0011-229 (OFC)LICENSED CONTRACTOR DECLARATION
41 hereby affirm under penalty of perjury that I am licensed under provisions
Chapter 9 (commencing with Section 7000) of Division 3 of the Business a
Professionals Code, and my License is in full force and effect.
License ##¢p� Lic. Class Exp. Date
.P '; $15093
?Date Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contracto
License Law for the following reason:
( ) I, as owner of the property, or my employees with wages as their sc
compensation, will do the work, and the structure is not intended or offered i
sale (Sec. 7044, Business.& Professionals Code). .
as owner of the property, am exclusively contracting with licens
contractors to construct the project (Sec. 7044, Business & Profess ionE
Code). f",e'
O I am exempt under Section B&P.C. fo, this;reson
Date, /P` �'► Signature of OwnerCQ4 A-41.
WORKER'S COMPENSATIONDECLARATION
I hereby affirm under penalty of perjury one ,of the following declaratior
(.) I have and will maintain a certificate of consent to self -insure for worke
compensation, as providedfor by Section 3700. of the Labor Code, for tl
performance of the work for which this permit is issued.
( )� I have and will maintain workers' compensation insurance, as required
Section 3700 of the Labor Code, for the performance 'of the work for which tf
permit is issued. My workers' compensation insurance' carrier & policy no.•al
Carrier Policy No.
EXF?IOIP1
(This section need not be completed if the permit valuation is.for•$100.00 or•les:
() I certify that in the performance of the work for which this permit is issue
I shall not employ any person in any manner so as to become •Subject to tl
workers' compensation laws of California, and agree that"iff, I should becon
subject -to the workers -compensation provisions• of Sec, {ion,43700 of the Lab
Code, I shall forthwith comply with those pj;o isions..
Date: /Applicant�-•'
Warning: Failure to secure Workers' Compensation coverage is unlawful al
shall subject an employer to criminal penalties anclCivil fines up to $100,000,
addition to the cost of compensation; damages as provided for in Section 371
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safe
for a permit subject to the conditions and restrictions set forth on f
application. .
1. Each person upon whose behalf this application is made & each.person
whose request and for whose benefit work is performed under or pursuant
any permit issued as a result of this applicaton agrees to, & shall, indemni
& hold harmless the City of La Quinta, its officers, agents and employee
2. Any permit issued as a result of this application• becomes null and void
work is not commenced within 180 days from date. of issuance of sul
permit, or cessation of work for 180 days will subject permit to cancellatio
I certify that I have read this application and state that the above information
correct.. I agree to comply with all City, and State laws relating to the buildir
construction, and hereby authorize representatives of this City to enter up(
the above-mentioned property for inspection pu pones.
Signature (Owner/Agent) .� °. Date ?!r' 2'
of
BUILDING PERMIT PERMIT#
14 .
id
DATE VALUATION LOT TRACT
11/27/20C IT111.18It1A0 60
29147.1,
JOB SITE
APN
'
ADDRESS 81-070 C M.-fffXC.'1ri`3r'02
OWNER
CONTRACTOR / DESIGNER / ENGINEER
KAHURUL-.COR i�Z YCIMONWIC
is
35-161 C113OU�',I;F..�M BILLS
PO DOM 366
IAr)icT114TA Cts. 92.253
I.A.OF.F'LWrA
CA 92253
le
�1�/dI332.
CMA3I
A 3237
or
USE OF PERMIT
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Its
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POi MPAT IO ?ADD SP
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CtAPL'sti,WCAPIFOR (M ?,W3.20
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CONTRACT AN10IMT lk
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gy��f���1177.gg••�{�,,tyttqq .�tt C'•,�.py,,y�•.4ygei�'�,A.JiAKi'."hJ�.CD
K.iw3V.6ZF.YXrY,�Kr,P�. ��x.1.C9'Y.�5�+7.1pZ3..S.v,..
d,
CONSTRUCTION &ATE 101.000.418.000
,e
PiA14 CHECK IPM 1.0'1•=000-439-318
ie
FRE URPOSIT 101u000 -43!M 1'S -000,00
or
t aa1� 101 -00041:21 4
1 0101
.ftiil�..C:I>7.ANICAL,
[�-000
�ilG:�h. 1 RIC.- AL FRF I Ct.l 'pM1YVM'""K.PeVa®0101 � `Y: iK
�x:l'i�$13lIdNCi ;�fl+ . fil1Y-OC?0-4 r �►..U13t� �'.Y�.F1,4
id
STRONG M0'40N FEE - COMM i 00-0004A x �GW SZ4,40
in
C1P,ADINO PES 1.01 _14.6•.+12;�-(31)0 $N.00
)s
ART IN PIMAC PLACES < COA4111 ?0I x►.3W-'2:5S-M Oil i I
ty,
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at
fy
11=9 S'I ,: PATDVRVS
4250,00'
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py' y qn qy �p HOW
IF01V, PF.R l IP..i3�.iniEN C ITE e4�./i9'.
g
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RECEIPT
DATE . _ f,
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
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wail 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 Pibg. Test
Final 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:
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LICENSED CONTRACTOR DECLARATION
1 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
83,510 1B1 - 08A1r12(
Date Signature of Contractor
OWN ER-BUILDE"ECLARATION
I hereby affirm under penalty of perju,0 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 KPT 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 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
BUILDINGPERMIT - PERMIT# ////�//////���-1/n'
DATE VALUATION LOT 001.1-41" TRACT
11,rlMM $111AO Cir' 29,4-1
JOB SITE
APN
ADDRESS Tal -070 (MAN17CIZUR
� ^
OWNER
CONTRACTOR/DESIGNER/ENGINEER
WIDO 7PF PAR'1NER>3 i 3.UI*
TS tit'it11C4a7 to CGjA'14`iiZLl 'i`ICrbd' Z�;IG
.55-765 SC�'t7`I'E iii.1�;3
I'ODOX366
C =CA CA 92253
LA QvwrP. CA, 92253
(760)564.4832 CN41 37,37
USE OF PERMIT
T1::MPOPLAR.Y SALES nvl-"1ce, a f.�4lmut3dCP
PORC HIPATIO 7$0.09 SP
(1A11.e 0FJCARPQP,T (SF) %io.20
31"RINKIER I,63"Im SY
,A1C •- COB6MIRCl.Ps.)L 2,632.00 SP
CONTRACT AMOUNT 1..4
DiN
Pk%T Y". 9Klltr TSAAR'It""
CON ITRUC"1'10N 101-000-418-000 $691.30
FLAN CHECK: FEE 101•(1100-439.318 $539.7?
TW EP001'f 101-000.4350.110 42.Sj3,00
@ WEIANiCA , •F l i31-t3(1t7>42 8 -Od0 $47.00
PILECTRIC.AL FF 101.000.420.000 434,93
PLUMBING FEE 101-000-419-0100 MOD
ST R.ONO WO'MH FEE - COMM 100-000-241 -000 Sri -00,
0RADIN 9VEE 301 -000 -423. -WO $30.0
ART IN PUBIX •PL4.t;RS - CC?Y,+9k 701-000-255-000 15$9.11
OTH34 MAL C01481.I&'Q TL 1109 AtY3, P:f„A9 CT:I1~4K
°$2,0:33.84
J'(Y1* L.YV_9M X FEES DUE, NOW
2fit.41k€f9�
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
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 3_
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Hacks
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
OX 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
OAS Z
Final
UtilityNotice (Perm)
COMMENTS:
q
j
b city of La Quinta
Developers Project Approval Form
. Prior t ;the issuance of Building Permitsfor the project listed below, the following Departmental
clearances must be obtained. Please return this form to the Building and Safety Department only .
after approval. Contact applicant for resolution of conditions preventing or delaying approval.
Project: 81-070 Chanticleer - Temporary Sales & Design Centre.
Applicant Contact: Summitt/Weiskopf - Jim Avenell.
Application / Circulation Date: 11/5%00 2"d Check
Date
Community Development Department
sq
C
Christine Di Iorio, Planning Manager
Publiclw:Vorks Department
Building and'Safety Department
Greg Butler, Building and Safety Department Manager
PLEASE RETURN ASAP - SECOND REQUEST.
Date
i/ Z Z 2moa
Kate
Date
Certificate of Occupancy
City of La, Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS: 81-070 CHANTICLEER
Use Classification: TEMPORARY SALES OFFICE BUILDING
Occupancy Group: B Type of Construction: VN
Owner of Building: WEISKOPF PARTNERS LLC
Building Official
Bldg. Permit No.: 0011-229
Land Use Zone: RL/COMMERCIAL c
Address:
55-161 SOUTHERN HILLS
City:
LA QUINTA, CA., 92253
By:
DANIEL P. CRAWFORD JR.
Date:
3/14/01
POST IN A CONSPICUOUS PLACE
(W'Sladden'."E h.gineering
6782 Stanton Ave., Suite A, Buena Park, CA 90621 (714) 523-0952 Fax (714) 523-1369
39-725 Garand Ln., Suite G, Palm Desert, CA 92211 (760) 772-3893 Fax (760) 772-3895
January 17, 2005 ( p7o Project No. 544-0088
�J 05-01-037
Southern Hills Development
55-161 Southern Hills
La Quinta, California 92253
Project: Lot 60 — Tract 29147-1
Weiskopf Course — PGA West
La Quinta, California
Subject: Foundation Plan Review
Ref: Geotechnical Update prepared by Sladden Engineering dated September 3, 2003,
Project No. 544-0088, Report No. 03-09-573.
As requested, we have reviewed the Foundation Plans and Details prepared by Raymond
Frangie Structure Consultants, Inc. Based upon our review, it appears that the recommendations
included within the referenced geotechnical report have been properly incorporated into these
plans.
If you have questions regarding this memo or the above referenced report, please contact the
i
undersigned.
Respectfully submitted
SLADDEN ENGI EER G
QROF ESS/0
` ANOF �9l
ti 0 No. C 45389 Z
Brett L. Anderson w m
M Exp. 9/30/06 M
Principal Engineer
Letter/pc el
Copies: 4/Southern Hills Development
f
MIA .
Mar 28 05 02:29p RF STRUCTURRLLSRNTRMRRIR 760 836 0856 p.2
17 F SIREJCTURAL CONSULIANTS, INC.
75-15; MF.RI.F: DRIVE, STF, H. PALM DESERT. CA 02211
PI IONF. (760)1(36-1000 FAX (7(so) X364YA56
E:- MAIL RA)'MONDi?nRFSTRtjCTURA1..C'OM
MARCH 16, 2005
SOUTHERN I IIt.t..S 0 VELOPMENT
R 1-070 C:HANT'IC:LE K DRIVE
LA QUINTA, CA. 92253
Altn.' MR. JIM AVFNELL
Re.: THE SUMMIT AT PGA WEST, LUT 44 42, PLAN 6
57-605 BALLYBUNION
LA OUINTA, CA. 92253
FOLLOW-UP '1'0 WALK THROUGH
JOB No.' 4149
DEBAR JIM
THIS I.F:'I"I'F:R ADVISES THAT WI-; HAVE OHS1:RVlsD THE STRUCTURAL
KI;.QIIIREME;N'1'S 'I'tiA'I' ARL' VISIBLE; DURING CONSTRUCTION AT THE TIME OF
OUR SITE VISIT.
WE HELIEVE. 'I'llAT THE AS-Kl1ILT CONSTRUCTION ATT'HE TTMEs OF OUR VISIT IS
IN GEINERAL CONFORMANCE WITH OUR S'T'RUCTURAL PLANS AND RE:I.I:VANT
CORRESPONDENCE ISSUED BY OUR OFFICE'.
Wh. O6SEiKVE:D'l'HF BUILDING IN ITS FRAMED CONDI'T'ION PRIOR TO
INSTALLATION OF DRYWALL AND STUCCO, WEOBSERVF:D't'ttL VISUAL AND
AC'C'ESSIRLE ST'RUC'TURAL RE.QUIRE✓MENT'S. ( EXCLUSIONS ARE, ITEMS SUCH AS:
FOOTING SI%li AND REINFOKCIsME'sNT, TOP PLATT: SPLICES, ROOT SHEATHING.
AND ANY STRAPS ABOVE; THE ROOF SHLATHING.).
RESPECTFULLY StAiMl' TE -D
%I;YAD FAQ11I, PE
/opRpFESS/pN
/ 0 M.
CX' No. 57958
* Exp. 06-30-0(0
`r�' OIVI
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