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