0001-114 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
•F�— Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
04 W Professionals Code, and my License is in full force and effect.
p c) License # Lic. Class Exp. Date
LLJ
o Z r`
VDate'-eI6711
1 Signature of Contractor
OOWNER -BUILDER DECLARA ION
HLU I hereby affirm under penalty of perjury that I am exempt from the Contractor's
co License Law for the following reason:
Z_ ( ) 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).
CV) O I am exempt under Section , B&P.C. for this reason
O N Date Signature of Owner
o)
d< WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
p () 1 have and will maintain a certificate of consent to self -insure for workers'
K LU Y: compensation, as provided for by Section 3700 of the Labor Code, for the
D -i Q performance of the work'for which this permit its issued.
n Q () ( ) I have and will maintain workers' compensation insurance, as required by
j U Q Section 3700 of the Labor Code, for the performance of the work -for which this
L LO Z permit is issued. My Workers' compensation insurance carrier & policy no. are:
oo 5 FREMONT COMPE142 Caffier
Policy No. SAMO"10320
to C Y
g (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
s
A. to he workers' compensation provisions of Section 700 of the. Labor
ode I hall fo 'th comply with ttfFae'(
Dw
Da Y Applicant Warning: Failure Failure to secure Workers' Co pensation 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
any permit issued as a result of this applicaton agrees to, & shall, indemnity
& 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
Zignatuvre
boe-mentioned property"o� inspectipr ses.
(Owner/Agent) /' f ��� Date • f -�' ��
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 0001-1.14 TRACT
€ 4126M C $214,42590
JOB SITE
APN
ADDRESS 2- 10 DTINT. -D., CC11( r
_
OWNER
CONTRACTOR /DESIGNER / ENGINEER
HANIfI.biso2d, MW. JOPI%1
MDR -RW 1'%a�M t'MPO'I AMION
PA"I i7L"MRT CA 42.261
(760)346-322.8 C;i]* 03031
USE OF PERMIT
I�..FIC3M FAWLY DWELIDI0
SFD- I -DT 3 PM 18613-MMIT DOHS INOT INCLUDE BLOCK' -WALLS OR
POOL,
CUSTOM CONSTRUCTION $442,00 U
PORMPATIO M.00 Sf?
OARA,CIEICARPORT (FF) t2,Sg3.20
`
i)S'T 011' C()_NYF �tUC3 t{?N
234,425,90
II RFV. I' FKE SUMMARY Y
r
CONSTRUCTIM I FEE 301-000-418-000 bl,0000
PLAN CHECK FEE 101,00c"439-318 052.80
"M DEPOSIT 101.0009.31.6 4500100
A/1EVRANICAL VZE 101-000-421-000 $98.30
ELECTRICAL FELL 101 -WO-420-000 .31
PLUMBING FEI? 101-000-419-004
STRONG MO T I0N FEE - RUI Q 101-000-241-000 M-44
ORADINO FRE 101-000=493-000 $20.00
;
DEVELOPER IMPACT FEE Si,�707,00
'
ART frrf PUBLIC PLACES - A.ES11701.004-2653-000 $36.06
,
:Ute-IMAl, C°0WffRUCUM AND PI -W r7ICK
� 4,3111.35
IX PRE PAJD FR&S
4500,00
OTAL PYRMY YFFS DU:K .NOW
RECEIPT
DATE
DATE FINALED
INSPECTOR
iNSF'PELTINN9*10111'
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
B4.D LDING
APPROVALS
MECB AN► CAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
_(Z-.00
Exhaust Fans
O.K. to Wrap
n p 151
F.A.U.
Framing
eo Z •
Compressor
Insulation
CC 5:.
Vents
Fireplace P.L.
-13-Oo S'Z-
Grills
Fireplace T.O.
- - dp SZ•-
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
-
DrIwall - Int. Lath
p
Final
Final
®LOCK@f ALL APPhOVAL S
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUM BWG APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
d
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final?
Utility Notice (Gas)
ELECTRICALS APPROVALS
Temp. Power Pole vc 0 1�0 �
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)
COMMENTS:
sem. slr Awc OK S 7,_
Building
Address
Owner
Mailing
Address
State Lic.
& Classif. �
Arch.,,Engr.,,
Designer•
City
0
Cv
P.O. BOX 1504
78-495 CALLE TAMPICO
�T• LA Q.UINTA, CALIFORNIA 92253
APPLICATION ONLY
I C3'" r-% jurrm BUILDING: TYPE'7CONST.- te, OCC. GRP.
� A.P. Number f -7 0 -,Z40 — Ow
Zip Tel. L 3 inN� 2- Z
Legal Description D'��
Project Description
P
C�1
32 Z 26
City
Lic. 4 031 Sq. Ft. No.
Size. Z4-171 Sto
I Lic. #'
DECLARATION
of Chapter 9 (commencing:wlth';Ssctlon
:ode, and my. license Is In full force and
r�
N T � l
M ...• • OWNEMUILDER DECLARATION
t� I hereby 'affirm thA11 am .exempt from the Contractor's Llcense Law for the following
reason: (Sec. 7031.5,8uslness and, Profe"ealone, Code: Any city or county which requires a
pemilt to 6onahUnt, 'atter, briprove, dsrI h. or repair any structure, prior to'8s issuance. also
requires the <applfcgnt for such pe(mh to lila a 'gned statement that he is Ite ised pursuant to
me provislorrs of the Contractor's License Caw, Ch'spfei 9 (commeridleg w1tA Sectlen X7000) of
Lkv/sbn 3 of the eusinesa+and Professions Codii or that. he Is exempt therefrom, and the basis,
'for the alleged exemption. -Any wlolatlon of Section 7031.5 by any applicant for a. ,permit
subjects the,applicantto;a civil penalty of not morelhan rive hundred dollars ($500).
ID I, as owner of, the property; or my employees.with wages as thetbaole compensation, will
do.the work, and the, structure, is not intended�or of tered for sate. (Sec: 7044, Sularresirind,
Professions Code: the Contractor's License Law does not apply -to an -owner ofproperty who
builds or improves thereon and who does- such work himself ;or through h*, own employees,
provided that such improvements are not intended or offered for sale. ti, however, the building
or improvement Js, sold' within one year of- comWletion, the :ownerbuNd' r will have the burden
of proving that he did not: build,00improve for the purpose of sale.)
I J I; as owner,of the property, am, exclusively contracting with Iicensed',contraotofs to con-
struct the project (Sec. 704.4, Business and Professions Code: The Contractor's License Law
does not apply to an owner of'property who bonds or improves thersonl, and who contracts for
such,pro)ects with a contractor(s),Ikensed pursuantto the Contractor's License_ Law.)
ID I am exempt under Sec. a. B.P.C, ,forthis'reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm -that 1 have a certificate of consent, to selMnsurei or,a certificate of
Worker's Compensation Insurance„or a.cerNtied copy thereof: (Sec. 3800, Labor Code.)
Policy No Company
(7). Copy Is filed with the city: O Certified. copy is hereby furnished.
CERTIFICATE OF.EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(Thls sectfoo hood not be completed .If the permit is for one hundred dollars (411.00) valuation
. less.)
I certlfy'that)n the performance,of-thg work -foe which this permit is Issued, 1 shall not
employ say,
ny person In any mannir`so'as to become. subject to the Workers' Compensation
L;aweof Calrni
Date_ wrier
NOTICE
. ~
NOTICE TO APPLICANT., ti, after making this' Certmlwts of Exemption you 'shouldbecome
subfect to .the Workers' Compensation provisions of Me Labor Code, you must'Yorttiwllh
comply,wimtsuch provisions or this perms shelf be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a, construction lending agency for the performance of the
work for which this paimit'is issued: (Sec. 3097; C/O Code.)
Lenders Name
Lender's Address
This Wa:building permit when properly filled out, afgned.and vaildated„and is,subjecl to
expiration, it work thereunder is suspended for180 days..
I certify that I have read .this application and state that the above'Inf6mration Is correct.
I agree to comply; with sll city and county ordinances,'and state laws relating, to building
construction; and hereby, authorize representatives of this city 20 enter the `above
mentioned. pro partyfor inspection purposes
Signature of applicant Date
Mailing Address _
City, State; Zip
Dw:
New'❑ Add,❑ Alter 0 Repair ❑ Demolition.❑
ZONE: BY:
Minimum Setback Distances:
FrontwSetback from Center Line
RearSetback 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:
WHITE= FINANCE YELLOW a APPLICANT PINK r= BUILDING DIVISION
? 00 AW
Estimated Valuatiofr,',•
PERMIT
AMOUNT
Plan Chk: Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driyeway Enc:
Infrastructure
TOTAL.
REMARKS
ZONE: BY:
Minimum Setback Distances:
FrontwSetback from Center Line
RearSetback 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:
WHITE= FINANCE YELLOW a APPLICANT PINK r= BUILDING DIVISION
Notice:
Document Cannot Be Duplicated
Desert Sands Unified School District
47-950 Dune Palms. Road
La. Qainta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 4/26/00 APN # 770-240-020
No. 20338 Jurisdiction La Quinta
Owner NameJohn Hankinson Permit #
No. 52-1.10 Street Dunlevie Court Log #
City La Quurta Zip 92253 Study Area
Tract # PM 28612 Lot # 3 Square Footage 2442
Type of Development Single Family Residence No. of Units 1
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered
patios/wa&ways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It
has been determined the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility°fees imposed pursuant to Government Code 53080 in the amount of
2.05 X 2,442 or $ 5,006.10 the property listed above and that building
permits and/or Certificates of Occupancy for thi& square footage -in this proposed project may now, be.issued
Fees Paid By CCNalley Independent Bank/John.Hankinson Telephone
Name on the check
By Dr. Doris Wilson
Superintendent
-r
Fee collected /exempted by Mary Atm L. Bo& Payment Received $5,006.10
Il l / _ „ i n 'Jo - Check No. 216314
Signature
INOTICE PWm and of Assembly BW 3081 (CHAP 549, STATS. 1988) We wl8emve to notify you that the 86dey epproval Period In wtdoh.you may Piet the hes or otirer payment Identified I
above will begin to nar from the dere an wtdch the building or trgtalletlon permit for tlds project is $woad or on whldi V" are paid to the Dishicgs)'or to arWw purple entity Gut zod to
collect Mem on the Dtefrbt('e)(s') behalf, wtdchwer Is.eereer.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original -Building DeptJApplicant Copy - Applicant/Receipt Copy- Accounting
-1 03/14/00
13:12 a
rmwgwliiv nu4umwu Joy
RWM"m Ta Cmp"
am�q- firm "moi SU ps
Do& L Raddbom
oft Of ON PAID
Cm TMW&Tat
Form rhiL
760 *
oum
MR Pon m
Npx.-
FEs -s im
7;1
WON
A VAIXIA39.w COMMUMIMIK ftg* a(mmall
M�C*6 M, 134 lkbftNftl&"umftcw*w
IMARMS AM MM W Mi .MWNO. 210% of=y#g= 1pl MgM dg,"VgG CM PAUM
um =N= cw, I - I
VdTmftuffftM&% &WEASARM
Ar
;T 04/14/00 13:33
_
**I.F 'I R S T AMERI CAN T I T L E***
wwwwYe.+ti+k.�ew�Y. ror�k9e**r.ek,h9r 3 6 2 5 r, O U R T E E N T H' S 'I
R I V E R S I D E, C A 9 2 5 0 2
*
Parcel Number : 770-240-020
Owner 7st : TRADITION CLUB ASSOC
*
and
*
Site Address
Mail AddrUSIS :
-k
phone wumber
*
Legal Desc. : .35 ACRES NET IN PAR 3 PM 191/065 PM 28612
*
Acreage : .35Acres
*
Census Tract Map Mage -Grid /
*
------------------------
Property Characteristics
A
Use Description Vac Residential Zoning
*
Bedrooms : Bathrooms : Square feet
*
Yr. Built: Lot Size :15,246 Constr. Type:
*
Fireplace: Pool/Spa - Structure
Num Units.: Lot Dimens: Shape :
Num Story: NUM Rooms : Roof
*
Gas Water Acoess
*
View lot Floor Garage Type
Heat 2nd Floor Garage/CarPt:
*
coal Addition Gar/Car SgFt:
*
Sewer Patio # Garage Spc:
*
Electric -Basement Appiiances
*
*
*
--- --
--------------
Sale Information
Sale
*
--------- --------
*
*
Last Sale Date; 02(O5/99 Prev Owner TRADITION CLUB A
*
Amount. : $1.25,000 F Frev Sale Date
'Document Num : 48992 Amount
*
Cost/SQ Foot Document Num
*
Last Transfer W/O Transfer Tax Doc Num
*
-- - --------__-------
*
Assessment/Tax Information
*
-__ ....-.. -- --- -----------
---- ----
Assessed Total: $6430 Tax. Amount : $93.04
Assessed
*
Land : $6,630 Tax Rate Area : 02011
*
Percent : 0% Exemption
*
Any Questions:' Please Call (909) 787-1730
*
The information contained herein ;is an accommodation only. A search
of the county records is necessary to complete the examination of any
documents affecting said property: No assurances can'be given, express
or implied, that the information is complete and accurate without the
benefit of a policy of Title Insurance.
THE
ABOVE INFORMATION 15 SOURCED FROM PUBLIC DOCUMENTS AND IS NOT GUARANTEED
Copyright (C) 1998 Acxiom Corporation
w,.
-W10
April 5, 2000
Mr. & Mrs. Joh_ n Hanldnson
5 Circle West
Edina, MN 55436
Tradition
ARCHITECTURAL DESIGN REVIEW
Re: Cottages Lot 3, Tract 28612
Construction Document Submittal
Dear Mr. and Mrs. Hanldnson,
vid Hmed vim►
The ADRC of Tradition Golf Club has approved your Construction Document submittal to
move forward, in obtaining a building permit: If you have any questions or need additional
Information, please do not hesitate to call.
Thank you.
Sincerely,
Christina J. Dores
Architectural Rev! oordinator
/cjd
pc: Gary Lohman, APC, via fax
Greg Butler, City of LQ, via Jaz
Nake Marsh, via fax
78505 Otte AVEwE 52 -- L4 QUNTA -- CA 92253.1120 - PHONE 760/564-3355 - FAX 760/564.2356
Ce''dific,ate of Occ*upancy-
City
of La. Quian'ta
Building and Sa'fety'Department
I
This- Certificate. issued pursuantto 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
ollowing:BUILDING ADDRESS:— 52-110 DUNLEVIE COURT
-Use Classification: "SFDBldg: Permit No.:' '0001-114
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL
Owner of Building: M/.M JOHN HANKINSON Address: 5 CIRCLE WEST
City: EDINA, MN 55436
By: STEVE TRAXEL
Date: 12-07-00
Building Official
POST IN A CONSPICUOUS PLACE
JNJOHNSON & NIELSEN ASSOCIATES
CONSULTING STRUCTURAL ENGINEERS
647 N. Main Street • Suite 4-B Riverside • CA - 92501 • (909) 686-5122- FAX (909) 686-6752
LOS ANGELES 0 RIVERSIDE •. IRVINE
January 19, 2000
Andrew Pierce Corporation
44835 Deep Canyon Road
Palm Desert, CA 92260
Attn: Bill Burgess
Re: Dolinar Residence
52124 Dunlevie Court (Lot 4)
@ Traditions Country Club
La Quinta, CA 92253
Dear Bill,
Carl B. Johnson
Svend H. Nielsen
Per T. Ron
Wen Y. Lin
Lonnie P. Mount
Steen T. Thomsen
Jackson K. Wu
J & N Job No. 43-004
This letter is to serve as written confirmation of the framing inspection I made at the above
address on the morning of January 19, 2000. Based on that visitation, it is my opinion, that
the framing is ready for final framing inspection by the city building department. _
If you have any questions, please feel free to call.
Sincerely, t
AQ
N0.3W
nie P. Mount, S.E. EXP 3.31.2=
JOHNSON & NIELSEN ASSOCIATES
Consulting Structural Engineers
1\43-004\LETTERS\INSPECT. LTR
McCEE SURVEYING, INC.
43-755 Skyward Way — La Quinta, Ca, 92253
Phone (760) 345-3828 — Fax (760) 772-5705
Thursday, April 20, 2000
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92253
Re: Pad Certification — Parcel 3, PM 286.12
Pursuant to your request a field survey was conducted on the above referenced project to
determine the vertical location of the building pad. The above mentioned was found as
follows.
IAT ADDRESS PAD (DES) PAD (MLD)
3 Dunlevie Ct. 46.0' 45.5'
SOeMc(Gee
W
L.S. 5419
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 922.11
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
)� REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY D
❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ OTHER
❑ REINFORCED MASONRY ❑ FIRE PROOFING'
JOB LOCATION.S'?//D !MUNI/� �� La 6K`�
REPORT SEQUENCE NO.
TYPE OF STRUCTURE (LES �i�f
SFDr4jo R -G
PERMIT N L OO 5 - 2 &D
pc n� OO
DAV OF WEEK
MATERIAL DESCRIPTION
3 coo s e "tJ cc(wXe-
ARCHITECT �T
/ ' , J+
.INSSPECTTOjRR
A, ,
MRS. CHARGED
ENGINEER
J o {�NN $
So1'.S PIJ
ASSISTANTS
HRS, CHARGED
A ��ff pp�� sue
DATE ECTION GENECONTRACTOR Atidlo� Rizo icce CONTACTOR J S �Ele-
5 0o
b,5,# -"ed l ac e-rwe,*J1-
I-1 l cu A ' s
UbS-ett.ae lace ,eon- oE 10bD S'i C,0QrA +e
. -Pt irU ullopAyeck
i 40%o c e+ 3 r, A,
7 -es+ IIIc ;,.gid Nd x-med s /&cam.
�-es Y s L l+ - s '' V9 ids IQ �d
COPY SENT TO CLIENT ❑
CONTINUED ON NEXT PAGE ❑
PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THEABOVE REPORTED WORKUNLESS'OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS, SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
w �?,
SIGNATURE IF REGISTERED SPEGTOR
5 2 &10 a
DATE 6F REPORT REGISTER NUMBER.