9802-136 (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
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
7
fes..
a
�i�' ' � f�.
VDate ' r 'Signature of Contractor;' / •
/ r
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
( ) 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.
(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 California, and agree that if I should become
subject to',the workers' compensation provisions of Section 3700 of the Labor
Code,•1 shall forthwith comply with those'provislo s. — �+ -�✓`
t,Date:Applicant,
Warning:
Warning: Failure to secure Workers' Comp sation 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 lr�s7pectionpurposes:��
Signature (Owner/Agent) �' J �rre
PERMIT # CONTROL #
BUILDING PERMIT
914112-136 7g65
DATE VALUATION x`3'7 `{{ h17 LOT ;1r1 TRACT 7a e
-JOB
µ f n .
S1
ADDRESS 78-49i1,.0Y0TEL01"NYONCOUR
APN 764)-16Z-0411
OWNER
CONTRACTOR / DESIGNER / ENGINEER
DAVID & SE INU C1tAE'NIAN
ION'
ANt)1tF:1tr PlE.R.CC
10
PAUM DI -SE RT CA 92261
(7fti01 t.a{+-3228 011.0 3031
USE OF PERMIT
SE) - Hhii,'LiJ T DOES'. NOT j241•,`t UDEi CS{.lA.K Wit 71 E, OR POOL -
r \..,1'��fLi f3iv. "� hid Cf �fJ 4.-•5{3.(X1 Nil
c:ittitAt:elJCtlttE lt2'{' V44.04 SF
.. ,
! N,�� !�{ 1 t �7
�, tis 1, 3 IC 1, ! �q r CONI
L' S UNI'CR..OW ��l'�'6..l�t�IN 14111M YON
t ,[
31, 1,61449.69
t;�:�t3 31'{<tiCl'1r.jt� 1r1iE: 101•(W-418-000 Ii'SIAL.141
101.000-439.319 t1.141.711111
I IAis E)fiPOS 3T 101-(100 t° 41.01A00
hllit lEr1NiCA1 lir; Etil (k)Cr-�i2E fxru it ►J.va
1;LV- H1CAl,{till I01-000-420.000 V19.)941
P1,1110111NO V4.), 101-voo-.119-(H10 S: -'F 1.00
STPI(Y:c11 atllr*4 is{i-1,t�.+r) t0;-(X,K)-2,11-0*0' s:�;.16
ORADINO PEE E1)1 -flat? 1°.23-Cifit� S:ti,ii<i
11WRA.S110JO'URI, FEE 223.000 -443? -34." St�,tNati�h�
k"T 1N P011,1f, F+1.ACTS - Rv,,41, 7 }I-000-255.t*0 3K;9. F0
C _
4 �"tijJfi-{rr 1T'l11, c�Ct:`(`'Y7%L1C'i 1(�jd 11Nf) )�t,�j_IV CM—CK
5
LESS 111U.11 -11,M) 1.
JUN 2 41998
40W.00
TOTAL PERMIT h`EMS ijliF, NOW
S9.299.9g
aO
RECEIPT
DATE
BY p
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
_2
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
— f
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
3d
'
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
/
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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
- f -
Encapsulation
Gas Piping
Gas Test
C -
Appliances
Final
COMMENTS:
Final
��sD`ir1d 9�%��9FST
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
t
FinalUtter
Notice (Perm)
� f' y8' •�f .
Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated 760-771-8515
CERTIFICATE OF COMPLIANCE
Date 6/24/98
No. 17221 Jurisdiction La Quinta
Owner NameDavid & Sherri Chapman
No. 78-495 Street Coyote Canyon Court
City La Quinta zip 92253
APN # 769-162-001
Tract #
Type of Development
Comments
Lot #
Single Family Residence
Permit #
Log #
Study Area
Square Footage 4,358
No. of Units 1
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
1.93 X 4,358 or $ 8,410.94 the property listed above and that building
� 4
t,
permits and/or Certificates of Occupancy for this square footage in this proposed projact may, now be issued
Fees Paid By Cashier Check/1 st Community Bank/Jeff Lohman ; " Teleph'cne .
Name on the check -
By Dr. Doris Wilson y ''r:•. ,
Superintendent
Fee collected /exempted by Juanita Green Payment Received $8,410.94
Check No. 079775
Signature �
NOTICE: Pursuant of As mbly 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 frpfn the date 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
collect them 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
TRADITION GOLF CLUB 760 564 2356 06/22/98 08:28 :02/02 NO:730
- - - ra ifio n
April 3, 1998
Via Hand DeUvery
W. and Mrs. David Chapman
c/o Tradition Golf Club
Re: Lot 44, Tract 28470-1
Construction Document Submittal - Final Submittal
Dear W. and Mrs. Chapman,
The ARRC of Tradition Golf Club met on April 1, 1998 and a motion was made and
approved to accept your Construction Document submittal, subject to approval of Landscape
plans. Final approval by the committee will follow in writing upon review and approval of
Landscape plans.
If you have any questions or need additional information, please do not hesitate to call.
Thank you.
Sincerely,
Christina J. Dores
for ADRC at Tradition Golf Club
/cjd
pc: Gordon Stein, via fax
78505 OLD AVENUE 52 -- Ln QUINTA - CA 92253-1120 - PHL)Ne.760/564-3355 - FAx 760/564-1.356
ESI/FME, Inc.
STRUCTURAL ENGINEERS & CONSULTANTS
PROJECT SUMMARY
SITE Single Family house is situated in a developed area.
Field Observation on December 23, 1998 with Jim [framer]
FIELD OBSERVATION
The following structural items were observed and need to be addressed:
' ITEM
General
1 Provide 1/2" dia threaded rod with Simpson Set Epoxy Tie embedded 4 1/4" into
monothic foundation for missing anchor bolts.
2 Improper shear nails were used. For Shear panel #10 & #11, provided one additional
every 12" o.c. at all panel edges and for shear panel #12 & #13, provided
two additional nail every 12" o.c. at all panel edges. For Shear panel
#14 & #15, renail panel with 10d common nails:.
GARAGE `
3 Shear wall in Front of 2 Car Garage: Provide fix for missing anhor bolt per item #1 above
4 Shear wall at right side of 1 Car Garage: Nail perimeter of shear wall with 8d nails at 6"o.
DINING ROOM AND LAUNDRY
5 Shear wall in Front of Dining Room: shear nail plywood to same block line the bottom
chord of truss on the garage side is nailed.
1 ,
6 Shear wall in Front of Laundry: Provide fix for missing anchor bolts per item #1. Shot
pins are not adequate.
FAMILY ROOM
--Shear wall at left side of Family Room: Simpson A35's should be spaced at 8" o.c.
and not 16" o.c.
ENTRY
8 Shear wall at left side of Entrance: Shear nail plywood at horizontal edges.
1921 E. CARNEGIE AVE., UNIT 3-J, SANTA ANA, CA 92705 • Ph. (949) 261-1811 / FAX (949) 261-8506
FIELD
REPORT
;SITE VISIT NO.: ONE
DATE
Dec. 29, 1998
PROJECT NO
198-8386
PROJECT:.
CHAPMAN RESIDENCE
CLIENT NO:
STEIN
BUILDER
ANDREW PIERCE CORP.
FILE NO :
8386FR
LOCATION:
La Quinta, California
SHEET NO- :
1 OF 2
ARCHITECT:
STEIN AND ASSOCIATES
ATTENTION:
Jeff Loehman with Andrew Pierce Corp.
PROJECT SUMMARY
SITE Single Family house is situated in a developed area.
Field Observation on December 23, 1998 with Jim [framer]
FIELD OBSERVATION
The following structural items were observed and need to be addressed:
' ITEM
General
1 Provide 1/2" dia threaded rod with Simpson Set Epoxy Tie embedded 4 1/4" into
monothic foundation for missing anchor bolts.
2 Improper shear nails were used. For Shear panel #10 & #11, provided one additional
every 12" o.c. at all panel edges and for shear panel #12 & #13, provided
two additional nail every 12" o.c. at all panel edges. For Shear panel
#14 & #15, renail panel with 10d common nails:.
GARAGE `
3 Shear wall in Front of 2 Car Garage: Provide fix for missing anhor bolt per item #1 above
4 Shear wall at right side of 1 Car Garage: Nail perimeter of shear wall with 8d nails at 6"o.
DINING ROOM AND LAUNDRY
5 Shear wall in Front of Dining Room: shear nail plywood to same block line the bottom
chord of truss on the garage side is nailed.
1 ,
6 Shear wall in Front of Laundry: Provide fix for missing anchor bolts per item #1. Shot
pins are not adequate.
FAMILY ROOM
--Shear wall at left side of Family Room: Simpson A35's should be spaced at 8" o.c.
and not 16" o.c.
ENTRY
8 Shear wall at left side of Entrance: Shear nail plywood at horizontal edges.
1921 E. CARNEGIE AVE., UNIT 3-J, SANTA ANA, CA 92705 • Ph. (949) 261-1811 / FAX (949) 261-8506
ESI/FIVIE, Inc.
STRUCTURAL ENGINEERS & CONSULTANTS
FIELD OBSERVATION: "Chapman Residence" Date: Dec. 29, 1998
ANDREW PIERCE CORP. ESI/FME J.N. 198-8386
Sheet No.: 2
Masterbedroom, Exercise Room, and Powder Room
9 Shear wall at left side of Masterbedroom: Provide fix for missing anchor bolts per
item #1, above.
10 Shear wall at rear of Masterbedroom: Nail ledger to block line with 16d nails at 4" o.c.
and shear nail plywood to same block line.
11 Shear wall at rear of Exercise Room: Provide fix for missing anchor bolts per item 1.
12 Parapet at left side of Powder Room: Provide 44 post or double 2x4 studs every
48" o.c. from top of parapet to side of roof truss and nail truss to post
with (4) 16d nails at top and (4) 16d nails at bottom of truss. Alternate
solution is -to provide kickers at 48" o.c. to stiffen wall.
THIS WAS A WALK-THRU REVIEW. WE DID NOT INSPECT THIS BUILDING. OUR
OBSERVATION WAS FOR GENERAL COMFORMANCE TO PLANS AND /OR
DESIGN INTENT. A'DETAILED AND COMPLETE REVIEW WAS NOT PERFORMED.
ISSUED BY:
Dan
1921 E. CARNEGIE AVE., UNIT 3-J, SANTA ANA, CA 92705 • Ph. (949) 261-1811 / FAX (949) 261-8506
COPIES TO:
(3)
ANDREW PIERCE'CORP.
(fax)
Attn: Jeff Loehman
(1)
Stein and Associates
Attn: Gordon Stein.
1921 E. CARNEGIE AVE., UNIT 3-J, SANTA ANA, CA 92705 • Ph. (949) 261-1811 / FAX (949) 261-8506
CI7y OF �► :IItI7'
SEC _ s '� JON TANDY
'ECD 37630 Medjool Ave.
SUIL®INU s.tPalm Desert, CA . 92211
` -r E79ifice (760) 772-7192
• Fax (760) 772-7193
Pager (760) 776-3338
REGISTERED INSPECTOR'S WEEKLY REPORT
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
❑
❑ OTHER
JOB LOCATION -7$s qj_5
CoP� q
aV•`•'�
�/ ^
l�
REPORT SEQUENCE N0.
TYPE OF STRUCTURE,
1�
PERMIT No.
DANE
DAV OF WEEK
MATERIAL DESCRIPTION
ARCHITECT
INSPECTOR
HRS.�CHARGEO
ENGINEER _
Gr
ASSISTANTS
HRS. CHARGED
INSPECTION
DATE
GENERAL D
CONTRACTOR T I V�LC
SUB
CONTRACTOR
p
P :rs
fL
/E
-1 -7/81`ki
3`�
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.
IGNA UR OF REGISTERED PECTOR d �r
a9
DATE 0 REIPORT REGISTER NUMBER
A
�. - C r ®1 REe=
Uknih,-
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fk� 7y Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
❑
❑ OTHER
JOB LOCATION
�, ��
7 s' cc>�/, �� �L A !T au,
REPORT SEQUENCE NO.
TV��TgiJCTURE ����• ,
PERM'NO.
DATE
DAV OF WEEK
MATERIAL DESCRIPTION
Q 1
ARCHITECT
INSPECTORI i
T� 4.�6
HRS. CHARGED
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPECTION
DATE
GENERAL� 11 SUB
CONTRACTOR RQ (�J P(Q0_ CONTRACTOR S ��
6, .'W UTO A
o
w cl
�k
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.
SIGNATU REGISTEREO INSPECTOR
DATE OF REPORT REGISTER NUMBER
CITY.OF I -A ca���n�rAJON TANDY
VOV 10 REC'0 �/ 37630 Medjool Ave.
Palm Desert, CA 92211
U6L�1dh�� a�di� 6�;�=��-yOffice (760) 772-7192
/ Fax (760) 772-7193
�
REGISTERED INSPECTOR'S WEEKLY REPORT Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE
O POST TENSIONED CONCRETE
❑ REINFORCED MASONRY
❑ STRUCT. STEEL ASSEMBLY ❑
❑ ASPHALT ❑ OTHER
❑ FIRE PROOFING
JOB LOCATION
A 9 S' o C0
41�
, A v `
REPORT SEQUENCE NO.
TVP Fr TURE
PE MIT NO.
DAT
DAY OF WEEK
MATERIAL DESCRIPTION
ARCHITECT
INSTPECTO
J
HRS. CHARGED
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPECTION
DATE
GENERAL
CONTRACTOR �� &Le ,,) Ipt <
SUB
CONTRACTOR
1 l
3
seq K
�
W It —DV,
- VS c�
ISA cn,- S ov., ac v
QAJ F i
COPY SENT TO CLIENT ❑
NTINUED 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.
I OS NAIEP
RE OF REGISTER IN6EUOR (
3
DAT OF T REGISTER NUMBER