9904-231 (SFD)LICENSED CONTRACTOR DECLARATION
'hereby affirm .under penalty of pe.jury 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
date Signature of Cont
OWNER -BUILDER DECLARATION
7
[hereby affirm under penalty of perjury that I am exempt from the Contractors
L,icense Law for the following reason:
1, as owner of the property, or my employees with wages as their sole
compbrisation, 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
to construct the, project
contractors (Sec. 7044, Business & Professionals
Code).
O.1 am exempt under Section , B&P.C. for this reason
Date:: Sidnaldre- of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affim,under penalty of perjury one of the following declarations:
O I have and will maintain a.certificaWof consent to self -insure forworkers'
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 carver & policy no. are:
.carrier `Policy No..
(This section need not be completed'if the, permit valuation is for $100.00 or less).
( ) I certify that in the performanceofthe work.for which this permit is issued,
Gall not employ any, person in any manner so as to. become subject to the
workers,',compensdtion laws of California, and agree that if 1. should become
subjec(to the workers' compensatioh,provi.sions of Section 3700 of the Labor
C , . .
I shall forthwith comply With,those.-provisions
- e
,[ate: Annfirnnt.�� ilA (-Z- .
1_/ ' 6N__ , - -
WarnIng: Failure to secure' Workers' Compensation coverage, is unlawf7and
shall subject an employer'to criminal penaltieszrid civil fines uWto $1 0�000, in
addition to the cost of compensation, damages as provided for in,Section,.370 . 6
of the Labor Code, interest and attorney's tees.
IMPORTANT Application. is hereby made to the Director of Building and Safety
afety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person: uponwhose behalf INS application is made & each person a!,•
whose requestand for whose benefit,work is performed under or pursuant td -
any permit issued ras 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 (':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 fdrinspection purposes.
Signature (Owner/Agent)' Date. -
BUILDING, PERMIT PERMIT #
DATE os/ isn" VALUATION LOT 5 TRACT 2R47011
;
JOB SITE ]D
ADDRESS iZ-5" EL DIUVE
76Q)-161441Z
,OWNER,
CONTRACTOR/DESIGNER/ENGINEER
ff J'Alkill's GRIGGIS
KJAI CORP
PALM Dh,S1`fCi' CA 92261
MA
USE OF PERMIT
FAAMY MLLIANO
SH) - NO BWN-_X'W1UA,S OR P(X4,, C(__)MPLJMv�::E'W1TH ALL FJRDERI,%�L &
S7'1 .Th LAWS, SPE-CM8 AQr Ov' 15173 (16
U -8,C. § 1531, FII SKO IF APYLICAKJ_i, _V; REQUIRED.
CWSTONI C01-13114FRUCT IC)7114 6i89,?A() III'
P(:mcivvxno 454.00 3F
0ARAG1s CA"ORT 7114(w) Sill
vaus'FIDIA19.79DO 3STOV ON
�57,31. j 5 7. f
1.13,AN 002CK F'913'
Fill f)^It, 10 I'll I I W -00043':1-31 a
J,'EE i111—OW-42i—Ulla
FAX'C-TVACAL FEE &%5.74
P1,1Jk4131Wc4 FK, 101 4W)()-4 I ()-Q00 $2,12.50
I Ilk a0N10 NXIT10 PCE R ESID 101-000-24JI-000
ORALPiNQ FER 10 (-000-4213 000
1 NP RiViTRUC. (TIRE, FPM 22.5 -WO -443-342,
ANT iN M(R11',,47 Pi. ACE5 - 144. 6A
Aa
AL ("I 1STkt,JC1 'ioN'Ajk1T) PLAN (11-J.Pc"K
$i :102 151
jj 4
LESS PRF*' ,1,`A.F1,) fl -,ES
MAY .1'0-,O'A
J i P;!. ft M. I T FE, F -S I.-) V X, N OW
S10,63Z.51
0 F L A 04.0�- . ;,J
RECEIPT
DATE
BY,'
DATE FINALED
INSPECTOR
I
I
OPERATION
DATE'
INSPECTOR
OPERATION
DATE —TINSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS,
Set Backs
Underground Ducts-
uctsForms
Forms&Footings
Ducts
Stab Grade
Return Air
Qkei:2&&rc oe
f7
Combustion Air
Roof Deck
y
Exhaust Fans
O.K. to Wrap
37
F.A.U.
Framing
daep
Compressor
Insulation
Vents
Fireplace P.L.
Grills
F i7r-e—p I i; e- T. 0.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall, Firewall
Exterior Lath
Drywall - Int. Lath.
'
Final
Final
POOLS-SPAS.
,BLOCKWALL
AP ROYALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond. Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbq. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Fans
O.K. for Finish Plaster
Sewer Lateral
0q
Pool Cover
Sewer Connection
.Kj
Encapsulation
Gas Piping
Gas Test
Appliances
U
Final
COMMENTS:
Final'
Utility Nofioe:(Gas)
ELECTRICAL APPROVALS
Temp., Power Pole.2
,;7L
Underground Conduit
Rough Wiring
LowVoltageWiring
Fixtures,
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
SmokeZetectors
Temp. Use of, Power
Final
Utility Notice. (Perm)
fit
rda'r
A.,
P O BOX 1504
� 9a 79-496 0 tTAMPICo APPLICATION ONLY
52- ,Del Gato Drive L'.AOUINTA.CALIFORNIA.92253
I
City Zip y Tel.
C
Zip
it
.DING: TYPVCONST. 5 OCC: GRP. L
Number Lot#5 Tract 28470-2
&Description New Single Family Dwelling
wt DescriptionXith attached Garage. Pool
I Landscape Improvement Design
& Classif.Lic. # Sq: Ft. No. No. w'
Size 6897 Stones One Units NSA
bi;igner Hunt 'Hale Jones, Architects
Address Tel.
475 fimsome S Ste.1820 415-512-13
City rZip. State
San FRancisco 94111 Lit:.# C-19030
I hereby affirm that.' am licensed under Provisions,ot,Chapter 9 (commencing with Section
7000) of Division 3 of the Suslneesand Professlona.Ccde; and my license is In full force and
effect:
-SIGNATLRE. DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that 1 am ex rnpt,from the Contractors License Law for the following
reason: • (Sec: 7031.5,8ush ss a , Professions Code: Any city of county WAch reoulres a
permit lb :conalnret;. after, hriprove, 'dimoiitihi or' repair any .structure; prior to *lts. Issuance also
reouiras�the applkent-for such -pelma to file a N9ned,statement-that he is. licensed pursuant to
the provisions of the Contractor's License .Law, Chapter 9 (commenckty with Section 7000) of
Division 3 of the Sualness and, Professions Coda or Met; he Is exempt Merelrom, and the basis
for (he aseged exemption. Any violation of Section 7031.5 .by -any sppscant for s -permit
-subjects the;applicant to s:oivil penally of not more:than live hundred4blore ($500).
(111 1, as owner of the property, or my employses:wlth wages as their sole compensation„will
dodhe wbik, and thestructure,is not intendsd.oroffered for sate: (Sec. 7044, Sulaness. and
Pioleastons Code: The Contractor's License Caw does not apply .to, an owner of property who
builds, or knpioves ,thereon and who does such 'work'himself or through his own empigyess„
piovd0ed the( such knp"rovemerits Bre not intended or offered tarsals. d, however, the bullding
or knprovement is sold within one year of complsoon, ,the owner -budder will have theburden
orpro.An Ihat'he'dld nol,buad or knprove for the purpose-ofaats.)
1.) I, as;ownerrof'the property, atn.-exclusivelyconlrecting with licensed,c_on0actors4ocon-
struct the project. (Sec. 704Ii Business, and Piolession5 Code: 'The Contractor's Lkepss Law
does not .apply to an owner of property who builds or Improves thereon, and who contracts /or
such, projects with a contractor(s) Ncansed.pursuantrto the Contiactor's.License,taw.)
a -,d. I,am exempt under Sac. S. & P.C., for this, reason
-
Date Owner
WORKERS' COMPENSATION DECLARATION
1 hereby affirm,that I have a certificate of consent to selMnsure, ora', certificate of
Worker's,Compensation Insurance, ora certified copy thereof. (Sec. 3300, Labor Code.)
Policy;No. -Company
n Copy is,filed'.with the city. ❑ Certified�copy'Is hereby fumished.
,CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION' INSURANCE
(This section need nor be completed If .the permit Is for one hundred dollars ($100) vefusbon
or less.)
1 certifythat'in the performance of the work -for which this permit is Issued, I_shall, not.
employ 91fporson In any manner "so as to become subject to the Workers' ' Compensation
Laws o1 Cal{fomla
Date Owner
NOTICE 70, APPLICANT 'd, alter making this Certificate. of Exemption you should become'
subCompensation subject to, .the Workers' Coensation provisions of the Labor Code, ,you must /orthivith
comply with such provisions or. this permit shall De deemed revoked..
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending"agency for,the performance of'the
work,forwhich,this permit {sIssued. (Sec.,3097, Civil Code.)
Lender's Name -
Lender's Address
This, is a building permit wean properly filled out, signed and validated, and to sub jact 10
expiration it work, thereunder is suspended for 180days-
I certify that have read this,application and statethat the above Information Is correct.
1 agree to•comply with all city and county ordinances and state laws relating to; building
construction, and hereby authorize representatives of this oily to enter the above-
mentioned property for inspection purposes.
'Signature of a0plicant Date
Mailing Address
City, State, Zip
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition. ❑
.-Do NILfrill (-AA!!MW t t tp -
ItimatedValuation 795,000.00
PERMIT
Plan, Chk. Dep. 11250.00
Plan Chk. Bal.
Const.
Mech:
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.,
Infrastructure
TOTAL
WHITE- FlNANCE YELLOW -=APPLICANT PINK= BUILDING- DIVISION
ZONE:
BY: JI
Minimum Setback Distances:,
dr
Front Setback trom Center Line
dear Setback from. Rear Prop. Line
S,ideStreet Setback from Center Line
31de:Setbeck fromPznp rtyy,
FINAL DATE
INP T099R
Issued by-
Date, AR 1 RPM
Validated by-.
y/
s s �. A `'L ��"V' i f
Validation:
i 1 6
c
WHITE- FlNANCE YELLOW -=APPLICANT PINK= BUILDING- DIVISION
Notice:
Document Cannot 'Be :D.uplicated
Desert. Sands Unified School District
47-950 Dune Palms'Road
La Quinta, CA 92253
76.0-771-8515
CERTIFICATE OF COMPLIANCE
Date . 5/17/99 APN # 769-162-002'
No, 18774 Jurisdiction La Quinta
Owner NameH. James Griggs' Permit #
No. 52-590 street Del Gato Drive Log.#
City La Quinta Zip 9225:3 Study Area
Tract ;# Lot # Square Footage 6897
Type of Development Single Family Residence No. of Units
Comments
Atthe 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 accessorystructures 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 imposed pursuant to Government Code 53080 in the amount of
1.93 X 69,897 or,$ 13;311.21 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/Virst National Bank - Robert McKai
Name on the check
By- Dr. Doris Wilson
Superintendent
Fee collected /exempted by Ellen Patino
Signature
Payment Received
Check No..
NOTICE: Pursuant of Assembly B ll,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
above willbegin.to run from the date on which tha,building or installabon,permd,fonthis projeet is sssuedor on which.they areipaid to the Districts) or to'another public entity.authoraed to
tolled 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 DeptJApplicant Copy - Applicant/Receipt Copy - Accounting
1 h� , _ � f � - roti. "L 'w� ti •..�, i, �� "s{ � +�,{�,J' ,
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'Tradition
ARCHITECTURAL .DES:IGN REVIEW
May 6, 1999
Mr. Greg Butler
CITY OF LA QUINTA
78-495 Calle Tampico
La Quinta, CA 92253
Re: - Griggs Residence
Lot 5, Tract 28470-2, 52470 Del Gato Drive
Dear Greg,
Via First Class Mail
and Facsimile
Please accept this letter as approval for the above referenced.residence to obtain a building
permit. Conditions that apply to this submittal are minimal and will be forwarded directly
to the architect, Mr. Benji Yen.
If you have any questions or need additional information, please do not hesitate to call.
Sincerely,
Christina J. Dores
Architectural. Review Coordinator
/cjd
pc: Mr. and. Mrs. James Griggs
Benji Yen
Bob McKay
Gw.— W4-&-'0
78505 OLD AvwuE 52 -- LA QuNrA — CA 92253-1120 — PHoNE 760/564.3355 FAx 760/564-2356
NO
Dear Builder:
T, &t 4 4 Q�& &
PUBLIC, WORKS CLEARANCE LETTER
FOR
CUSTOM HOME LOTS
.Prior to 'issuance of a building permit, you will be required to obtain clearance from the
Public Works Department for one, or more, of the following:
1. Verification that rough grading is complete,, -and the pad elevation certifications.
prepared by a licensed surveyor, or, engineer, are on file in the Public Works
Department.
2. Verification that infrastructure improvements and other required tract improvements
are complete, or sufficiently advanced to warrant building permit issuance.
3. Prepare an engineered grading plan that provides `for on -lot storm water retention,.
and have it checked and approved by the Public Works Department.
• Tract. 26524 (Estancias)
• Tract 26769 (Mountain View Estates)
4. Prepare an engineered grading plan that provides for building pad ,grading in
accordance with the existing soils reportand tract grading plan, and have it
checked and approved by the Public Works Department.
Tract 28034 (South Valley Estates)
52 - 5qa 76L CATo 179. .
FQR INTERNAL.USE.BY PUBLCVYORKS DEPARTMENT
TRACT: ;?9470- 2
LOT:
FAPWDEPrDQCMFORMS%PW CLEARANCE LETTER.ss
COMMENTS:
TOSEPH N. CICCHINI, P.E.
CIVIL AND STRUCTURAL ENGINEERING
P.O. BOX 4206
PALM DESERT, CA 92261
TEL: (760)-776-6687
July 19, 1999
The City of La Quinta
Department of Building and Safety
78-495 Calle Tampico
La Quinta, CA 92253
RE: Griggs Residence
52-590 Del Cato Drive
Dear Sir,
The continuous footings shown on plan sheets S 1.2 and S2.2 for the subject residence are
to be placed monolithically wherever possible. They may also be placed in 2 concrete
pours when warranted by field construction conditions. The construction joint is to be
located at the top, of the footing, a minimum, of 6 inches below the adjacent finish floor
elevation, and a minimum footing depth of 12 .inches: Sill plate anchor bolts are to be
embedded a minimum of'5 inches in the remaining monolithically placed concrete, with.
the hook engaged to the top no. 5 rebar.: Special.footings and anchor bolts required by
Simpson Holdowns are to be constructed, according to details 1 and 2 on sheet S 1.2.
N. CICCHM, P.E.
JNC/sel
D:\PROJECnGRG2_19\OFFICE Ngii gs
2.
QFESS%
N0. 35727 Zrn
M
J'f, CWIL
9�F
Of CAO���.
JON TANDY
37630 Medjool Ave.
CIT)" 37630 �-A 01-P.'dltq, Desert, CA 92211
'JOL 22 REC.Lpffice (760) 772-7192
Fax (760) 772-7193
-`
-,c,,. Paa- er (760) 776-3338
REGISTERED .INSPECTOR'S WEEKLY REPORT
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY
11, POST TENSIONED CONCRETE ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
❑
O OTHER
JOB LOCATIO � ^
•j,�`
Cie- - ` L w U `�
REPORT SEQUENCE N0.
TO URE
i I
PERMIT NO.
TE
19 -ql
DAY OF WEEK
MATERIAL pESCR TION_
A- 0 6 ^
ARCHITECT,
JN" CTOR l
HRS. CHARGED
GO
7I � I
ENGINEER_ ` c c-� ;
(/-�
l~
ASSISTANTS
HRS:. CHARGED
INSPECTION
DATE
GENERAL SUB
CONTRACTOR CONTRACTOR _S
J
A Ti-tCif6J g2l C i i o N
ove-l—
- ax-) kw Q- Coin e.1
W eLo -e 00
COPY SENT TO CLIENT`
CONTINUED ON NEXT PAGEO
PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE' BEST OF MY -
KNOWLEDGE ALL 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.
SIGNATURE OF REGIISIERLDaPPECTOR
DATE OF REPORT REGISTEWNUMBER y1
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
ollowing.
BUILDING ADDRESS:
52-590 'DEL GATO DRIVE
Use Classification: SFD Bldg. Permit No.: 9904-231
Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RL
Owner of Building: H JAMES GRIGGS. Address:
By: STEVE TRAXEL
Date: 02-20-00
POST IN A CONSPICUOUS PLACE