15646 (SFD)Please. nate Owner and�W
Contractor information C&tyl 4
hale been reversed.
P.O. BOX 1504
Building TOIADi� Et�Ci(.E �' 78-495CALLETAMPICO No. 15646
Address 79-9.25 V e «.1- 5l • LA QUINTA, CALIFORNIA 92253
Owner
Rancho Capistrano Dev.. Corp. VN OCC. BUILDING: TYPE CONST. OCC. GRP.
Mailin
Address 79--687 Country Club Dr. #20 769-730--012
A.P. Number
Her ds Dunes, zips 9220 769-730-012
,619) Legal Description Farce? 2 Lot 8 'bract 28194
Contractor Project DescriptionS.FD Plan 2C Model
--S&aeKSL/LAND 1.1 PGA West Ryder -Collection
AddrPss
56-:40 PGS, Blvd.
Lay Quinta E CA "ItI2253 Tel.:
State Lic. City
& Classif. B 597975 Lic. # 15-69
Arch., Engr.,
Designer 13 B G Architects, Inc
Address Tel.
26 Corporate -Paxk (714) 261.--179!
G1rvina, CA zip 92714 Lic.t# C6885
j LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000 of ision of the sine_ss nd Professions Code, and my license is in,ful forcle and
effect.i Ai �.OeC A Qut ski✓ ! a
SIGNATURE DATE
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
x requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisionsof the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 oh 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 five 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 of property who
builds or improves thereon and who does such work himself or through his own employees,
I , 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 or 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) licensed 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 No%v Company
❑ Copy is filed with the city, O Certified copy is hereby furnished.
V CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(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 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.
Date Owner
NOTICE TO APPLICANT., N, after making this Certificate of Exemption you should become
I subject to the Workers' Compensation provisions of the Labor Code; you must forthwith
i 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:
Thii is a building permit when property filled out, signed and validated, and is subject to
expiration it 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
ZONE: BY:
Minimum Setback Distances:
Front Setback from
Rear Setback from
Side Street Setbb
Side Setba\c, fir m I
FINAL DATE \�y INS
Issued by:
Validated by:
Validation:
Top- ne
Cent&kLine
EM
Sq. Ft.
Size 2324
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Permit does
not include block. walls or
pool.
Estimated Valuation
�196 333.00
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
552.38
Const.
979.00
Mech. —
96.00-
6„0,.0-Electrical
Electrical
157.54.
Plumbing
156.00
S.M.I.
19.63
Grading
20.00
Driveway Enc.
.00
Infrastructure
4,353.43
Arts in Pub) c Places
240.83
1
TOTAL
6,824.81
1 6,574.81.
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from
Rear Setback from
Side Street Setbb
Side Setba\c, fir m I
FINAL DATE \�y INS
Issued by:
Validated by:
Validation:
Top- ne
Cent&kLine
EM
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. S0. FT.
FORMS
< EWER OR SE IC AN
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
AS (ROUGH) -
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT.
GROUT
WATER HEATER
WALL S0. FT.
FINAL INSP.
DRINKING FOUNTAIN
SO. FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
IN L INSP. =
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
VENTILATION
LAWNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZOIC-. ROOFING
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
THING .. /
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 V. c
SEWAGE DISPOSAL
SO.FT.GAR ® 34c
HOUSE SEWER
FINISH GRADING
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 GOND. SOLAR
SETBACK - C .
ROUND PLUMBIN/4 -
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
< EWER OR SE IC AN
ROUGH WIRING
DUCT WORK
ROCK STORAGE
REINF.
AS (ROUGH) -
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
LFOUND.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ Plus x$
_$
LUMBER GR.
IN L INSP. =
AMINGCq� O
�ALINSP . �� v/(
fes-'
OFING --9c)
vv 1G
�REMARKS:
1 / ace,
VENTILATION
FIRE ZOIC-. ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING .. /
MESH
INS LATIONISOUNOYS
FINISH GRADING
//-FJ-NAL INSPECTION
c
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
August 24, 2001
RIVERSIDE COUNTY ASSESSOR'S OFFICE
3255 East Tahquitz Canyon Way, Suite 114
Palm Springs, CA 92262-6962
To Whom It May Concern:
"IOU .O
�a
(760) 777-7000
FAX (760) 777-7101
Please be advised of a street name change only for the following nine structures. The
structures formerly addressed as 79-995 (Lot 1, APN#775-250-001-7), 79-985 (Lot 2,
APN#775-250-002-8), 79-975 (Lot 3, APN#775-250-003-9), 79-965 (Lot 4, APN#775-
250-004-0), 79-955 (Lot 5, APN#775-250-005-1), 79-945 (Lot 6, APN#775-250-006-2),
79-935 (Lot 7, APN#775-250-007-3), 79-925 (Lot 8, APN#775-250-008-4) and 79-915
(Lot 9, APN#775-250-018=3) PGA Boulevard, will now be addressed as 79-995,
79-985, 79-975, 79-965, 79-955, 79-945, 79-935;,79-925 and 79-915 Double Eagle
Way.
Please note this change and contact me directly at (760) 777-7019 if I may be of further
assistance.
Thank you.
Sincerely,
Diane Aaker
Building & Safety Department
w,
Certificate of Occupancy ,—
0
City of La Quintaowl -
Building and Safety Department OFnt°`s
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 incompliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification:
Occupancy Group:
SINGLE FAMILY DWELLING
79-925 DOUBLE EAGLE WAY
R-3 Type of Construction: VN
Owner of Building: KSL/LAND II
Building Official
Bldg. Permit No.: 15646
Land Use Zone: RL
Address:
56-140 PGA BLVD
City:
LA QUINTA, CA., 92253
By:
RICHARD KIRKLAND
Date:
2/28/96
POST IN A CONSPICUOUS PLACE
Ic
y' qQ+`
O•
a -
0 30 60 120 240
PARCEL MAP 24005
P.RB. 185140-55
713.26'
T
CURVE TABLE
♦\
4 ra'sr.
a
L
? •Ltr
b
'Jg 1B� ` 1 2
86.06'27'
=
\ \ ♦♦ 66.02'
37.57'
N89'59'4 E
79.25'4•
2
42'04'02'
166.50'
122.25'
0 30 60 120 240
PARCEL MAP 24005
P.RB. 185140-55
713.26'
T
CURVE TABLE
sel Doug
e
a
L
r
I
86.06'27'
25.00'
37.57'
23.36'
2
42'04'02'
166.50'
122.25'
64.030
3
1 45.57.35•
150.00'
120.32'
63.61'
� ♦0' •v l'P. X621/' ♦�
96'52'53'
42.27'
29.20'
S
39'04.42•
�25.00'
.50'
91.05'
47.38•
6
64'53'28'
.so•
584.97'
328.36'
7
64.53'29'
500.00'
566.28'
317.87'
8
64.57'28•
483.50'
547.59'
307.38'
9
7.16'25'
1 483.50'
61.38'
30.73'
10
12.00.48•
483.50'
101.38•
50.87-
11
8.40'20'
483.50'
73.18'
36.66'
12
3'49'53•
483.50'
32.33'
16.17'
17
5.27.53'
300.00'
. 28.61'
14.32•
14
12.45'25•
300.00'
66.80'
33.54'
l5
12.54'16•
300.00'
67.57'
33.93'
t6
6'47'22'
500.00'
59.25'
29.66'
17
7'08'12'
500.00'
62.28'
31.18'
18
4'14'29
500.00'
37.01'
18.52'
19
8'23'20•
415.00'
60.76'
30.43'-
20
8.23'20'
431.50'
63.18'
31.64'
21
8'23'20•
1 448.00'
65.59'
32.86'
22
4.19'04•
1 49.00'
33.63' 1
16.82'
23
4'05'16'
448.00'
31.96' 1
15.99'
24
55'55'40166.50'162.52'
88.39'
25
55.55.40•
1 150.00'
146.42' 1
79.64'
26
32'35'20•
173:50'
75.93
39.02'
27
23.20'20'
133.50'
54.38'
27.57'
29
55'5540•
133.50'
170.31'
70.88'
29
73'29'20'
25.00'
32.06
18.66'
30 1
74'10'16'
25.00'
32.36'
IB.90'
31
20.55'20'
126.50'
46.19' 1
23.36'
32
8'22'12'
98.50'
14.39'
7.21'
33
35.43'07•
98.50'
61.41'
31.74'
34
55.22'52'
35.00'
33.83'
19.37'
75
31.24'05•
35.00'
19.18'
9.84'
36
19.13'50'
1 250.00'
83.91'
42.35'
37 1
77.06'06•
35.00'
47.10'
27.89-
38 1
45'43'30'
141.50'
112.92'
59.66:
39
11'02'01'
483.50'
93.11'
46.70'
40
06'52'32'
1 250.00'
30.00' 1
15.02'
41
44'29'15'
1 105.00'
81.53'
42.94•
42
12'18.39•
105.00'
22.56'
11.32'
43
32.10'76'
105.00'
58.97'
30.29'
44
20.35'19'
398.00'
143.02'
72.29'
46
47.44.48
120.00'
100.00
53.11'
47
53'16'44' 1
105.00'
97.64'
52.67'
48
36'50'50' T
105.00'
67.53'
34.99'
49
16'25'54'
105.00'
30.11'
15.16'
50
(20.52'15'
398.00'
144.98'
73.30')
51
37'07423' 1
121.50'
70-.24•
36.13'
52
86'46'57•
35.00'
53.01'
33.09'
S7
07.54'16'1
250.00•
34.49'
17.27'
54
11.02'00'
483.50' 1
93.11'
46.70'
0 30 60 120 240
PARCEL MAP 24005
P.RB. 185140-55
713.26'
T
sel Doug
768 LOT 4' f40t
`\\ LOT C
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n
8 �• \ \
4C \\ 1.03 AC.
3
Soh T/O/y 7 �\
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b
C7
19
8 7 0- 6 a/ ti ♦\
. tai �� ti (' `� ' �' ♦ \
U
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♦� l� Ste'
x360! • /�LY
1 �• ( 1 1 6 • ? A4i ° \
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PARCEL MAP 24005
P.M.B. '165/40-55
REMAINDER
nal
c_ s 3
`➢d$• ! ted.
54 µST
r9
V aw
\
J `
f DETAIL 'A
I SCALE 1'=40'
T'2ACT NO. 21642
M.M 20 2/51-61
SCALE 1'=60'
N 64'00'40-
_ FCC CRFDF
A = 01758151f__11�1'
R = 598.00'
T 5.13'
L 10.26'
04Y
SHEET 3 OF 3 SHEETS
IN THE CITY OF LA OUINTA. COUNTY OF RIVERSIDE, STATE OF CALIFORNIA
6 6a TRACT N0. 28259-1
BEING A SUBDIVISION OF A PORTION OF PARCEL 4 AND THE REMAINDER PARCEL
OF PARCEL MAP NO. 24995. AS FILED IN BOOK 165. PAGES 49 THROUGH 55.
I INCLUSIVE. OF PARCEL MAPS: AND A PORTION OF LOTS 1 AND 3. AND LETTERED
LOT D OF TRACT NO. 25499-4 AS FILED IN BOOK 231. PAGES 73 THROUGH 76,
INCLUSIVE OF MAPS, OFFICIAL RECORDS OF RIVERSIDE COUNTY. CALIFORNLk
MDS CONSULTING GROUP GARY W. DOKICH LS.4693
MAY, 1996
1
Ag f N 64.53'iT E
sDl PRc (RAD) \
285 (RAD}
N 6��� S619h�1
_N_89'05.17'
'mills(�'%
EASEMENTS.
INDICATES A 10.00 FOOT WIDE EASEMENT FOR PUBLIC UTILITY PURPOSES
DEDICATED TO THE IMPERIAL IRRIGATION DISTRICT.
Q -INDICATES A 10.00 FOOT MADE EASEMENT FOR PUBUC UTILITY PURPOSES
DEDICATED TO THE CITY OF LA OUINTA
'� 30 -.INDICATES A 12.00 FOOT VIDE EASEMENT FOR GOLF CART ACCESS PURPOSES,
9 \ as PEuib� rrE�onr
\ SEE SHEET 2 FOR SURVEYOR'S NOTES.
0,�/ INDICATES ACCESS RIGHTS RESTRICTED HEREON
a N5�2o�£(R�`q�O IN,
\
11 �'9 + \
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TRACT NO. 251'A0-4
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