The URL can be used to link to this page

0104-337 (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 g (� � Dae 0 Signature of Contractors �.' it t� t if• 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. 70.44, 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 Seddon 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. M$�,• { PT (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 beeotne subject to the worke' compensation laws of California�''°° and agree that if/I should become subjeAR ct to the workers' compensation prWsions of Se iion"3700 of the Labor C®e, I shall forthwith comply with -those proions: ,f ate: y:, i P1 / Applicant..• "_. Warning: Failure to,secure Work d' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety�„- for a permit subject to the conditions and restrictions set forth on his. application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is Correct. I agree to comply with all City, and:,State laws relating to the building constrAction, and hereby authorize representatives of this City to enter upon the r4ove-mentioned property forilnspection purpo s. Si nature (Owrpr/Agent)°' Date ' -� t I r F `BUILDING PERMIT PERMIT# - DATE VALUATION LOT OJ0dJ- .� J TRACT r yy y� 1914-7-1 JOB SITE ADDRESS APN 1 -125 93111TINEC CCK E&i.i�t�sro� X OWNER CONTRACTOR / DESIGNER / EN (NEER 1.. .V ..yI:I::t: we XA ;�� 0,03 t�Ir,�iZ.ZI�"BION O tr i.�C})�Y��`.Nwp';nyPQ,t}�{��'2Q)�,�$ 515163 ��✓.+"X{{I.�A '.�,�� LA,QU INTA. (w?.. 9225' 1 A.0'd1WT.A4 CA 92253 (7150)564-4832 (Mlif 323"? USE OF PERMIT P11.4995 &Z (.A.JL'1EREI7'8V11ASIs,OV17 PLAN 3). VERMIT !IONS NOT INC:LAIDY 1#bOCK WAL.•IA Ft304 OR DIVEW.t Y A7PPROACH, OU8101d CONSTRUCTION 9,89100 3F 1�C�3dCHIPATIO � 086.001317 +0ARAGRUC•.iRi'ORT (SP) 1;.%995.60 t ' "1 A.!L�� COW OY C.•.NA�ir.'�4,&BinAaC170. 1i 415,64.9" _ �t�M FER SUMMARY C0I48TP U MON ME 101-000-41 U-000 $10,745,50 PIAN CRECK ;?PZ 1f12-000-429-318 $1,410AS VIECHA211CA1. RE 101.000.421-100 $137.00 E1.8 rParaul, FEE `f01 -OW) 420-100 *255.115 XSI.MONG IEC 101-00041!R-000 W7.75 TPRONO MOTION FEE • REMIa 1X31-00 -- 41-000 $41.536 01UU NO FFLT, 101.xONN4.23.000 20.00 I7iT�if;4tA.Ctp1�J7.9'�S�.�C'P PTSY� $i,9t'f3.bfb ART M PUBLIC MAC= , RESK 701 -=-255-M SS39,12 t Am-t U y . T�.23 PR;r;TF..' lr4S 1$0.00 I MAY — 3 2001 . � .r F1018 DUE ]NOW s�,„ �1�: m, CITY OF LA QUINTA FINANCE DEPT RECEIPT DATE BY DAT NALE INS T r 4 INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings_ Slab Grade G� of Underground Ducts Ducts Return Air Steel Combustion Air Roof Deck O.K. to Wrap �� Framing _ _ _ S( �01 �6 _,/�LLI l -/ Exhaust Fans F.A.U. Compressor Insulation ��5�% �, Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall -Int. lath ��o� _ Final�y��_� BLOCKWALL APPROVALS Final 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 _ Waste Lines/��i Water Piping Gas Test Electric Final Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Sewer Connection !�/ D� Pool Cover Encapsulation Gas Piping Gas Test Appliances —a—_ 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 � /7 g9�,' Final Utility Notice (Perm) LICENSED CONTRACTOR DECLARATION 1 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 783503 " S1 to Signature of Contractor 08/31/2( 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 pert rmance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by c'on 3700 of the Labor Code, for the performance of the work for which this perces-issued:.W—y nrorkers' compensation insurance carrier & policy no. are: Carrier Policy No. EXIEMPT (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 worker ' compensation laws of California, and agree that if I should become sub' t to the workers' compensation provisions of Section 3700 of the Labor C e, I shall forthwith comply with those provisions. ate: 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 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 constr ction, and hereby authorize representatives of this City to enter upon the ove-mentioned property,for inspection purposes. nature (Owner/Agent) Date //E BUILDING PERMIT PERMITk DATE VALUATION LOT 0104-337 TRACT 1b415,64990 f n JOB SITE APN ADDRESS 81-125 SFnNNECOCK HHLS 61-830-010 OWNER — CONTRACTOR/DESIGNER/EN (NEER EISKOPF PARTNERS I LLC 1; & UII.,L'iA CONSTR iJCTT013 II -TC 551E1 S30 ]1 F114=1,S PO> t.;iC366 LA. QUINTA CA 92253 LA QU�-TTA "''A 92253 f160i564-4832 C'EI # 3237 USE OF PERMIT c^ i> r.' C T = i i r_" Tf` SFD - 40-95 S.F. (ALTERED `ddEISKOPF PLA NI 3). PER1,41T DOES NOT INCLUDE BLOCK WALLS, POC1L, OR APPRoAC:H, CUSTOM C.'()"NSTRU(_':TI0'N 4,195.00 1F PORCH/PATIO 1,396.00 EF' ; sAR.ACIE/CA.RPORT (SP) i5,$95.t G T;a- L.6t r 56T L44 i ESTEVA'LED COST OF COI STRUJICTION 415,649.90 PERMIT FEE SI %UVIAR ' � CONSTRIIC:T1 CIH FEE 101-000-4.18-00,C) 4:1;;4; n! - PLANT CHECK FEE1Cii-t 00_439-318 $1,4i0.49 AFEC I :A.II IC AL FEE 101-000-421; J00 $13?, Gil ELECTRICAL. FEE 101-000-4 LU-wJv d,455.: 5 PLL1iriBIliC FEE 10 i -000.419-000 $257,75 STRONG MOTION FEE • RESID 101-000-241-000 $41.56 ORADTINCt-F EE 1.0)1-000.423-000 $20,00 DEVELOPER 1MPACT FEE $1,90700 ART 114 PUBLIC PLACES - RESIL 701.000-255-000 $339,12 SUE-TOTAT CONSIRUCTTO?NT AI.TL% PLAIT CFMCIC $6,313.46 LESS FRE-PAIII) FEES $0.00 TOTAL PERPMT FEES DUE NOW X6,313.45 RECEIPT DATE BY DATE FINALED INSPECTOR r. f• .a }:t w O 1 O r -3Z7 Twit �j, W. P.O. BOX 1504 APPLICATION ONLY Building ,kl' 78-495 CALLE TAMPICO Arfrfross �t .. �2`'s" �fl/i.�i�.. r/J/_� �i�LS LA QUINTA, CALIFORNIA 92253 Owner 1d'a1SKQ FMailin Address o -14r l So�/TN&�N lG 5 City lZip _ ITel. Contractor ,It A d d i LL /A �cl RJc4;crc1 /SIG. V1ty c1pg�21e1-4 4d, 072_,repw- -,/83�1 State Lic. City A Classif. 7? Lic. #Gel. J9 Arch., Engr., f Designer :AAAA J/J MA1r24`K 4550ZIArcS Address I Tel. 6/'r✓'rte �Arluj o!'irl7n City Zip State A1,95d . /44. Voo Li°. # C21,/72 LICENSED CONTRACCTOR'S DECLARATION I herebyy affirm tha/Ih.).' icensedpurttfer Provi)))sions of Chapter 9 (commencing with Section 70Dp) of Divisin 3 ot9sirte andlProf �)iP Code, and my license is i, I fore and effect. j� /� /�\.__ 6 OWNER•BUIEDER 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). I'J I, as oner of the property, or my employees with wages as their sole compensation, will do the wowrk, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Proles,ions 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.) r III, as owner of the property, am exclusively contracting with licensed contractors to con- struct ornstruct 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 under 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 r7 Copy is filed with the city. ❑ 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 lhp 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. tt Date Owner NOTICE TO APPLICANT: If, 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 Ihereby 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. 1 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 sof this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING: TYPE'CONST / G/ Ni OCC. GRP. A.P. Number C�/�� -�/O -` (G Legal Description- /13 OF '12244'1' 29/$17"1 Project Description Sim /g REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INS Issued by: Date_ Validated by: / Validation: WHITE = FINANCE YELLOW 'APPLICANT PINK, 8UILOINOOIVISION Sq. Ft. Size -yi- 0 No. Stories / No. Dw. Units / New V4 Add ❑ Alter O Repair ❑ Demolition ❑ PLA 11 3 r$ ^WM]15,90 Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. 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 INS Issued by: Date_ Validated by: / Validation: WHITE = FINANCE YELLOW 'APPLICANT PINK, 8UILOINOOIVISION T Coachella Valley MY` I School District 4 , `: P.O. Box 847, The, inal, CA, 92274 (760) 399-5137, Ext. 235 This Box For District Use Onl DEVELOPER FEES PAID AREA: AMOUNT: RCPT R CK R CASH: INMA S: DATE: CERTIFICATE OF COMPLIANCE (California Education Code 1.7620) Project Name: Date: May 2. 2001 Owner's Name: Wei skopf Partner>st1I='LEC Phone No. 771-1761 Project Address: 81-125 Shi nnecock Hills PGA West, La Qui nta Project Description: Single Fami 1Y Dwelling APN: 761 830 010 Tract #: 29147-1 Lot #'s• 18 Type of Development: Residential XXX ommercial Industrial Square Feet of Building Area: 4895 Sq _ ft _ Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized to sign on behalf of towner/developer. Dated: 2 01 Signature: A t SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOW PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code Project 17620 65995 Approval Number of Sq.Ft. 4895 Amount per Sq.Ft. $ 1134 Amount Collected $ 9.30 Building Permit Application Completed: YeMo Agreement Existing Not Subject to Fee Prior to 1/1/87 Requirement Note: By: Foch "Tut" Pensis Assistant SUgerintendent Administrative Services Administrator in Charge Certificate issued by: Marcel a Valdez Signature: Facilities Clerk Section 66020 of the Government Code asserted by Assembly BW 3081, effective January 1, 1997, requires that this District provide (1)a wri notice to the project appellant. at the time of payment of school fees, mitigation payment or other exactions ("Fees,% of the 904ay period to proles a imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government eede and other applicable law, this Notice shall serve to advise you that the 904ay protest period In regard to such Feta or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees Imposed Is as herein set forth. whether payable at this time or io whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted At such time as this Certificate expires, if a building permit has not been Issued for the project that Is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. Rev. 09/27/99 THE .SUMMIT AT PGA wEST. Wehrly Residence Plan 3B' Changes Schedule EXERCISE ROOM; EXERCISE: ROOM • 1:" Delete door `into Mast& Bathroom 24. Add sink and.cabinets MASTERBATHROOM REAR PATIQ 2. Add°window above tub area 25. Extend, overhang at Family Room 3. Reconfiaure:his.trath area: 4. Reconfigure tub and shower layout 5; Reconfigure her, bath layout 6. Relocate and' reconfigure water closet and bidet area 7: Rec6i figure•and enlarge his closet- 8. loset8. Reconfigure hallway from bedroom to.bath 9: Reconfigure•and enlarge her closet MASTER BEDROOM 10. Remove windowfrommall and shorten wall length 11. Reconfigure entrance into bathroom and add niche: 12: Reconfigure, fireplace wall layout HALLWAY 13: Reconfigure hallway.into•Powde ENTRY 14`.: Push wall'out:and-recoufigure<layout, DINING ROOM 15.. Reconfigure comer.and'add-French doors to exterior 16: Add 36" ligli:'low wall I.T. Add'niches-at:wall°faeingkitchen.• DEN/BEDROOM I8`:' Add =niches`at-entrance KITCHEN , 19 . R onfigure layout of kitchen FAMILY' ROOM 20 Push.outwall-and-delete •i:6a;i niche :; 21'. 'Reconfiguit.windowsin.wall 1;11J1NG ROOM :,�.' . 22:`' Reconfigure fireplace wall layout POWDER, ROOM 23. Remove glass blocks and'add:operable window 79-985 PGA BOULEVARD LA QUINTA, CA 922$3 , TEL: 760.777.8870 FAX: 760.777.8789 SOUTHERN HILLS DEVELOPMENT, INC. r TEL: 760.777.8870 FAX: 760.777.8789 SOUTHERN HILLS DEVELOPMENT, INC. r City of La Quinta Developers Project Approval Form eOHP"-IL\-e'V. Prior to the issuance of Building Permits for the project listed below, the following Departmental clearance must be obtained. Please return this form to Nickie Gormley, Building & Safety, only after approval. Contact applicant for resolution of conditions preventing or delaying approval. Project: 81-125 Shinnecock Hills -Plan 3 revision I Applicant Contact: Weiskopf Partners LLC 760 771 1761 Jeff Read Application/Circulation Date: 11, 0L Community Development Department: Christine de Iorio, Planning Manager. c%o q.. 15L�J0 \41�-4 is � "ir.6IL- k44Ti11ati Y' CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE =4L4PL01- BY _ cfFta �P� 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: Use Classification: SINGLE FAMILY DWELLING Occupancy Group: R-3 Type of Construction 81-125 SHINNECOCK HILLS Owner of Building: WEISKOPF PARTNERS LLC #e— Building Official VN Bldg. Permit No.: 0104-337 Land Use Zone: RL Address:. 55-161 SOUTHERN HILLS City: LA QUINTA, CA., 92253 By: BILL GORDON Date: 4/26/02 POST IN A CONSPICUOUS PLACE