0107-219 (SFD)LICENSED CONTRACTOR DECLARATION
-�, I hereby affirm under penalty of perjury that I am licensed under provisions of
t`.. •
In
hapter,Q (commencing with Section 7000) of Division 3 of the Business and
N LNU /' Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
1�,0Lr)
LLJ
r` 67 Z03 1� �,v, e - � � ., 131101
Z r- i Date % ' Signature Of Contract -
0.
Ori.
JU Q `•N "" OWNER -BUILDER DECLARATION
W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's
~ t1
V)License Law for the following reason:
Z_ ( ) 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).
C'') () I am exempt under Section B&P.C. for this reason
LO
N Date Signature of Owner
O N
o)
CL Q WORKER'S COMPENSATION DECLARATION
o Cr I hereby affirm under penalty of perjury one of the following declarations:
r FZ O () 1 have and will maintain a certificate of :onsent to self -insure for workers'
X w �= compensation, as provided, for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
m Q 0 ( ) I have and will maintainworkers' compensation insurance, as required by
O U Q Section 3700 of the Labor Code, for the performance of the work for which this
Il 0 Z permit is issued. My'workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
w a ���, . c �a'r CO k'1? iW 135 9 �D•193�A
Q (Tfiis 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 California, and agree that if I should become
subject to the workers' compensation 'provisions of Section 3700 of the Labor
Code, I sh'}all forthl�'�'ith comply with thhosoyprovisior�s.
n,..... A! ZIP -.tea P! a n._. -i: --- . .C_'%'.;�'.,:d'.r1�../ti•"'1r ..9' /F• �%'..fifA.. ..wr
'—Warning:-'Feilure-to-secur.e• Workers' Cortfpensation coverage is unlawful and
shall subject an employer to crimi`n`al-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 anqqf Pt
for a permit subject to the conditions and restrictions set forth is
application.
1. Each person upon whose behalf this application is made & each pill III
whose request and for whose benefit.work is performed under or pur nt t
any permit issued as a result of this applicaton agrees to, & shall, in ni
& hold harmless the City of La Quinta, its officers, agents and em I ees
2. Any permit issued as a result of this application becomes null an void i
work is not commenced within 180 days from date of issuance f `suc
permit, or cessation of work for 180 days will subject permit to canc Ijation.
I certify that I have read this application and state that the above infor
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-Aspection purposes;
Signature (Owner/Agent)Date "fir
4r• Yl'P �.�.. h Ir
.r
BUILDING PERMIT PERMIT#
DATE j� �' VALUATION LOT 010'`%-1'19 TRACT
JOB SITE
ADDRESS
APIN
pyo'
n{ }� g p /��y/ y LAM
IS'4412 CSJd6f.�I.L/ d:2M�df.
y Y(+� ryry�q �r9x
Q Y' -31 0-021
OWNER
CONTRACTOR /DESIGNER / EN INEER
'78-.505 01DAVENUE E 52
4 435 DIW (74WY%q RD
1nFA QtlM'A Ca?! X253
1 ALM DERTiRT CA 922-61
(760146-32213 CB14Y 030#2
USE OF PERMIT
AOIX FANOVI' DWFUv.ry0
.
aYrl (Li Pk?�T x 2 CYC?€2-S 'NOT ri>16::C.UDX BLOCK WALUP'CQ:3U39nA OR
.APP12rACH iAWKWAY:Cf:tMPLIANCZ TsiHAU? F%DKRAL 94'NfE IAWS'
CUSTOM fi"� 11Y..TRUCTION 3.41,37.i0 SIF
Cad#�:�'►Kilr:,iG;:.o-�1,22W��'.�' &�t3.4#f �'
t�
F�
<.
M.Wff M. HM_M RY
C pd `3` ST1Ci1'L:IN ? 101.000.418-000
PLAN iNHJWX DVE 10.1-000.439-318
A4VI412.d NICA,L, RXI 101.000.421.000
V1.oi '-TRIC'AL IfErt 101-000-420-000 U04130
PLUib1�€1�0 3��;2� i X31-C?(10ttQ S �d�100 �2'3t,fxQ
. HTP. NQ R2Ci' 10M F'F:-'R.F,Sp1<D 101-E?W-241-000
CdP.ADL1OFER _ 101.000.423-000
YPrZV2W ER, IMPACT "IF, .03
ART rK PUBLAC PJ AICrill- RLME 01.4X*1255-000
"Y, DT�`r0""IT 101,000.439-31,6 • 334.0
130B1 Ci''.a1.`Ft'l3Ca°T]:�1X A9iD KAJ CH vC`r,
«u,285.81
JUL 2 0 2001 L PRS -PAM M-9
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r4,IP3,m,ao
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CITY OF LA OUINTA
FINANCE DEPT
��CEIPTDATE
BY
DA NALED
INSPECTOR
1 i ;rVj r,
0,1111-11/
INSPECTION RECORD
.T
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
t,_�
Underground Ducts
Forms & Footings
��� �"
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
I— _ / /� ( _
Exhaust Fans
O.K. to Wrap=6
Z
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall -Int. Lath
2 Z/ G Z 6
Final
_
Final
POOLS - SPAS
BLOCKWALL APPROVALS
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
T
Electric Final
Waste Lines
/Q�S/D/
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
_
r �%
Pool Cover
Sewer Connection
Encapsulation
'Gas Piping
Gas Test
Appliances
Final
COMMENTS:
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)
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: 78-142 CORAL LANE
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0107-219
Occupancy Group: • R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: TRADITION CLUB ASSOCIATES
Building Official
Address: 78-505 OLD AVENUE 52
City: LA QUINTA, CA 92253
By: RICHARD KIRKLAND
Date
POST IN A CONSPICUOUS PLACE
06-19-02
JUL-31-2001 14:08
July 31; 2001
TRADITION GOLF CLUB
qradation
ARCHITECTURAL DESIGN REVIEW
Ms. Nickie Gormley
Building and Safety
CITY OF LA QUINTA
78-495 Calle Tampico
La Quinta, CA 92253
Re: Tradition
Old California village, swimming Pools
Dear Niclde,
760 564 2356 P.01i01
Via Facsimile
760-777-7011
This letter will serve as ARRC approval to obtain a building permit for the swimming pools
at the Old California Village at Tradtion. If you have any questions, please do not hesitate
to call.
Thank you.
Sincerely,
Christina J. Dores
Architectural Review Coordinator
Aid
CC; Jody Jones, APC (via first class mail)
I cvey0aionnw�cnlaJ.wu�.huYnved,-�
78505 OI.o AvwuE 52 --- Ln QUINTA -r CA 92.253-1120 PHONE 760/564.3355 -- FAX 760/564-2356
TOTAL P:01
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
TYPE OF
INSPECTION
PERFORMED
O REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE O ASPHALT
O REINFORCED MASONRY ❑ FIRE PROOFING
O
fG OTHER F�OX�
JOB LOCATION
2 ��\\o.LN
N�aLok
REPORT SEOUENCE NO.
12
TYPE OF STRUCTURE
PERMIT NO.
-2
DATE
i -Q-
DAY OF WEEK 7
MATERIAL DESCRIPTION,,{{��
ao
ARC ITECT
INSPECTOR
. Q
HRS. CHARGED
ENGINEER `
IS
ASSISTANTS
HRS. CHARGED
INSPECTION
DATE
GENERAL .> SUB
CONTRACTOR CONTRACTOR ob
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COPY SENT TO CLIENT ❑
CONTINUED 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.
0)&.1,4- 0&kalk-M
IGNATURE OF fEGISTERED INSPECTOR
11-13 - 01 plrbk 6�7? 71'Z
DATE OF REPORT REGISTER NUMBFR
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
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE O ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
❑
OTHER
JOB LOCATION
TVP OF STRUCTURE
•
h
ERMIT N0.
REPORT SEQUENCE NO.
DATE DAY OF WEEK
MATERIAL DESCRIPTION
S'
t cr
ARCHIT CT
INSMORF
U
HRS. CHARGED
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPECTION
DATE
GENERAL• SUB �•
CONTRACTOR CONTRACTOR
$ A
w
Azo�m• e% Mir
v(
nhro
f
COPY SENT TO CLIENT O
CONTINUED ON NEXT PAGE 0
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
AA at S.' -kl
UREOF REG TERED INSPECTOR3qoT
�cleo =7-717- $c/
T OF REPORT REGISTER NUMRFR