9807-045, 9808-056 (SFD)LICENSED CONTRACTOR DECLARATION
�`l 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
106,110 B � n Y3Ml 9
,Date�% ;1 Signature'of Contractor
_4 f,
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.
(f) 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� 7{ Policy No. f
f9.UT-4i 1114' l.l�sti L++AAiyCTiv L -12, 62$i).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 to the workers' compensation provisions of Section -3700 of the Labor
C�d, I shall forthwith comply with t� o's
eprov sions. , �r
gate: Applicant +
I� ✓ y
Warrnng: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IW,
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
,Signature (Owner/Agent) ( �" Date -�N -+
J
BUILDINGPERMIT PERMIT# °°NTR°`
�Hf1Y_a�a
DATE VALUATION +'z 0 LOT TRACT A, 024?
t
JOB SIT
ADDRES 7",.10 R$i,Ml~NG;IE`ON DRiVE,
APN
761-070-00 7
OWNER
CONTRACTOR/DESIGNER/ENGINEER
t ti)1.fa`� se vOl..r' fi�Rt l'� rt 1rF3
'r.'Y�t�l m, "ONS !tu l lm ccs. -
I (:iiJ,l1#ttC Y I.N
78-120 CAW-' - 91'AD0 Mi.
LA (;?r,):!N'r'A. CA 412243
LA K11Jiad"I~A CA 92253
17�t}1777. 1 C€ LIf 3751.
USE OF PERMIT
14-4) - TRA NS1T74T L1SE. l:OTTACII✓ 42 A`f QDARRY ILEI R€, AT. OLAN
(;Hl::f:Q;. FEE RCt)U( FI) 75% FOR. it4U1 1'11 LE. ISSUANCE 14 AN A :.. f
TYPE.
USTO&I t ONS TRU i IGN 3, 2 1.00 SF
1it)kt i°ti['n`i'1C, SilJ.i10 18F. rl
yy �
OF L A, � i "
C•AKAC7#� CARPORT 1,064.00 SF
f
UN f ` W i SED'W' S ' 011 CONS UC``TliON,
x :0.21151340
CXINSYJ12trr; 11'1011 PK !;)1 lIfNJ-41K-tiles 51.273.fX1
FIT IA'nt r„! IECK FEE 9 (11-000-43911 1�
&III ;11A1d!CAL 1,,06 t0l-t)M 421-000 S l7S tw
F LE(:'i'RI AL PEE I!)1-00;-420-060 $233,19
►-'1XMBING F33h 101-000-419-WOS1921.75
''ATI+ION(;i.t1Rr,'1'�fCIN )i 1;.. RMAD 101 -000 -?41 -WO *213 0(slZ.f14
)tNG PEE 101-000-423-0300 $20.00
W.Ftt.wMUt'°IRAW,”, ITT- '2'5 -tutu -444 4,2 1060.66
ttl��:t' rrf I�lf9?I,1t 171..Ac�:�-121�*�f ;: `7(11-()f:tli-Z6S-0F)C1 �454.h�;
}C 1;3
nriI?CFt
• .j•lrSS PRE -PMD RES
ES
16�?
'D'MAt. VERMIT Ff, l:.% DUE NOW
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
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
- 2-
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
r
Final
Final 12 77 1
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
5 -
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
t
Final
t<Jtility Notice (Perm)
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
M.
Date Signature of Contractor
OWNER -BUILDER DECLARATION
5/31/99
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 Z042062503
(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 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
Ft Lc.
PERMIT # CONTROL #
BUILDING PERMIT
9807-045
DATE .NL___. 30 _'98VALUATION 280,253.80 LOT 3 TRACT P9i 802
�
JOB SITE
ADDRESS79430 REMINGTON DRIVE
APN
761-070-007
OWNER
-19NTRACTOR / DESIGNER / ENGINEER
LA QUMTA GOLF PROPERTIES
TURPIN CONSTRUCTION CO.
1 QUARRY LN
78-120 CALLE ESTADO #206
LA QUINTA CA 92253
LA QUINTA CA 92253
(760)777-7611 CBL# 3751
USE OF PERMIT
SFD
SFD - TRANSIENT USE. COTTAGE #2 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 101-000-439-318 $265.15
MECHANICAL FEE 101-000-421-000 $175.00
ELECTRICAL FEE 101-000-420-000 $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 56,000.00
ART IN PUBLIC PLACES - RESEC 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
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 7/14/98
No. 17318
Owner NameLa Quinta Golf Properties
No. 79-830
City La Quinta
Street Remington Drive
APN # 761-070-007
Jurisdiction La Quinta
zip 92253
Permit #
Log.#
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
i
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-that,b6ildi-ho
permits and/or Certificates of Occupancy for this square footage in this proposed project may-- w, -be issuedy�
6 Y
Fees Paid By Bank of America/Ed
r
h 1
:r eieVone.�7'17611
Name on the check
�` r
�. --�
•
.��=
% .+� i y 1-55v t14.
By Dr. Doris Wilson
lli
..�-
Superintendent
Fee collected /exempted by Juanita Green
Payment Received $6,258.99
Check No. 2011202526
Signature
NOTICE: Pursuant of As%6mbly 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 frrlVm 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 Districl('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
' + - Building De t./APPlicant Copy - Applicant/Receipt t CoPy - Accounting Original
0
LICENSED CONTRACTOR DECLARATION
w7 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
7061110 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 foi 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.
z; N1111'.f'.t 4111TJTtAtICE Z042062-"31
(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 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) 1 Al' DateeT r'
%� ` '7j F
BUILDING PERMIT PERM' yrt0-0M CONTROL#
DATE S/6198 VALUATION S,0() LOT TRACT IY �nQ(A
V 9
JOB SITE
ADDRESS 79.830 �.�,i��. NGTO.iN DRIVIL
APN 7461-070-00„ I
OWNER
CONTRACTOR/DESIGNER/ENGINEER
s.,,^, QjA;L';" u Rfr:'E,; �ti?S
T.3€?P€`IN, !101111SIMAXt' IN Co.
1 QUARRY UN
78-110 CIU LE ES`T'ADO 9206
LA 0U19YA G" A 922,
LA QCJthi',l A CA 922:x3
0760)777-76ti 081.9 -17SI
USE OF PERMIT
MIS(,'F LLAN'ROUc4
SUPf`i'.t EW-NTAL CONDITION TO PERMIT 49807 -MS - A 3 C` Ut GARAGE
SHALL JM PR0VTT)ED ,P'1tfRA)R'rO FINAL IN:}Pt C'CI<. N tF SPH'ClFIC
PLAN 98-.012. IS N(Yr At7l)P TFI) BY CHT.
MI?1tATEDD COST OF zO MTRUCTION
0.00
PERAUT FEW SUMMARY
SUB -"a OTAL CONS" RUCTION AND PLAN C'14EC:K.
1,9000
LES PRE -PAW FEES
$0.00
TOTit i. PERMIT FEES OflE NOW
�tl.dlt�
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
i
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
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
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
1.
c
Final
Utility Notice (Perm)
COMMENTS:
DEC
SPECIAL INSPECTION SERVICE
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANGY
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
❑ STRUCT. STEEL ASSEMBLY
❑ ASPHALT
❑ FIRE PROOFING
❑
❑ OTHER
JOB LOCATION 9
REPORT SEQUENCE NO
TYPE OF STRUCTURE
srib
PERMIT NO�j G.,�
/' /-5
DATE
/11
_
DAY OF WEEK
MATERIAL DESCRIPTION
V% u
ARCHITECT A
IN ECTD
NRS. CHARGED
ENGINEER
uuj"D %u k-
SCo
ASSISTANTS
HRS CHARGED
INSPECTION
GENERAL u� i
CONTRACTOR
SUB
CONTRACTOR
%DATE
1 5
T
A-rf�+rA�4�
/j
Lt. CSL-
IAC■ L Sr f ■
[._
t�{JIt� J .S
V(` f}
i` Fly
1 u�
d � -
L•I ' C -rt7 '
r�. � 3
��
1
'-R) '
t l
eu
COPY SENT TO CLIENT ❑
NTINUED 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 I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS
SIGN TU OF REGISTE INSPECTOR
ATE CIP REPORT REGISTER NUMBER
03/15/1999 12:44 619-777-7613 TURPIN CONSTRUCTION PAGE 05
7�
$ 3335 �
.►�� �.r
Ute, PO ZA
AS ofnoo
1'0 YA T NPI;
Po L-9 ODW a S
(5)
(6)--,,.
NOTES.
r
l�) 1.
MIN 2-2X POST.
2
OPTIONAL STUD TO COVER
(2)
BOLT HEADS.
3.
BOLT.
4.
BOLT HOLE AT EPDXY
EPDXY BOLT (e EMBED)
BOLTS.
5.
WOOD STUD WALL
G.
SIMPSON HOLDOWN.
7.
TOP OF CONCRETE — SEE
7/8" DIA. HILTI 'HVA' EPDXY
BOLT (10" EMBED)
PLANS.
(7)
ri
(4}
_�afZ... I PSra�f r4H6'4-f-- P- 144 pf ' 022._ czL TI��I
7 ._. lea Pr=cDw,
HOLDOWN
INTERIOR
EXTERIOR OR
SIZE
WALL
INTERIOR WALL
i M T
MTT28B
5/8" DIA, HILTI KWIK
5/5' DIA. HILTI 'HIT`
BOLT (7" EMBED)
EPDXY BOLT (e EMBED)
HD5A
3/4" DIA. HIL11 KWIK
3/4" DIA. HILTI 'HIT'
BOLT (8" EMBED)
EPDXY BOLT (10" EMBM)
HD8A
HDIOA
7/8" DIA. HILTI 'HVA' EPDXY
BOLT (10" EMBED)
SKi DRILLED BOLT OPTION — HD HOLDOWN
134-91.02M 93420 NO SCALE
4 110 CARUSO ■ TURLEY ■ SCOTT ■ INC. CONSULTING STRUCTURAL ENGINEERS
2702 NORTH 44TH STREET SUITE 200 PHOENIX, ARIZONA 85008 (502) 912-9120