0207-097 (SFD)CO
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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 Jorce and effect:
License # Lic. Class Exp. Date
Date f -2 Signature of Contractor! - --' R L r
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:
O 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.
(•y). . 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 STATE I173'dD 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 provision-`
Date: I OZ I If) Applicant l.. - Zp R --
Warning:allure to secure Workers' Compensatior^ce erage 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 p4rson 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, & Mall, indemnify
& hold harmless the City of La Quinta, its officers; agents and employees.
2. Any permit Issued as a result of this application becomes mull 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)-^�ateJ�1
BUILDING PERMIT PERMIT#
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DATE I VALUATION LOT TRACT {,�S47-
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JOB SITE
ADDRESS Swr .Q�.� (Y,�K.I
TO )pr
APNylA-041
OWNER
CONTRACTOR / DESIGNER / EN (NEER
DM SEL` W (5-DINFIf
AMi"►l&w ;4'i IRC E CCfRP()RNVi �N
PAY. M. i1RMUCT CA 9226 1
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USE OF PERMIT
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6501 5V SFD, MCi.UDES `riff:L,T.SII►002/1' k1V-;~'�.,q'y'
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7'PiF.+ "41 AAICIKUD SPEC-= ACT OF IVY IV.APPLIC..ABL,KIS
CUSTOM t"•C?14 MUC T101! 6030 SF
VOR.CIMATIO '11970,00 SP'
C)ARACIFICATIPOR'P V?4,00 3TC
COST OF C0 ti1TS � C-_r.E�" N
-.557.67720
e'nn ��yy��Q�P yyrr y�[,,7[�I�� ��,(yy ��yyyygg ,� ��AKSTIMA�,'T'ED
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COMS't RUCT)ON FEE 101. -MOA 18-000 V. :,1E3.1*0
PL A14 Ckil3f K P'f?5i 1()1-I1t30 Is 31R I;I,"74L+.9�
FEE DY.PO rf 101-M-4.39.316 -SI m.00
iCF�:f•f�F;WICAI.I�E 101 -COW -4201-000 's"'07.so
E-VT1VV,&L FEE 101 -000 -4',* -O -(N CI S3Vi.$5
FLLl.MHINf,I FFE 101-1.1(10-4' 9-000 n 0.A5
9'i•i .c' WO MOT 109 FKP,' - MID 1014100- 241 -000
GRA. 3TNU F -WE MAID
D6?V'EWPEti ,tMl ALIT i�:E $;t 40,00
_'.IZ.':•'.1W PUBLIC PLAMS • ". 3L'2 0-000•40-000 88f►+i.i9
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MR -Tr TPI (".ON1.1MaC."'E"lr'+.N AIM $''.i.,V4 01SC"- ,
$R,207.74
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CITYOF Lp DEP TA
FINANCE DEPT
RECEIPT
DATEa'.:
B - f
D FINALED
INSPECT
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set BacksUnderground
_74
Ducts
Forms & Footings
A0
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
i
Exhaust Fans
O.K. to Wrap
; Q
F.A.U.
Framing
—
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
4" Wall Firewall
Exterior Lath
— D
Drywall - Int: Lath
Final
Final
BLOCKWALL AP ROVALS
(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
-p
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
�• Z
Encapsulation
Gas Piping
Gas Test
__- 7
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 — 7 Q
Final
Utility Notice (Perm)
COMMENTS: ,G'
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STONEY CREEK DESIGN STEDIO
Robyn S. RUCHEY, ARCHITECT
Architectural Design, Planning and. Design Consultadon
Monday,.April 28, 2003
City of Quinta.
Building and Inspection Department., ,
La Quinta, CA
RE: Cheney Residence, lot 2 Delgado Drive, Tradition Golf Club
La. Quinta, California.
Structural Observations by Architect of record for substantial
compliance with structural plans and specifications.
Dear Inspector:
After completing a walk through inspection of structure for the above project with
the project Superintendent for Andrew Pierce Company I find the structural
installation to .be in substantial conformancemith the plans and specifications for
this project.
If you have any questions feel free to call me at your convenience.
RSR/dmr
Cc: Cheney/AP
72.925'Fred WUM9',DFIVe, SURe 201
Palm Desert, Q 92260
(760) 341.6997 Fax (760340.5191
Certificate of Occupancy
may' 4 4Qr�a
Building & Safety Department
This Certificate is, issued pursuant, to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure_ was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
Use classification: SFD
Occupancy Group: R-3 U-1
Owner of Building: D. CHENEY
Building Official
BUILDING ADDRESS: 52-500 DEL GATO DRIVE
Building Permit No.: 0207-097
Type Of Construction: VN Land 'Use Zone: RL
Address:
By: K. KIRKLAND
Date: 12-15-2003
POST IN A CONSPICUOUS PLACE
STONET CREEK DESIGN STWIO
Robyn S. RITam, ARmncf
Architectural Design, Planning and Design, Consultation
Friday, .March 28, 2003
City of La Quinta
Building and Inspection Department.
La Quinta, CA
RE: Exterior shear nailing review and approval.
Cheney Residence, Lot 2, Del Gato Drive
Tradition Golf Club, La Quinta, CA
Dear Inspector:
After completing a walk through inspection of exterior structural nailing with the
project Superintendent I find the exterior structural nailing to be in substantial
conformance with the plans' and specifications for this project. I approve the
exterior ready to wrap.
The project is going to require.additional structural observations for interior
framing and shear wall installations and these observations, will follow in time as
required.
This letter is not intended to imply that the entire structure at this time is in
substantialcompliance with the plans and specifications. Only that the exterior
nailing is approved so the builder can start wrapping the exterior.
If you have any questions feel free to call me at your convenience.
Project. Architectand engineer, (Cgo8o) exp. 13/31/04
RSR/dmr
n-96 Fred Waring Drive, Offe 201
Palm Desert, a 92260
(70111-M In'(760F'U"191
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TUBE STEEL DETAIL_
AT TRELLIS EXTENSION
52 -Sao 119L-6AT6 -D?
CHENEY RESIDENCE
LOT 2, DEL GATO
TRADITION GOLF CLUB.
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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
❑ REINFORCED CONCRETE❑ UCT. STEEL ASSEMBLY
❑POST TENSIONED CONCRETE ❑ ASPHALT
0,'AEINFORCED MASONRY ❑ FIRE PROOFING
❑
❑ OTHER
.JOB LOqemqM
..+ ^,�, ��1
REPORT' SEQUENCE NO.
TYPE. OF STRU TUBE ,
PER T 10 017v
Dp ' _
DAY OF WEEK
MA IAL DESCRIPTION' O
ARCHIT ���
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HRS. CHARGED
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPECTION
DATE
GENERAL
CONTRACTOR _CONTRACTOR
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CONTINU N NEXT PAGE ❑
PAGE OF
CERTIFICATION OF -COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV
KNOWLEDGE ALL OF THE ABOVE4,REPORTED WORK UNLESS OTHERWISE
NOTED, 1 HAVE FOUND THIS WORK TO COMPLY WITH'THE APPROVED
PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
.GOVERNING BUILDING LAWS,
INA RE� F REGISTERED TT70017
DATE OF REPORT REGISTER NUMRFR
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CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
4��1n�o
47950 Dune' Palms Road
0
Date
10/15/02
La Quints CA 92253
Quinta,
BERMUDA DUNES
�' "IANWEL.LS v
�. INDIAN WELLS
No.
23740
(760) 771-8515
LM DESS �y
QINDIO yt
O
Owner
Mr. and Mrs. Cheney
APN #
770-290-002
Address
52500 Del Gato Drive
Jurisdiction
La Quinta
City
La Quinta Zip 92253
Permit #
Tract #
Study Area
Type
Single Family Residence
No. of Units
Lot # No. Street
S.F. Lot # No.
Street S.F.
Unit 1
52500 Del Gato Drive 6502 Unit,6
Unit 2
Unit 7
Unit 3
Unit.B
Unit 4
UnW9
Unit 5
Unit 10.
Comments
At the present time,. the Desert Sands Unified School District does not collect.fees-on garages/cerports, covered patios/walkways, residential additions under
500 square feet;, detached accessory structures (spaces that do,not contain facilitie's for living,.sleeping, cooking, eating or sanitation) or.replaoement mobile
homes. It has been determined that theabove-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 imposed pursuant to
Education Code -Section 17620 and Government Code,65895 Et Seq.
in the amount of $2.14 X 6,502 S.F. or $13,914.28 have been paid for 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 CC/Palm Desert National Bank - Jody Jones Check No. .084793
Name on the check Telephone
By Dr. Doris Wilson
Superintendent
Fee collected /exempted.by Monica Guillen
Signature, 1.4 A VY11
Funding Residential
$13,914.28 000
Payment Recd OverfUnder
NOTICE: Pursuant to Government Code Section'66020(d)(1), this.wjli serve to notify you.that the 90 -day approval period in which,you may protest the fees or
other'payinent.identified above•willbegin to run:from the date on which the building or'installation permit for this project is issued, or from the date on which
'those amounts are paid to the District(s) or to another public entity authorized to collect them on the DistrictCs) behalf; whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original --Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting