15712 (SFD)P.O. BOX 1504
Building 78-495 CALLE TAMPICO
Address 57-540 InteZlachen-.-......,.. LA QUINTA, CALIFORNIA 92253
Address 79_687 Country Club Dr. #201
City Zip Tel.
Bermuda Dunes 92201 345--7?55
Contractor
same as above
Address
City IZiD I Tel.
State Lic. I City
& Classif. 59 975 Lic. # 1959
Arch., Engr.,
Designer , Arehi'l ecture
Addresl.
17992 Mitchell South Te,714-fr60-0970
City Zip State
irvkne 92714 Lic. # C15621
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm.that I am licensed undel p vro isions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions /C,ode, and my license is i full ffoecce and
effect. ��
WENATU OF
OWNER•BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors 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 rile a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or
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 rive hundred dollars ($500).
❑ 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner or 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.)
❑ 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
such projects with a contractors) (Icensed pursuant to the Contractor's License Law.)
4 ❑ 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 N6� Company
❑ Copy is filed with the city, ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section . need not be completed it the permit, is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thF 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
Date Owner A
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.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($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.
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 certlfy 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 of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
. � a
No. 1571
BUILDING: TYPE CONST. V-14 OCC. GRP.
A.P. Number ,761--480--039
Legal Description Lot 3 T-2`7332 P -M 27356
Project Description SpA
Issued by: Date Permit
Validated by:
Validation:
Sq. Ft. 3907
Size
No. No. Dw.
Stories Units
Newel Add ❑
Alter ❑ Repair ❑ Demolition.0
Permit domes not i.nfflude block
wi
or rsoci,,
Estimated Valuation
$330,168.00
PERMIT
f AMOUNT
Plan Chk. Dep.
256 nk1
Plan Chk. Bal.
930,
50 .
Const.
1448.00
Mech.
13 6
5n
Electrical
Plumbing
14 C)
A
S.M.I.
Z
9
Grading
7n
Driveway Enc.
Infrastructure
6000
0
t 'PtibTia
4a n ^n rz
Al
TOTAL
9 A.
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 INSPECTOR
`
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
IST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CARP. SO. FT. ®
WALL SO. FT.
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING.
DRINKING FOUNTAIN,
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
LAGRADE GQ ��
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROUGH WIRING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROCK STORAGE
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAS (ROUGH)
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET-
COMPRESSOR HP
POLE,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
WATER HEATER
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
- SO. FT. RESID ® I'A c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/4c
IHOUSE SEWER
$
GRADING.
CU. yd.
-plus-x$_=$
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
OUND PLUMBIN� g
UNDERGROUND
A.C. UNIT
COLL. AREA
LAGRADE GQ ��
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REIN!. •
/y1
"!
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
EINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING.
CU. yd.
-plus-x$_=$
i
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
� - S
12--f
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
-
GARDEN WALL -FINAL
COACITEI.,L.A VALLEY UNIFIED SCHOOL DISTRICT
CERTIFICATE Ole COMPLIANCE
(Government Code 53080)
Pr-oject Nanus:
Project Address: 57-540 Interlachen, La Quinta, Ca 92253 (PGA)
Project Owner's Name: Rancho Capistrano Development Corp. Phone No.: 714-660-0970
Project Description: Miell e
Building 'hype (Checkle): Residential XX nclude No, of Dwellings)
Commercial �t
Tract No.: Lot No.:
(lf tract attach Schedule "A" ol'all lots by tract, square footage for each lot and total.)
Assessor's Parcel No.: 7_6-1 480 03.9 _
(II'SCltedule "A" is used show Assessor's Parcel No. I'm each lot il'one exists or Assessor's Parcel
No. 1'0r parcels bet'ore Subdivided.)
Total slluwe feet of Building Arca: 3907 Sq.Ft.
C:ertilic,ltion of Aliplicimt/Owners. The person signing certifies that the above int,►rrttt►lloll is
correct and stakes (his statement under penalty of'peijury and further represents that he/she is
uttlhorized to Sign on behall'ol'the owner
/developer.
Dated: Signahu'c:
City/County Certification:
(Signature) Optional
('Title)
SCHOOL DISTRICT REQUIRENIENTS FORTHE ABOVE PROJECT 1-IAVE BEEN
OR WILL BE SA1.ISFILD IN ACCORDANCE WITH. ONE, OFTHE FOLLOWING:
(CIRCLE ONE)
Gov. Code Gov. Code Agreement Existing Not subject to
53080/65995 6,5970 prior to 1/1/87 fee requirements
(AB 181, SB 1287) (S.B 20 1.) Note:
Total Nuber of S(I./Ft. 3907
Amount per Sq/Ft. X 1.72
Amount Collected $ 6,720.04
School District Official)-QQ,. gM> Title: Asst. Superintendent, Admin. Serv.
Foch "T.'ut:" Pensis Date: September 12, 1995
Phonc: (619) 399-5137 .Ext. 235
Note: AB 2926 and S.B 201 fees arc capped at X1.72 per squaa'e foot for all residential
Construction, and at: $0.28 !►el' sallal'e foot fol' 11T,aaorfc
F DELJTY PD
TEL:
9• - -.
C1 .:i.! A:y:
AMD $MIN aICMID MAIL TO
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Mr. & Mrs. Fou Ik
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bmw
TAY
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a.... Sara AS AW"
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CAT. Me�NNEOfaa
Oct 20'95
5:18 No`.010 P.02
1
WAW A@CvE THIS LIME FOR Ri0011a X1 tlBE
Partnership Grant Deed
rna vpwp Iy�.trto a TS�Oa T.�La MMllRaa
ne un&CAF d prantor(s) dedsms): 104.50
Doeuf tarry traasfer ux is
(x) emputed an 6n11 value wf ,. ,p•-,rrr; CDUVCYed.IN
( ) eomputed on 611 value less value of liens and ertenr w ms at brae of suis.
( ) Unincurporsstd
am;( E ) City of La 9glata . aAd
FOR A VALUABLE CONSIDERATION. m-ccipt of whieb is haeby adumwirdfed.
SUNRISE DESERT FARIFERS
a Cal Hernia Liaited PUUK ship afa"iwd cadet the taws d dee t -2-e of 411 fotnis
hereby GRANTS to
Robert W. Faulk and Viona K. Faulk, husband and vife as commuuity property
the fotiowiag desvibed teal proprM in the City of La 9alate
County of Riverside . State of Califormsa.
COMPU ?E LEGAL DESCRIPTION ATTACKED REREW AND KADE APART RLREOt AS RIRIRIT OX0
Dated; August 17. 1493
(Corpreuoe b ♦ tMowr ad a lnan+d►y}
STATE Of CALWIPMA 1
COUNT' w i
On August 17. 1993 pow Aw
ltutb A. at
aft=ypfjftfftLie r "vu+esaawo.�+�rrIMF
bl! lied
poroo� sows oe e.o (or v� b �,. en aw e.ra d aaeaeioif
a,�ono.1 ee e. n» n.no�tN •ae•• +�+.a1 o►au aue.vw•e a �.
whtrn prtufMnl ane atanowMaOaa ro � U+at 1MIMMMAy a:aaaa0
tM MIM 1n M NMeRir t+swoha�9 � EMF �
U an no arvnwn "m opomft & aw d"my Upon b"
at oltleA vo POP1041 ad.4 o �nM .
VATW55 MY "dT
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$�amyyrl
SUNRISE MERT PART, A Califoraia
Llnitad Pastr&TMP
art SUVRISL CORPORATI011
A CaliforvilA eoraoration. Ceaaral Par
PRILLV IL Sr4!>t J=.
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August 22, 1995
Mr. Robert Foulk
PGA WEST H RESIDENTIAL ASSOCIATION, I
P.O. Box 1282 • La Quinta, CA 92253
Re: Approval of Working Drawings - 57-540 Interlachen
Dear Bob:
SEE 07 y99
p�N°dINC t3EftA8TirMENT
I am pleased to inform you that the working drawings submitted for your new custom home at 57-540
Interlachen have been approved by the PGA West II Residential Association Architectural Committee,
with the following conditions:
1. 15' Rear Yard Setback
2. All yard walls maximum 6 1/2 feet in height (including 6" cap)
3. Step-down on rear sideyard walls to conform to existing community standards
4. "Meadowbrook" stucco color must be consistent with existing neighborhood stucco color(s).
5. No satellite dish will be installed, per your representations.
6. Minimum side yard setback 5', per City code.
7. Maximum combined side yard setback of 15'.
8. Owner responsible to ensure a clear definition between properties on front yard landscape.
The Committee also strongly recommends that your contractor utilize high density concrete throughout
your driveway, walkway and patio areas, with a minimum thickness of four inches and a maximum
distance of seven feet between expansion joints. This should minimize cracking and exfoliation due to the
extremely high salt content of PGA West soil.
Additionally, should there be anv changes desired from the submitted plans, either architectural or
landscape, they must be submitted in writing for approval by the Committee. Thank you for your
cooperation in, these matters, and we look forward to an exciting new custom home in PGA West Ii
Residential Association.
Sincerely,
DT/jhh
Enclosure: Submittal Form
cc: Board of Directors
s
Lot # PT W nja
Lot Address 5:2-j42 juTeec.,LcareA
$10 000 Deposi ec ived:
Yes Date
.0-4j-13 6 IM
Lot owner, _ me * rues OaSEar Fn-„Lg , has substantially satisfied Custom
Lot Architectural Committee pre -construction requirements and is hereby
authorized to commence construction of the approved improvements for the
above Custom Lot.
The work shall be done in accordance with the approved plans and the Custom
Lot Architectural Guidelines.
Any changes to the owner, architect and/or general contractor information
originally supplied on the Design Review Application, shall be noted below:
Address
.
Phone
Architect carp torr- vuano.aac
Address _rt!992 LL Sor,-r
1sv,�n 92714
Phone C'1 ta) upo - o!-9?a
Contractor 2_.ojfi3yd"o
B-1 License # 293 - 9115
Bus. Owner's Name_ C Am �rtwB�av
Address_.Z2,,8ox
LA C2 w ura CA,
Business Phone_ 3��
Home Phone
Job Supt tZoj-!3, GA9i-r-z
Site Phone -111 - SQ -1 o
Home Phone
W
08/18/95 15:19 FAX.16195642011 ROBERT FOULK
W, /A I
OV
a.�. .LOU
Together with this Design Review Application, t have attached the requested
application fee in the amount of $200 made payable to EgAWF-ST if
and the schematic plans far this custom
home. The schematic plans have bean prepared with the most recent copy of
the "PGA WEST CUSTOM LOT DESIGN GUIDELINES". I understand that it will
take no longer than 30 days to complete a formal review of each submittal we
present to the Association.
AlAr
Lot Owner's Signature & Date
Lot # Lot Address 61-542 1bac u
e= -r- a�•ul- ..
Owner Ot
Address ' ,•�,���
Phone
Architect
Address���wt+ r SouU
'7(
Phone ,CA -
924
o
• -i« -• �_ ME
Contractor R c jreA cc
B-1 License #
Bus. Owners Name__Vam WAU49-
Address
Business Phone 3
Home Phone -j-19 Ig
Job Supt One Cd a,-= _
Site Phone -r
Home Phone
Date Date Initialled
.. ".IU
It 3.1 -.TGm
♦. _ Construction ■Eanifitims _
1
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WAPdHosa Rih .
time • ..- • 1
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11
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27
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4
78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 -/(619) 777-7000
FAX (619) 777-7101
September 14, 1995
Grant Hornbeak'
Rancho Capistrano Development Corporation
Post Office Box 1848
La Quinta, California 92253
SUBJECT: SETBACK ADJUSTMENT 95-345 (Parcel 1, PM 27766; 57-540 Interlachen)
r
Dear Mr. Hornbeak:
This letter is to report approval of your application for a setback adjustment pursuant to Chapter 9.188
of the City of La Quinta Planning and Zoning Regulations. The following setback adjustment has been
approved, subject to conditions and in conformance with the attached exhibit "A" (site plan).
The setback adjustment approved is a reduction of the- rear yard setback from 10 -feet to eight -feet to
allow construction of a new residence.
We find that there are special circumstances applicable to the size of the property to justify approval
of this adjustment. Furthermore, we find that the adjustment will not be detrimental to the public
health, safety, and general welfare of the community, due to the fact that the Homeowners' Association
has reviewed and approved this request.
The approval is subject to the following conditions:
1. A building permit shall be obtained.
2. The columns of the structure shall not be closer than eight -feet to the rear property line.
Should you have any questions regarding this matter, please feel free to contact the undersigned.
Very truly yours,
JERRY HERMAN
COMMUNITY DEVELOPMENT DIRECTOR
STAN B. SAWA
Principal Planner
SBS:cbw
Enclosures
cc: LBuilding &_ Safety,Department—"—�
MAILING ADDRESS P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253
Ltrss.314
09/12/1995 13:49 7149789926 VCA ENGINEERS
VANDORPE CHOU ASSOCIATES, INC.
.' CONSUL TING ,F. NrINEERS
�
295 N. Rampart Street. Suite A
Orange. CA 92668
Tel: (714).978-9780 Fax: (714) 978--9926
September 12, 1995
PAGE 02
Since 1979
Facility Planners
Codo Consultants
Structural Engineers
Fire Protection Engineers
ATTN: Mark Harold
Building and Safety Department
P.O. BOX 1504
La Quinta, California 92253
Subject:. Truss Shop Drawings
Foulk Residence, La Quinta
Dear Mr. Harold:
We have reviewed the truss shop drawings for the subject project and found them to be in
general compliance with the design intent.
If you have any questions please call me.
Very tr.ty`;.j�osaFs'
V "N." E CHOI A►TES, INC.
V_ t • .. ,.
• R ,Chou, SE f
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