0209-188 (AR)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# LLic.�{C•lass Exp. Date
2 T r }
68
d�G
Date 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:
( ) 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:
CarrierV.-OfeXr&d emogM,6;t)S Policy No. Avkf lo -1
(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 trp the, workers' compensation provisio'ns)of Section 3700 of the Labor
.Code, I hall orthwith comply witKthose ovi ofS. R
Date: U�
2 _� Applicant la _
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
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspectiop,purposes
.
L.. �e lis bl
,Signature (Owner/Agent) � —� �' c�i/ as Date
BUILDING PERMIT PERMIT#
DATE r msaoc VALUATION $3.9 12.94) LOT TRACT Y I
JOB SITE APN
ADDRESS 79-W.5 PE(,3A,N VdI.MXY 76"2.3-013
OWNER t CONTRACTOR / DESIGNER / EN (NEER
.s�.ANDY MAC, .ipi-s'0,WON BOD WWAWS Ci5N'� xR IJ"i~'i;Si)14
79-865 PEACAN VAL"L,RY 79-920 FtE,`3.CAD.1,.1VE
LAQUOIT.,A Ck 92253 Lit,.Q1.RNTA CA 922.53
f760pt?5.7933 M1..4 :5:12
USE OF PERMIT
RESIDP2-TIAL ADT:+:C 1014
51 Slr. KITCHEN
CUSTOM CONST
51,1?0 3F
EvI f`InVIA'T'S D COST OF CON1z"rRUC110IN
CO1i1SYRUC T ION f+MEE )01 -000 -418 -OW 16310 b
PIAN CHI= PXE 101-0100-43V-318 V3.09
MiE°TRIC.AL FILE 101.000-420«000 $16.70
PLUMBING MF 101-000_11 9x000 $:30.00
STRONG MOTION FRE - R-8, 10 101-000-241.000 1.50
SIRADINO FEE 101-000.423-000 $15.00
.AND Pi k4 (7,-RFCX
3X290
1'x'.1.29
$0.00
2 b IS, I 'AL PV, ?AT.f YKEEN DUFF OW $1915,29
SEP
RECEIPT DATE BY �✓ DAT INA U wsi�h
Date
9/25/02
No.
23650
Owner
Randy Mac Pherson
Address
79-865 Peacan Valley
City
La Quinta Zip 92253
Tract #
Type
Residential Addition
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760):771-8515
APN #
Jurisdiction
Permit #
Study Area
No. of Units
4C���o
Q BERMUDA DUNES r
RANCHO MIRAGE Cj
INDIAN WELLS
PALM DESERT ,y
�T LA OUINTA
�Q0 INy)
O
762-023-013
La Quinta
1
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 79865 Pecan Valley 51 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
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 (spaces that do not contain facilities for living,'sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that 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
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $0.00 X 51 S.F. or $0.00 have been paid for 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 - Bob Edwards Check No. -
Name on the check Telephone 760/775-7933
Funding Exempt
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Monica Guillen So.00
Payment.Recd Over/Under
Signature
NOTICE: Pursuant to Government Code Section 66020(d)(1), 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 issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
a 4--
R EGISTERED
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
❑POST TENSIONED CONCRETE ❑ASPHALT
MASONRY ❑ FIRE PROOFING
❑ REINFORCED�*y
❑
❑OTHER
Ee
JOB IOCATIO
f, e! A
�I (e �^ ,/'`, �, ���A
b v(, ���'►
REPORT SEQUENCE NO.
T� CTURE
"-
I• �17� _S '
T: -
PERMIT NO. *
D TE
J
DAV OF WEEK
MATERIAL DESCRIPTION
_
ARC <�
I
HRS. CHARGED
SENGINEER
ASSISTANTS
HRS. CHARGED
'INSPECTION
DATE
"GENERAL-_. - _ _ _ �A ��c SUB .... . .
CONTRACTOR( 3,(%..�f/C/-CONTRACTOR -
-
16
s,�
. 5n
' COPY -SENT TO.CLIENT: O
f CONTINUED ON NEXT -PAGE O
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.
i
I NAT RE OF RfrGISTEREO IN ECTOf�, r
DAT OF EPORT REGISTER NUMBER
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
Exhaust Fans
O.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
_
Drywall - Int. Lath
_
Final lg
BLOCKWALL APPROVA S
Final
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I
I
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:
�,,
i I . �' A ' F/ 2
BirlO
OW of La Quinta
Building,, 4r. Safety Division
P.O. ox 'B' 104 78
. S 7B-495 Calk Tampico
.. ,
La,,QUinta;,CA 92253 - (760) 777V012
din P
Bdil ermit Appi,
)IOtimand Tracking Sheet
Permit
Project Address:
Name: v2rA�cw fvc
A. P. Number:
-Address;
Legal Description:%
ST
Cit% _7aZip: 7X__ �9 KfT 7&'
Contractor:
Address:
'Telephone:
'.Project escription:
Cin% ST. Zip:
Telephone: _77S�-7*
.......... .
M0644 67
State Lic. #
Arch.. Engr.
OtN, Lic.
Address4k
City. ST.
Telephone: -;5,f
............. .......
.............. ..
... . .........
Xons•truction T,,
.,pe*. Occupancv:
State Lic. #:
ro
P N cirile one):- Ne- Add'n Alter
h� ject tYpe Repair Denio
Name of Contact Person:" -Sq.
Ft.,:
Stories:
Telephone # of Contact Person: -)t- -77 5- _7 r3
Estimated Value'o'f Proiect:
APPLICANT... DQ--.NClTAkRITt BELOVN,THIS LINE
P
Submittal
Recl'cl
Rec'd
TRACKING' �e
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural CaIcs."Plan
Reviewed. ready tor corrections
Check- Deposit
Truss CaIcs.
Called Contact Person
-Plan Check Balance
Title 24 Calcs.
a
Plans picked up .
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2n'•Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
JH Re.%'-iew• rca6 for correction sue` �ZS
-Developer Impact.Fee
Planning Approval
Called Contact.Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue. 4
School Fees
Total Permit Fees
-00
...... .....
CV
6 � L#ter of T
smitt-a-1
To: YOUNG',ENGINEERifiG
Attention:
Telephone:
'Date.
..Lot/Tract:-,
0a
I IIIQ I I IdWrldl -senT, Tor:
.Your.File'S':
Your, . Revi ew'. 77. 71 At Your Request
F"A
Chekking pr. ppr6val
Atlhe:.-request.of:
Other:
From: EURAND4LL
Telephone COUNTER TECHNICIAN.
Office. (760) 777- ?012
voice (760) 777-7042= Building &;Safety Depart
m.6,nt (760) 777-7011 fax
DATE:
CITY OF LA'QUINTA'*** BUILDING,"DEPARTMENT
09/25j20021
LOG FILENAME:
1020q=IW._
JOB-ADDRESS:
170-865 PECAN -VALLEY
OWNER.NAME:
IMACPHERSON
MAILING ADDRESS:;.
'10
CITY, ST. ZIP 'PH#
10
USEOFPERMIT:
51 S.F. ADDITION
CONTRACTOR NAME:
BOB EDWARDS CONSTRUCTION
CONTRACTOR.ADDR:
0
CONTRACTOR PH #:
0':•
LOT/TRACT:
0
ASSESSOR PARCEL #
762-023-013
(C)OMM or (R)ESID: R
BUILDING CONSTRUCTION VALUATION
UNIT UNIT $
TOTAL
GOOD CONSTR_(SF)
51
77.90
3972.9
AVERAGE CONSTR (SF)
0
54.30
0
PORCH/PATIOS (SF)
0
13.30
0
GARAGE/CARPORT..(SF)
01.
19.60
0
BLOCK WALL (HT/LF)
0 0
0.00
0
BLOCK WALL (HT/LF)
0, 0
0.00
0
WOOD FENCE (LF)
0.
8.50
0
SPRINKLERS (SF)
0.
1.70
0
A/C -- RESID (SF)
0
2.90
0
A/C --COMM (SF)
0
3:50
0
CONTRACT
0
0.00
'0
ESTIMATED VALUATION TOTAL
***SUMMARY OF FEES
UNIT
3972.9
CONSTRUCTION FEE
63.00
PLAN CHECK FEE,
70.00
PLAN CHECK DEPOSIT
0.00
MECHANICAL FEES
0.00
ELECTRICAL FEES
16.79
PLUMBING FEES
30.00
STRONG MOTION (R
0.50
STRONG MOTION (COMM)
0.00..
TOTAL VAL
GRADING
15.00
3971.90
DEVELOPER IMPACT FEE
0.00
PRECISE PLAN
0.00
ART IN PUBLIC PLACES -(RES)
0.00
TOTAL FEES
ART IN PUBLIC PLACES;(CO M) 0.00
195.29
Page 1
*** CITY OF LA' QUINTA ***
JOB ADDRESS:
BUILDING DEPARTMENT ***
79-865 PECAN :VALLEY
** ELECTRICAL FEES."
'UNIT UNIT $
TOTAL
FLOOR AREA (SF).
51
0.04
1.79
GARAGE/CARPORT (SF)
0
0.02
0.00
ELECTRIC UNITS (EA)
0
3.00
0.00
SUB -PANELS
0
7.50.0.00
CONSTRUCTION POLE
0
15.00
0.00
SERVICE (AMPS)
0' .
18/37/75,1
0.00
SWIMMING POOL (EA)
0
30.00
0.00
SPA (EA)
0 .
15.00
0.00
OTHER
0
0.00
0.00
OTHER
0
0.00.
0.00
PERMIT FEE
1
15.00' '
15.00
ELECTRICAL SUB -TOTAL
16.79
** PLUMBING FEES
UNIT UNIT $
TOTAL
POOL/SPA (0, 1 P 2)
0
21/27
0.00
WATER PIPING
1
3:00
3.00
ROOF DRAINS
0
6.00
0.00
SEWER CONNECTION
0
22.50
0.00
GAS PIPING
0
4.50/1.25
0.00
WATER HEATER
0
`7.50
0.00
FIXTURES
2
6,00.
12.00
SEWAGE DISPOSAL
0 '
45.00
0.00
LAWN SPRINK..SYSTEM.
0
9.00
0.00
OTHER
0
0.00
0.00
PERMIT FEE
1
15.00
15.00
PLUMBING SUB -TOTAL'.'
30:00..
G
** MECHANICAL
UNIT
FEES
UNIT $
TOTAL
DUCT ALTERATION'(FF)
4.50,'
#VALUE!
EXHAUST,HOOD,FAN(EA)
0
6.50:
0.00
HEATING <=100000 BTU
0
9.00
0.00
HEATING >100.000, BTU
0 ..
11,:90.
0.00
EVAPORATIVE; COOLER
0
6:50
0.00
COMPRESSOR <= 3 TON
0
9:00
0.00
COMPRESSOR > 3 TON
0
16.50
0.00
SWIMMING POOL HEATER
0
24.00
0.00
OTHER
0
0.00i
0.00
OTHER
-0
0.00
0:00
PERMIT FEE
0
.15.00
0:00
1
MECHANICAL SUB -TOTAL
#VALUE!
Page 1
Date: Sept 23, 2002
Project Address: 79=865 Pecan Valley
Project Description 51`'.5 S.F. Kitchen Addition
Applicant: BOB EDWARDS: CONSTRUCTION,
Status: First Review
Plan Checked by:`.STEVE TRAXEL (760) 777-7018
Respond in Writing to; each correction below, notin .where correction can be found. Return this
P g. , , 9 .
list and all red-marked planswith next submittal'. Revise plans' as necessary, reprint and
resubmit two complete sets of:plans, wet-signed,by,the personwh'o preparedjhem.
1. Show and provide on-plans all plugs in: kitchen serving countertop space to be GFI
protected.
2. Show missing plug dedicated to disp:.
3.. show energy lighting for kitchen
4. Provide-extra floor plan for assessor
5. Provide site plan showing offsets'fromhouse to property lines
6. Show on sheet 1 the u-values atach window.
7. 12eaq�r�G` (40 Pt A rA`
As further information.. is�.prgvided•and reviewed, additional corrections.may be required.
Returned_ for correction: Required forresubmittal:
2-sets plans 2-sets evised plans (signed)
2-sets T-24 2-sets T-24
1:;f166r. plan for assessor
END'C0RRECTI0WLIST
0
Page 1 of.1
..Se,!a 17 02 11:29a BOB EDWRRDS CONSTRUTIOM.- 760 775 9093 p.2
FROM MONARCH PHONE NO. :: 760'.776 5111 Jun. -26 2002 01:06PM P1
PGA NEST II RESIDENTIALASS(-)C IATInN, INC.
P.O. BOX 1282, LA QUIIVTa., CA 9321,
(760).776.-'5 100,.FAX (760) 776-5111
!inti �1F- S.T�
rune 19, 2002
W. Randy. McPherson
1247 Crchshaw;Road
Eugene, OR 97401'
Reference: 79-865 Pecan Valley, La,QWnta, .CA •
Architectural°Ctiange,,Reques -Room Addition
Dear Mr. McPherson:
The Architecnual Cgmtmittee reviewedyou application for a room addition. Your application was
unanimouskapproved`as submitted,
Review by the Committee is only for genera} conforntartce with the aj clutectitral guidelines , It is the
responsibility of'the owner.to fully understand and cgnfoxtti;to the.arc mtecturaI gwdeliae criteria whether
or not all deCtctencges are:noted during review It 1s •ilso the owner s -lith responsibility to BE)d verify all
existing conditions. the Comte iree,s decision with regird ioprotect design" will be FwaL Please refer to
the Architectural Rules for -all requir2w sabminals.
Approvals given by, the.architectural Committee area o0tl:for.0ol0k,r nouthi from the date on the
approval letter:''AAei tha Mime a new,appl- ti must be submitted.
Upon completion of your project; please, complete and:returr llc Notice of Completion of Architecrural
Cltmtge•
In the mealttime. if you have sny additional questi6ns or concerns; pleg.se do not hesitate to contact Carol
Fuller, AssociaiionMan;�y'pt 700/776-510Q;Eat; 20...
Sincerely,
PGA -WEST II RESIDENTIAL ASSOGIATTON
For the Architectural,Coi' tittee
Carol Fuller, CCAM
Association Manager
cc: Board of Directors
Unit File' .
YOUNG ENGINEERING SERVICES
•Engineering •Architecture•Surveying• Building & Safety Services
Letter of Transmittal
To:
City of La Quinta
Date.
Project.
Attn:
Ed Randall
PC #:
Tel
(760) 777-7012
Tract No.:
No..
We are forwarding:
No. of Copies
1
x By Messenger
Description:
Set of plans/calcs
Comments: Plans are acceptable.
Thanks
This Material Sent for:
09/21/02
79-865 Pecan Valley
0209-138(1st Check)
By E -Mail Your Pickup
Your Files Per Your Request
Your Review x Approval
Checking At the request of:
Other
By: Eric A. Frenzel
Phone # 360-5770
77-804 Wildcat Dr. • Palm Desert, CA 92211 • (760) 360-5770
•Bron Young •
f
�4�
POR
ao
023— d
3� cm
`t It AC
PMUCT 20 ,
Z�.�1 AC �IAI
AN ADDITION FOR:
MR. & MRS. RANDY MA CPHERSON
79-865 PECAN VALLEY
LA QUI NTA , CALIFORNIA
')I
4.91 AC
0
�
44.6
PROJECT
1 LOCATION
SIAS
two
4 4.11 AC
Date: Sept 23, 2002:
Project Address: 79-865.. Pecan Valley
Project Description: 51.5.$'.F. Kitch'en Additio-n'
Applicant: BOB EDWARDS CONSTRUCTION
Status: First Review
Plan' Checked by: STEVE TRAXEL (760) 777-7018 : ,-r
Respond -in writing to each correctionbelow, noting where correction can be found. Return this
list and all'red=marked.plans with next submittal:' Revise plans as necessary, reprint and
resubmit two complete sets of 'plans, wet -signed bythe person who prepared,: them.
1. Show and provide on plans all plugsJn kitchen serving counter t,o.�, �space:to be GFI
protected. SFEV
2. Show missing plug dedicated to dis .
3. show energy lighting for.kitchbn -� 3
t oN ELEC
4. Provide extra floor pl n fdr,ass ssorCpo�.€�
15�
5. Provide.site'•plan showing'offsets#rom"�>hppus�eeJo propertylinesi
6. Show .on sheet 1 the u -values. at each wi mow. 'T- �-
7. 1carta qOA apPtzo�►n�=
As further information is provided and reviewed, additional'corrections may be required.
Returned for correction: Reguired-for resubmittal:
2 -sets plans 2 -sets revised; plans (signed)
2 -sets T-24 2 -sets -.T=24
1 floor plan'for assessor
END CORRECTION LIST