14346 (SFD)4
P.O. BOX 1504 r'ayw ,1
Building 78-495 CALLE TAMPICO
Address 50-640 Calle Paloma LAOUINTA,CALIFORNIA 92253
Owner
Peter Rodholm
Mailing P. 0. BOX 176
Address
City Zip
Rancho Miraqe, CA 92270
Owner/Builder
Address
City
State Lic.
& Classif. E
Arch., Engr.,
'Designer
Address
City
No. 14346
LDING: TYPE CONST. VN OCC. GRP. R3
P. Number
6 1) 3 4 0- 6 4 6 0 Legal Description
Project Description SFD
Lic. # Sq. Ft. 2747 No. No. Ow.
Size Stories Units
State
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.
SIGNATURE DATE
OWNEW13UILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License law for the following*
reason: (Sec. 7031.5.Buskmss and Professions Code: Any coy or county which requires a
permit to construct. after, krprove, demolish. or repair any structure, prior to Its Issuance also
requirersuant to
the provisionsthe ofoff/ etfor such 'Contracror's �t ere law. statement
that-he
amie re4p with Sectis s 7000) of
Division 3 of the Business and -Professions Code, or thaf: he is exempt therefrorn, and the basis.
for the alleged exemption. Any viofefbn of Section 7031.5 by any appocant for a permit
subjects the appticant to a civil penally of roof more than me hundred dollars (11500).
O 1, ani owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure,ls not Intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractors License Law does not apply to an owner of property who
builds or improves thereon and who does such wofA himself, or through his own employees.
provided that such improvements are not Intended or offered for sale. If. however, the budding
or Improvement is sold within one year of coripletion; the owner -builder will have the burden
of proving that he did not build or improve for tic purpose of sale.)
O 1, 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
does not apply to an owner of property who'builds of Improves thereon, and who contracts for
such projects with a contrsctor(s) licensed pursuant to the Contractor's License Lew.) .
O 1 am exempt under Sec. R, d P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of, consent to self -insure, or a certificate of,
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
O Copy Is filed with the city. O Certified copy Is hereby fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff the permit is for one hundred dollars (11100) valuation
or less.)
1 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., ff, after making this Certificate of Exemption you should become.
subject to the Nbrkers' Corpensadon provisions of the Labor Code, you must forthwith
comply wild such provisions of Oils Pam* shay be deemed revoked. '
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION.,
DAMAGES AS PROVIDED, FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is abuilding permit when property 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 for inspection purposes
Signature of applicant— Date
Mailing Address
City, State, Zip
'ctrl R nll^.c
New 0 Add O Alter 0 Repair 0 Demolition 0
Permit includes 200 l.f. of 6' high garden
block wall. Pool permit to be obtained
separately.
Estimated Valuation $159,260.00
PERMIT. AMOUNT
Plan Chk. Dep: 2:50 00
Plan Chk. Bal:466 5
Const.
Mech.
Electrical
Plumbing 174-00
S.M.I.
Grading
Driveway Enc. -00
Infrastructure
Arts in Publ-'c Places 148.1
TOTAL 5,842.02 5,592.02
REMARKS
ZONE BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop= Line
Side Street Setback from Center Line
Side Setback from Property Une
FINAL DATE INSPECTOR
Issued by mate Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
7.s --
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT.
ROUGH PLUMB. �.�{
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER OR SEPTIC TANK
ROUGH WIRING
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SO. FT.
HEATING (FINAL)
OTHER APPJEOUIP.
WALL SO. FT.
GAS (FINAL)
DRINKING FOUNTAIN
SO. FT. ® r
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
L
!�
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
GAR. FIREWALL
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 C
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
LIND PLUMBING L
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE r'2
ROUGH PLUMB. �.�{
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL / J
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
✓
BOND BEAM
000
WATER SYSTEM
$
GRADING
CU. yd.
plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING / /
L
!�
REMARKS:
VENTILATION
/� ��S TGulls �lJTlory
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
CALVIN C. KAMINSKAS
Assislanl Commissloner
(714)275.3000
DATE III ` 2 3
4+ o r a-
c
V 0
OFFICE OF
AGRICULTURAL .COMMISSIONER
JAMES,&VALLACE. Commisslooei
. 83-612 Avenue, •9 5 Suite 7
Indio, CA 92201
16191 342-8291
DAN RILEY
Sealer, Welghts & Measures
(714) 275.3030
` /J
y r F. CAST; NO. / C. /� w5 ! ! z 3 9 .Y /�. .
#K ;
DEVELOPER'S NAME: ''t'a": J4, .
Dear Developer:
After reviewing your landscaping plans, a]]�,$lant material listed isnot in
violation of .quarantine laws governing ttie' ,Coachella`Valley.k. If substi.tUtions
do occur and they differ from .plant ritaterial, li.s�ted, this office must tie notified
immediately.
,Thank you for protecting and preserving -the - Coachella Valley's pest -free environment.
Agr cultural Comnis s ione : ; +s ' Of f ice
cc: Indio and Riverside
'I 4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 — FAX. (714) 275-3012
of
�'IJ.Crr,
mu
Ttot�r of 14a.Wuinta
�u'ct?�rn� �n��''��fet� �iui�i�n
This Certificate issued pursuant to the requirements of Section 306 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 50-640 Calle Paloma
Use Classification
Single Family Dwelling Bldg. Permit No. 14346
Group R-3 Type Construction VN Fre Zone Use Zone SR
Owner of Building Peter ROdholm Address P O Box 176
City Ranc i a By;
Daniel P. Crawford
'✓�,����.' ir— °'
Date; July 24, 1995
Building Official U '"
POST IN A CONe?ICUOU! PLACE
Temporary
'I - t*, 4* OPA /�/
Qfk' it
�• (�.L`1`ff Temnorary
T �19 .
(L4 -11f Ica1)utttta
utl t U stub a ettit to
This Certificate issued. pursuant to, the requ,ireme,nts. of Section 306 of the Uniform Building
Code certifying that at the time 'of . issu,anci this'.steuctu re was in compliance with the.,various
ordinancis of the City regulatingi.buildin-.construction or use. For the,fbilqwing:
g.
BUILDING ADDRESS '50-640 Cal le. Paloma
Use classification Sincrle Farhily, Dvi6ilina, 1,4346
Bldg. -Permit No.
Group. R Type 6n-sOuction. y"'i -Fire-Zone Use Zone P 'I
Owner of Building Peter Rodholin Address P.O. Box 176
city Rancho i r a S e CA, 9227.0
By; Daniel P., Crawford Jr.
Date; — I= 22, 1995.jFxpjrL-.q jriily 22, 1!
lin
Builc ? g Official
POST IN A 00MVIPICUOUS PLACE
11
SINCE 1974
----------------------- - - - - -- --------------------------------------------
0;20 ESI DESIGN FAX N0. 7142618506 P.02
' ESI/FM.E.ln'c.
STRUCTURAL ENGINE
&CONSULTANTS
MEMO LEIIER
MEMO LETTER NO.; 94-11--21 DATE ; NOV. 21, 1994
PROJECT NO: 1094-6705
PROJECT: "Rodholm Residence,, CLIENT NO: --------
DEVELOPER:
--_----
DEVELOPER: Mr. &. Mrs. Peter Rodholrn FILE NO 6705M01
LOCATION: La Quinta, California SHEET NO : 1 OF 1
PER�EI�EPHfMfi!5,-�Tl�il`Wj10�R'E I'kYFC3IFi�LT1A , 21,1994-
REGARDING: 1) LOWERING THE PLATE HEIGHT FROM 9'-0" TO 8'-0" WOULD NOT
DIMINISH THE STRUCT•RAL INTEGRITY OF THE.BUILDING.
P
Thank you for bringing this matter to' our attention. If you
have any questions, please do not hesitate to give us a call,
-------,—-------------._—•------------------
ISSUED BY:
ESI / FME, INC. ��_T,�•! COPIES TO:
STRUCTURAL ENGWFT,� sJnN (3) PETER RODHOLM
BY:
G.j, �.� (fax) Attn: Peter
�`
Danny Matsumoto,
DESERT SANDS .UNIFIED SCHOOL. DISTRICT
82-879 .Highway .111
NOTICE: Indio, CA':9.2201.
Document" CannotBe-ADuplicated 619:775 3500
7.
Date 10/11/94 Typeof.Permit La'Quinta
No. 13116 i permit #
Log
Owner Name Peter Rodholin
No. 50640 Street _611e.Paloma,
uint
La a ; t:
City Q '
Zip. 92253 Study Area. 125
APN # 4 -Tract # ;, Lot # 0 Square Footage 12747
Type of Development Single Family Residence No: ofunits
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
followingreason: "
EXEMPTION NOT APPLICABLE"
This certifies that school facility_fees imposed pursuant'to Government Code 53080
in the amount of 1.65 X 2 747 , or $,•4;532.55. `, have beeii paid'to D.S U.S.D. for
the property liste&above and that buildin " : { r '
p p ty , g permits and%or Certificates'of Occupancy for
this square footage in this- proposed projebect`may now issued.-
Fees Paid By Peter Rodholm ,. Telephone 340=6460
Name on the check -
By Dolores A. Ballesteros
Superintendent
Fee collected /exempted by Vickie.J. ,Durrett
Payment Received
Signature Check 1"Jo. 15=00507
Collector: Attach a copy of county or city plan check application form,to district copyloi all waivers.
Embossed Original= Building Dept../Applicant' Copy, - Applicant/Receipt Copy'- Accounting