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9701-057 (SFD)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 O'rofessionals Code, and my License is in full force and effect. License # lL))ic. Class Exp. Date 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. ( ) 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. WTION ON [T-1 (This section need not be completed if the permit valuation is for $100.00 or less). 1)( 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 California, and agree that if I shoul-q become subject to the workers' compensation pro7v"i' ions of,.Section 3700 "Ithe Labor ode, •I,shall(forthwit comply with those rovlsions / Date:--< ` ' i � Applicant ,,,; �^ �r�►-- �� 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 all City, and State laws relating to the building construction, and hereby authorize representatives of_,this City to enter upon the above-mentioned property for inspection.pD poses. r Sig re (Owner/Agent)�� Date /� ty,✓ PERMIT # CONTROL # BUILDING PERMIT 4703 VALUATION �i�i��°i� LD1) LOT TRACT DATE_1ZIt 4_7 TOB SITE' ADDRESS Yi -i3�d1 4�l(�)[s C,I F��.. APN OWNaE/R CONTRACTOR /`DESIGNER / ENGINEER y 4 ryy 'Gi Pvi / ��yf' t`[1 �! )f iAV `le i, 11f V?'v RANI llf t !i IRA4 it' f 'r e) a i'f) 1t AN `11'f 7 kAR A% 11: 0"? .;0 USE OF PERMIT sen01, t� jiAl bN dd�U L 1,*_r1c10kiifi 1a�^5h1.1."tLatIII-it "111t,"1ra.A!� 1 i0 'T 0)'N3,Vv Y it gi P 1.4,44 00 W., RIJ W;' , WAIJ;1111 IV 1 ,ff; 111JAIRV, (1),44 1'01i, VON Y TIIIXI 10 -NI 1054412 .uy; i Et f)u��I tFsf:�t" ��'�t)+ui • d' lvc,' lANIN :Aj 11411 SS3 �41 ) t 14.110 •Ai_, FEE It11 000-C 1120 000 5t3i) 9h tai'"sltt)H , 'F, Il)t-f?f1'rt-410-to)O '?irfGi 71S 191—th1a41�Si31� S1t3_`e-f 4="01)i:fv�.1l iA" !()j-t)t U -423 -ft) <s20.40 1N01A`i"fTif�f iel-,tiW -7)S-t?f)11 !ti f)(jfY Il a 511' 1 4;11 N'0mO111,A0!('UV(.tt 93A�`® FEB 14 11997 14 $sok, Prr= YINUT »'V -9 OFF XcAV S3,,56107 CITY OF LA QUINTA RECEIPT 7 RECEIPT ATE DATE BY " DATE FINALED INSPECTOR INSPECTION RECORD * OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs dl, Underground Ducts Forms & Footings Ducts Slab Grade J J Return Air Steel T Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing 3 Compressor Insulation j Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath 777771 Final Final: POOLS - SPAS BLOCKWALL APPROVA 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 i3 Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole y Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Mity Notice (Perm) Buttress 7l� 6 Address Owner Mailing / 7;z Address -?&�js /� i k(110 X/11#01-1 _ Zip 9a a -7 4 Contractor�� / yr-•vo G Address ,34,7a0 .dry/12? City Zip P.O. BOX 1504 APPLICATION ONLY 7&105 CALLE CALIFORNIAESTAD9 LA QUINTA, ORNIA 92253 BUILDING: TYPE CONST. -7 OCC. GRP. A.P. Number 60q �! 9" 772 /7'7` ,Legal Description Project Description `4ifA a 74 9-770-Z77oZ State Ljc.� City �O 7th & Classif. J�/ Lic. # Arch., Engr.� d� Designer Address Tel. 7,;4 - d// ,�lG,y /// 779- 91101 City Zip State ,DW tJ17 Dc��a.?�o Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provision Chapter 9 (commencing with Section 7000) of Divistion�3/o-f -the Busin/ess and ProfessionJCode, and my license is in f3ull`force:a/nd effect. /7/W1 / �e%.l��C/�"r 772 SIGNATURE N DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its 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, or that. he is exempt therefrom, and the basis for 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). 17 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 or offered 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 purpose of sale.) II 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.) 1"1 1 am exempt urider 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 17 Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of,tfig work for which this permitlis issued, I shall not employ anyype_rson in any manner so as to—become bjecttoothjewbrkers' Compensation Laws Zell r 1 /�A�/C�✓vJY" Date � P Owner / NOTIC TO APP (CANT: 8, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration 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 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING DIVISION Sq. Ft. No. NO. Dw. Size Stories Units New ❑ Add O Alter ❑ Repair ❑ Demolition ❑ hzmw , 110 /Of t lo D Cl �- Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. • 00 Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. . Grading Driveway Enc. Infrastructure TOTAL REMARKS 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 R Issued by: Date PeF Validated by: r Validation: IAN 1 3 19971 3 1997 CITY OF LA QUINTA CONSTRUCTION ESTIMATE IST FL. SO. FT. @ $ 2ND FL. SO. FT, (a POR. SO. FT. @ GAR. SO. FT. @ CAR P. SO. FT. 0 WALL SO. FT. @ SO. FT. @ ESTIMATED CONSTRUCTION VALUATION $ NO. ELECTRICAL FEES UNITS MOBILEHOME SVC. POWER OUTLET NO. PLUMBING FEES YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used'as property tax valuation COLL. AREA FLOOR DRAIN MECHANICAL FEES BONDING WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) LAUNDRY TRAY AIR HANDLING UNIT CFM OTHER APP./EQUIP. KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB GRADING cu. yd. $ -Plus-X$-=$ SO. FT. p c WATER HEATER MAX. HEATER OUTPUT, BT.U. SO. FT. RESID ® 1 I c SEWAGE DISPOSAL FINAL INSP. SO.FT.GAR lQ 3/4c HOUSE SEWER GAS PIPING PERMIT FEE VENTILATION PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ -Plus-X$-=$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Notice: Document Cannot Be Duplicated Date 2/4/97 No. 15234 Desert Sands Unified School District 82-879 Highway 111 Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE Jurisdiction Owner Name John Turnock No. 78820 Street Nolan Cir. city La Quinta zip 92253 Tract # Lot # APN # 604-233-013 La Quinta Permit # Log # Study Area 233 Square Footage 1644 Type of Development Single Family Residence No. of Units 1 Comments 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 1.84 X 1,644 or $ 3,024.96 the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may:.n6W. be ;issued Fees Paid By cc/First Bank/John Turnock elephene 770-1772 _ o J ",• V Name on the check t, f By Dr. Carol McGrew - Administrator in Charge Fee collected /exempted by Pauline Pearson Payment Received $3;024.96 Check No. 037421 Signature - 21.1aP M 0 ,1 Pl l�l�(L 21/►'` 40TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the dale on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to .,,actthem on the District('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original -Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting Recording Requested By American. Title Insurance Comp RECORDING REQUESTED BY: CHICAGO TITLE COMPANY AND WHEN RIECORDIED MAL TO: John Tumock and Conni Tumock 36-720 Palm Court Rancho Mirage, CA 92270 ESCROW NO. 0437085 -S -SP 720724 RECEIVED FOR RECORD AT 2:00 O'CLOCK (' :"14 1996 Pkf'.) Doc. Tru;is#er Tax wcvaenOft* Mc«m FRANK K. IfOHMS0N aar 0ftC4U a.ca>atmia Riv. Co. Recorder Re°°rder� 41 XFoes$ THIS SPACE FOR RECORDER'S USE ONLY: TITLE ORDER NO. 2048419 THE UNDERSIGNED GRANTOR(S) DECLAR DOCUMENTARY TRANSFER TAX s C-9.00 [X] computed on full value of property conveyed, or [ J computed on full value less value of liens or encumbrances remaining at time of sale. [ ] Unincorporated area [X ] City of La Ouinta, AND FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged, ` I Judith Gearon Blackburn, Trustee of the Casper Family Trust U/D/T dated November 27, 1985 hereby GRANT(s) to: JOHN TURNOCK and CONNI TURNOCK, Husband and Wife 4S J0i'nd4 the real property in the city of La Ouinta, County of Riverside, State of California, described as: r� Lots 182 and 183 of Tract No. 23268, as shown by Map on file in Book 213 pages 67 through 73 of V Mans, Records of Riverside County: California. A.P. # 604233-013/014 DATED February 28, 19N Judith Gearon Blackburn, T ee of t e Casper STATE OF CALIFORNIA rril Tru COUNTY OF Riverside On ADril before me, flip unrtPrcipnPrj /Judith Gearon Blackburn, -TRTISTEE� a No t�y Public in and for id Brae, personally appeared -•Judith Gearon B ackborn- personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name i�e subscribec"o the within instrument and ackno ledged to me that i>g h they executed the me in ails or qtr authorized capacity(teg), and that by ifs h&/their signature'o) on the Instrument the person), or the entity upon behalf of which the personxacted, executed the instrument. WITNESS my hand and official seal. Signat .* I Mail tax statements to: SHARIN I. PERRY COMM. #988347 � C& Notary Public•Califomia RIVERSIDE COUNTY b My Com;nisSion Expires Y March 18, 1997 iV( (This area for official notarial seal) til JNJOHNSON & NIELSEN ASSOCIATES. . CONSULTING STRUCTURAL ENGINEERS 647 N. Main Street '• Suite 4-13 Riverside • CA • 92501 • (909) 686-5122 • FAX (909) 686-6752 LOS ANGELES RIVERSIDE IRVINE January 31, 1997 To: Dan Thornbury .72-811 Hwy 111 Suite 205 Palm Desert, CA 92260 Re: . Turnock House . 78820 Nolan Circle La Qunita, CA Subject: Roof trusses Carl B. Johnson Svend H. Nielsen ' Per T.' Ron Wen Y. Lin Lonnie P. Mount Steen T. Thomsen Jackson K. Wu Dear Dan, I recieved the Trussworks truss designs today and reviewed, them for fidelity to my design intentions. It's my opinion that the truss designs do indeed conform to the criteria required for this project. The spacings and bearing loads are essentially the same used to calculate wall framings and foundations. It's my recommendation these truss designs be accepted by the local building department. If you have any questions, please feel free to call. Sincerley, Q�pEESs/ Lo nie P. Mount, S.E. W No. 3834 � I JOHNSON & NIELSEN ASSOCIATES ExP.131 Consulting Structural Engineers siRIIc�Q$�`�