9808-228 (SFD)LICENSED CONTRACTOR DECLARATION
;-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
.0-- W74 t3 i 7/11V99
/ �
►� A
Date '? Y signature of Contractor
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 perfalty 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.
(v)'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.
-V 1 .f UN ID 018.93 UN.j.T0007338
(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, I sgall forthwith comply with those p ovisions.
/Date: `" 1 �� Applicant U"
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 persop 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 inspection purposes.
S gnature (Owner/Agent). i___._ -- Date t (�
i
BUILDING PERMIT PERMIT #
DATE, VALUATION'LOT- �� TRACT 252
JOB SITE
ADDRESS 79-400 S (3N LeGAfl E
APN
769-764-622
OWNER
CONTRACTOR/DESIGNER/ENGINEER
-A QUTNI A ORCHARD PA RTN1.RS
4STARKS CONS Ru(:rr ON
1'0 BOX 1716
79-295 .RUNCHO LA. QU1NTA UK:.
LA OUf TrA. CA 92253
LA QUIN-M CA 92253
(760)7711-1941 CAI. -41 23396
USE OF PERMIT
.SlINGLE d Atiill..\y DWEL,LINCY
- rt1'1` INCLUDES 40 L.1., 6° Ut4k01;N yilA2.ly, 012t"-) SYS -flim..
POOL BY SEPARKVI:• PHRIIMIT.
CuSTON,l CGi437.nuc7l'C3g : 4,140.007
'
txi3 C11'rI'A`i°(O, 370,00
0ARACKWC:•A1i.N;3.WF &ass Ao SF"
6 FT. WAU 450.00 LF
.rasIUMIT ME SVINI}0 ARV
Cd."+NSTRl,:JC;,'110NF1:.�3 101•-000-4184W 31;63200
N . A:N i:_�1C'K .03E 101 -MO -439-319 s t.',, Y'29
izr_7t_,1)Err0SsIT 4250.00
Af3301AN1CAL i i01-OQ -121-000' t ;.uif
0 -000-420-00(1 hf1.(tU
P1..1rMAINCtFFF. I01 -000-419-0M) R�St.7s,
1st'1%C7NOMOTION TT13-.liESID 101.000-241-000
GRADING EE. 01 -0W -4234W �2f;.uf•
IN 4�
1NERAbllkliC:"1'1J1tSFEE � � �.3`?5000-943-:�12 Su,(No.�k3
Ak' f IN PURIAC: PLA -'s ..175 Srp i 701 •.(100-235-000 $6111:9
4
�tii,, ;�+p y�F r�
S� f1;il .3TAL t.rOINS t c.� UC110N A.ND W AN�CHyzrTi..
$10,19929
LESS, FRE -PMD- P ,Fs
�250.0l3
JNA � � �,-
i q„r•. All PERMIT FIIF'R3 01 F, NOW
TIM
$9,948.20
RECEIPT '
DATE
BY '�I %1
DATE FINALED
INSPECTOR
ss
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
CQ
Ducts
—71&
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
(
Exhaust Fans q101
O.K. to Wrap
-
F.A.U. C
Compressor
Framing _
Insulation
d'L_
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
_ 1_4:�Izpt A9,611 -
Drywall - Int. Lath
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
Electric Final
Waste Lines
- G
Heater Final
Water Piping
-
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
u U J 13 ( -2
1 r -SJ G ✓h j Q-�- ��� Q C �z/--Q �� (!—'l
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)
Notice: k
Document Cannot Be Duplicated
Desert Sands Unified School District
47-950 Dune Palms Road
La'Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 12/29/98 APN # " 769-760-022
No. 18185 Jurisdiction' La Quinta
Owner NameLa Quinta Orchard Partners Permit #
No. 79-400 Street Stonegate ;Log #
City La Quinta Zip 92253 Study'Area
Tract # 26524 Lot # 32 Square Footage 4,140
Type of Development Single Family Residence '.: No. of Units 1
Comments
At the present time, the Desert Sands Unified School District does Inot 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 4,140 or $ 7,990.20 the property,listed'abcue and;thatbuilding,
•�J)
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
.Fees Paid By CC/Eldorado Bank/Sparks Cons. -Judy D elephone .771-19;41
Name on the check'-
By Dr. Doris Wilson k,
Superintendent
Fee collected /exempted by
Signature
Juanita Green
Payment Received $7,990.20
Check No. 851318598
NOTICE: Pursuant of AssemWBill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
above will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
collect them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant , Copy - Applicant/Receipt. ' Copy - Accounting
1171
C®'), ®erg JON TANDY -
of,,37630 Medjool Ave.
4&p�1 Pa'I .Desert, CA 92211
Vr�
Off ice
Alt
Fai
�`'Oager
REGISTERED INSPECTOR'S WEEKLY REPORT
(760) 772-7192
(760) 772-7193
(760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
❑
❑ OTHER
JOB LOC I
�,
REPORT SEQUENCE NO.
t�'�$�S-�i1J�T�.cr�
TYPE_E - URE
PERMIT -NO.. . _._ _ _
D �Aq
DAY OF WEEK
MATERIAL DESCRIPTION
ARCHITECT��' 1�/
INSPECTOR
NRS. CHARGED
ENGINEER
ENGINEER
ASSISTANTS
T
MRS. CHARGED
INSPECTION
DATE
GENERAL�/�
CONTRACTOR_. A vt S
SUB
CONTRACTOR
oX vL,\�
COPY SENT TO CLIENT ❑
C NUED ON NEXT PAGE ❑
PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT 1 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.
_ SINTURE OF REGI ERE{�Lk ' �vR (o�
1
DATE CIA REPORTS REGISTER NUMBER
WALLING & McCALLUM/LTD
ARCHITECTURE • PLANNING • ENGINEERING
45-190 CLUB DRIVE WALLINGARCHOAOL.COM "
INDIAN WELLS, CA 92210 FAX (760] 360-0786 -'
(760) 360-0250 —
September 7, 2006
City of La Quinta
Department of Building and Safety
Post Office Box 1504
La Quinta, CA 92253
Re: Cummings Residence
79-400 Stonegate
La Quinta
Gentlemen
I have inspected the shear walls, post and beams and their connections to the structure f(
this residence, and have found them to be in reasonable compliance with the drawings.
Yours truly,
J n G. Walling, A.I.
JGW/jis _
s
--Iz 3?d y fy / �) 1 -7 e -�4
irli"
`z t dc 4.t.
A
0
'43
jor'
0
Certificate of Occuaancv
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: 79-400 S.TONEGATE
Use Classification: SFD Bldg. Permit -No.: 9808-228
Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RL
Owner of Building: LA QUINTA ORCHARD PARTNERS Address: P.O. BOX 1716
City. LA QUINTA, CA 92253
By:. • KIRK KIRKLAND
Date: 12-09-99
Building Official
POST IN A CONSPICUOUS PLACE
9
PUBLIC WORKS CLEARANCE LETTER
FOR
CUSTOM". -HOME LOTS
Dear Builder:
Prior to issuance of a building permit, you will be required to obtain clearance from the
Public Works Department for one, or more, of the following:
1. Verification that rough grading is complete, and the pad elevation certifications
prepared by a licensed surveyor, or engineer, are on file in the Public Works
Department.
2. Verification that infrastructure improvements and other required tract improvements
are complete, or sufficiently advanced to warrant building permit issuance.
3. Prepare an engineered grading plan. that provides for on -lot storm water retention,
and have it checked and approved by the Public Works Department.
• Tract 26524 (Estancias)
• Tract 26769 (Mountain View Estates)
4. Prepare an engineered grading plan that provides for building pad grading in
accordance with the existing soils report and tract grading plan, and have it
checked and approved by the Public Works Department.
• Tract 28034 (South Valley Estates)
FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT
TRACT: Z�5�
LOT -
PURI Ir
OT-PUBLIC WORKS AUTHORIZATION DATE
FAPWDEPTIDOCS\FORMS%PW CLEARANCE LETTER.ss
COMITiENTS-
/0