9701-093 (SFD)U)
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LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
Date - 2- -3` Signature of Contract or%_ od i }-�f
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 Sianature 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.
()() 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 r Policy No..
(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
spject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply withrthose`provisions
.•r}
Date: 1 - ?a%A
,pplicant
Warning: Failure to secure Workers' 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*
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& 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 he authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes. i
/ignature (Owner/AgenDate (' 7
PERMIT # CONTROL #'
BUILDING PERMIT 4640
DATE 11 23/97 VALUATION $304,307,60 LOT. TRACT
JOB SITE
ADDRESS 49-035 CA.iILF, .�fLORti
APN
OWNER
CONTRACTOR / DESIGNER / ENGINEER
JOHN (:MCDONA.LO .
00-14 VVLSgLS COTT,, RUUTON
7i1dt1.A.vrr►vC�3ti�ri�t�iANIJIJ.
302—T VA'LON
1.,A. QU1Wr.A CA 922.53
VA1. M D SFRT CA. 02211
(619;1340-0 421 C: L# 4,-0
USE OF PERMIT
SFO-'t?irRR�tT1.'OR POOL,
WSTOM CONSTRUCTKA41 3,11128,0/3 Sr.
i ARAM/CA133=`C)Wr 70.00 8F
a ' ' 1i1m'�sv1� C%'.s" ° or coNSouC7t`1oN
304,:107.60
11'maRIVB:U C PEE SUMN'tAftY
C0Ns'i'RUa.r;T(.+N �,w tA.l 4?00 414 �.i.;3 i.01?
€L1Nfi1EOEE - ' $1,141A2
TLA!iry((EWY lG0071'1. J�00
t�%C�+,A�I:t�A�..E�}i;� • .. I(i:l.M�t�-d:�'i-i�0 ;b1�k�.ti�,
R'I: EMRICAL FffiSS 10.1-000-420-001
f'LVN.181NQ F *1a . 10)-WO.40-000
'i'1Zt?NZi%a1ls `2 I.V tfs' m>) 101-000-241-000
€;i� Ai i11d�3 101-W0423-000 O.Usi
'I?di'y'f2.t�;c'4'il�,'T�.ff:�•�; 22�-1?1)f)-�rg3.'�4'Gt `BF,dt?it3.00
AR R413 d 1f`1'T.� `f (RL'Jj 70)-01�(�ZSS-0 $5,10.77
CONSTRUC9i' ON X1ND ti'x:AN CHECK
$9,744.2./1
PAI•®iMAL
IAES.8' PRE -.1'./311: PEES
-$750.01)
JAN 2 3 1997 :.. TOTt -1111, NOW
CITY OF LA,QU.1NTA
�FiECEIPT
DATE
BY/
DATE FINALED
INSPECTOR
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
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
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
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral,_Pool
Cover
Sewer Connection
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. Useof Power
Final
Utility Notice (Perm)
. r
�• j
AddP.O. BOX 1504 APPLICATION ONLY
Building �(� _ 0 3E /1 a i ll r1or � . LA QUINTA, CALIFORNIA 92253
ress J t.
Owner r Q �� A
J l P614 A A -DI
Mailing C
Address
City� Zip Tel
4a 6 ,, 192zS3
Contractor
ty lZip I Tel.
State Lic.I City
& Classif. Lic. #
Arch., Engr.,
Designer GhkikL Gn gy- -
Address -7f--4-61 Del)lj u- WA, Tel.
City Zip State
t�' � Dtl te+ �i'1.2 6 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
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
requires the applicant for such permit to file 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 civil penalty Of not more than five hundred dollars ($500).
l: 1, 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 roving that he did not build or improve 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) licensed pursuant to the Contractor's License Law.)
I I I am exempt under Sec. B. & P.C. for this reason
Date f7 9 Owner N^ d�J� fi
WORKER'S 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. Company -
r7 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars (8100) 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., If, 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.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is i Sued. (Sec. 3097, Civil Code.)
Lender's Nam e_�PJAlC
Lender's Address s
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 stalealaws relating to building
construction, and hereby/aute r�esentat4 this city to enter the above-
mentioned property for ins (actio"purposesK.(�//{J��J q yLL
Signature of applicant I Date J I / / v
Mailing Address _ Q1-41,—sqoLlirLA
City, State, Zip
rIt 4
BUILDING DIVISION
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description
Project Description
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep. (% 0 U
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPEC
OR
n
i I"
Issued by:
Date
Permit
OCT
1n� III 11j.
Validated by:
i�
1 ,96 tI /
U
Validation:
n,.
+
�y
CONSTRUCTION ESTIMATE
NO, ELECTRICAL FEES
NO. PLUMBING�FEES -'A
IST FL. SO. FT. $
UNITS
SLAB GRADE
2ND FL. SQ. FT, @
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. C
DUCT WORK
ROCK STORAGE
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEQUIP.
DRAINAGE PIPING
CARP. SD. FT. 0
TEMP. POLE
WALL SO. FT. (ED
r
DRINKING FOUNTAIN
SO. FT.
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
—
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
GAR. FIREWALL
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID Ctp 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR 14c
HOUSE SEWER
INSULATION/SOUND
GAS PIPING
PERMIT FEE
FINISH GRADING
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 R AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL, AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu, yd.
$ plus—x$—=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
—
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCG.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
Notice: 82-879 Highway 111
Document Cannot Be Duplicated Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Date 1/21/97
No. 15189
Owner Name Mr. & Mrs. John McDonald
No. 49035 Street Calle Flora
City La Quinta
Tract # Lot #
Type of Development Single Family Residence
Comments
Jurisdiction
zip 92253
APN # 631-771-008-3
Permit #
Log #
Study Area 109
Square Footage 3728
No. of Units 1
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered
patios/walkways, 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
1.84 X 3,728 or $ 6,859.52 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may pow be issued
}- ` U
Fees Paid By oc/Citibank Telephone
Name on the check
By Dr. Carol McGrew
k,
Administrator in Charge
r
Fee collected /exempted by Pauline Pearson Payment Received 'r6;859:52
Check No. 201606294
Signature 4
IOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
bove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
ollect them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
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:
49-035 CALLE FLORA
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction: VN
Owner of Building: JOHN C MCDONALD
Building Official
Bldg. Permit No.: 9701-093
Land Use Zone: RL
Address: 77-140 AVENIDA FERNANDO
City: LA QUINTA, CA., 92253
By: DANIEL P. CRAWFORD JR.
Date: 2/9/98
POST IN A CONSPICUOUS PLACE
Mr. John C. McDonald
77-140 Avenida Fernando
LaQuinta, CA 92253
Re: Santa Rosa Cove Estates - The Enclave
49-035 Calle Flora
Dear Mr. McDonald,
This is to advise you that your revised construction plans have been approved by the
Architectural Review. Attached is the signed copy of the Architectural Review
Committee's approval.
Good luck with the construction of your new home.
Sincerely,
'6
Don Wolfe, Property Manager
for Santa Rosa Cove Estates - The Enclave
cc: Glen Enger
14,
enc.
n
Post Office Box 4772 Palm Desert, CA 92261-4772
73-550 Alessandro, Suite 5 9 Palm- Desert, California • (619) 346-1161 . FAX (619) 346-9918
SANTA ROSA COVE - THE ENCLAVE
FINDINGS OF THE ARCHITECTURAL REVIEW COMMITTEE
Re: Application No:
Name of Applicant: Mr. & Mrs. John McDonald.
The above Application has been reviewed by the Architectural
Review Committee, and has been:
XX As Revised
Approved.
Conditionally Approved (see below).
Disapproved (see below).
Findings:
THE ARCHITECTURAL REVIEW COMMITTEE
BY :`/%0
— Property Manager
For Santa Rosa. Cove estates - The -Enclave
Architectural Review Committee
jg/h5/src.1
77-140 Avenida Fernando
La Quinta, CA 92253
September 17, 1996
City of LaQuinta
P.O. Box 1504
La Quinta, CA 92253
Attn. City of La Quinta,
Regarding our application
residential building permit on
I hereby authorize Glenn Enger,
during my absence.
to the building department for a
Lot 8 in the Enclave, Tract 21120,
my architect, to act on my behalf
S' cerely,
Jo McDona d
er
J
I .'
01/21%97 11:31 FAX 4153433856 RENDEN
JOH--21-97 TUE 9;43 CITY 01-6 LA UUIN i is b17 r r r rei i r�n�
CITY OF LA QUINTA
U-
cL%a�. Gc'� s sc s 3e,. mil 4.1, �y+,
,QNTRACTOR_ ADDRESS �P �cl'a�1/ ('�,
lWhlr=R JOS ADDRESS �9-G35' C�i�//Ny�a�.
Jjj fQrm_sha Il be po9ted on tha job with the B &ding-(n*2&c;Lg 1-QaE at ei1 tlme$ in a conspicuous place.
! is the responsibility of the General Contractor or the Owner/Builder to monitor the sub -contractors that
,re on this list are the same persons performing the work. Any changes to this fist must be approved the
;ity of La Quints Department of Building & Safety pri.ot to work being performed by a changed sub-
ontrector. Failure to cormoly wiil result in a stoppage of work and/or the voidance of building permit.
SUB -CONTRACTOR'S.:
. TYPE I]I=
BrATE;..•,'. : ; ". ,`: '
'WORKER'$ . '
BUSINEM :.•
TRADE
NANAi;.
•
LiC6MSE " '
•:.�
CONTIfACT0R_t - ~•.
.
COMP. NAME/ :.
LIC1111SE .. " .•
..
:. ..
LICIwNS� .�•: _'`=
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NIlNi�Rl�:
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December 10,1996
Mark Harold
Building Department
City of La Quinta
Ref: McDonald Residence
Dear Mark,
I have reviewed the truss calculations provided by
Trus Joist the project and find them to be in substantial
conformance with the structural design.
i
Sincerely,
J ®reyiB oung
QPof ESSIOlk
�Q�O �P�Y B: 1�p1✓,�, �2
CO No: 4044
0
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ST
toy �\`r
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h� Be
AR YON TAN DY
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a
BIJ,E011VG RECV3580 Condalia Ave.
1 6AY�ucca Valley, CA 92284 INSPECTION SERVICE�
(el 9) 365-5045
REGISTERED INSPECTOR'S WEEKLY REPORT
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETETRUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
0 SH -V
-*ZTHER `����iJ
JOB UQCAgN`S
aREPORT
CA O PowLA
DATE OF REPORT
SEQUENCE NO.
TYfL OF STRUCTUR e PERMIT NO.
&C- O Z) ACO Q'P'if G
D64E
-5-3—q?
DAY OF WEEK
MATER L DESCRIPTIONe�
` ARCHITECT
S (/J
IN �O R'�
HRS. CHARGED
E
ENGINEER
K
ASSISTTAA/INIITIS,
HRS. CHARGED
TEECTION GENERAL SUB
DATEINSPECTION
�Q,.Ss�� CONTRACTOR K./
2CONTRACTOR
l (�� J 11�G�.
014+
-�
'
W _17- pa Grj -i
9.L._O r 1J
O-e—CLS If U e- eS f
939
COPY SENT TO CLIENT C
CONTIN 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.
SI ATURE OF REGISTERED IN CT R
��-�
iS
DATE OF REPORT
REGISTER NUMBER
0
jFnJ.
F. DAVIDSON
ASSOCIATES, INC.
ENGINEERING PLANNING
SURVEYING LANDSCAPE ARCHITECTURE
Corporate Headquarters
77.150 Sheryl Avenue 27349 Jefferson Avenue
1777 Atlanta Avenue, Suite G-5
Suite D Suite 115
Riverside, CA 92507
Palm Desert, CA 92211 Temecula, CA 92590
(909) 686-0844
(619) 346-7772 (909) 676.7710
FAX (909) 686.5954
FAX (619) 346.2510 FAX (909) 699-1981
TRANSMITTAL LETTER
Client Reading File
TO: C,/' z ir✓ Date �% /"G4 , ,//z
PROJECT
ATTENTION:01��ii�
PROJECT: �iy �.rf.�rral`�/� �G�7"��/Y�. ��✓2�
WE ARE TRANSMITTING: THE FOLLOWING: FOR: /
s""' Via Messenger Contract y Your Approval
Via Mail Prints Your Files
Via Overnight Mail Legal Description Your Use
Via UPS Other Your Review
REMARKS: `/`Z _ _ _ 1,, _ _ l r,.--44-_ _ A, - .%-e u.••1.1
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