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15645 (SFD)Please nate C7wssm<r and �W . Contra6tor information have been reversed. T444t 4 P.O. BOX 1504 N o . 15645 Building U3J 78-495 CALLE TAMPICO Address R 79'915 err n ,9 d -a LA QUINTA, CALIFORNIA 92253 Owner Rancho Capistrano Dev. Corp. BUILDING: TYPE CONST. V.4 OCC. GRP.. R-3 Add ess 79-°687 Country Club Dar. #201 769--7301-'412 A.P. Number City Zip Tel. Bermuda Dunes, CA 92201 (619) 345-"7755 Contractor 40me K.SL/LAND 31 Address SI --140 PGA Blvd. C Quinta, CA Zlo92253 Tel.: State Lic. City & Classif. 8 597975 Lic. # 3969 Arch., Engr., Designer -5 B G Architdcts r Inc. Address Tel. 26 Corporate Park (714)261--1795 ltsyrx> e; CA zip Sta92714 Lic.t# C6085 LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 oftheBusiness and Professions Code, and my license irs�in.full forceand effect � °4 SIGNATURE a D 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 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) 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 civli penalty of not more than five hundred dollars ($500). O 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 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 inprove for the purpose of sale.) ❑ I, 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 contractor(s) (Icensed pursuant to the Contractor's License Law.) ❑ 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 lNo. Company 6 opy is filed with the city. O 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 thg 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 NOTICE TO APPLICANT. ff, 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 if work thereunder is suspended for. 180 days. I 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 -of this city to enter the above, mentioned property for inspection purposes. Signature of applicant Date _ Mailing Address City, State, ZIp ,Legal Description Parcel 2 List 9 Tract 28194 Project Description SFD Model Plan 1A PGA West Ryder Collection Sq. Ft. 2074 No. No. Dw. Size Stories Units New ❑ Add O. Alter O Repair O Demolition ❑ Permit does not include block malls or poop.. Estimated Valuation $177,089.00 PERMIT AMOUNT Plan Chk. Dep- 250.00 Plan Chk. Bal. 502.52 -752—.S2 Const. 912.50 Mech. 62.00 Electrical 148.81 Plumbing 162.00 S.M.I. 17.71 - Grading i.71Grading 20.00 Driveway Enc. .00 Infrastructure 3,915.68 Arts in Publ..0 Places 192.72 TOTAL 6,.183.94 5933.94 REMARKS %ote that street name will be changed at a future date. ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rearejp�op.. Line Side Street Setback fr, fn Cenre Line Side Setback fro ert.�1� FINAL DATE INSP' R Issued by: Dated !�59rmit n Validated Validatior CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 1ST FL. SO. FT. ® $ UNITS Y ARD SPKLR SYSTEM 2ND FL. SO. FT. p UNDERGROUND A.C. UNIT COLL. AREA MOBILEHOME SVC. BAR SINK POR. SO. FT. ® HEATING (ROUGH) STORAGE TANK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS DUCT WORK ROCK STORAGE DRAINAGE PIPING CAR P. I SO. FT. METER LOOP HEATING (FINAL) WALL SO. FT. ® REINF. STEEL DRINKING FOUNTAIN SO. FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER HEATER WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER I/MRAMING - �C / AVr-c"'. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ROOFING LAUNDRYTRAY AIR HANDLING UNIT CFM REMARKS: 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 INSPECTOR'S SIGNATURESIINITIALS SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER 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 S� S� ROUND PLUMBI UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS ��� """r EW OR SEPTIC/1 ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH),2. / P METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING CU. yd. $ plus x$ _$ LUMBER GR. AL INSP. ! r I/MRAMING - �C / AVr-c"'. ^' INAL INSP /� - ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH 01 NSULATION/SOUND/ 0?,2'0/S FINISH GRADING CFINAL INSPECTION 2 v CERT. OCC. FENCE FINAL�.2, - t— INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 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: 79-915 DOUBLE EAGLE WAY Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 15645 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL Owner of Building: KSL/LAND II Building Official Address: 56-140 PGA BLVD City: LA QUINTA, CA., 92253 By: RICHARD KIRKLAND Date: 2/28/96 POST IN A CONSPICUOUS PLACE