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LICENSED CONTRACTOR DECLARATION
I 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 force and,effect.
License # / Lic. Class Exp. Date
B -we � � 1011 1€/J-1
Dat- e ' 1'� ' Signature of Contractor
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:
( ) 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.
( ) 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 carrier & policy no. are:
Carrier :E;� K Policy No
(This section need not be completed jfrthe 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 a' y`manner so as to become subject to the
workers' compensation laws of Calfor lia, and agree that if I should become
subject to the workers' compeLitaiio rovisions of Section 3700 of the Labor
Code, I shall forthwith -comply rGosprovisions.
Applict
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal -penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application. ���
1. Each person upon whose behalf this application is made & each person at r
whose request and for whose benefit work is performed under or pursuant,t'o
any permit issued as a result of this applicaton agrees to, & shall, indemnf)3
& hold harmless the City of La Quinta, its officers, agents and employees
2. Any permit issued as a result of this application becomes null and vo'd if
work is not commenced with i 18ldays from date of issuance of s ch
permit, or cessation of work fo 180 days will §on.bject per to cancellati
I certify that I have read this application and state that the above information is
correct. I agree to comply with, all -City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the _above- mentioned propertyor Pection purposes. t
Signature (Owner/Agent) / Dated• � _/ ' Q ,
BUILDING PERMIT PERMIT#
DATE / VALUATION LOT TRACT
2� L Ly��..7>t#.� i f �-
JOB SITE
APN
ADDRESS 52- 7 D ,n GAT .f DEM.,
7 ,?0___W_01, 7
OWNER
CONTRACTOR / DESIGNER / EN (NEER
DAM AMI ,
RAAST0,1aDIR1:DERSC aRPORMION
PA1,,:MINUTURV :�'A 4:,1261
(7 60,P. to -Lff 3332
USE OF PERMIT
SFW =CLt3D SWAi.L.slPOIDIJORIVn, Y.A,9' '4aPl:CF1fi dG:Oi1 ?�L:F37t.`! 't"J]Tf;
.L1., 1JU3NAL &ST,ATF, LAW,% F14CF,,i,51 INQ THE 'WTi1:^A}dORRED
ACT OF 19931P.a: PPIACAi3t.X,15 .IiEQUIFd?~D.
CUSTOM (°OAif)'YRUCTION 4,947.01) V
1at3RS:'I3!Pe.'-+TIO 1,313.01 Sr
0.f RAORICA.1Y1'G)FtT 762.00 sy
0 0099 OF f.'ON1111;i;R'$.TG"dlMN
417,157;3.40
••��yy����??�- cv��p q R�:,��Sp�MM3.T?
CONNTRUCTION i'"E.,E 101.000.418.000 X1,7; 2,si1
PLAN CHECK :'ELL 101-000-439-31,8, $1,400,40
M. DEPOSIT 101.000.439-318 StsOUli o
MECHANICAL M 101-1100-421..000 *124.00
ZLEC'TRICAL PEE '101.0711-420^000 $3$&69
Y:i3OPAB1140 FEE 101-:700.419-000 $'a 9. ;+.5
BROW Pui6110NI n - REJ11D 101.00£Y-2,41.-000
ORAI N10 FEE 101-1300-423-000
DZVF,L0PE- R IMPACT RE
FIeEMSE? I'1.,,A'Nd 10'1-000-441-345 1�:Sltt,oU
T IN PUB,� A["U - IMUM 270-000-445•000 $30NI
t� 2 8 203
°�;,
STA `�'OTA:�►.�'[+°i�,@s' �� DIM'
�:, •"yz
Cts -OT L.i+ Ot,lt �.
• -; � �",
RECEIPT
DATEI
BY a
DATE FIN L C,�
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
—
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deckffz
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
_�(:57
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
`( ��Uj
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
_
��v3 ��
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
�e � � � •2 7- a � �� .
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=
Final
Utility Notice (Perm)
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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that 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
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.14 X 4,947 S.F. or $10,586.58 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/Flathead Bank of Bigfork-Curt Dunham Check No. 123758
Name on the check Telephone
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exemp by Patricia Barbuzza $10,586.58
Payment Recd Over/Under
Signature
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or
other payment identified above Will begin 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 District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
Summit Structural Engineering
P.O. Box 813
270 North Main Street
Donnelly, ID 83615
(866) 862-8148
(208) 325-8148
Fax (208) 325-8149
June 9, 2003
Easton Builders
P.O. BOX 3235
Palm Desert, CA 92261
Attn: Curt Dunham
Subject: Structural Observation
Lot 53 @ The Tradition .
Averial Residence
La Quinta, CA
Dear Curt,
Per your request, we visited the subject job site on June 5, 2003 to perform a structural
observation. While we were at the job site, we found several omissions and deviations
from the plans. All missing items were installed while we were at the job site and at that
time we found the structure to be in general compliance with the structural design
concept.
If you have any questions, please give me a call.
Yours truly,
SUMMIT STRUCTURAL ENGINEERING
of
N0. C054193
Benjamin Herbst, P.E. Exp. 12/31/03
BH
gAMy Documents\2002\ obfiles\Sv-181\181—field 1(cert).doc
Residential. Commercial. Industrial. Land Develooment
9 P.O. BOX 1144 LA 9UINTA, CA 92253-1144 (760) 771-4722 FAX (760) 771-4922
u n V is t a
DEVELOPMENT CORPORATION
February 26, 2003
Greg Butler
c/o City of La Quinta
78-495 Calle Tampico
La Quinta, California 92253
Re: Dan Averil
Lot 53 - Tradition
52790 Del Gato Drive
Dear Greg,
I am writing this letter to let the City know that on the above project I applied for a
building permit. Sun Vista Development Corporation will not be building this home. I
would like to have my name and contractors license removed from the application. It
will be the property owners responsibility to satisfy the Cities requirement for either
General Contractor or Owner Builder.
Sincerely,
Aobert'J. Capetz
President
RJC/gp
CITY OF LA OIJINTA
FEB 2 6 RECD
BUILDING tiIvu SAFETY
Summit Structural Engineering
P.O. Box 813
270 North Main Street
Donnelly, ID 83615
(866) 862-8148
(208) 325-8148
Fax (208) 325-8149
November 26, 2002
Sun State Components
P.O. Box 4077
4505 Mohave Airport Drive =
Kingman, AZ 86402 ---
Attn: Steve Buttler/Truss Designer
Subject: Roof Truss Shop Drawings and Calculations
Lot 53 at The Tradition
La Quinta, CA
Dear Truss Designer,
The roof truss drawings by Sunstate Components for. the subject project were received by
our office on November 20, 2002, and is approved. The submittal has been reviewed for
general conformance to the design concept of the project structural plans. The
fabrication processes, techniques of construction, dimensions, and quantities are not a
part of this review. Since the shop drawings were reviewed only for general conformance
with .the structural plans, unless ' variations from the structural plans have been clearly
indicated, we may not have listed them. Our review of these drawings does not relieve
the truss engineer and the framing contractor from complying with the structural plans.
Yours truly,
SUMMIT STRUCTURAL ENGINEERING
Benjamin Herbst, P.E.
CC: Rob Gapets, Sun Vista
BH
c:\2002jobfiles\sv-181\181—trussl.doc
Residential. Commercial. Industrial. Land Develooment
Mc GEE SUR VEYING, INC.
79-301 Country Club Dr., Ste. 102 — Bermuda Dunes, CA 92201
Phone (760) 345-3828 — Fax (760) 772-5705
March 19, 2003
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92253
Re: Pad Certification — Lot 53, Tr. 28867
(2697)
Pursuant to your request a field survey was conducted on the above referenced project to
determine the vertical location of the building pad. The above mentioned was found as
follows:
LOT ADDRESS PAD (DES) PAD (FIELD)
53 52-790 Del Gato Dr.
Sin erely,
4 x
Wayne A. McGee
L.S. 5479
86.0' 86.0'
i:�OF A.
LS 5479
d G+�
W
;0
SL-7�� �� C CITY OF LA QUINTA SUB -CONTRACTOR LIST
�iUi�t OBUILDER
JOB ADDRESS PERMIT NUMBER OWNER S1u►�l
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in A stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade / Classification
Contractor
State Contractor's License
Workers Compensation Insurance
City Business License
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(x /xx/xx)
Carrier Name
le.g. State Fund, CalCompl
Policy Number
(Format Varies)
Exp. Date
(xx xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK (C-12)
AiiO n
-7 _I
R N 03
S �! ��
03
S
I i i
0
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 TRUCT. STEEL ASSEMBLY ❑ S
O POST TENSIONED CONCRETE ASPHALT THER
O REINFORCED MASONRY O FIRE PROOFING
,108 LOCATIO) a.- 0 b e� � ./ k ^ u i�
/~i(`,+
REPORT SEQUENCE N0.
TYPE F TRUyy``CTUR •
V¢.� I A
PERMIT NO.
D TE 11 0�
DAY OF WEEK
MATERIAL DESCRIPTION _3( • _Y
Cv7*',
ARCHITECT
11LSPiiTgR
-
HRS.CHARGED
�► r / ��' 1 � /�^ _ �
`
ENGINEER
ASV
ASSISTANTS
HRS. CHARGED
I SUB INSPECTION
CONTRACTOR DTEOR S CONTRACTOR v �II'P VYK.r�
0 rBSr112(,r� S�� 1 ePAS-S i 6&s It47ES
c�� .
9 Col. 7r:.%. 9 K9 y. 31k 4)..5
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,ate �.�i� Cr Cts
eAN 116 1X7 0
COPY SENT TO CLIENT O
CON HUED ON NEXT PAGE ❑
PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MJ
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.
IGH TUBE OF REGISTERED NSPECTQR��
03
66
P47E Ot REPORT REGISTER NUMRFR