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LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that] 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
/74gt)')i. t3C
�nIn
Dat4' "*» -J 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 isnot 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. 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 isoissued.
(�() 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 Policy No.
+Tr�`1`l: `'ii>fi� 2'K�}••iS»E7L12t�`i�:
(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
work rs'' compensation laws of California, and agree that if I should become
suct to the workers' compensation provisions of Section 3700 of the Labor
9ode, I shall forthwith comply with those provisions. -
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'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.
II -Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to n
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 bove-mentioned property for inspection purposes.
18ignature (Owner/Agent) Date
PERMIT #
BUILDING PERMITa11x-�1;,aa
DATE VALUATION $44..62(, Z0 LOT I -I TRACTJOB
7/"d
S
ADDR SS $2-728 C.LARET COVE
APN 769-920.09
OWNER
CONTRACTOR DESIGNER
7
yj{ p �( IV
�//
(/YgENGINEER
, (rw y cor
78,855 LINTA
42590'i RI01MN
LA Q111Nnk CA 92253
PALM DESERT CA 91,
(760)772-2626 t BMI 52416 t
USE OF PERMIT
SINGLE .i -E9: 41LY D* C- UINO
SI -D - NO BLOCK WAIIS OR POOL. 00WI'1,IANCE WITH. ALL FED Mi �L �w
.`i I'A.'TH LAWS, Ii4CL1:1)INO THE Ist`(DA.[yGHKE-0`.kVV.0 iLS ACV 0F 1973 (16
b.S.C. 15.31, 1r'I' STKQ j IF AP1 IACAU11 19REQUIREU.
i
CUSTOM CO 3STW%k—TIONt 51302-00 00"
r
V01101TA 10 612-00 STS
GARMI&CAIRi ORO' 1 V18.00 9F
El SDAIATEED COST OF COleSTRUC'.'1<ION
445,626 20
PCRIVil<CI!EV,sumhIARAI
C."iiid:3'I'RUC*T'1c'WFEF; 101.0(* -41.134110 $1,850.50
P(,AN CgFCK FEE:; 1014)00-439-318 $1,SVY 87
ITE b- DU? S.1T 101-000-439-318 41.000.00
fMTYCHANI AT, RM 101••()Ot]-4121.-000 3220.00
Ts1,F'C' ICAL 1:iEE 101-000-420-000 5309.53
P1.0WO)NO F•Ft a' t olAX110-419•-000 $285.
.>Ti QR'Ci40110N1`17.33-RITSU) 101-000-241-000 $44,56
C3R11UWO irMl 101 -OW -42.3-000 $2f3*1
TTaFii.41.�'CltUC tJR F.FE W25-000-443-342 U,dliit m
AR*r IN 03SLIC PLACES - I1.FSM, 701-040-255-x300 5w.cr-1
a
.5MR-TOTAL C ON4"?'W3G3'1O'N ND PLAN C HF,,C,X
$11,121,111
LTH &S Mme. -MD HM'S
PI
4100.00
JUN 2 81999 TOT1kL _f��:�t'na.I VETS DUE NOW
RECEIP
DATE
BY 1::16
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE'
TINSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts • ?i -
Forms & Footings
_ dOct 5�
O- c
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
0. K. to Wrap
F.A.U.
Framing
Compressor
Insulation
v
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
/
POOLS - SPAS
BLOCKWALL A PROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test -
Electdc Final
Waste Lines
C
°�1 J—
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
Appliances
Final
COMMENTS:
Final
Notice
GG
Utility (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
- 2 -
Underground
Underground Conduit
Rough Wiring
Law Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
veJ
Final
S
Utility Notice (Perm)
_ ». i!- . - ",-'N'r �• •.0-c+. *�w-p'�t-n�,;. v+=� 7r � e ., �y ,�,�{y� �ti..Jy,t�j....
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P.O. BOX 1504
uildin_ 78-495 CALLE TAMPICO
Addrress L a —1 aB CLiiv.'ZE 1 (AUC LA OUINTA, CALIFORNIA 92253
a 1&e12 -r -Hiu_
Mailing
City Zip
,,;q
g;or &)iJVIgT kley, (fo � I
11441 T12-AaWo
State -LiC. L'Ity
& Classif. I Lic. #
Designer �"�1)Ity
x14-6 C. Ar-vem
2AC'fttYll�l'� Zip � State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 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
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason; (Sec. 7031.5.Buslness and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to Jts issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code,; orshat- he is ,exempt 4herefrom,tiand the basis
.1 the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500)
1, as owner of the property, or my employees with wages,as`their sole compensation, will
do the work, and the structure is not intended ortifeied for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License 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 offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the pmirpdse of sale.)
I l I, 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 or improves thereon, and who contracts, for,
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) M
y
17 I am exempt under Sec. B. & P.C. for this reason
... 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 Insurance, or a certified copy thereof. (Sec. 3800, Labor _Code.)
Policy No. • Company
n Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM - f..•m•-
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is.for one hundred dollars (E100) valuation
olless.) , .y
I certify that in the performance of thg 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: If, alter making this Certificate • of Exemption you should become
suvject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed tov, oked. ,
CONSTRUCTION LENDING AGENCY
I hereby alfirm that there is a construction lending agency for the performance of the
wprl for which this permit is issued. (Sec. 3097, Civil Code.) '
Lenler's Name
Len(er's Address
T'tis is a building permit when properly filled out, signed and validated, and is subject to
expiation 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 agne to comply with all city and county ordinances and state laws relating to building
consruction, and hereby authorize representatives -of this city to enter the above-
mentoned property for inspection purposes.
Signaure of a0plicant Date
Mailirg Address
City, State,` Zip
APPLICATION ONLY
ILDING: TYPE"CONST. W(RU-) OCC.
-•-vvG��RsP...
Q1. Number el (0 M 9zo- � h° e
Description—g, O-2
ItDescription ,rKAYh
13
CC..0
Sq. Ft. 5®•Z.. No. t No. Dw.
Size Stories Units
New e Add 0 Alter ❑ Repair ❑ Demolition ❑
LIVING 5302
C80'A rrAC-:c:: 113 3
11
rA CAANtCAL % "S 'V
ccaiIE v2ua PA -1 t o (01 2, '
tstlmateo valuation
PERMIT AMOUNT
Plan Chk. Dep. I 'Q b
Plan Chk. Bal.
Const.
Mech. _
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL -
REMARKS
Nr .
• t
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 Line
FINAL DATE INSPECTOR
Issued by:
WHITE = FINANCE 'YELLOW = APPLICANT PINK = BUILDING DIVISION
Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated 760-771-8515
CERTIFICATE OF COMPLIANCE
Date 6/28/99
No. 18935
Owner NameRobert Hill
APN # 769-920-009
Jurisdiction La Quinta
Permit #
No. 52-728 Street Claret Cove Log #
City La Quinta Zip 92253 Study Area
Tract # 28470-2 Lot # 13 Square Footage 5,302
Type of Development Single Family Residence
Comments
No. of Units 1
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 imposed pursuant to Government Code 53080 in the amount of
1.93 X 5,302 or $ 10,232.86 the property listed above and.`that building .
permits and/or Certificates of Occupancy for this square footage in this proposed project may now,issued
Fees Paid By cc/Orange National Bank/Sun Vista Dev. Corp. Telephone :
Name on the check ~
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Juanita Green Payment Received $10,232.86
/)^ V - Check No. 4901697801
Signature
NOTICE: Pursuant of Ass#bly Bill 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 will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized 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 Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
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 ADDRESS: 52-728 CLARET COVE
Use Classification: SFD Bldg. Permit No.: 9902-050
Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RL
Owner of Building: ROBERT HILL
Building Official
Address: 78-855 LIMA
City: LA QUINTA, CA. 92253
By: STEVE TRAXEL
Date: 06-12-00
POST IN A CONSPICUOUS PLACE
Dear Builder:
PUBLIC WORKS CLEARANCE LETTER
FOR 1
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 report and tract grading plan, and have it
checked and approved by the Public Works Department.
• Tract 28034 (South Valley Estates)
FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT
TRACT: 1/� "I 70 -Z—
L T.
I
UBLIC WORKS A ORIZATION TE
F:UPWDEPrDOCS%FORMSIPW CLEARANCE LETTER ss
-0t
Received Jun -09-99 03:07pm from 760 560 3696 -4 ROB CAPETZ page 1
st-in and Associates 760 560 3696 06/09/99 15:145 :01/02 No:831
Tradition
ARCHITECTURAL DESIoN RgviEw
7
: 0Fb)9V14A toy
1 12.•-2S0Z.-.
June 7, 1999
Mr. Gordon Stein
STEIN & ASSOCIATES
74091 Larrea Street
Palm Desert, CA 92260
Re: Hill Residence
Lot 13, Tract 28470-2, 52-728 Claret Cove
Construction Documents / Conditions Review -1" Submittal
Dear Gordon,
The ADRC of Tradition met on June 2, 1999 and reviewed the revised Construction
Documents submitted for the above referenced residence. This residence has been
approved to move forward into construction; however, the items listed below must be
received within 30 days of this letter or construction will be delayed until All items have
been received, reviewed and approved by the Committee.
&_ghifecturgl Review
Approved as submitted.
Materials Review
1. Provide sample of gold quartzite that will be used on swimming pool, Currently,
plans specify tile which is not Acceptable for an infinity edge pool.
2 . Provide sample pavers being used.
3. Provide color samples for concrete.
hgn_4i age Beview
1. The Committee has approved the request to encroach onto the golf course to allow
MQW"ff bW=_"%VV"40L-*
78505 OLD AvENuL 32 - LA QuiNTA -CA 92253.1120 - MoNE 760/564.3355 -- FAx 760/5642356
Received Jun-09-99 03:07pm from 760 560 3696 4 ROB CAPETZ page 2
S%in and Associates 16 760 560 3696 06/09/99 15:14.15 :02/02 N0:831
the owner to enjoy a greater view of the golf course and amenities. However, you
will be required to expand upon the area being graded to soften the entire frontage
along the property line and not just, "create a hole" for the infinity edge to function.
As we reviewed in the ARRC meeting, you are aware of what is expected. Please
revise and resubmit the revisions to the ADRC. Upon review and approval, I will
forward the information to the Golf Course Committee to request a "Special
Variance" approval.
2 Light fixtures specified in front yard .are not approved. Provide revised fixture
selection.
If you have any questions or need additional information, please do not hesitate to call.
Thank you.
Sincerely,
Christina J. Dares
Architectural Review Coordinator
/cjd
pc: Mr. Robert 11111
78.855 Lima
La Quintu, CA 92253
Hassan Zarenejad, P.E.
P.O. Box 491509
Redding, Ca 96049
(530) 246-7200
May 3, 1999
City Of La Quinta
Building Department
La Quinta, Ca.
Re: Hill Residence
Tract 28470-2, Lot 13
La Quinta, Ca.
Gentlemen:
This is to certify that I have reviewed the truss shop drawings prepared by Brown & Honeycutt Truss
Systems, Inc. of Hesperia California and found them to be in compliance with the design intent. .
a"M
9
HILL RESIDENCE
LA QUINTA, CA.
(Sheets 1-47)
Hassan Zarenejad, P.E.
P.O. Box 491509
Redding, Ca 96049
(530) 246-7200
February 8, 1999
Job No. 99-01
Design Criteria:
1 - Foundation design based on the soil investigation report no. 522-
6138-G1, by Sladden Engineering, dated july 30, 1997.
r
2- Wind load: 70 M.P.H. Exp. °C"
3- Seismic zone: 4
4- Codes U.B.C. 1994
A.C.I. 318-95
A.I.S.C. 9t' Edition
r.ITy 05=1, nl IINTA JON TANDY
AUG 2 3.; REC'D 37630 Medjool Ave.
Palm Desert, CA 92211
BUILDING AI,4� 6W,=, Oflfice (760) 772-7192
SPECIAL• • Fax (760) 772-7193
REGISTERED INSPECTOR'S WEEKLY REPORT Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑
❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ OTHER
❑ REINFORCED MASONRY ❑ FIRE PROOFING
JOB IOCAT�pN�
_'�/•i\ /C v e- LA /�UC�'1 '
REPORT SEOUENCE NO.
TYPE STRICTURE 1 /� L�
PERMIT N0.
/�
DVI ' q
ll,
DAV OF WEEK
MATERIAL DES IPTAN ���
ARCHITECT
INSP CTOR
HRS. CHARGED
�' T �' �- Q
ENGINEER
ASSISTANTS
NRS. CHARGED
INSPECTION GENERAL SUB
DATE CONTRACTOR s CONTRACTOR (.c.l�.v�c N C -
v 1U
�SG 1 C L��JD
2l CTL ave . d
o (,t�oLl0 c 0 rte- Cow,-�c
COPY SENT TO CLIENT
INLIED ON NEXT PAGE ❑
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 REGISTER INSPECTOR
I I —� a
DATE OF REPORT REGISTER NUMBER
1
*Materials and weldments conform to plans and specifications and RISC, and AWS Dl -1
Shipping Mark Special Deputy Insp.
905 SHEL
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(ACC)
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(Date) Remarks
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Shipping Mark Special Deputy Insp.
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