0002-241 (SFD)D
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of,
-.hChapter 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
7 3 17 A 05/0V2(.. ...,.
Date —� Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that l 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).
O I am exempt under Section B&P.C.1orthis reason
Date Signature of Owner -_
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations'
O I have,and will maintaima certificate of consent to.self=insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the
perf mance of'the work forwhich this perniit is issued.
(7 1 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 tamer & policy no. are:
3TATRFUND PolicyNo' 1423333
(This:section need not be completed if the permit valuation is for'$100.00 or less).
O
[certify 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.wkers' compensation provisions of Section 3700 of the Labor
Code„ I shall o with• comply with thoseIsl
Date:. Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100;000, in
addition to the cost of compensation, damages, as provided for in Section 3706
of the Labor Code„ interest and attorney'&fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application:
1. Each person upon whose behalf this application is made4 each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date 'of issuance of such
permit; or cessation of work for 180 days will subject permit to cancellation.
I certify.that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for==inspectio�VP'7—
es.
Signature (Owner/Agent)'yf + Date 7 QU
BUILDING PERMIT REKNIT# -
DATE % j1 VALUATION LOT 2-241 TRACT
1Z VALUATION
9460,237,10 88
1— 28470.1
JOB SITE
APN
ADDRESS %2.41.0 DFCL TATO DRTVIP
770-280-018
OWNER
CONTRACTOR'/ DESIGNER'/ EN (NEER
GEORM, & SAWDY Pf!7rkTi J"0N
1:110U4 Cr ORO iX9K GFNRR�L COFICRAC,"ii7.v
56-4051tN11~RA
74-991 JONIDIZ.VF,#11
LA CSV NTA CA 92255
p.,,%1" D,r^.+qcR'1' CA 92260
(760)568.6070 CBL -4 2274
USE OF PERMIT
f 1WGLit FAMILY LW LLTNIQ
SPIN PMI MIT VOLS NOT INCLUDE OLOCK -WALLS OR P60L
CUSTOM CONSTRUCTION 3.:1 X00 3F ,
FORCWPATK(3'
0A1tAC#K?IGIef PORT (3F)
M
ZT, nMAUD COST OF COPiYM.UC 0.K
4610,),37.1.0
Pliff MPT VKE gUhfi19'AI3'tt
CaNSTRUCTION FME 101-0004)aD00319A3.ao
PLAN CHECK FEE 101-000-439-31$ 4t,ir]3.6"r
YEE DEPOSIT 101.000;439.318 -$1,0100,00
UIRCHANICAL FEE 101-000-421-000 $175.00
t{LECTRICAL FEF 101-000.420.000 $302.86
PLUMBING FEE 101-000-419-1180 $7.4$.25
STRONG MOTION FRE RESID 101,,000-241.000 W4 02
ORADING FEE 101-K)"13-000 $20,00
DEVELOPER IMPACT FEE $1,9072
ART 1N PUBLIC PLACES • RF31L 701-000-2:55-(140 $9UO.s9
ST) t3 -TOTAL 1416TRiTC' ON AND PLAN 041:CK
$7 052.39
1,x.99 PRE-PAll) T4EES
-$1,000.00
'1'V.C'A), YEPW r 1KPY_S DUE NO
RECEIPT
DATE
BY l
I DATE FINALED
INSPECTOR
INSPECTI�rJ �'ECC��L�
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
(MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
4
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
0.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
ti� �'z
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation.
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Ij
Final
Final
v
POOLS a SPAS
BLOCKWALL AP ROYALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBI6i G 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
—09
Appliances
Final
es SWE fit. t Alts' �� *ODP
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole —�,(�
Underground Conduit ,v
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final Of
Utility Notice (Perm) " s
BOX1504 APPLICATION ONLY
Building - (-i 78-495 CALLE TAMPICO
Address LA QUANTA, CALIFORNIA 92253 Pit iD4
Owner CA c! �da�� ��,(�
MailingJl `'
"� A.P. Nu er ��� Vav Q (16 0 O- (?It
� Legal Description
Address'
JW i 2 . A,0 -,,`Jr . "In,•�
State:LiC. city
& Classif. sic. #i
Arch., Engr.,
Designer
Zip 61 I'State,L#
tar
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that.l am,licensed under provisions of"Chapter;9 (commencing with Section
7000) of Division 3 of the.Budlnese and Professions Coda, -and my license ie In full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am.,exempt from the Contractors License Gaw for the following
reason; (Sec: 7031.S;Bustness erid Pro/easlona 'Code: Any city or county whkh requhes. e
parmll to cairstNCI, alter lmpriove, delifollsh, or' repair any atruclure, prior to Iia lasuance. also
requires the eppkcarrt fol aitch perms to Rte a sS,,@d statement that he k dceirSed pursua'et to
th proviskurs 'of the. Contractor's Lh:ense Law, Chiptei Y (cemmeridnp with Swoon 7000)_ of
Division '3 of the• BusMeae%aind'. Prolesslona Code; or that. he Is exempt rheielrarrr; and the ba81,
for the asegad .exemption. Any ~Ion of Settlor 7031:5 by 'any app/M.airt for s pertnit
-subjects the applicantto's civilpenalty of not,more than five hundred dollars ($500).
L"1I,as owner,ot,he properly, or my employees with wages:as their Bole compensation; will
do the work, and.the structure le not Intended -or offered for sale. (Sec. 704/,.Buknon,,and
,Prolessions Code:- The Contractors &cense law does not apply to, an owner of, property who
builds or improves. thereon and who does such work himself or through his own employees;
provided that such improvements -are -not Intended or offeredfor sale: I!, however; the bulk ing�
or Improvement pis solei within one year of completion, the owner -builder wig have :the burden
of provinpJhaf hs:dld not,
bt4d'or. broprove,for thepurpose;o! sale.)
1'1 1, as owner:of°the-property,,am exclusively contracting, with licensed contraotoreto con-
struct, the project. (Sec. '7044, Business and'Professlons Code: The Contractor's; Ucense 'Law
does not apply to an', owner of property who builds; or improves thereon, .and who connects, for
suchprojects with a,contractor(s)-licensed pursuant to the Cbntreclor's Ucanse Law.)'
17. I am exempt under Sec B. 6 PZ. for thia,ireason
Date owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I'have a certificate of consent to self -insure, or a -certificate of
Worker's Compensation,lnsurance, or. -.a certified copy -thereof. (Sec. 3800, Labor Coda)
Policy No. Company
n Copy is flled;with the city. .G Certified,copy is hereby fumished.
CERTIFICATE OF'EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit Is for one hundred doyars ($100)- vsluellonf
or fess.)
I carlify that in the performance of thp'work"for which this perrnibis issued,:i shall,not
empioy-any person,iri any manner so4s to I%come subject'fo the Workers' Compensation
Caws of California:,
Date Owner'
NOTICE TO APPLICANT: s, eflef mailing this Certificate o! Exemption you should become
subject to the lMoikers' Compenwtlon piovL9Mns of -'file Labor Code, you must foMwsh
comply with such'provislons or'rhis permit ahal/:be deemedrevoked.
CONSTRUCTION LENDING AGENCY
Ihereby, affirm that there ism construction lending, agency for the performance.of"the
work tor.-wMch this permit is issued. (Sec. 3087, Cbrl Code.)
Lender's Name
Lend er`s Address
This is'a.building, permit when., property filled lout,rsigned.and validated, and'Is subject, to
expl'ration It work' thereunder is suspended for 180 days:
:1 certify that I have read this,applicationand state°tha['.the above information' Is. correct.
I agre 0 comply, with all city and county ordinances and state laws relating to, building
conatnZlon, and hereby authorize representatives -of this city to ,enter the above•
mentioned property for inspection purposes.
Signature of a0plicant bate
Mailing Address
City, State, Zip
Description
Ft.� No.
Stories
Add O Alter ❑
No. Dw:
Units
r O Demolition 0
PERMIT AMOUNT
Plan Chk. Dep.
Plan'Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:_
Mlnimum,Setback Distances:
Front Se
Side
Side
FINAL DATE
Issued'by:
Validated by:
Validation:
WHITE = FINANCE YELLOW o.APPLICANT PINK ='BUILDING DMSION
Line
Line
Notice:
Document Cannot Be Duplicated
Desert. Sands Unified School District
47-950 Dune Palms Road
La Quints, CA :92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 5/4/00 APN # 770-280-018
No. 20394 Jurisdiction La Quinta
Owner NameGeorge. & Sandy Peterson Permit:# 0002-241
No. 52-410 Street Del Gato Drive Log,#
City La Quinta Zip 92253 Study Area
Tract # 28470-1 Lot # 88 Square Footage 5357
Type of Development Single Family.Residence No. o 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 unposed pursuantto Government Code 53090 in the amount of
2.05 X 5;357 or $ 10;9MM the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
Fees Paid By CCNalley Independent.Bank/Brian Ludington Telephone
Name on the check
By Dr. Doris Wilson f
Superintendent
Fee collected /exempted by Maty Ann L. Bora Payment Received
Check No. 216343i
Signature r _
I NOTICE: Pursuant of Assembly Bhp 3081 (CHAP 649. STATS. 1998) Oft will serve to rwfitf' you that the 9Dday approval period In which you may,protast to fees or other poem Wan&led I
above will boon to nut from the date on which to buildfrg or 4ateNetlon permit for this project Is sasued or on which OW am paid to the Dietdd(s)'or to soother public entity authorized to
thorn
coiled on the Dls1rWsXs') behalf; whichever Is earlier.
Collector. Attach a copy of county or city plan check application farm to district copy fbr all walven.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
0
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2 (103
03-2000
09.08 TRADITION GOLF 'CLUB
q_radiffon
ARCHITECTURAL DESIGN REVIEW
May 3, 2000
Ms. Krista Hanson, Architect
44-850 Las Palmas
Palin Desert, CA 92260
Re: Peterson Residence
Lot 88, Tract 284704, 52-410, Dei Gato Drive
Construction Documents -- P Submittal
Dear Mst4
760 564.2356 P.02
Ya.,Firsr C1= Mad
mtd.famkHe
The ADRC of Tradition met and reviewed the above referenced submittal. This submittal
,has been approved to obtaina building permit; however, the .following items must be
provided'for review and- approval within the next'30 days.
ACCNtectur it Review
1. Light fixtwres were not provided; therefore, not approved. Fixtures must be provided
for review and approval prior to installation.
Landscape Review
1. Grading for infinity edge shown. onto golf course property. Please provide planting
and grading for review, All modifications on golf°course must be approved'by Golf
Course Committee. Upon review and approval from this body, I will forward the
plans to the Golf Course Committee. They will contact you direct,
2. Provide two additional canopy trees to buffer garage doors.
3.. Show pots on .back of spa per Section,A.
4. Provide details for infinity edge pool.
S. Surge basin on infinity edge does not conform to 5' setback:
*ftV.WaW"PW—WmPd
78505 OLD-Amxm 52 LA QU[NmA — CA 91253.1120 -- PHONE`760/564.3355 — FAX 760/564-2356
MY -03-2000 09:08
ky-
Material Board
TRADITION,GOLF CLUB
760 564 2356 P.03
Submitted on November 17, 1999 and approved as submitted. All materials colors are
subject to field, review by the ADRC for approval prior to installation. The Committee will
conduct a,:site visit during the regularly scheduled ARRC meeting held the first and third
Wednesday of the month. Notificat wInust be received no later than the Mondayprior to the
meeting. Failure to receive approval of these items may result in removal,and: replacement of
these materials and delay in construction.,
If you`have any questions or need additional information, please do not hesitate to call.
Sincerely,
Christina I Dores
Architecuwal Review Coordinator
Aid
pc: W. and Mrs. George Peterson
56-405 Riviera
IA Quinta, CA 92253
TOTAL P.03
-sient B�: Palm Desert;,
To: CITY OE LQ
760 346:9368;
At: 97777011
ApTil,27,2000
Mr, Steve .Speer
Scriinr Engineer
City of La Qdinta
78-4950 Calle T4mpico
La Quinta; UA 924.33
REs The Tradition — Pad Elevations
Dear Steve:
Per your request, wo have field verified the, Paid qICvatibfts.for ;Lots 88
and 89 of T�ci
No. 28470-L'
The on, of L& 89 d L& 89 is blfffieet. "I'afn uncertain as to `the
" 64. 1. f6ei ;Ai
o d those hown. - on the
reason for the differenpes betwekn the curreni clev.fiti is an.
Ccri 1'rication datedjanuary 29, 1948.
atinAs do
1solatcd ca, ad Otw'
As ;> vu J�now, there have been some cases where the MiSting P
not Co'nform to the clevatiOns as field verified at the end of the tough grading operation in
1997/.1998.
PI ase feel free to call me if you have,zny questionsor conifiientSrat'34&9844.
Sincerely,
T Companies; enc.
i an J. Palumbo PLS
Vice President Survey and Mapping
P.4,n Desert DiY&Vn
41-865 Boardwalk -
wit 101
P21M Desed
CaMorria 9221 1-9031
FJO-30-93M
OA40256NI X X:S\LO f 9849 Fdcv.tkx wwwk6MtO.Cwn
YOUNG ENGINEERING SERVICES 4
47159 Young Lane -Indio, CA 92201 (760) 342-9214
December 5, 2000
Tom Hartung
Building Official
City of La Quinta
RE: Peterson Residence 52-410 Del Gato Dr.. Tradition . La Quinta
Dear Tom,
We have reviewed the framing for the above referenced project and And it to be in general conformance -with the
approved. structural plans.
If you have any questions please call.
Sincerely,
Jeffrey B. Young S.E.
47-159 Young Lane Indio; CA 92201 (760) 342-9214
April 6, 2000
Tom Hartung
Building Official
City of La.Quinta
RE: Peterson Residence.Lot 88, La Quinta
Dear Tom,
We have reviewed the truss calculations andlayout and find it to be in generale conformance with the design
intended.
If you have any questions please =11.
Sincerely,
Jeffrey B. Young S.E.
No. 404
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool 'Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760:) 776-3338
TYPE OF
INSPECTION
PERFORMED
O REINFORCED CONCRETE UCT. STEEL ASSEMBLY ❑
❑'POST TENSIONED CONCRETE O ASPHALT O OTHER �V /
❑ REINFORCED MASONRY 17 FIREPROOFING Lt( 4-EAIt6j V
JOB CO"ov® n j ��y-�f S V' �T./►
(` J \ (�
iPEERMIT
REPORT SEGUENCE N0.
Tvy4 O T CT RE Q�((—�v
'
.MATERIAL
NO.
D1j'j ,)*
DAV OF WEEK
DESCRI TION��
ARCHITECT
WSW\
I SPE T
VT
HRS: CHARGED
e�
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPECTION GENERAL. �` SUB
DATE CONTRACTOR CONTRACTOR JP1r3'�4
21
DLLs. S �6-6 S�- ewwc� 4K
1 CATC KI U GKV-X D 0 7--S
—L, `PiL.O e.C.*n i (Q C-, w• lam
COPY SENT TO CLIENT ❑
CONTINUED-Ok, T, PAGE O
PAGE OF
CERTIFICATION OF COMPL'1"ANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGEALL 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.
SI N E OF REGISTERED INSPE
C.�-v Z 'q- q 73
DATLI OF REPORT REGISTER NUMBER
//
Certificate of Occupancy
City of LaQuinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 7.09 of the Uniform Building Code,
certifying .that, at the time of issuance, this structure was in comp/lance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS: 52-410 DEL GATO DRIVE
Use Classification: SFD Bldg. Permit No.: 0002-241
Occupancy Group: R 3 Type of Construction,: VN
Owner of Building: GEORGE &. SANDY PETERSON Address!
Building Official
Land Use Zone.: RL
By: STEVE TRAXEL
Date! 08-30-01
POST IN A CONSPICUOUS PLACE
JUNE. 2--00 FRA 06:36 CAHULLLH POOL CONST INC 6`193606602 P:03
ITY OF QUINTA
-''ING & SA ETY DEPT.
,. s PR® ED
F�R C NSTR CTION
` /
_- DATE V BY
C?IO FEE •Of 330
A � ; p RE- NS APPROVED
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D ti I PU1NS D. B HEDUEED
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