0005-225 (SFD)D
LICENSED CONTRACTOR DECLABAON
I hereby affirm under penalty of perjury that I am licensed nder provisions of
Chapter 9 (commencing with Section 7000) of Divi ion 3 ojthe Business and
Professionals Code%and my License is in full force n ffect.
License #j / Lic. Class % Exp. Date
BMC _44"71Z( JOP31i2t
Signature of
OWNER -BUILDER
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 Signature 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 EMFT Polic o.
(This section need not be completed if th permi
() I certify that in the performance oft a wol
I shall not empl y any person in any n er
workers' comp nsation laws of Calif m an(
subject o the orkers' compensayca�rpr visiq'
Cod 71 li 1111f with comply W, fifi t e vii:
Date L Applicant-
Warning: F ilure to secure Worers' Co pen
shall subjee an employer to crimin I pena tiles
addition to the cost of compensation, a e
of the Labor Code, interest and attorney's fees
valuation is for $100.00 or less).
for which this permit is issued,
o as to become subject to the
agree that if I should become
of Section 3700 of the Labor
sation coverage. is unlawful and
and civil fines up to $100,000, in
s as provided for in Section 3706
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pSrsuantrto
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La O in'ta; its officers, agents and employees.
2. Any permit issued as a result 180
this application becomes null and void if
work is not commenced within 80 days from date of issuance of such
permit, or cessation of work for days will subject permit to cancellation.
I certify that I have read this ap
correct. I agree to comply with
.construction, and hereby aytM
the above-mentioned property I
VS gnature (Owner/Agent)
state that the above information is
State laws relating to the buil ng
itatives of this City to nter on
purposes. Z�
Date
BUILDING PERMIT PERMITN
DATE VALUATION LOT$`TRACT
JOB SITE
ADDRESS I8-541 DFACO.N' DIZM?: EAST
APN
770-27.0-004
OWNER
CONTRACTOR/DESIGNER/EN (NEER
BFXC13
FPZf0X RLM 2 ERS CORPORA'110N
10.311 qM4KGDALE DRM,
P 0 BOX 3235
'RANC110 W2AGE CA 92270
PALM DJESD.iCf' CA P2261
(760)772-1531 CBU 6237
USE OF PERMIT
OLt FAMILY DWELLWCA
SFA • NO BIZCK WALL; OR POOL COMPUANC'ZWITH ALL FEDERAL &,
STA` F. LAWS, INCL(IUTAiCYTHE F,96iNOERE17 SPECIESACT OF 19'X3 (i6
U.S.C. 1331, ET SEQ.) IF.APPLIC.ABLi; I3 RxQ11"RW.
CUSTOM CON;3TRUC711ON 2,970,00 SF
PORCHMATIO 433.00 SY
0ARAGPICARPORT (81F) 16,777.60
EYMIATF'.97 COST OF COMMUCTiON
2'3; 9.30
PERWr .1's"Ia.FJ 10!MARY
CONSOMUCTION PEE 101.000.418.000 $1,329.00
PIAN CHOCK VEE 101-000-439-315 $I,OII.I.S3
FEE DEPOSIT 101.000-439-319 -"50100
NIPCHANICAL FEE 101-000-421-000 $105.00
<
ELECTRICAL FEE 101-000.420.000 S2I g,15
ALUMBINQ FEE A 101.000 19-000 $205.00
STRONG MOTION FEE - RMID 101-000-241-000 $29A
ORADMO VIVE 101-000-423-000 $20.00
0
UEVEWPER Ill PACT FM a $1,90700
.ART 116 PUBLIC PIACES • RIE 701-000-255-000 $240.89
1 �
JP&-255mkC(�+N8'fRU(w110'X AND PLAN C`F'.?'WK.
t IMSPRE-PAU) FM
� $3,133.20
4750.005�
+ '.CA_1' . IMM !qNS VIRE INOW
$4,31320
ov
RECEIPT
DAT.Ei
BY /:.
DATE FINALED
INSPECTOR
L,V
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Retum Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final �l
BLOCKWALL P_ P OVALS
Final -/� _D
POOLS -`$ AS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
_
�
Gas Piping
PLUMBING AP/0OVALS
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
Final _
Utility Notice (Gas) 0
ELECTRICAL AP OVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
TAh
� 'CIC�iw
RFs' t 4
) Lt f PfACOa/ 44 (V IE . P.O. BOX 1504W
t ` / t 78-495 CALLLE TAMPICO
Addrress L t �`C t", )� • � • LA QUINTA, CALIFORNIA 92253
uwner t (I A '.� { � I W(J
Mailing
A.P. Number 10
el. �
Legal Description
,Li 1f I TA \\AH! Project Description
I. +l
& Classif. j Lic. q
Arch., Engr., / \ t
Designer!��1 /� �1
�� `�rr l-1 �� 1'if l��lr(7, �M, Tel.
Citylzipc(" 1�f'V Lict�C-11
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, atter. 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 thealleged 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: 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 improve for the purpose of sale.)
(I
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.)
17 I 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. Company
r7 Copy 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 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 issued. (See. 3097, Civil Code.)
Lender's Name
Lender's Address
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
ateMailing Address
City, State, Zip
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Sq. Ft. r� `
Size
No. No. Dw.
Stories Units
New [ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Pian Chk. Dep.
z;- f ,0 2<5o. 6 •CJI
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 • ` INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Notice:
Document Cannot Be Duplicated
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 8/25/00 APN # 770-220-004
No. 20932 Jurisdiction La Quinta
Owner NameElizabeth Bench Permit # 0005-225
No. 78-541 Street Deacon Drive East Log #
City La Quinta Zip 92253 Study Area
Tract # Lot # Square Footage 2970
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/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
2.05 X 2,970 or $ 6,08850 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be, issued
Fees Paid By CC / bank of America / Curt Dunham Telephones
Name on the check --
'r -
' ,r
r
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Annette Barlow Payment Received $6,088.50
J"'� t�'to . Check No. 401243953
Signature
NOTICE Pursuant of Assembly Bill 3081 (CHAP 549, STATS, 1998) this will serve to notify you that the 9"ay approval period in which you may protest the fees or other payment identified
above will begin to run from the date on which the building or installation permit for this project is assued or on which they are paid to the Districts) or to another public entity authorized to
collect 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
CITY OF LA QUINTA
PLAN CHECK CORRECTION LIST
August 4, 2000
Kristi W. Hanson APPROVAL
44-850 Las Palmas # A
Palm Desert CA. 92260
PLAN CHECK NO.: 005-225
JOB ADDRESS: 78-641 Deacon Dr. OCCUPANCY: R-3 / U-1
AREA-S.F.- : 3515/803
TYPE -OF -CONST.: V -N
The submitted plans and specifications have been reviewed by VANDORPE CHou ASSOCIATES. It is
our professional opinion that the plans are in substantial conformance with the building codes and
regulations adopted by the CITY OF LA QUINTA.and the State of California Amendment.
APPROVAL FOR A BUILDING PERMIT IS HEREBY RECOMMENDED SUBJECT TO OBTAINING
APPROVALS/CLEARANCES FROM ALL APPLICABLE CITY DEPARTMENTS, AGENCIES,
ASSOCIATIONS, AND THE FOLLOWING CONDITIONS:
1. City to verify corrected job address for this project: 78-541 Dacon Dr. as shown on plans.
2. Soil report is required unless waived by the City Building Official.
Plans checked by:
VANDORPE CHOU ASSOCIATES.
295 N Rampart Street, Suite A
Orange CA 92868
(714) 978-9780 VCA File No. LQ -12051
'Tradition
ARCHITECTURAL DESIGN REVIEW
July 31, 2000
Via First Class Mail
Ms. Elizabeth Bench
10-311 Sunningdale Drive
Rancho Mirage, CA 92270
Re: Lot 4, Tract 28470-1, 78-541 Deacon Drive East
Building Permit
Dear Ms. Bench,
The ADRC of Tradition.met on July 19, 2000 and approvedthe Construction Document submittal
for your home at Tradition. I am in receipt of the $5,000 Construction Compliance deposit,
therefore, these plans have been approved to receive a building permit from the City of La Quinta.
Please make note of the comment below.
Material Board
All materials/colors are subject to field review by the ADRC for approval prior to installation. The
Committee will conduct a site visit during the regularly scheduled ADRC meeting held the first and third
Wednesday of the month Notification must be received no later than the Monday prior to the meeting.
Failure to receive approval of these items may result in removal and replacement of these materials and
delay in construction.
Going forward, you will work with Mindy Gutierrez of PCM/Desert Resort Management (HOA
management company). With a copy of this letter, I will turn over your file to Mindy. Please direct
any questions you have to her.
If you have any questions or need additional information, please do not hesitate to call.
Sincerely,
• - i
Christina J. Dores .
Architectural Review Coordinator
pc: Kristi, Hanson, -Architect (via faz/first class mail)
Curt Dunham, Builder- (via first class mail)
Mindy Gutierrez, PCM (via hand delivery)
78505 Otte AvENuE 52 — LA QunarA -- CA 92253-1120 -- PHONE 760/564-3355 -- FAX 760/564-2356
/'
Sep 12 00 03:24p Brad McGee
(7601 772-5705
McGEE SURVEYING, INC.
73-301 Country Club Dr., Ste. 102 —Bermuda Dunes, CA 92201
Phone (760) 345-3828 — Fax (760) 772-5705
Tuesday, September 12, 2000
City of La Quints
78-495 Calle Tampico
La Quints, .CA 92253
Re: Pad Certification — Lot 4, Tr. 28470-1- Bench Residence
Pursuant to your request a field survey was conducted on the above referenced project to
determine the vertical location of the baalding pad. The above mentioned was found as
follows:
LOT ADDRESS PAD (DES) PAD (FIELD)
4 78=5*rDeacon Dr. East 43.0'
Siger ���epWO SU.gyE
Wa Gee LS 5479
L.S. 5479
sr
43.0'
p.2
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE RUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
❑ L -•—e
❑ OTHER 1
VAJ�P,C/J w1k
JOB LOCATIONI �� q '�
a `k
REPORT SEQUENCE NO.
T�QL�TiJ11CTURE �
PERMIT NO.
O �� �
DAV OF WEEK
MATE�`R,IA�fYY E Ci}L lr
ARCHITECT
IN --LE i R
HRS. CHARGED
�.s
E—✓G�/\O� /� P7
ENGINEER
ASSISTANTS
MRS. CHARGED
INSPECTION
DATE
GENERAL
�`
CONTRACTOR) 1�l V� CONTRACTOR
44-V 9 �- - �-
kj-
' 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 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.
S GN TURE OF REGISTERED SPECTOR
DATE OF REPORT REGISTER NUMBER
YOUNG ENGINEERING SERVICES
47159 Young Lane Indio, CA 92201 (760) 342-9214
January 18, 2001
Tom Hartung
Building Official
City of La Quinta
RE : Bench Residence.. 664 Deacon Drive East. La Ouinta
Dear Tom,
We have reviewed the framing for the above referenced project and find it to be in general conformance with the
approved structural plans with the exception of following:
1. Provide post strap as per detail 2/S3.2 for shear wall 15.-
2.
5:2. Provide strap and blocking as per detail 6/S3.2 for beam 5 to shear wall 5.
If you have any questions please call.
Sincerely,
Jeffrey B. Young S.E.
Sep 12 00 03:23p Brad McGee (760) 772-5705 p.2
Mc GEE SUR VEYING, INC.
73-301 Country Club Dr., Ste. 102 — Bermuda Dunes, CA 92201
Phone (760) 345-3828 — Fax (760) 772-5705
Tuesday, September 12, 2000
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92253
Re: Pad Certification — Lot 4, Tr. 28470- l- Bench Residence
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:
LOT
ADDRESS
PAD (DES)
PAD (FIELD)
d
(-7&541 Deacon Dr. East.
43.0'
43,0'
S%w A�4
Wee
L.S. 5479
LS 5479
JON TANDY
.,,.� 37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
ISPECIAL INSPECTIONFax (760) 772-7193
REGISTERED INSPECTOR'S WEEKLY REPORT Pager (760) 776-3338
TYPE OF O REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY 0
INSPECTION O POST TENSIONED CONCRETE O ASPHALT ❑ OTHER
PERFORMED O REINFORCED MASONRY O FIRE PROOFING
JOB LOCATION �� t_A p REPORT SEOUENCE NO.
TYPE F STRUCTUREPERMIT N0. D DAY OF WEEK
-Sr-Z>- 6-0-w C44 bees.
MATERIAL DESCRIPTION
INSPECTION._._._. _ _- GENERAL
DATE CONTRACTOR
AN -s4 rA
l V :n
SUB
CONTRACTOR
iRol of
INSP T R HRS. CHARGED
ASSISTANTS HRS. CHARGED
I I COPY SENT TO CLIENT O 1 CONTINUED ON NEXT PAGE O 1 PAGE OF I
CERTIFICATION, OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY' KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE IGNATURE OF REGISTER INSPECTOR I -7 9
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED Q ++ D
PLANS, SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS. DATE OF REPORT REGISTER NUMBER
YOUNG ENGINEERING SERVICES
47-159 Youngs Lane, Indio, Ca. 92201 (760) 342-9214 (760) 342-6164
July 27, 2000
Tom Hartung
Building Official
City of La Quinta
Re: Bench Residence, 78-641 Deacon Drive East, La Quinta, California.
Dear Tom,
We have reviewed the truss calculations provided by Trussworks,' Inc. for the above-mentioned project
and find them to be in general conformance with our design intent.
If you have any questions please call.
Sincerely, X
Jeffrey B. Young S.E. �
p. ea3o20D1
9
�NgX100
lf
wt�