0107-342 (AR)LICENSED CONTRACTOR DECLARATION,
ars I hereby affirm under penalty of perjury that I am licensed provisions of
Chapter 9,
1W ev , ,(commencing with Section 7000)' of Division 3 of the Business and
c'4 L Pr6fAsio-nals"Code, and my. License is in full'force an - d effect:
= — cense
pV, Li # Lic. Class 4 Exp. Date
ll_lw LID
ll��l I11W
V?
Z Date -1 Sig6atu re of Contractor
-6
tcP
OWNER -BUILDER DECLARATION
W UJ I hereby affirm under penalty of perjury that I am exempt from the Contractor's
F- Q_.. License Law for the following reason:
W
Z, 1, 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).
1, as owner of the property;" am exclusively, contracting with licensed
contractors to construct -the 'project (Sec. 7044, Business & Professionals
Code).
coI am exempt under Section B&P.C: for this reason
0 LO . . I 1 1. .
N Date -Sighature of Owner
<
WORKER'S COMPENSATION DECLARATION
C) CE:
It Z I hereby affirm under penalfy. f,perjury one of,th6 following declarations:
Lo <
— F-; 0 1 have and will maintain a certificate of consent to self -insure for Workers'
X 1W LL compensation, as provided for by Section 3700 of the Lab6r Code, for the
O. _J < ;.j performance of the work f& which this permit is issued'.
_J
< I have and will maintain workers' compensation insurance, as required by
b/6ection 3700 of the Labor, Code, for the performance of the work for which this
LO
CL permit is issued. . My workers' compensation insurance carrier & policy, no. are:
Z Cartier Policy,No.
Ob Z) A-CCRIPTANC11 ftt'DD
r -
J(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! anoyagree that if,l should become
subject to the workers' compensation peovisi6ns of Section 3700 of the Labor
Code, I. shall forthwith comply with thos'd proVisions.
Date`_i/i, Applicant P
Warning: r4llUl((�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 totheconditions 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 emploiees.
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 iti'chtr
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
411 /
correct. I agree to comply with allpty,* and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
0/
i
r
the above-mentionedpopbrty.f rispection purposes.
Signature (Owneir/Agen*'� Datedd, -.e . f,
BUILDING PERMIT PERMIT#
DATE Er. VALUATION LOT TRACT
JOB SITE APIC_..
ADDRESS
OWNER CONTRACTOR/DESIGNER/EN (NEER
ME'RIANG A ISTACE Y _BALL PamCONSTRUMUN,
79430 SANMMTIT�0 1"'USOLOIRAU,
LA QUWEA, CA, 92253 YUCCAVAUYY CA RMA
USE OF PERMIT
RE, MMrIIAL AM)II-101T
RffA501X% rITCH2341 ADD SKYWCHT AW MASTRO! BEDROOM, 133 S.AK
LN,1140 RrXIM ANDWMI V FIR APPROVED PLAW,
VAILUAT MN A116.00 LS
CUSTOM 171WO COW ERSAON 153.00 Sy
E917MATXDC09.r01rC0X11;rRUC 1011
'T
P1.441 CH W?K FEE
S'32W
CONSTRUC TION FFIn
MECHANICALFFEj1014*0-421-000
3 .fits
PIAWWO W
$11,00,
STRONG MOTION FUE - RIWI)10
1 - 000-241 -0 W
ao,qmeo � I"
SEP 17 2001
'30YAMITSTM M1109 Akym. PIm CHECK -1-7.61
DEPT
LOS PKII-PADIT-1-=y =13 1$10,00
Dw
ysv"At
RECEIPT DATE, BY DATE FINALED INSPEgQE
jib—_IA3
Y
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Ducts
Forms & Footings
_Underground
Ducts
Slab Grade
Return Air
Steel
Roof DeoaExhaust
_
Combustion Air
Fans
O.K. to Wrap
/—
`�-s�l�
F.A.U.
Framing
Compressor
Insulation
/�/g�_�,
Vents
Fireplace P.L.
_
Grills
Fireplace T.O.
e� /��
Fans & Controls
Party Wall Insulation
�7
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath�1e3—
Final
Final
_
—
POOLS - SPAS
BLOCKWALL APPROVALS
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
COMMENTS:
Final
Utility Notice
(Gas)
7—dz
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G. F.1.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
0
-Bin#
,City of b Quints
Building at Safety Division
P.O. Box 1504, 78-495 Calle Tamp*
La Quints, CA 92253 - (760) Tampico.
777-7012
Building Permit Application and Tracking Sheet
Permit #
'0
Project Address: 18
A. P. Number
Aqw (P
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- I � 0 -
I
Owner's N_ame:��
'K0 k 11,
Address: Sch� T1 mo
Legal Description:/L ni—
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Ltng
City, ST. Zip:
I n4o I G
Telephone:
_-Z
Contractor.,?
Perri C.ot�t�wu
Address: �22(.a
ne&(fr+
Project Descriptio
T
CitN,. ST, Zip:
Telephone:
n rr
(AP, q227r)
Vfj2
State Lic. #: -7q 3-3
7 `7
City Lic.
dnh i fl� 1_1)�� r_060
onstru ction Type:'
C Occupancy:.
Arch.. Engr.. Designer.
Address:
City, ST, Zip:
Telephone: 60
.......
StateLic.
Project type (circle one): Ne- Add'n, Alter Repair Demo
Name .q -Contact Person:
r
11 IS q.. Ft.:_
Stories:
4 Units:
1epTone of Contact Person -f--7
T6_k
-213
Esii
R 4r) st'm
�ated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
-P
�.n Sets
Req'd
_?
Rec'd
TRACKING
Plan Check submitted
PERMIT FEES
Item Amount
Structural CaIcs.
z
Reviewed, ready for corrections
Plan Check Deposit
Truss CaIcs.
Called Contact Person'
I I q?11_
VF 2,0
an Check
PI Balance
Title 24 Calcs.
-21
Plans picked tip.
Tip
Construction
Mechanical
Flood plain plan
Plans resubmitted
g
Grading plan
2"d Review, ready for correctiKs/i'ssu)e
Electrical
-7
Subcontactor List
Called Contact Person
Plum
Plumbing
ing
b.
Grant Deed
Plans picked up
SANI.I
H.O.A. Approval
Plans resubmitted
'
Grading
Developer Impact Fee
A.I.P.P.
F
IN HOUSE:-
Review, ready for corrections/issue
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
71t2lal
School Fees
Total Permit Fees
bt7Y'W 60PI
Mrtk.6-, or- fq_r(
J O H N H A C K E -R & A S S O C I A T E S
CIVIL ENGINEERING D E S I GN • L A N D :P L A N N IN G • S U R V E Y I N' G
E N V I R O N M E N T A L S E R V I C E S
October 22, 2001
City of La Quinta
Building Department
Remodel for 78-230 San Timoteo, La Quinta
Inspection of structural elements:
This letter is certification that the, structural elements on the above remodel have been completed as
indicated on the approved plans.
Re ' ect y,
H Hacker, PE
.c�QRO,E SIOA,
2
No. 14614 m
EXP 3-31-05
N �
CI VI1.
OF CALWO
68487 E PALM CANYON DRIVE •SUITE 44 - CATHEDRAL CITY, CA. 92234
(760) 324-0216 FAX (76'0) 3.21-5701 -
Notice:
Document Cannot Be Duplicated
Y
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253 ,
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 9/17/01
No. 22505
Owner NameSterling & Stacev Ball
No. 78-230
City La Quinta
APN # 646-160-017
Jurisdiction La Quinta
Permit # 0107-342
Street San Timoteo Log #
Zip 92253 Study Area
Tract # Lot #
Type of Development Residential Addition
Comments
Square Footage 153
and Addition at living room - 153 sq. ft.
No. of Units 1
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:
Residential Addition 500 Sq Feet or Less
EXEMPT
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
0.00 X 153 or $ 0.00 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project maynow:be issued
Fees Paid By EXEMPT - Robert Perry r,"'Teleph®3
Name on the check '
By Dr. Doris Wilson ;
Superintendent 4W
Fee collected /exempted by Annette Barlow Exempt $0.00
� W ' Check No.
Signature
OTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
bove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
'Ilect them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy Accounting
hely 16, 2001
Ptamnin Department
City of L.aQuinta
P.O. Box 1504
La Qtdnta, CA .92253
RE: Ball Residence
7$-230 San Timoteo
La. Quinta, CA 92253
Lot 17
La Quinta Golf Estates Not
To Whom it.lay Concern:
The purpose of !his fetter is to designate Robert Perri permission to perform certain
functions on my behalf in my absence. These. functions include submitting drawings and
applying for permits, calling for inspections and pavin; City fees.
Thank yang
S;e,.lin, B,11t, Hnr�2G'wrer
E'd Sb6T IBE SOB ouj ' TTeg 8tuu3 e9t,:L0 TO LL [nC
Friday, August 10, 2001 2:01 PM Perri Construction (760)776-5888 p.02
Cc
1? 0. S=1t�
6;3
'160/5,54-2177
+may 111, 2VJ 1
PLANIN! Ufa DEPAMiE.W-
City of La Winte
P. G, €pax 1504
La Quinta CA 9:253
RE: Rwodel of R*a idence
78-230 Sdn iimote o
CentlOMWa ;
The Arch itec4wral•.{ ns•fitee-of La Quin'ta Golf c8ta es has r aviftieea the plans
for pn x. -)sod rftiodel for. the Ster`ring Ball rasidwice at va loc%aiion.
We find these plans meet all the requirements of our CC&Rs and have.
trierefore, affix&d c>>r approval,
If you have any questions, please cw tRct mo office.
hank you.
JIM WOOMI
Architectural Chairman;
e:1,wezooe\secua+ENt\Q1\8AL6
Friday, August 10, 2001 2:01 PM's Perri Construction (760)776;5888 p.03
t;cr ct .'._ tli 1_...i'_ ;t.ct'�c•�,d '.: iR!all"1-62
G'[SA4if9C8t'2rl �t,�l .�.�i�t'..•�.�.� ivFit
ASB i.dM1�b3�L.G is_' 92253
TeJ r °sAJi1Zc, da:'t Fri= 7160/564 -4=
`1 r
Amgvst 9, 2001
PL'AaNNI NC DIPA.1 fT ENT
City of La Q.,intm
P. 0, Box 150 -
La Ouinta CA :2253
RE: Ramodei of Residence of
sterling Bali
78-•230 San Ti mi tee 1
^sin t t amen:
Please be advised that the glans suh!1~ittod by Perri Caristructiors were reviewed
by our ArchitacturAl etwdmittse.
It was oetermined that. since t,_e nor -Thep -at apctisan that intrvde5 upon the
Fairway ay ;).asexisted ns such o a ?N.-mb+�3r c f y` ars t n*d based upon the
Contractor's assurance -that there would be ?b7olvtcly no charigAs made to
set backs/ rooT freight of this particular section, ihA plasm were approved.
Please reference our letter to you of May 11, 200W.
Mr. Perri is aware that any choriges effecting our prior approvai for re,`r;odal
would result in job stoppage and would require resubmittal of plats with
stringent adherence to our PreS4ht setbacks/roof hoight.
If you have any questions, please contact the Office at the number 1isleo
above.
Yours truly,
'�........ .
Anne Tuttle
Association Manager
for
THE AKHT T ECTURAL , i.41TTEE .
Enclosures
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PROJECT DESCRIPTIO!
• A REMODEL PLAN FOR 78-230 SAN TIM OTEOR
IN Ln QUINTA, CA.
OWNER -RSR. & MRS. BALL
PN - 1-79
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PATRIOT
ENVIRONMENTAL
LABORATORY SERVICES, INC
REPORT NUMBER: 42233
CLIENT: Lisa Perri
72263 Desert Drive
Rancho Mirage, CA. 92270
POLARIZED LIGHT MICROSCOPY ANALYSIS
NUMBER OF SAMPLES: 07
REPORT DATE: 07/23/01
PROJECT:
Sterling Ball
78-230 San Timoteo
La Quints, A. 92253
—' — - -.
—
CLIENT
IDENTIFICATION
AREA
SAMPLED
TYPE OF
ASBESTOS
SAMPLE
RESULTS
01
Den
Acoustic
None
(White)
Detected
02
Hallway
Drywall/Plaster
None
(White/Brown)
Detected
03
Den/Kitchen
Drywall
None
(WhiteSrown)
Detected
04
Kitchen
Floor
None
(Gray/Beige/Red)
Detected
05
Exterior Stucco
Stucco
None
(Gray/Beige/Pink)
Detected
06
Upper Roof
Roof
None
(Black)
Detected
07.Lower.
Roof
Roof -
_None -
(Black)
Detected
COMPOSITION
Carbonate/Binder/Foam
Cellulose/Fiber Glass/Minerals/Sulfate
Cellulose/Sulfate
Minerals/Carbonate/Ceramic Tile
Minerals/Carbonate/Paint
Fiber Glass/Minerals/Binder
Fiber Glass/Minerals/Binder--
PRINCIP - roved Signatory
Disclaimer: Bulk samples with results between 1/10 and 1 percent are visually estimated and therefore low percentage results may not be accurate. We
recommend samples having negative results and less than 1- percent results be tested using SEM or TEM. The EPA PLM method of 600/M4_82_=W
"Interim Method for the Determination of Asbestos in Bulk Insulation Samples" is a semi qualitative procedure . The results are representative of the sample
delivered and may not represent the entire material from which the sample was collected. Non -friable materials analyzed using a methodology spec fled in
the ASTM Committee "Standard Method of Testing Asbestos containing materials by Polarized Light Microscopy." This report is published by a ,NIST
accredited laboratory through NVLAP and does not claim endorsement by NVLAP or any agency of thp
reproduced without the expressed written consent of Patriot Environmental. e U.S. Government. This report cannot be
12832 Valley View Street, Suite 107, Garden Grove, CA 92845
• Tel: 888/743-0998 • Tel: 714/899-8900 Fax: 714/899-7098
PLANNING DEPARTMENT
City of La Quinta
P. 0. Box 1504
La.Quinta CA 92253
RE: Remodel of Residence
78-230 San Timoteo
Gentlemen:
The Architectural Committee of La Quinta Golf Estates has reviewed the plans
for proposed remodel for the Sterling Ball residence at above location.
We find these plans meet all the requirements of our CC&Rs-and have,
therefore, affixed our approval. -
If you have any questions, please contact the office.
Thank you.
9JIMi--LS—
Architectural
WOODSArchitectural Chairman