9807-046 (SFD)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
4)
Signature
vDate Signature of Contractor r `' • ''
J
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:
Carrier Policy No.
(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 3700 of the Labor
'Code, I shall,forthwith comply with thop`c�-e pyovisio s. 1
tate: ��'' .� Applicant
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
Zthe above-mentioned property for inspection purposes.
fSignature (Owner/Agent) �J �� '�' � Date f t
: BUILDING PERMIT PERMIT# CONTROL#
9907-00
DATE VALUATION LOT TRACT SAM
S280+2*53'101i1 +
1 yr{
JOB w T
+19.106
APN
S
ADDRESS
��aliliN{i��6l1�i f/ Qt�f6`it
74.11-6e04RP
OWNER
CONTRACTOR / DESIGNER / ENGINEER
1 11 11 a' �� t1 ):'a:1 ; ti' °J 2: E' ^,'
,.l� ��.,, � P!',� f`� �i.r t,,.,� t.t, � �..� � �
) f.l f ":! •'-'rr' 1Af r"R'1
' `#.11�� .1r! tr^.f..�+1 .I!,��'1t.., , �..�,.
i
J,A (Al1.hT1% (-A
I,AX,iUIIVI`A CA 9225:
06007:.7-7611 i;f;l.ff 1711
USE OF PERMIT
PAID
JUL 3,0 1998
c1e1J8/lt.tJ1 r\t21t�€t'€' I,UFr►.ti!)'3r
a^�a .9A1
OF LA C� UIN
%NI
,Y�3
�
,(' t N{k,�y`j;^ vp`�r, 07►1
V3T! pn 4 a y COST OF
_ 80 s ?slyp
C.v 1N,'JFtl,ft"i 1C�1�€ F 1 i 1€11-00)-418,fft 4}.2i�.i)!►
13t, AN i%!•'!•r 101-090-434.1118 Vfr51g
1X1D,.t ANtC4V.1"11. 1.01-000-421-000 S!I�Ao
1.1.&_1 r 2A11i1i, FEE 1014JJI00-42.0•dJt1Q V23179
Rl3A2[dOKI FEE 101-W0419-000 419-000 5192.75
53`iRONO Plfc)`I'!<)N VV - t V444 1% 101-OW2r11-0!111 $21 .03
(AA011".4(i (?iIl: 101-000-123-000 S210.00
iNHJtrtti'1'1ttilC N(rc .i K61 235-WO-cW3-342 S6.000.0)
A KI €N 1y€ BLIC PLAf:,HS - RRSIC 70.1-000-255-000
fftt_iiTrA 1, romsmR.Ty—fIGIN AND PIAN f;111 (;
$8,63935
e'sS) PRY -11"U"11) FEES
$3.00
'R OT..'1,E, PF:3ifilYC 1+`h;J` S 4$i.+1+a 1\'4 llV
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
- INSPECTOR
OPERATION
DATE
TINSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
C
_
Return Air
Steel
Combustion Air
Roof Deck
Qj
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
(j_ 2i%
Compressor
Insulation
Vents
Fireplace P.L.
-
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
- fj
Drywall - Int. Lath
- -
Final -
Final — -
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 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
_
Z
Appliances
Final
Final y�
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
f
Final
Utility Notice (Perm) T
COMMENTS:
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
706410 B 5/31/99
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:
Cartier Policy No.
ZENITH INSURANCE 2042062503
(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,
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 provisions.
Date: Applicant
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 inspection purposes.
Signature (Owner/Agent) Date
PERMITp °°NIR°`#
BUILDING PERMIT
9807-046
DATE JUL 3D 98 VALUATION LOT TRACT nn QQ 1
8280,253.80 4 P 486Ef,.
JOB SITE
ADDRESS 79-840 REMINGTON DRIVE
APN
761-070-007
OWNER
CONTRACTOR / DESIGNER / ENGINEER
LA QUINTA GOLF PROPERTIES
TURPIN CONSTRUCTION CO.
1 QUARRY LN
78-I20 CALLE ESTADO #206
LA QUINTA CA 92253
LA QUINTA CA 92253
(760)777-7611 CBL# 3751
USE OF PERMIT
SFD
SFD - TRANSIENT USE. COTTAGE #3 AT QUARRY RETREAT. PLAN
CHECK FEE REDUCED 75% FOR MULTIPLE ISSUANCE OF SAME PLAN
TYPE.
CUSTOM CONSTRUCTION 3,243.00 SF
PORCH/PATIO 509.00 SF
GARAGEICARPORT 1,064.00 SF
ESTIMATED COST OF CONSTRUCTION
280,253.80
PERMIT FEE SUMMARY
CONSTRUCTION FEE 101-000-418-000. $1,273.00
PLAN CHECK FEE 101-000439-318 $265.15
MECHANICAL FEE 101-000-421-000 $175.00
ELECTRICAL FEE 101-000420-000 $233.79
PLUMBING FEE 101-000-419-000 $192.75
STRONG MOTION FEE - RESID 101-000-241-000 $28.03
GRADING FEE 101-000-423-000 $20.00
INFRASTRUCTURE FEE 225-000-443-342 $6,000.00
ART IN PUBLIC PLACES - RESIB 701-000-255-000 $450.63
SUB -TOTAL CONSTRUCTION AND PLAN CHECK
$8,638.35
LESS PRE -PAID FEES
$0.00
TOTAL PERMIT FEES DUE NOW
$8,638.35
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
Notice:
Document Cannot Be Duplicated
Date 7/14/98
No. 17319
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253,
760-771-8515
CERTIFICATE OF COMPLIANCE
Jurisdirtinn
Owner NameLa Quinta Golf Properties .
No. 79-840 Street Remington Drive
APN # 761-070-007
La Quinta
Permit #
Log #
City La Quinta zip 92253 Study Area
Tract # Lot # Square Footage 3,243
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
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 3,243 or $ 6,258.99
the property listed above_,and thP.Vb'uilding
-�
permits and/or Certificates of Occupancy for this square footage in this proposed projectinay,.now be issued ,
Fees Paid By Bank of America/Ed
"Tele hdhe)' 7?77761;1_- "
Name on the check
a
Dr. Doris Wilson
3.:-
i
By
' + m
Superintendent
,;
Fee collected /exempted by Juanita Green
Payment Received $6,258.99
Check No. 2011202526
Signature /EIA
(NOTICE: Pursuant of Asser��
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 date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) of to another public entity authorized to
collect them on the Dislrict('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
03/15/1999 12:44 619-777-7613 TURPIN CONSTRUCTION PAGE 02
PTY OF LA QUINTA
dow5 NG & SAFETY DEPARTMENT
777-7012
i �"oECTION REQUEST LINE
mol777-7153
owner SLA �,TyIl4.fP�i GOLF PROPERTIES
Contractor C 0- NSIRUCTION CO
Permit Nu9807-046
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL. APPLICABLE SPACES
JOB ADDRESS 79•-840 REN INGT9N DRIVE
SFA- TRANSIENT USE. COTTAGE #3 AT
QUARRY RETREAT. i
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK P11-7 z
FOOTING STEEL
i
MAIN GROUND SYSTEM !
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
•r
DO NOT P UR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGI
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST,
HEATING & VENT- AIC
FIREPLACE -i i /�..• �� .' Z
ROOF
BOND BEAM
O_K. TO WRAP
GROUT ❑ 4' ❑ 8' f
FRAMING
INSULATION �G
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR Y�
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK 27lC' E`
FINALS
ELECTRICAL.
PLUMBING T
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER _.
0