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0307-076 (AR)LICENSED CONTRACTOR DECLARATION _ I hereby affirm under penalty of perjury that I am licensed under provisions of CKapter 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 6133969 18 Ba (4- 1' j� '�?13 1 AD4, Date ^+ ! '-'Signature of Contractor � j OWNER -BUILDER DEC•L_ARA IONS 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 A, - } Signature of Owner it rt T, 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: CarrieritiipT 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 anykmanner so as to become subject to the workers' compensation laws of California, and agree -that if I should become subject to the workers' compensationjprovisions df Section 3700 of the Labor Code, I shall forthwith comply with those proyisins. Warning: Failure to secure Worker's' Compenbation'llcoverage is unlawful and shall subject an employer to criminal�penalties hand civil fires up to $100,000, in addition to the cost of compensation, damages as proVided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all ,,City, and State layvs relating to the building construction, and hereby authorize representatives of\this City to enter upon the above-mentioned property for ins ection pu doses. -Signature (Owner/Agent) ± / N-4 Date ��-?21,:,>? BUILDING PERMIT PERMIT# 0307_047f f1 DATE 'q p� VALUATION LOT TRACT pp JOB;SITE hrnn u%�:�L=. ADDRESS .i`I �stJ�a��aJ'Ia + . a lJ = . V APN 772-4)7114)19 I OWNER1� - CONTRACTOR / DESIGNER / EN_INEER _ �I t7A VAN �J`lIJ..JV1.7ERG i 111,J.1}!.l...LZi.l:.VELOP.lY].EV,VT COIZPOR,ATION Si '84.r iaGa'D 731,552 nIF.Rr«MJJMIE CA t1221? 33d.DI WE(,..eyl�y (7 611177 39 5..5}. GiJ�it 3St1.1 USE OF PERMIT CUM' )M CON:iTRUCTIONi�C Pa 0 li;V'r. °e!1fi' fF,'ia ,n,OST t.)r COexs'Y3.ARU'MTX,? ` l;sl��~i�.>`1f$ PLAN CMCK ME 11,0 1 -000-45.318 W-90 ' 101.4;) )0f 418 -OW $126.00 4►4FCT'1, VNICAL• TIES 101-fl00 421.000 431.50 000-24.1.000 S1.66 MS. -T fJTALtS��I+T� ::'�Z I �7�+�a �E 1�� i? ,,t��3 0141 A;;.K D AUG 2 7 2003 IT CFI OF + A QUINT ✓ Ar1XIge DEP,, . * RECEIPT DATE f% its By `•. DATE FINALED INSPECTOR i? r .•_._. .4iv INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings — Ducts Slab Grade Return Air Steel — . 3 Combustion Air Roof Deck Exhaust Fans O.K. to Wrap rl, 91— 23 F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath -3 Final — < Final _ _ � BLOCKWALL APPROVALS Steel POOLS - SPAS Set Backs Electric Bond Footings - Main Drain Bond Beam _ p .. d b 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 1A A Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test 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 Final Utility Notice (Perm) — COMMENTS: 0 A X 77 # City of La Quinta Building 8L Safety Division P.O. Box .1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # f� Project Address:,56 7- O%srer's Namc: 5�c.le'j o 16 Ge -4x A. P. Number: - - Address: �� N S' Leval Description: Lor qO I/ / % 8 7 City. ST. Zip: L - L6 fZ ZS 3 Contractor:� � ��,' Telephone: � Lf_ Address:-? /yl4 l ewe Project Description: City, ST, Zip: y'(rti �L /• c4 C! Z�Z I ( i _ 7 ,,-•., w d{ + Telephone: 3 1f j'— 1 �l 3 (v State Lic. # : i ii Engr., Designer: _ :.: City Lic. # kT 3—� V. g- CYC54P4c II Address: ' 136 City. ST, Zip: Telephone: P `r ' ''.:`. •. �`�::.: — Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: J Sq. Ft.: t q7 # Stories: # Units: Telephone # of Contact Person: Zsp - '5 1 stimated Value of Project: _ (ftr p U" -=--Aso APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets p� Plan Check submitted 7/,7 Item Amount Structural Calcs. '� . Reviewed, ready for corrections 12 Plan Check Deposit Truss Cates. Called Contact PersonQi°y,(,� Lt Plan Check Balance Energy Cates. a Plans picked up -7 Construction e Flood plain plan Plans resubmitted Mechanical a 3 S �( Grading plan 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.I.I. e H.O.A. Approval QQ Plans resubmitted W' 114 Grading IN HOUSE:- '^' Review, readv for correctionissu g%Jo/ Developer Impact Fee Planning Approval Called Contact Person %AP Y.A.I,P.P. .Q /Pub. Wks. Appr Date of permit issue O j iS v <tJl� School Fees Z) 0 w P I'Ae4 S SI /✓G.' .Sd"0 L Total Permit Fees Comments S.F. 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: Residential Addition 500 Sq Feet or Less EXEMPT This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.00 X 136 S.F. or $0.00 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 Exempt - Jimmy Haltzopoulos Check No. Name on the check Telephone 760/773.9574 Funding Exempt By Dr. Doris Wilson Superintendent Fee collected /exempted by Sharog McGilvrey Payment Recd $0.00 /2", ,/' , 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 CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road zq�o o r Date 8/27/03 La Quinta, CA 92253 _< BERMUDA DUNES Cn RANCHO MIRAGE d No. 24887 (760) 771-8515 �¢ INDIAN WELLS ") PALM DESERT y .�INDIO LA QUINTA ,y7i d Owner Steven Goldberg APN # 772-070-019 Address 50845 Nispero Jurisdiction La Quinta City La Quinta Zip 92253 Permit # 0307-076 Tract # 24890-4 Study Area Type Residential Addition No. of Units 1 Lot # No. Street S.F. Lot # No. Street Unit 1 69 50845 Nispero 136 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments S.F. 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: Residential Addition 500 Sq Feet or Less EXEMPT This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.00 X 136 S.F. or $0.00 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 Exempt - Jimmy Haltzopoulos Check No. Name on the check Telephone 760/773.9574 Funding Exempt By Dr. Doris Wilson Superintendent Fee collected /exempted by Sharog McGilvrey Payment Recd $0.00 /2", ,/' , 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 UIRUS COURSE HOMEOWNERS ASSOCIAY'ION July 9, 2003 Steven & Elvia Godberg 50-845 Nispero La Quinta, CA 92253 RE: Architectural Request Citrus Course Homeowners Association 50-845 Nispero, La Quinta, CA 92253 Dear Mr. & Mrs. Goldberg: Members of the Architectural Committee have reviewed the application and plan that you submitted to extend your guest bedroom. The Committee has approved the application and plan as submitted. The Committee would like to remind you to please forward a copy of your permit from the city of La Quinta to Desert Resort Management. When all work on the project has been completed, please notify this office in writing so that the improvements may be inspected and signed off by the Architectural Committee and your deposit can be returned to you. Thank you for your patience during the review process. Good luck with your project! Sincerely, Tom Miller Association Manager On behalf of the Board of Directors Citrus Course Homeowners Association P.O.. Box 4772 Palm Desert, CA 92261-4772 i 73-550 Alessandro, Suite 5 Palm Desert, California 760.346.1161 - FAX 760.346.9918 - E-mail: drm@drmiriterner.com - www.citruscoursehoa.com 3/03 `. CARLOS ELIAS Civil.Engineer 38825 Charlesworth Dr. S T.12JCTu26L CBC M4TION'S Cathedral City, CA 92234 (09).328-7271 Lf►QcJrNT�I GSI . �0orI/U6 PLywn. l,5 ZX lVe 24"O,C. Lq INSUL, 0.5 . - -. RIS 3TRIPS 1.0 , ROOF �N� ftaoF W Arc ((�� Rc F W= `8,�n��,5�(j.Z.zrZ3.7(15)+ j(f2att0)+2o =.2¢p 4. If, 133 D.L,� M= 24fl (Iz.o,)z/8= 93-78 5- Ric- 43?oC,L).� 32.27 Coxa s=:51,56 V RF61b-- 1448.(1,1)_ 20.45 666 �z 30.25 (VOI D.L.) 1 REQ'o(�j��- 4so z o ra.o� 3 118.69 �.x�3.1'; 193.3 4, 6:Y, off. 67(s�111..2tto�� 2(IS) + S2f.-06- 22 !Zj14,55 (ok6.s-Z.7.7�, �3.0� (OxG,A=.38,21 R Erah ..USE (o.x l 0. I �-TFR +L LOW SE�SMiC 6F1S� 5HE42(l,. Wp r-kAmw6� =: 2,6 Ca w.L 2,5 ¢ ul_ d,17S VJ! 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SH -R, PrIN'L, CAPaCtT f . 50 %L, r~ 4 x 6M.# 1, ALWNATE M= 240(12. 11�z/g. `}-4003S.Zo 4x r.0 "$ = `f9,9 r I7,00 1,25) =140(1z,r11 5= 1.45' �i.REc�o=1 53 r,s . 18.3 4X 10 2.37 9S 1,2� T REc� D(.Q/40,� I,10o0a�oo USS 4X 0 No, 16839 �. •"`.,._ CMI. .-�' 3-4 ( /Z 3/0 3 DESCRIPTION/S >> >> STC COC.. (3459 P(,T• 065104 ----- DESIGN DATA -------- --------------------------------------------I AXIAL LOAD kips 0.80 0.00 0.00 0.00 0.00 X -X AXIS MOMENT ft -k 10.41 0.00 .0.00 0.00 0.00 AISC SECTION NAME ---->> TS7x5x1/4 None None None None BOLT CAPACITY k 8.8 0 0 0 0 # BOLTS PER SIDE 2 0 0 0 0 BOLT AREA in 0.4418 0 0 0 0 ...DIST. FROM PL EDGE in 1.25 0 0 0 0 BASEPLATE HEIGHT in 14 0 0 0 0 of WIDTH in 14 0 0 0 0 SUPPORT PIER HEIGHT in 48 0 0 0 0 It it WIDTH in 48 - 0 0 0 0 f1c psi 2,500 3,000 3,000 3,000 3,000 Fy ksi 36 36 36 36 36 LOAD DURATION FACTOR 1.33 1.00 1.00 1.00 1.00 AISC SECTION DEPTH in 7.00 0.00 0.00 0.00 0.00 .....FLANGE WIDTH in 5.000 0.000 0.000 0.000 0.000 .....FLANGE THICKNESS in 0.250 0.000 0.000 0.000 0.000 .....WEB THICKNESS in 0.250 0.000 0.000 0.000 0.000 ------ PLATE DESIGN ------ --------------------------------------------- MIN. REQ'D THICKNESS inj 0.59 0.00 0.00 0.00 0.00 Plate Analysis Type #1 0 0 0 0 Anchor Bolt Tension k 5.66 0.00 0.00 0.00 0.00 Actual Bearing psi 509 0 0 0 0 Allowable: Per ACI 10.15 2,975 0 0 0 0 Per AISC 1.5.5 2,328 0 0 0 0 Max. Plate Capacity for Allowable Bearing k 456:2 0.0 0.0 0.0 0.0 ----- PLATE ANALYSIS ---->>> Use If Actual Thickness Varies From Min. -- ACTUAL PLATE THICKNESS in 0 0 0 0 0 Max. Allow Plate Fb ksi 35.91 0.00 0.00 0.00 0.00 Actual fb ksi 0.00 0.00 0.00 0.00 0.00 DESCRIPTION/S >> ----- DESIGN DATA----------------------------------------------------� AXIAL LOAD kips 0.80 0.00 0.00 0.00 0.00 X -X AXIS MOMENT ft -k 10.41 0.00 0.00 0.00 0.00 AISC SECTION NAME ---->> TS7x5x1/4 None None None None BOLT CAPACITY # BOLTS PER SIDE BOLT AREA ...DIST. FROM PL EDGE BASEPLATE HEIGHT of WIDTH SUPPORT PIER HEIGHT of of WIDTH k in in in in in in 8.8 0 0 0 0 2 0 0 0 0 0.4418 0 0 0 0 1.25 0 _-:: 0,-� , 0 0 14 0 �Q�� _c� 0 F. 0 0 14 0 ci 0 0 0 48 0 No. ' 839 , 0 0 J' CFVR. ,� •• REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 78-194 Elenbrook Ct. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED O REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ REINFORCED_ MASONRY ❑ FIRE PROOFING O ❑ OTHER JOB LOCATION -� e `�_ •! CxJ v' Y3 ��. REPORT SEQUENCE N0. TYPE F STRUCTURE fPERMITCAXJNO. D yjq DAY OF WEEK MATERIAL DESCRIPTION-VO lU� S ARCHITECT INSPEOCIR HRS. CHARGED ENGINEER ASSISTANTS MRS. CHARGED INSPECTION DATE..-. GENERAL SUB CONTRACTOR — CONTRACTOR '�• (.C�Z� i GJ `�JL. �- .. Y S 06 L 04 Na asp .- G��J • v `e -S �•�-els c � � � �.. —77 COPY SENT TO CLIENT'.p,•CONTINUED ON NEXT PAGE O 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. S URE JOF REGISTERED INSP O DATE OF RE RT REGISTER NUMBER