0006-204 (SFD) (STRUCTURAL & TRUSS CALCS).4 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
•y,Date Signature of Contractoj f ••�•J^j'
Y OWNER -BUILDER DELLA TION 1 `
I hereby affirm under penalty of perjury that I tem exempt fro the Contractor's
License Law for the following reason:
(. ) 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, Business & Professionals. Code).
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
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'
compensatiori; as provided for by. Section 3700 of the Labor Code, for the,
performance of the work for which this permit is issued.
(s')' 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.
STATE FUND
(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 t7V
l should become
subject to the workers' compensation �ovisions'Of : ection of the Labor
Code, I _shall f�rthwith comply wi% thgs jprpvisignSk 1 r, A '
Warning: IFailule to secure WorkeWrs' CotmI pensa ion coverage is unlawful and
shall subject an employer to criminal pel!t',re1 ao civil fines up to $100,000, in
addition to the cost of'compensatioh; da ages as pro"vided for in Section 3706
of the Labor Code, interest and atMrney's.fees.
IMPORTANT Application is hereby mak 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 Bit,
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 prop°e'y for'inspection purpose .
Signature (Owner/Agent). ; . ,. 'i ✓ Dateko� VA
Y
BUILDING PERMIT, PERMITk
DATE VALUATION LOT M66 204 TRACT
410
JOB SITE '
APN
ADDRESS
W-642TALTaNG ROCK YM?K
7V- 400-02a
OWNER
CONTRACTOR/DESIGNER/EN INEER
1 7
A./DInlMD FIHA 0�Y 1,LC,
BEAVI?RTON' OR W068
PAHA DRE r CA 92160
(7401168-1712 CBUI 6W3
USE OF PERMIT
swalJW F.AL&LY t.► .x.
S W a P".Ir IT DOOM 2+8OT I'NCE:f DE'RALOCK WAX.,I.w=POCILIAlyP R.OAC€i l i
DIUVRIWAY
CUSTOM COir'S'1'RUCTIt:aN 42.5100 SF
PORCKMATIO • 552.00 S
y
ikr'4.IZ.lYWC,dri.Itt ORT (OF)
9SnN 1 ski WgIr OF COWIR
517,10,70
CONSTRUCTION P�.1?. 101-000-419-000 SZO93,
;:SWT C?W, ,K FEE 1694,119
FETRIC ZP021T. 1.01-000.439-319 41140104
�s�c:1i �i1'SICAL,f4�1~a 1(7�^ID�i3�t?t-u�tl . �IG2.dtt?
I?1R1?C t.1CI. i1 ��213�3.2tia(1i' ' ' - v1.c95
d.QF t i �f01? 101-0.00-419-000 $312.75.
�e�'iZC3A1� } MOTION I�fi? -1:t1S11) 101-000.241.-000 S5I.7
aptiNI3IA(I jru? 101 -ON -42:3-00 6A 00
D1�"�'W)PER.146iPACT RE,
.r>,1''T 110 YaI.JBUC PLACEN PLACE,1W, x.701-000.25'5-( 00, V92.91
1ffiJ'a-"IVfAL.C0W61L.tJC-1109AND 1?LANCHMK.
$"1„,iil.r3
TOTAL T�KM
'RECEIPT
DATEµ
t .
BY y
DA E FIN ED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
;INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
4.o /
�
_
"s-!%
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
�_� , c
$�
Exhaust Fans
O.K. to Wrap.
aS . p e
ST
F.A.U.
Framing
7=(/ , �p
Compressor
Insulation
-7 :-L7—= v jam
Vents
Fireplace P.L.
,Z_a — O (
$
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
•
Final
�{_(�Z
�—
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
Electric Final
Waste Lines
c9 _5
Heater
Heater Final
Water Piping
l/%/5
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
/ao
_
Pool Cover
Sewer Connection
`
_ _6
Encapsulation
Gas Piping
Gas Test
6—. O Z/
>
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
E; S _O�
"$
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) EGt_tc
y
Building
Address'
�Ju�c
Mailing
Address
City
20J
T4ht
"
44Q 4
0
Zip Tel.
g10Og
r78-495 CALLE TAMPICO APPLICATION ONLY
�oe�LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE'CONST. OCC. GRP.
P. N
Legal Description) �
u—a—,
Project Description
Jdress J( r
-,81(,e) y. �1c t to
F k State Lic.
& Classif.
Arch., Engr.,
Designer'
Address
ZiWJ� 56 (_712_
Lic # Sq. Ft.
Size
c6 , New&
Tel.
CityZip I State
a i1,1 �, �/�'( 012.2_ 11 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE 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
Add ❑
Estimated Valuation
ki
No. No. Dw.
Stories Units
Alter ❑ Repa�irJC Demolition ❑
P
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).
1 ' I, as owner of the property, or my employees with wages as their sole compensation, will
PERMIT
AMOUNT
Plan Chk. Dep.
`q ,,,,....�-•-
Plan Chk. Bal.
- -
Const.
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
Mech.
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. It, 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 or sale.)
Electrical
Plumbing
1 1, 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
S.M.1.
such projects with a contractorts) licensed pursuant to the Contractor's License Law.)
1-1 I am exempt under Sec. 8. 8 P.C. for this reason
Grading
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
Ihereby affirm that I have a certificate of consent to self-ingpre, or.a certificate of
Worker's Compensation Insurance, or a certified copy thereofi(Sec. 3800, Labor Codes
Policy No. Company
F1 Copy is filed with the city. O Certified copy is hereby furnished.
O f
TOTAL
V
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE ` ,�+
This section need not be completed if the ,
( p permit is lor�onelhundred dollars (EY00) valuation
or less./
I certify that in the performance of thg work. for which this permit is issued; I shaJI not
employ any person in any manner so as to becomtsubject to the Workers' Compensation'
Laws of California.
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.
>• REMARKS .0P .r '
-
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
0,
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of theme
work for which this permit is issued. (Sec. ,3097. Civil Codef) „,
Lender's Name
FINAL DATE
Issued by:
Validated by:
INSPECTOR
Date - Permit
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the aboverinformation is correct.
I agree to comply with all city and county ordinances and state laws relating to buildings
construction, and hereby authorize representatives of to to enter the above•
mentioned property for inspection purposes.
Signature of adplicant Date
_
Mailing Address
Validation:
City, State, Zip
r
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
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 10/13/00 APN # 770-300-022
No. 21088,u' La La Quinta
Owner NameDutfield Financial a Permit #
No. 78-642 Street TalkingRock Turn Log #
city La Quinta zip 92253 P Study Area
Tract # Lot # ' Square Footage 6255
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
2.05 X ' 055 or $ 12,822.75 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
Fees Paid By CC / Bank of America / Geoffrey Henkle Teiephone 760 568-17.12
Name on the check
'0
By Dr. Doris Wilson
Superintendent •,i `t, f '
Fee collected /exempted„by' Annette Barlow Payment Received ” $12,822.75
Check No. 400168569
Signature
NOTICE: 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 idenFdieO
above will begin to run from 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
Fidelity National -Title Company
74-785 Highway 111 Suite 210 • Indian Wells,. CA. 92210
(760) 674.9616 • FAX (760) 674-9516
DATE: March 3, 2000 TIME: 14:37:33
ESCROW NO: 3115 -CAH
ESCROW OFFICER: Catherine A. Hammons CLOSING DATE: March 3, 2000
BUYER FINAL CLOSING STATEMENT
SELLER(S): Fisher Capital Corporation
BUYER(S): Dutfield Financial,*— - ---
PROPERTY-
PROPERTY: Vacant Lot 40 Tract 28470-2 AP#770-300-022 5, La Quinta, CA 92253
$ DEBITS $ CREDITS
FINANCIAL:
Total Consideration
775,000.00
Deposit - Dutfield, Financial
10,000.00
Deposit - Dutfield Financial
777,837.89
PRORATIONS/ADJUSTMENTS:
1° Prepaid County Taxes at 52,236.39 .Semi -Annual from
1,466.08
03/03/00 to07/01 /00
HOA Dues at $239.14 Month from 03/03/00 to
231.17
04/01/00
TITLE CHARGES:
Recording'Deed
32.00
ESCROW CHARGES
Escrow Fee 975.00
BUYERS REFUND $ 10,133.64
TOTALS $ 787,837.89 S 787,837.89
SAVE THIS STATEMENT FOR INCOME TAX PURPOSES
YOUNG ENGINEERING SERVICES
Engineering • Architecture -Surveying- Building & Safety Services
Letter of Transmittal
f
To: City of La Quinta Date: 10/3/00 .
Project: PC0006-204
Dutfield Residence 3check
Attn: Greg Butler W.O.:
Tel No.: Tract No.: '•
We are forwarding: By Meisenger By Mail Your Pickup.
No. of Copies Description:
2 Resubmitted plans from previous check
2 Revisional plans/calcs.
Comments: Plans are approvable for building permit.
This Material Sent for:
Your Files Per Your Request
Your Review' Approval '
X Checking At the request of. '
Other
By: Marcell McElroy '
Phone # 342-9214 `
' 47-159 Youngs Lane • Indio, CA 92201 • (760) 342-9214
*Bron Young •
Tradiaon
ARCHITECTURAL DESIGN REVIEW
August 24, '2000
Via First Class Mail
Mr. Gordon Stein .'� `
STEIN: & ASSOCIATES
41-945 Boardwalk, Suite K
Palm Desert, CA 92211
Re: Dutfield Residence, Lot 40, Tract 28470-2;. 78-642 Talking Rock Turn
Construction Documents — 2Rd Submittal
Dear Gordon,
The ADRC of Tradition Golf Club met on August 16; 2000 and reviewed the above
referenced submittal. Please provide the following information:
Architectural Review
1. Fixed windows must use the same frame and finish as the main windows and doors.
Material Board
Approved as submitted.
All materials/colors are subject to field review sy. the ADRC for approval prior to
installation. The Committee will conduct a site..*ie during the regularly scheduled
ADRC meeting held the first and third Wednesday of the month. Notification must be
received no later than the Mondayprior to the meeting. Failure to receive approval of
these items may result in removal and replacement of these materials and delay in
construction.
Landscape Review.
Approved as submitted:
t
78505 Ow AvENuE 52 -., Ik QuwrA ..- CA 92253.1120 — PHONE 760/564.3355 -- FAx 760/564.2356
If you have any questions or need additional information; please do not hesitate to call.
Sincerely,
Christina J. Mores
Architectural Review Coordinator
/cjd
pc: Ross Stout, owner (via first class mail)
P
Citj. Of LaQuinta
Building and Safety_De artment CF�%f tO F
p
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: 78-642 TALKING ROCK- TURN
Use Classification: SINGLE FAMILY DWELLING _ _ Bldg. Permit No.: 0006-204
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: DUFFIELD FINANCIAL LLC Address 8205 SW CREEK"SIDE PLACE
City: BEAVERTON, OR 97008
By: RICHARD KIRKLAND
.�d�b•,t - Date: 06-04702
Building Official
POST IN A CONSPICUOUS PLACE