9701-015 (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 Division3 of the Business and
Professionals Code, and my License is in full force and effect. '
z License # Lic. Class Exp. Date
347732 —7) 113111*
Date _21—' Signature of Contractor •^ k` /% %
r r `�✓.. c i
( 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
performance of the work for which this permit is issued.
W t 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.
wwtr'1t 11;x& Co. °w;,S3S V tS
(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
itubject to the workers' compensation provisions of Sectio` 3700 of the Labor
Code, I shall forthwit, comply with those,provisions.
Date: '' Applicant 11`�/a.<1~' r(I ,V 1 ,
Warning: Failure to secure Workeis' 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 A
any permit issued as a result of this applicaton agrees to, & shall, indemnify l
& 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
th above-mentioned property for inspection pu rposes. F '
Signature (Owner/Agent) �,r•��...[��./ ^� -ytU_ Date 5r—%
BUILDINGPERMIT PERMIT# CONTROL#
.
17 l 4873
DATE .OTRACT .
,. VALUATION Z
2JR1,10 I
JOB SITE
ADDRESS .;5 �t�• IV��,► t�f�f {L.7�li��?,�t��Z�
APN �iD: \�-���.«4
OWNER
CONTRACTOR / DESIGNER / ENGINEER
KSL DEVELOPMENT CORP.
56-1-10
56140 ('vtVBc:sULEVARD
I'.,►>.l;1.11t�`I'i> CA 9225;1
LA QUIWA, CA, 922:x:1
(760)171 3642 C>3114
USE OF PERMIT
�4fla
•
i.-IGA WE 14 T - R.5ro%k w. AN 2C
VLAN E f }:•;k; volt i\' 0.'.i'iF'LE IS31113L0}% AI PLAN
1�t5:tt4ttJt'A'l'.it:f '„1J�,flEi S!^
0ARAORICARPORT SP
'W( ION
PLNN e;'11WX Y -EF o l _OOi>,439-318 520.1.06
CONISIT WITCONFTME 101-M-4184.0S"A.00
0O�ryt
L'I..00TKY(,AL R l.t i-�i13d-d�'ti-titin 51.3 t
PIXTM13);N'0 05143 101.000-419-4010 $M,25
S'l'1ONt"tMOTION (Rms) 1111.940.241-6M 520.0.2
CRAIDlNCT 10.1 -000 -423 -OW 520.00
1NFRASTUCTUR1s- a 225-1100443-342 _54:444.09
Parr IN PUBLIC'PLA�. ,33 (RES) 701-000-Vis-OOO S25050
�� •37. FAI \i0N81RUCf1*0J'R AND PLANCXT1'rCK
55 ME -PAID FES
$0.00
MAR 27 1997
'1"O CAL l"l+a.RAM1T FE FS'0[Jr _N°OkV
S6,356.63
y
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR 7�1
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
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
1/7 L
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
1149y -i
r
Final
Final
POOLS - SPAS
BLOCKWALL
APPROV LS
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
/S
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster "•
Sewer Lateral
dam
Pool Cover
Sewer Connection
11,041, 71
Encapsulation
Gas Piping
Gas Test
Appliances
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
Final
Utility Notice (Perm)
%�r "*_�o
114'Certificate of Occupancy
City of La Quinta
Building and Sa fety.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 fof/owing;
BUILDING ADDRESS: 56-285 JACK NICKLAUS BLVD f
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9701-015
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: KSL LAND II Address: 56-140 PGA BLVD
? City: LA QUINTA, CA., 92253
By: DANIEL P. CRAWFORD JR.
Date: 10/21/97
Building Official .
POST IN A CONSPICUOUS PLACE
REGISTERED INSPECTOR'S WEEKLY REPORT
ti
JON TANDY
3580 Condalia Ave.
Yucca Valley, CA 92284
(619) 365-5045
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
❑
❑ OTHER
JOB LPCYIONr;
/� \�
�Li(
��� (� K140 S J l `� r.-�
•x.11 If^9 • 1 1
REPORT SEQUENCE NO.
TYPE OF TRUCT(UURRE
PERMIT NO.
D TE
aa� q
DAY OF WEEK
M TERIAL ES RIPTION
ARCHITECT
&aeCTOR
HRS. CHARGED
ENGINEER
ASSISTANTS k
HRS. CHARGED
INSPECTION
DATE
GENERAL< j O�(' / ; B `� �n C tj
CONTRACTOR \ ` l CONTRASUCTOR tCi
��
C�
L�2(.l� u. (� t4S� Q.C�►D t N G- � 6 �AS�
CONN-
��
Dec v e -C 106.
COPY SENT TO CLIENT
TINUED 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.
4IG?NT � OF REGI �� �ECT�R���`
ATE nF(RFPORf REGISTER NUMBER l
07/10/1997 07:14
714-978-9926 VCA ENGINEERS
PAGE 02
VANDORPE CHOU ASSOCIATE$, INC.
+
CONSULTING ENGINEERS
Since 1979:
295 N. Rampart Street. Suite A
Orange, CA 92868
Plan Checking
Building Inspection
Te1: (714) 978-9780 Fax (714) 978-9926
Code Administration
UBC. UFC, Title 24, ADA
July 10, 1997
Attn.: Kim
Fincher
KSL
56140 PGA
Blvd,
La Quinta, CA 92253 '
Subject:
The Ryder Collection
PGA West, La Quinta
Lot 21, Plan 1A
Lot 22, Plan 3B
(Lot 23, Plan 2C'
-
Lot 24, Plan 3A
Dear Kim,
In accordance with your request we visited the jobsite on June 30, 1997 and July 10, 1997 to
perform structural job walks for the subject houses and found the structures to be in compliance
with the plans, calculations, and design concept during the back check on July 10, 1997.
If you have any questions, contact Benjamin Herbst of our office.
Very truly yours,
VANDORPE CHOU ASSOCIATES:
Robert Chou, S.E.
BH
C: I Paul Dooley
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714 978 9926