9512-121 (SFD)r
LICENSED CONTRACTOR DECLARATION
I hereby affirm 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. 46697.1 B 6/30/96
License # Lic. Class . Exp..Date- —
Date 2 - J 1 76Signatureof Contractor
OWNER -BUILDER DECLARATION
I hereby affirm 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).
O I am exempt under Section B&P.C. for this reason
Data Signature of Owner
£ WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
O 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.
(This sectiom nnb1 bdr'n6t1l3e:ddrfiploted if the permit valuation is for $100.00 or less).
( i),Il 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 should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those; provisions
Date: 11 19 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.
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 application agrees to, & shall, indemnity
A hold harmless the City of Indian Wells, 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 purposes. :. qq
Signature (Owner/Agent) F _ .c- GL, j/'✓'w' Date .v
ALC
PERMIT
PERMIT.#y12-921
12
DATE G f _01YO
VALUATION '":P-& V #-!,V f ' • 1001
LOT 'y TRACT b:9 t)Lt
JOB SITE ADDRESS -800 NOLANI CIRCLE
APN 604-233-0115
OWNER
CONTRACTOR
JOHN'IURNOC
JOHN T'UR.NOCK,
36720 PAT,M CQU1R1' --
36720 PALM' COURT
RANCHO MIRAGE CA 92270
LA (JUNTA CA CA :92253
, (6!.9)770-1772 C,8L## 4076
(619)7 70-17.72
.(619)770-1772
DESIGNERIENGINEER
IRAN `ii' ORtNBURY
USE OF PERMITt 11ki is i ALfV 1.L. I l i Ej', .tfdkj
iE3i01�3�i_Ri34
Persr[it ixtci.udes 100 If of 6' Clardan .Block Widl, AV. 1. and/or :Rotuining Wall pennits to N olAuirted
FEE DESCRIPTION
FEES
'ITRACT CO.NSTttUC. lON 060.00 SF
cPORCHIP.ATIO 312.06 S:F
Cx'ATtAtlWCARPORT 4%.00 Sr -
F4
4-FT:. VVAi L 100.00 LF
LSTIMATF13 COST.' O F' CONS'6 RUCTION
1011,07.0.$0
I':Elrtfl9:IT FEE SUMMARY
P1 !ANN C-MCts. FF.E U1.�0t)0-4?9-31R ,5�1,6
CON&fRLiCTION F'F,E .101-000-418-000 $646.50
tv C�fAN.1C`A1 r-03. 101.000-421-000 $53.50
.F;I..EC RICAL.FEE 101.-000-420-000 $128.02
.I'.T:tTMDING .Fly 101 -000 -419 -OM $I.at3.0cj
STONGMOTION FFI',--RESID 101-000-241-•000 S10:it
GRADING MGA 101 -000 -423 -MO $20.00
INFRASTR'UCR RN FEF 225.000-443.342 $4124.67
AIt.`l'.l?V PUBLIC rn.ACFES - RESM,11)1..000-255.4100 $20,03
IAC zit OSrT ' 4250.00
SL7 AL CON�STRi, MION ANDPLA N Ci-1FCK
$3,6P5,43
O LESS PRE -PAID FEES
FFe 1 -r ® f . :PE, RIMIT FIC US DUE NOW.
1996
4250,00
$3,44:5.,43
RECEIPT
JDATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION T
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
F.A.U. '
Framing Z
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O. 4 09
Fans & Controls.
Party Wall Insulation 7f.
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath (r lov
Final
Final
BLOCKWALL APPROYVALS
POOLS - SPAS
steel
Set Backs 7
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPR VALS
Gas Test
Electric Final
Waste Lines _
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Piaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APR VALS
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:
kmra
T4ht 4 4 a'*
Building 7896o 0%, / /
Address ,N N �l it. y_-
Owner
To dl,-, %7,r,voc,/s
Mailing
Address 7a Q / VIM GT
City Zip Tel.
,'4�yo ,,.,;6,,9a�7o Gt9—
Contractor
Address
p
State Lic. u//
& Classif. o6%yy 971
Arch., Engr.,
Designer z241j '7X6 ,e,
Address
Lic. #
/y
Tel
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
APPLICATION ONLY
BUILDING:. TYPE CONST. OCC. GRP.
4
A.P. Number
qrA-01177Legal Description
Project Description
1
Sq. Ft. NO: No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
City
State
1
lZip
Minimum Setback?Distances;
Lic. #
all
LICENSED CONTRACTOR'S DECLARATION
I am ons
hereby a ff irm?thal,l licensed under prov sli of Chap4dr 9 (commencing with Section
7000) of Division ofi(he Business�iid}Professions Code, nd my license is I full
** `
"`Front Setback from Center Line
"`F
M6d.
effect.
/f7�Y'�7! ./L
/all J_ `7 /7�i�
SIGNATURE ? I E
I', 1 / OWNER•BUILDER DECLARATION
Estimated Valuati,
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
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
for file he is licensed
requires the applicant such permit to a signed statement that pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Plan Chk. Dep.
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for Any Section 7031.5 'any for
the alleged exemption. violation of by applicant a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
Plan Chk. Bal.
[: 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, Buisness and
Const.
Professions Code: The Contractor's License Law does not apply to an owner of property who
FINAL DATE
builds or improves thereon and who does such work himself or through his own employees,
Mech.
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
Electrical
of proving that he did not build or improve for the purpose of sale.)
I 1 I, as owner of the property, am exclusively contracting with licensed contractors to con- •...
'Plumbing
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law"
Issued by:
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.)
Grading—
'
17 I am exempt under Sec. B. 8 P.C. for this reason "'^
t •ti 1
j Dfiveway Enc.
Infrastructure
Date Owner
/!/�
r
WORKERS' COMPENSATION DECLARATION
Validated by:
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
I
1 I+
17 Copy is filed with the city. ❑ Certified copy is hereby furnished.
,
TOTAL
1 CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
ULU ,I J
(This section need not be completed if the permit is for one hundred dollars ($100) valuation,
or less.) I
I certify that in the performance`of thglwork for which thispefanit is issued, !,4hall not
employ any,persor� �9gnSrmanner'so as to'become su,b{e• o th'e Workers' Co pensation
Laws f•Ca.f•rfif_
i
Date F L Owner
n � U�
AMOUNT
150
i
y/ K
v
7 Jr. t}
Y
NOTICED APPLICANT: If, alter making this Certificate o! Exemption you should become
(the
ZONE:
BY: . 14
subject Workers' Compensation provisions of the Labor Code, you must forthwith.1
Minimum Setback?Distances;
comply with such provisions or this permit shall be deemed revoked. ` ^ !.tl
"`Front Setback from Center Line
"`F
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY ..(
✓��
Side Street Setback from Center Line
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.) jl Fr
Side Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
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.
Issued by:
Date Permit
_.
I agree to comply with all city and county ordinances and state laws relating to building
con stwction, and hereby authorize representatives -of this city to enter the above
--�-
mentioned for inspection
/!/�
r
property purposes.
Validated by:
,1 /.r,�
Signature of applicant Date
1
I
1 I+
Mailing Address
Validation:
_ l
City, state, zip
ULU ,I J
��yy��_,yy
NJ� IUl
BUILDING DIVISION
I
RV
f:
CONSTRUCTION ESTIMATE
NO, ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
2ND FL, SO. FT. @
POR. SO. FT. @
GAR. SO. FT, @
CAR P. SO. FT. @
WALL SO. FT. 0
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1'A c
SEWAGE DISPOSAL
SO.FT.GAR @ ?Ac
HOUSE SEWER
REMARKS:
VENTILATION
GAS PIPING
PERMIT FEE
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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus xb
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S 5IGNATUHk:511NITIAL5
GARDEN WALL FINAL
Desert Sands Unified School District
Notice: 82-879 Highway 111
Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
CERTIFICATE OF COMPLIANCE
Date 2/13/96
No. 14131
Owner Name John Turnock
No. 78800
City La Quinta
Tract #'
Street Nolan Cir.
Lot #
APN # 604-233-015
Jurisdiction La Quinta
Permit #
Log #
Zip 92253 Study Area 233
Square Footage 1560
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 1.72 X 1,560 or $2,683.20
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.
{3.
Fees Paid By cc/ 1st Bank/J. Turnock ,� jelephone�770-1,'772
Name on the check
By Dolores A. Ballesteros-47
'Superintendent
Fee collected /exempted by Pauline Pearson Payment Received $2,683.20
Check No. 33523
Signature zAn
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
Received From: �'
Address: i:, 4'
-k-S' t—, >c.n
COACHELLA VALLEY WATER DISTRICTy
CASH RECEIPT DETAIL'.�'�1
L
Date:
Account No. f 11" ( (
'
Lots) 1 '� y Tract�<
3 �!
S
Service Address I
� {> > V E �� n i < C (� G.A. Code
�+t�"
-Q_iNeter(s)
$
❑ Service(s)
❑ Backflow(s)
❑ House Lateral(s)
❑ Detector Check(s)
❑ Meter Surcharge
ly�nitatlon Capacity Charge
C
P-Wi.S.B.F.C.
JC) U
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account -Name
❑ Inspection Fee -Tract -
Fee -
❑ Plan Check Fees Water I Sewer -
Tract -
❑ Bond Payment - A.D. -
Bond
Assmt.
❑ Customer Deposit
❑ Other
TOTAL
$
Remarks:
❑Copy to:
Cash Water Service
Check A- ! i -73 � �•
MoneyCashier
Order `` ` CVWD-438 (11189)
T4ht
78-495 CALLE TAMPICO.— LA QUINTA, CALIFORNIA 92253 - (619) 777-7000
FAX (619),. 777-7101
December 21, 1995
Mr. John Turnock
36-720 Palm Court
Rancho Mirage, CA 92270
.cUBjECT:: PRECISE vT_NM-'95_857 .17'8-800 NOLANT CIRCLE)
Dear.Mr. Turnock:
The Community Development Department reviewed your request to build
a'custom house at 78-800 Nolan Circle (Tract 23268). Staff found
the plans to be in conformance with Chapters 9.32 (R-1 Zoning) and
9.25(Compatibility Review Process) of the Zoning Code, as
conditioned. The construction plans shall be modified according to
the attached conditions prior to the issuance of a building permit.
If you wish to appeal the action of the Community. Development
Director, please -file your written appeal -with our office. within
10 -days from the date of this letter. Appeal requests are reviewed
by..the Planning Commission. The filing.fee is $300.00.
Lf you have any questions, please contact me at(619) 777-7067.
Very truly yours,
IE MAT VELOPMENT DIRECTOR
G✓ SDELLe Planner