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9910-177 (SFD)LICENSED CONTRACTOR DECLARATION I:here by affirm under penalty of perjury that I am Iicensed.under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and t Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date c '` A50748 12131iV Pae D. a S g atofil ractor r`r2 OWNER -BUILDER DECLARATION ' I hereby.a6rm 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 worker s'. compensation; as provided for by Section' 3700 of'the Labor, Code, for the performance of the work for which this perrnit.is issued. (J 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#'t': Policy No. ii�i'S�I:t; (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 subjectoto the workers' compensation provisions of Section 3700 of the Labor Cc I shfalfpo'rthw,'ith comply ith.t o e,provisions. ,ia'at �APPIi aD�t 1. -ii r' I r}'i Warning:Failure to secure Workers' Compensation coverage is unlawful and / P 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' Setforth 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. l: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 inspection purposes. ,,SSignat�3 ure (Owner/Agent) h[Ide? f14/';1?J Date 1T.. , PERMIT # BUILDING PERMIT DATE, VALUATION.%,?� $, LOT TRACT. JOB SITE ADDRESS i0-200-0 I. 2, OWNER CONTRACTOR/DESIGNER/ENGINEER s a eerrfPRG r V� 4�a 49 �o � �rJi; , ,,,D �.a 4-1VN% A aA a lu..:) CrRsa,�y r -T.S. .. 0.1. A' .t'A?!.•�• 45.350 SAN LUIS R.EY ' ' 45-3Y) SAN .i. b. IS liEY PALIM J ESE'RY CA, 92260 PAIL Ms: DF,SE,Wr (°A 92NO t7t (!17' i.g2i1S (131.4 252:3 _ USE OF PERMIT .5 lNi ;L ��' � ' �VYL1 f��..1�2'a ��}'�..�..'� ��. �iJr..°.P:..'S"�i�t�:J?���,�?S' •�I'.I'�'��:.�" �'S�.�iL. c4: .. • . STATE LAWS, INIC 1,4lii)F.faS0 1141,1'.-W :iANd 1b-NtED SP'DZIES o .C":e OF 073 (1fr . U.S.C. 9.5.11,1x"1' 8111.) I APPIACAbLri., IS REQU1l7;FiD. t,8iryry3' ax 3'F am; -3ii1��Lppfyy ppt.i^+;sii.`,'>".f".r'4,ft""�i.'i:3iti PORCl10 9.00 0.17 UA�V1G✓O'% P.�4LR � PERMIT FEE 96NOMARV CONST RLI't;1't0NFViB 1014KO-4➢9-t?00.... $.Z(RA-00, CK PIfP f1.(j--fti0f)-4'ry!eA,1}R Y.65" 198 `P1,A114 yy0 Fri..6 �M11110S1 L, b'�•/S •.\!4\S•q l�'.. '� d+f+ aQ.a9'.i.N0./ Nh£yti;%ISMij�.A3. FM :►iiK-�iti�3 «); i-Obd� $1i7.:5L1 ; 101 100420-(1435? S.�6. • � 717 Tiv[1�tj3�lir t� f±� f f~1 t ftflf3••tl3?tD-il�{1 :^y'x"r;9;a.'i'i �7't� ��;rt Er�� r@r N T ; :tt?: �a 1£11 0015 41.001.) S03.977 tRJk1ilv6-422 00 3:013 D Vh3.QPEt J1V1fAA.0.'tyC 3007.00 0 00 Aldi' fN Plftl),VC PZ: %1f k.,8 - $19711N 3 3 S1.RA-"IN- AL (',47NS7.R,F jl;"i'10N r'.ND PLAN t'HF<_,'.K 'LESS PRL,PAM FEES RECEIPT DATE Bl' DATE'FINALED INSPECTOR - INSPECTION RECORD ' OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs l Forms & Footings I �� Slab Grade I —A4 4� ryQ' Iy Underground Ducts Ducts Return Air Steel 1 Combustion Air Roof Deck Exhaust Fans O.K to Wrap lr� _ rfrQ 5' F.A.U. Framing Insulation ��i12? / 7(� 31�G Compressor Vents Fireplace P.L. — - d0 / Grills Fireplace T.O. i Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall p Exterior Lath 1 Drywall - Int. Lath x•25 � is - fs- r g Final Final l/�(? BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain .Bond Beam Approval to Cover i Equipment Location 1 Underground Electric " I Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Water Piping i Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral ? Pool Cover Sewer Connection Gas Piping 1 Gas Test Y—/ 7,r a ��0� S 7 Encapsulation Appliances i Final COMMENTS: sLrva P4*A- oK k,y�r Beh/�'�/ice m6G 1'—ll�vST 7 Final 1i� Utility Notice (Gas) ELECTRICAL APPROVALS f Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service .,Sub Panels ,Exterior Receptacles " G. F.I. Smoke Detectors 1 Temp. Use of Power 1 i Final Utility Notice (Perm) If t:.S..jvtt.:J�:'Via:.+LsYwYti>r;C«„�+.iY.�.�i-%9'•x=v^l�,r�.."+�'c`+-.a:-xha�;+:f:"a,%�a�'-w`R7!3»fw':'r1a�r-.iS.;�.i.:iY'�'"4��r�,j•�-�...a�.r 1 �P.O. BOX 1504 Building ?,� y� 78-495 CALLE TAMPICO Address MQQ LA QUINTA, CALIFORNIA 92253 Owner aa^— Address City lZip Co ress Tel. State LiaI City & Classif. Lic. # Arcn., tngr.,- Designer Q i Address � � Al.s'+!' �. J i' t j t A 1�.)((J j✓•{.k...'l �/dfol� fU City Zip r, State i! 1 �.�. �. I i, 1 'i ' J D Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I 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. �LGNATURE DATE OWNER -BUILDER DECLARATION I he affirm that I am exempt from the Contractor's License Law for the following reason: (Sac. 7031.5,Business and Professions Code: Any City or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance also requires the applicant for such permit to rile 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). 12 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, Btiisness 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.) Cl 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 doesnot 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 7 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 sell -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. O 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 ame 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. I 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 lot inspection purposes. Signature of applicant Date Mailing Address City, State, Zip 33 APPLICATION ONLY QgI(9 1-77 LDING: TYPE•CONST. OCC. GRP, Number Description Project Description Sq. Ft( Size New ❑ /1 No. Q No. Dw. C.I Stories Units Va Add ❑ Alter ❑ Repair ❑ Demolition ❑ PERMIT AMOUNT . Plan Chk. Dep. -. 2 0 — rr� Plan Chk. Bal. f Const. Mech. Electrical Plumbing S.M.1. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: 9 Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOP If Issued by: Date Permit 1000 Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION 17 Desert Sands Unified School District .4.7=950.Duue"Palms Road'. Notice: La Quinta;' CA'; 92253: Document Cannot Be Duplicated 760-7.71=85'15 CERTIFICATE OF'COMPLIANCE Date 11/1/99 APN #a 769-162-001 No. 19532 Jurisdiction' La Qiunia Owner NameFedderly Companies Permit #9910-177 No. 78-592. Street• : • Peerless Place Log # City La Quinta no 92253. Study Area Tract # 28611 Lot # 33 Square Footage 5888: . Type of Development Single Family. Residence. No. of Units 1 Comments By At the present time, the. Desert.: Sands Unified School. District, does not collect fees on garages/carports, covered patios/walkways; residential additionsun'der.500 square `feet, detaehed'accessory structures or replacement mobilehomes. It has been determined the'above-named owner is exempt from paying school" feesat this'time due:to the following reason: EXEMPTION "NOT"APPLICABLE This certifies that school facility fees imposed;pursuant to Government Code $3.080. in the amount of 1.93 X 5,888 or $41,363.841 the property,listed above,and that building permits and/or Certificates of Occupancy for this square footage in this proposedproject may, now 6e:issuede, Fees Paid By cc & cash/PD National BankTelephone 7,73 5205 Nameon.thecheck Dr. Doris Wilson Superintendent Juanita Green Payment Received : $11,363.84 Check No. 75544'' NOTICE: Pursuant o ssembly.Bil1 3081 (CHAP 549 STATS.' 1996] this will serve to notify, you that the 90 -day approGal �penod in whim youimay, protest the fees or other payment identified above will begin to - 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 eaiiier. .. r, Collector: Attach a copy of county or city plan check apphcation.form to district copy for all waivers. Embossed Original- Building Dept./Applicant 'Copy- Applicant/Rec'eipt Copy - Accounting Fee'collected /exempted by Signature FROM FEDDERLYCOMPAN IES PHONE NO. ?: 760 X773 '0875 •:. Nov.. 15 cc1��999 10: 01AM P2 �� ar . 'O9Fibl First Americarl Ti;;e Co F v . �r..RECORDI1NC- RT;QUM_S"CiD BY , �lrst American Title Ins. Co. pit, RECEIVED FOR RECORD A.Nb WHEN RECORDED MAII. 'rd;. rr AT B:OQ�M Michael W. Fedderly, Sr. s� �sr� r� • 45 -350 -San Luis Rey Avenue: Rr MAR 10. 1999 Palm Descrt, CA 92260 FW0~ In 015da1 Fteeatli d 1 Counbt CMJw++1t fte=*r Few S Space Above TI k.Lmc for• Recorders Use ONy" - A_p.No.: TRA #: 07 Order No.,•2121273' Escrow No.~=P><b53 OkANT DEED I f FiE i1NDIrRSIGIVED GItANTOIt(s) DECLf+RE(s) THAT DOCUMENTARY -TRANSFER TAX IS: COUNTY_ $396.00 1 ( compuied on,full value of',propperty conveyed ore , computed onfull .value less value,of liens or encumbrances remaining at time of sale, unincorporated area; [ j City of La" utnta FOR A VALUABLE CON SIAERATI.ON, Receipt of which i',hereby:acknowledged, l Fisher Capital Corporation; a Colorado Coirporahol MAR �9gg S to Michael ,W Fedderly Sr., a widower hereby GRANT(S) the following described property m tyle,City of La Quinta, Countyof Riverside State of California; Lot 33 of'Tract No. 28611, as "shown °by »ap on file in Book 209,, ages) X2 through -17 of Maps, Records of Riverside County, Cajjfornia. Fisher Capital Corporation, a Colorado 4 corporation By= Don F. Fls cr :. Document Date: January 28, 4999 STATE OF CALIFORVIA' . > COUN OF 9 ,) O ! _ before me 15r--, personally appearrtl' to be'the ison whose name is/arc-cubscribcd to die `within instrument personally known'to Die ' ` „' ) Z Ee) E and aoknowledgedjone that hefskc +ey executed circ s�ine,n-}u authorb d Cap'acity(jW and that by-hisf9er eir signature4s}on thcirtstrrtntent 'the person* - the enpty upon belialf of which1. the pets6o4acted, executed �thc instu"ment. WITNESS nty'hand and official seal: . Signature yilk MIr C,Cnti1A £�!w Fib �, �l -Coulmission 411'27459- M0 Tax Statements to: ;SAME AS ABOVE .`:.,, 'Ira tion N REVIEWP l y OF 1 A n, li`:'T-q OCT 2 5 RECD ARCHITECTURAL DESIGN October 20, 1999 BUILD€NG %.v., Via First Class Mail and facsimile Mr. Greg Butler CITY OF LA QUINTA 78-495 Calle Tampico La Quinta, CA 92253 Re: Fedderly, Lot 33, Tract 28611, 78-592 Peer1e33,P--lace Dear Greg, Please accept this letter as approval for the above referenced residence to obtain a building permit. Conditions that apply to this submittal will be forwarded directly to the architect, Mr. Stuart Woodard. If you have any questions or need additional information, please do not hesitate to call. Thank you. Sincerely, Christina Dores Architectural Review Coordinator pc: Mike Fedderly, via fax Stuart Woodard, via fax C.V4 �­AADaCVdaly.�.Ipd 78505 OLD AvENuE 52 --- LA QuiNTA -- CA 92253-1120 -- PHONE 760/564-3355 — FAX 760/564-2356 lsll U V 1J meet : 1, 1 FLEXIBLE DIAPHRAGM Job No :20743 - Plan 2074 - Plan No : GUEST Client : THE WOODARD GRO Engineer:. BASHAR Wind 1328 Date. :,07/28/99(Ver4.10) Seismic 1840= 1395+ 445 r 100 • 10 17.0 7.0 A 24.0 0.0 17.0' 537 � • Drag::Force Analysis A: SIMPSON ST22." (1150 LB) ALT (12.) # 16d s_inkeY:per top plate splice S.W. #7 ZONE 4 ON SIDE OF LIVING ROOM:,.. EXTERIOR WALL 1ST FLOOR TWO POUR FOUNDATION . B. AREAr` 12.00 (SFT) UBC 97 1 y TOTAL WALL LENGTH , = 24 0 (FT) TOTP,L :'PANEL' LENGTH 17 (F T) ' = SHEAR DIAPHRAGM 1840/ ;24.0 77 REDUNDANCY FACTOR(I�=1.00 �y SHEAR 1840'/ 17:0= 108 (PLF)'(FLEXIBLE) `. MAX2MUMDRAG 537(<LB) USE PE �10 w/ 5/8" DIA. x101! -LONG A B: @ 48 0"',o/c 1VIAX */PL. WASHER DEAD LOADS: Wall 150.0= 15 * 10.0 Roof_P 120.0.='24 *10.0/2 FROM . 0 0' TO '24.0' OVERTURN ANALYSIS UPLIFT.(T) 'DOWN(C).• St e PANEL (Al LEFT SIDE : T=-738.(LB) C 1181'(LB).. NO ;SIGN. UPLIFTO �J RIGHT_SIDE: T= -735 (LB), C=.. 11'81 (LB) NO SIGN.. UPLIFT() z17 - .� FOUNDATION -ANALYSIS sheet: F- i GE'Job #: 'Zr--7t 3 - � Client: (rJ�Gi�/�•�2D _p an No. �s t v4c Dater ($B) SOIL'BEARING, _PSF TO BE CONFIRMED PRIOR TO CONSTRUCTION eCONFIRM ED BY. SOILS REPORT CONTINUOUS FOOTING @ �N LOADS TO FOOTING: ROOF = ( L v ) 9i ( �y ) _ U Of WALL = ( n ). x 4>0 - FLOOR 0.FLOOR = ( ) { ) _ �•a ou " WT. OF FTG. TOTAL #/FT (W) WIDTH REQUIRED = USE ) a " WIDE X 1 " DEEP CONTINUOUS FOOTING-@ I -STORY PORTIONS USE " WIDE X " DEEP CONTINUOUS FOOTING _@.2 -STORY PORTIONS ALLOWABLE POINT LOAD ON CONTINUOUS FOOTING P MAX,= 'SB'X S X.w PoST 144 x P MAX @ (I -STORY) = 0 D # _71 - 'P MAX @ (2 -STORY) _ # • , _ u _ [PAr.L0* = P MAX - TOTAL (S/12)] --� PUBLIC WORKS CLEARANCE LETTER FOR CUSTOM HOME LOTS Dear Builder: Prior to issuance of a building permit, you will be required to obtain clearance from the Public Works Department for one, or more, of the following: 1. Verification that rough grading is complete, and the pad elevation certifications prepared by a licensed surveyor, or engineer, are on file in the Public Works Department. 2. Verification that infrastructure improvements and other required tract improvements are complete, or sufficiently advanced to warrant building permit issuance. 3. Prepare an engineered grading. plan that provides for on -lot storm water retention, and have it checked and approved by the Public Works Department . • Tract 26524 (Estancias) • Tract 26769 (Mountain View Estates) 4. Prepare an engineered grading plan that provides for building pad grading in accordance with the ,existing soils report and tract grading plan, and have it checked.and approved by the Public Works Department. • Tract 28034 (South Valley Estates) FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT TRACT: _7@59-2_ LOT: 40162 � C'�_cQ . (1 1-I 9 PUBLIC WOR S AUTHORIZATI N I DATE F:\PWDEPTIDOCS\FORMSXPW CLEARANCE LETTER.ss COMMENTS: wvV'vv REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. ,D 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 ❑ OTHER ❑ REINFORCED MASONRY ❑ FIRE PROOFING JOB LOCATIONI ;C -0.r. } _ _ REPORT SEQUENCE NO. TVP OF STRIjCTURE "`�"'-"�� PERMIT -NO- DA*IlgqA DAY OF WEEK MATERIAL DESCRIPTI N -3 b A -S3 ARCHITECT INSP :TOR , g TA, wAY HRS. CHARGED O ENGINEER ASSISTANTS HRS. CHARGED INSPECTION L SUB DATE CONTRAGENECTOR /G� " CONTMCTOR -S ' �/G J C7 (wo�LI 1� S 2 A ttr N c o -TL ova o� lo'm '� '1�y �12(,C� -rte• iN L o y- a-�— `".S - � � �' ` z. Gots - • COPY SENT TO CLIENT O CONTINUED ON NEXT PAGE O 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. SIGN TORE OF REGISTE E INSPECTOR -v- A a (o ATE 01F R60RIT REGISTER NUMBER 005 SHEL NMI m-mmillmallm NMI moommmmmmomm NMI �MINEEMENOOM a U11MINUMME I . maimmomm �u Mimi�i� 005 SHEL