0003-189 (SFD)LICENSED CONTRACTOR DECLARATION
Cr hereby affirm under penalty Of =perjury that I am licensed under provisions of
v ppter 9 (commencing with Section 7000) of Division 3 of the Business and '
Professionals Code, and my License is in1ull force and effect.
License # Lic. Class Exp. Date
370768 13 FICC U3'' 112(
Date �' ` 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.
( 7f—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 STA:C3 1�ti1J1� Policy No. 229-00-0913329
(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 Californi and agree that if I should become
subject to the workers' compensation provision of Section 3700 of the Labor
Code, I sh Yforth ith comply with,those p%wrsio
Date: � _1 � i Applicant •>'0
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
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 allaGity, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property ford pectlon urposes.
Signature (Owner/Agent)` 8Mf!' • o�� Date `V
BUILDING PERMIT PERMIT#
DATE''. VALUATION LOT I'D11C33489 TRACT
$447,160M 68 24890.4
JOB SITE
ADDRESS 5"1.,SMpl dO CUM,
APN
a
OWNER
CONTRACTOR/DESIGNER/EN (NEER
1dl M i, GODS
GOLDID Co_=AUC''><YOW CO.
P O BOX 1417
44.,500 GRAND C-AWON L NB
:LA,QUJNTA CA. 92253
PALM II)ELITUtT C.A, 92260••3(
(160)7764215 CT3:t v x"787
USE OF PERMIT
,ffW011X 1?AAt R,Y D V .i:I1dCj
SN73• PERMIT DOM NOT INCLUDE BLOCK WALOS OR POOL
i
CUSTOM CONSTRUCTION 5,227.000F
PORCh/m'1'j0 1,510.00 SF
GA1RAs3F.7t"ARPORT%8Fjj 19, 1�9,9Q
E91IMNITT) COST 010 CONSIMUC-710Iq
OA7,260.30 -
PV-RWf FEE WARY
CONSTRUCTION IT%E 101-000.418.000 $1,437,54
PLA14 CHECK FEE 103-i1JC-4�St-3#f� �1,5�1.3'4
FEE DEPOSIT 1014100.439.316-ris0,09
,r1KCHANICAL 1f9C 101-000-421-000 �18�i.00
9LLCTPJCALRE 101-000.420.000
PLUMBING FEE 101-000.419-000
.WR01dO MOTION RE — R SID 101-X100.241.00- $44.711
`
CtltADINO FEE 101 -000-423-0;?Q
DEVELOPER IMPACT �Fk> �1,90ROU
�.: �2.
ART 1N PUDLiCr PLACF?S - REjy3.C'701-000 255-000
Li
SUB -TOTAL ± OMffRI.iCyTOR AND P1_ AW CHECX
$6,7792,42
PRF!,-PXD1M
4230,00
TOTAL •. PlamTrMON DUE ROW
RECEIPT
DATE
,BY
DATE FINALED
INSPECTOR
t'f
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
- OCA
Underground Ducts
Forms & Footings
2-0<1
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
F.A.U.
Framing
- • c (
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulati)n
Condensate Lines
Party Wall Firewal
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
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
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
&oat-'- jea, S
CU 6
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Condul
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:
FROM : GOLDEN CONSTRUCTION COMPANY
PHONE NO. : 760 776 4315 May. 07 2001 12:56PM P1
9
.s
oQ
`::(JFK LA QUINTA
Fro d '&.SAFETY DEPARTMENT
f 777-7012
kf0t0TION REQUEST LINE
7153
Owner,
Contracto*�'LDEN CO�'�t:STRUCTXOI�
0003-189':
Permit Number
wAAY A�Aw �A/►��AwA• •A• •w w
� rvvvn vvar n• wv�wrwarvvu ruwc
INSPECTOR MUSS' SIGN ALL. APPLICABLE SPACES
30-8-15 PERO COURT
JOB ADDRESS •
SFD•-PERMIT DOES, NOT INCLUDE BLOCK
WALLS OR POOL
TYPE OF INSPECTION DATE "'- INV.
FOUNDATION 8 SETBACK
.."..:,FOOTING STEEL --
MAIN GROUND SYSTEM
II' GROUND PLUMBING
!;; ; PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGM
:CONCRETE SLAB
lZ
>f. JOISTS 8131RDERS
*'p :.ELECTRICAL GROUND WORK:
;13
�,'t)O NOT POUR CONCRETE UNTIL ALL A80VE HAS BEEN SIGNI
?ROUGH ELECTRIC .:
#TOUGH PLUMBING :.
s
'!ROUGH GAS & GAS TEST pr
HEATING.&VENT-A(C 777
'FIREPLACE;i':,
F
r „BOND BEAM`
`:vO:K. TO WF AP • B 5
GROUT 0 4' O 8'
FRAMING
r
INSULATION Eel
-ROOF
COVER
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED .'
':DRYWALL INTERIOR
... EXTERIOR LATH
POOL PRE PLASTER
1'
ENCE 8 GATE
K`? EWERO
PTIC TANK CrJ
r.
FINALS
ELECTRICAL
PLUMBINGov
FINAL GAS TEST - •�
s. HEATING -A/C
.':'HOUSE NUMBERS
JOB COMPLETED
.TFMP Pr)wrn
EAIRD ENGINEERING
4939 GARFIELD ST.
LA MESA, CALIFORNIA 91941
(619) 460-6989, (619) 461-5803 fax
Mr. Paul Golden
Golden Construction .
44500 Grand Canyon Lane
Palm Desert, California 92260-3073
(760)-776-4215
(769) . 776-4315
RECEIVE®
JAN 2 9 2001
December 22, 2000
Subject :: Woods Residence .100%. framing inspection byr the - Civil
Engineer- So. -6115- 'A),s16ALo
Dear Mr.Golden,
I visited the site today for 1000 framing inspection. The
HD2A's asked for @ 70% inspection and were not shown on the plans
were in place (attaching various 6x posts. to the foundation that
were not covered by details) .
I did.notice a column footing by the pool steps that was
broken (a roof drain pipe was being placed in this footing). I
would like the broken and cracked concrete removed -and expose 6"
of a reinforcing bar then re-pour_the missing concrete.
.The 100% framing as completed is done very well. I did.not
check for roof diaphragm nailing or shear wall nailing.
^ ;
Thank...:you for the .:opportuni.ty... to do this work -.for you.
Yours -,Truly,
QROFESSIp y
Walter T: Baird Q�c� SER T,
2nd copy sent January 26, 2001
CO
O
No. C 31429
Exp. 12-31-04
* OF * CA��FO
CIVIL ENGINEERING • LAND PLANNING • SURVEYING • STRUCTURAL CALCULATIONS
PERCOLATION TESTS
Certifica'te' of Occupancy
City of La Quinta j� s
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Bui/ding 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:. 50-815 NISPERO COURT
Use Classification: SFD
Occupancy Group: R3
Owner of Building: M/M WOODS.
Bldg. Permit No.: 0003-189
Type of Construction: VN Land Use Zone: RL
Building Official
Address: 50-815 NISPERO COURT
City: LA QUINTA CA 92253
By: KIRK KIRKLAND
;•Date: 5-7-01
POST IN A CONSPICUOUS PLACE
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'
x
TYPE OF
INSPECTION
PERFORMED
REINFORCED CONCRETE O STRUCT. STEEL ASSEMBLY O '
O POST TENSIONED CONCRETE ❑ ASPHALT O OTHER
O REINFORCED MASONRY O FIRE PROOFING
JOB LOCATION
SD -515 f� i s - •1� - Q.���
REPORT SEQUENCE NO.
� j
TYPE OF STRUCTURE t rr
SFS OooD ers ® Ike G
PERMIT NO.DATE
" _
g y oo
DAY OF WEEK
-
MATERIAL DESCRIPTION
ARCHITECT
INSPECTOR
HRS. CHARGED
ENGINEER
ASSISTANTS
HRS. CHARGED
DATE INSPECTION ^T ^ CANTRACTOR G L SUB
=---CONTRACTOR +"-
$
oo
Obs�ee-v2� �c�crew�e of 3000 si Cor.�ct� i►.��-o
R1 oo-�i t -3 's Q►x� S, 6. c;.' \vS� CoIvt:R�.�-e. -
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bo
S250o
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COPY SENT TO CLIENT O
CONTINUED ON`NEKT PAGE O
PAGE OF
M
CERTIFICAON TIOFC
� 7 � . _
I HEREBY CERTIFY THAT I HAVE INSPECTED TO -THE BEST OF MY SIGNATURE EGISTI OR
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED * ' �, LI �j� zL(3p 11fj Zb , Y9
PLANS. SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE_LAWS. DATE OF REPORT REGISTER NUMBER
GOVERNING BUILDING'r .