1 ?. tri 3:
r_
„City ZIP..,. ; r Stets << y't
r'^ry r a.rs Ilii ti
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (eoinmencing with Section
70110) of Division 3 of the Business and Professions Code, and my license is In full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I. am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5.Suskress and Professions Code: Any «Y Of County whdah raotWres a
permit to construct, after improve, demdlsh, or repair any structure, prior to *ft issuance also
reouires the applicant for such permit to rite a signed statement Mat he Is kensed pursuant to
rhe provisions of the Contractor's license law, Chapter 9- (commencing with Section 7000) of
'von 3 of the Business and Professions Code. Or Mat. he is exempt thwoficim, and the oasis
the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
rects the applicant to a civil penalty of not more thea five hendred loiters (4500).
C1, 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. (Sac. 7044, Btdssese and
Professions Code: The Contractor's License law does not appy to an owner of property who
buids or improves thereon and who does such work himself or &tough his own employees.
_ provided that such onprovements are not intended or offered for sale. 9, however, the building
or irrprovement is sold want, one year of completion, the owner-buider well have the burden
of prowng that he did not build or improve for Me purpose of sale.)
I ; 1, asowner of the property, am exclusively contracting with licensed contractors to con.
51ruc1 the project. (Sec. 7044, Business and Professors Code: The Contractor's License Law .
does not apply to an owner of property who builds of nprovea thereon, and who contracts for
such projects wrtn a conuactorts) licensed pursuant to the Contractor's License Law.)
1 am exempt under Sec. B. d P.C. for this reason
Date Owner '
WORKERS' COMPENSATION DECLARATION
Ihereby affirm that I have a certificate of consent to sell -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800 labor Code.)
Policy No. Company
F7. Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS* COMPENSATION INSURANCE
(This section need not be completed it the perms is for one hundred dollars (f 100) valuation
or less.)
1 certify that in the performance of the work tar which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws OI California.
Date Owner
NOTICE TO APPLICANT., lf, after making this Certificate of Exemption you should become
subiect to the Workers' Compensation provisions of Me labor Code• you must forthwith
comply with such provisions or this perms shaft 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.)
Lender's Name
' Lender's Address
This is a building permit. when property filled out, signed and validated, and is subject to
•vpiration if work thereunder is suspended for 180 days.
certify that I have readthis application and state that the above information Is correct.
area to comply with all city and county ordinances and state laws relating to building
,instruction, and hereby authorize representatives al this city to enter the above
mentioned properly tot inspection purposes.
Signature Of applicant Dale '
Mailing, Address
City, Slate. Zip
WHITE = FINANCE YELLOW = APPLICANT PINK BUILDING DIVISION
ZONE
BY:
Minimum Setback
Distances:
1 "x
Front Setback from Center Line
Rear Setback from Rear Prop. Line
stimated Valuation
Side Street Setback from Center Line
Side Setback from Property Line
'
PERMIT
= AMOUNT_ "'2e r ;z i r
Plan Chk. Dep.
Issued by:
Plan Chic Bal.
Const.
Validated by:
Mech.
Electrical
; t,
Validation:
Plumbing
'
S.M.I.
S -
Grading. t
Driveway Enc.
Infrastructure
TOTAL
REMARKS
WHITE = FINANCE YELLOW = APPLICANT PINK BUILDING DIVISION
ZONE
BY:
Minimum Setback
Distances:
1 "x
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:
S -
WHITE = FINANCE YELLOW = APPLICANT PINK BUILDING DIVISION
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 3/16/00
APN # 769-930-010
No. 20167 Jurisdiction La Quinta
Owner NameDick Albers
No. 52-642 Street `Cahuilla Court
City La Quinta
Tract # Lot #
Type of Development Single Family Residence
Comments
Permit #
Log #
Zip 92253 Study Area
Square,Footage 5896
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:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
1.93 X 5,896 or $ 11,379.28 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/Wells Fargo Bank, N.A./Terry Smith
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by
Signature
Mary Ann L. Borja Payment Received
Check No
Telephone
~_•11,379.28
7377002773"'. l
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 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 DeptJApplicant Copy - Applicant/Receipt Copy - Accounting
FEB -09-2000 15:48 TRADITION GOLF CLUB 760 564 2356
q'radih*on
ARCHITECTURAL DESIGN REVIEW
February 9, 2000
Via First Class Mail
and facsimile (564-55a*
Mr. Bill Albers
ALBERS, INC. • ALBERS PROPERTIES
SS -120 Inverness
La Quinta, CA 92253
Re: Lot 28, Tract 28470-2, 52-642 CahuiQa Court
Construction Documents — Conditions Review
Construction Documents — Revision to Front Watt
Dear Bill,
The ADRC of Tradition met February 2, 2000 and reviewed the above referenced submittals.
Status of approval is written below.
Request to move the front wall has been approved as submitted.
2. Conditions have been met and approved.
3. Request to raise house has been denied because the overall result as presented is
equivalent to raising the pad as previously denied which was not approved by
adjacent lot owners. Should you wish to provide steps and raise a portion of the
house by modifying the architectural plans, it may be possible to do so. 1f you would
like to meet with the Committee on February 16, 2000 at 11:45 a.m., please let me
know.
P.01/01
4. Property line wall height along Lot 27.must be 6' from higher. pad elevation. Wall
height must be 73 not 72 as indicated.
This submittal is approved to obtain a building permit from the City of La Quina subject to
the above.
Sincerely,
Christina J. Dores
Architectural Review Coordinator
78505 OLD AvENuE 51— iA QurNrA -- CA 92253-1120 -- PHoNE 760/564.3355 -- FAx 760/564.2356
TOTAL P.01
Saturday, April 00, 2000 01:03:59 Charles D. Garland, Architect
Page 1 of 1
CHARLES D. GARLAND
011991 Architecture, Interiors, Space and Land Planning
Structural Calculations
9 March 2000
City of La Quinta
?=:~ Department of Building and Safety
78-495 Calle Tampico
La Quinta, CA 92253
Proj: A Custom Single Family Home for.
Mr—And-Mrs. Albers
LThe traditions
La Quinta, California
Re: Project Observation and certification
To whom it may concern,
On 7 April 2000, 1 visited the subject project site for the purpose of performing construction observations at the request of the
project's Owner/Builder,,Mr. Bill Albers. The following is my certifications and declarations with regard to this matter:
I found the project to be just getting started. The concrete subcontractor indicated that they were planning on
pouring the main house and the guest house foundations, footings and slabs on Monday, 10 April 2000. Overall
the foundation work appears to be built in a workmanlike manner to a high level of craftsmanship.
The owner/builder indicated to me that.the garage slab and the 3,000 psi concrete grade beams were scheduled'
to be poured at a later date.
As per the construction document specifications, the owner/builder is intending to provide special inspection for
the placing of the 3,000 psi concrete, the certification of which will be provided to your department.
By this letter :
I certify that I have made. visual structural observations of the project, that it has been constructed in a conscientious
and workman like manor and that all is in substantial readiness to pour the footings, foundation and slab -on -grade. The
reinforcing and all pertinent hardware intended to be cast -in-place is in substantial conformance with the design intent of
the structural design documents.
If you have any further questions about this or any other matter pertaining to this project please do not hesitate in contacting me.
Sincerely,
Ct1901 0
10/31!01
1P EV.. DME 2
CF CA�'�
Charles D. Garland, Architect
35-325 Date Palm Drive; Suite 151-J - Catliedral City, CA 92234 - Phone/Fax: (760) 324-7146
Thursday, June 29, 200006:25:12 AM Charles D. Garland, Architect Page 1 of 1
CHARLES & GARLAND
Architecture, Interiors, Space and Land Planning
Structural Calculations
27 June 2000
City of La Quinta
Department of Building and Safety
78-495 Calle Tampico
La Quinta, CA 92253
Proj. Albers Single Family Residence
�52-642-Kai uilla I
L-a-Quinta, Califomia
Re. Project Observation
To Whom it May Concern,
On 23 June 2000 1 visited the subject project site for the purpose of performing construction observations at the re-
quest of Mr. Albers, the project Owner. This visit was to observe the construction and certify it's conformance to the
structural design intent of the structural calculations, structural drawings, specifications and details and all applicable
changes.
During my observations only minor blocking, nailing and strapping issues were noted and brought to the Contractor's
attention. These issues have subsequently been rectified. The framing and foundation work appeared to have been
performed in a manor consistent with a high level of skill and workmanship.
Based upon my observations noted above, and the Contractor having addressed and corrected the minor issues we
noted in thew field that day, I hereby certify that the project substantially conforms to the design intent of the struc-
tural construction documents and is "ready to wrap" upon final building department inspection:
If you have any questions about this or any other aspect of the project, please do not hesitate in contacting me.
Sincerely,
Charles D. Garland
Architect
35-325 Date Palm Drive, Suite # 151 J - Cathedral City, CA 92234 - Phone/Fax: (760) 324— 7146
km 4bt�, ;;i;m:, �o;z!;7k4
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
❑ REINFORCED CONCRETE
❑ POST TENSIONED CONCRETE
❑ REINFORCED MASONRY
O STRUCT. STEEL ASSEMBLY
D ASPHALT
❑ FIRE PROOFING
❑
❑ OTHER
JOB LOC W f
REPORT SEQUENCE NO.
TVP F�y�TURE
(� ��""1� C�
1Ft'
PERMIT NO.
DAV OF WEEK
MATERIAL DESCRIPTION
ARCHITECT �� �� - `
W
I CjR lV
HRS. CHARGED
ENGINEER
ASSISTANTTSC1
HRS.CHARGED
INSPECTION
DATE
GENERAL
CONTRACTOR
SUB"
CONTRACTOR
C)(a's t't�
o !D -6)
!'7
STc rhe
S
COPY SENT TO CLIENT ❑
CONTINU D O 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.
GN RE OF REGIST TOR6(�,e•
ATE OF REPORTOO�RRTTT REGISTER NUMBER 1