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9805-016 (SFD)N'I LICENSED CONTRACTOR DECLARATION ,,.Cj ' I hereby affirm under penalty of perjury that I am licensed under provisions of H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and N W Professionals Code, and my License is in full force and effect. O =) ch License # Lic. Class Exp. Date r; dLLJ f►71 u� t3 %� SfZtl3�) i 7 ~o Z � 9 t� e `' c Signature of Contractor—j CD 0 J U C:) OWNER -BUILDER DECLARATION a- I hereby affirm under penalty of perjury that I am exempt from the Contractor's to 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). ( ) I am exempt under Section , B&P.C..for this reason LO N Date Signature of Owner ON Q WORKER'S COMPENSATION DECLARATION c p 2 Z I hereby affirm under penalty of perjury one of -the following declarations: LO Cc O () 1 have and will maintain a certificate of consent to self -insure for workers' X LU Y= compensation, as provided for by Section 3700 of the Labor Code, for the O J Q performance of the work for which this permit is issued. M Q U ( ) I have and will maintain workers' compensation insurance, as required by O C) Q Section 3700 of the Labor Code, for the performance of the work for which this LO Z permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. cb O STATE FUND 1:� 15713, Q (This section need not be completed if the permit valuation is for $100.00 or less). J ( -1 1 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 subject to the workers' compensation provisions Section 3700 of the Labor C1Qde I shall 'forthwith comply with those provisio4s. ,Date: Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to/rimilLial 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 hereby authorize representatives of this City t4enter thheabove-mentioned property for-inssppeection purposes. !, Signature (Owner/Agent) ',l/ `� Date BUILDINGPERMIT PERMITt# CONTROL# - 4116 DATE 7129198 VALUATION $11174810 1 t}.i�>f LOT ItTRACT , 7. - JOB SITE ADDRESS 718-6&COIN DRI E EAS �' 11. I)I'v APN UAk-162-001 OWNER CONTRACTOR / DESIGNER / ENGINEER BOB & CAR'.A_ DIXON Ah'1)EMY IIIFRC1i C01WOF.S11ON PALM DESE10' CA 92260 (764)346.3229 Ci3T'1 X031 USE OF PERMIT "IINt;%.i�; :illi •• f'I.iiC{Vll f t�ULa' IVT t:!* }N(�t.tJl)F 11).�:X;I�. Wl1i.l, t.7�{e 7.'C)t�l, 14000141AT 10 317 OARA00CARIP0 l' 6 1.1a1i 51' EST. IMA f E D COST 0 F C ONetl't tt. ,fC-fi0N 2 118, 0.411i t:c)N83'ftC)C'r10N 1^:t;3: 1131-000-419•000 PLAN /'; Pipit', Ir)�fi t a-/O�f�1/U� 4?�?)-z) i k) jt�i t$1,02�/5./:N�1 i lsh .l�6i)�Si l6 101 -IOW -11)-..i18 -^D I,Ltw.w ,•�nts<;ff.�Ni%Hi, i�i?l: 10!-Eit;�i•�t21-liGi3 5v�.iaa fUY(,'r.'kfCAI. KOi E' 101-001)-420-0(X) 4 t 1.91 Pr, r.FNiIli '0p,rIII, ONG JNIO'I`IOfr 1rL1s - R .;40 101-000-241-000 S,'.';,t:t► fRAUt.NO FEE 101-000423-0001 !NrritFl811R.t►{;:TLIKE VFF 22-S-000-443-342 S6.0000) ��•� rnf �t_tt)r.tt; ri. a!:r.s - tilz`.)). 7f) ffl)r�<S.t� �t5.A5 3'A 1.• 1'1:)Iv5! It(JC_"1`1�N n_vr} PLAN fy"11!";K t;� ? 1 S9 f..r PJM 7 AX) 11IT"ETAIDITES _V,0100,00 JUL 2 91998 YVA1, ii►ERN1IT FERS 011 F, NOW $%264.59 OF LA OUINTA i .0ITY RECEIPT DATE BY t DATE FINALED INSPECTOR V INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel _ _ Comtwstion Air Roof Deck —'y- Exhaust Fans O.K. to Wrap F.A.U. Framing Z Q 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 4 44 Final Final B OCr WALL APPROffA steel POOLS - SPAS 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 n Pool Cover Sewer Connection 0 Encapsulation Gas Piping Gas Test Appliances Final 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. Use of Power i c Final Utility Notice (Perm) COMMENTS: • BuildingD 78 �,� -AC.04 Address G7 t1 Owner c&tivl 4 P.O. BOX 1504 78-495 CALLE TAMPICO IM -EAST LA QUINTA, CALIFORNIA 92253 t5oP C: 14 MLA U00 0 Mailing Address 14 eae dome RLm beseIzT L"I'AA tr 17bo44•3Z28 State Lic. City & Classif. G7��y�� �� Lic. # Jo / Arch-, Engr., Designer Pamey umm Y AV,--uITEG"r"S Addressn c — Tel.A� 'veil^ J//�Irf0AQ PQe�v/7Q City n (Zip9th/n (State I Cn..iw a�tnnd ? Lic. # LICENSED CONTRACTOR'S DECLARATION 1 he eby affirm that I am,licensed under provisions of Chapter 9 (commencing with Section 7 sof Division 3 Uthe usiness and Professions Code, and my license is iFM n ull f ce a.1td elf 't �t�/ W NAT R - •.� ..+ DATE Z OWNER -BU LDER DECLARATION r 1 hereb. ffirm 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 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.) II 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 7 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 C PPer�.s,�t.io..n Insurance, or a certifie copyy thereof. (Sec. 3800, Labor Code.) Policy No. AMW Company �, QY! fle ;Copy is filed with the city. ❑ 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 ($100) valuation or less.) I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives sof this . city to enter the above- mentioned property for inspection purposes. Signature of atiplicant Date Mailing Address City, State, Zip f1$o5--- of 6 APPLICATION ONLY BUILDING: TYPE'CONST. OCC. GRP. A.P. Number 74.7. /601 -OCA/ Legal Description LOV6 11 , _rCACT ?B#770-1 Project Description S I tai (-_I LQ_ F -AH I I_`/ 6RSI nFAt CE Sq. Ft. Size New'9 No. No. Dw. Stories Units Add ❑ Alter ❑ Repair ❑ Demolition ❑ imated Valuation PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT 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 FATGO ESCRM' DIVISION FAX 700 588 9726 Cording Requesteo d) ';;agr3lputMrican P11F. Insurance Cornp 2084011-tL REMADED MAR. *C1., Dixon 4. I,-CAk1A.j -Divan Rand 1A $2722 FATCQ F.D. TEL: 1160 560 -0080 H4762 RECUMB F014 Fmconk AT O;OQAM IMAR 2 7 1998 Dae Tmqs,torTAm ftwz=0 mm = 00 -ft pamm"m Fame 'TAX STA_M- ,h WM TO: Space above Lhis we for pccor&er"m Uw DCCU%,4FNTARY TIANSFER TAX 3_zpa tr mvcyed; 01 va �_Compuvrd On QK comidcrafice or valuta 17T. - The UA g= r1matnt sjvwtwc arLx-cwwi or Allem &-ftm-IIining Ux-FirmMum GRANT DEED kLUABLZ CONIMERA110N. run* of whtch u bvmby mckmawledged. cLuu Assomms LLr- a rw4waim wed listAq mmpvu lbobtrz C ni-wnn And Carla. J. Dixono 14maband and Wife an -Joint Tenarit-9 duo City of LA Quiffla, r lluvw0k - state arcwiremi& described n -A* AmicM Hs w) Lot —IL Traci 14470-1 (Scr EnhitIk P. () () 1 2002 13t 1998 Txkb LrH AS LLC 9 Dcla trd hab ny W4, IN ka" w " (w mm to me on 0� bus or 14t4roctory �1 tilt On pmmnWr-h%* %pro=wWribed to the Md J1 4td to no gCkWRtm W ft tha the 4400=0 C"CiqWqrv�d LhAL krytWhTT1QK- irM Mnrjmt the pmoo/or OR rntity span behalf at 0ej*mmnmL"t%vj" the ijutrum"t. I MY HAND AND O"ICILAL SFA4 71 I ta; 1�?es . .4 dr , ,QFFKIAL StAL "ILIEt SH N a 113'"t;=14, 8 (MON) 16:21 07A3/98 16:23 FATGO ESCRM' DIVISION FAX 700 588 9726 Cording Requesteo d) ';;agr3lputMrican P11F. Insurance Cornp 2084011-tL REMADED MAR. *C1., Dixon 4. I,-CAk1A.j -Divan Rand 1A $2722 FATCQ F.D. TEL: 1160 560 -0080 H4762 RECUMB F014 Fmconk AT O;OQAM IMAR 2 7 1998 Dae Tmqs,torTAm ftwz=0 mm = 00 -ft pamm"m Fame 'TAX STA_M- ,h WM TO: Space above Lhis we for pccor&er"m Uw DCCU%,4FNTARY TIANSFER TAX 3_zpa tr mvcyed; 01 va �_Compuvrd On QK comidcrafice or valuta 17T. - The UA g= r1matnt sjvwtwc arLx-cwwi or Allem &-ftm-IIining Ux-FirmMum GRANT DEED kLUABLZ CONIMERA110N. run* of whtch u bvmby mckmawledged. cLuu Assomms LLr- a rw4waim wed listAq mmpvu lbobtrz C ni-wnn And Carla. J. Dixono 14maband and Wife an -Joint Tenarit-9 duo City of LA Quiffla, r lluvw0k - state arcwiremi& described n -A* AmicM Hs w) Lot —IL Traci 14470-1 (Scr EnhitIk P. () () 1 2002 13t 1998 Txkb LrH AS LLC 9 Dcla trd hab ny W4, IN ka" w " (w mm to me on 0� bus or 14t4roctory �1 tilt On pmmnWr-h%* %pro=wWribed to the Md J1 4td to no gCkWRtm W ft tha the 4400=0 C"CiqWqrv�d LhAL krytWhTT1QK- irM Mnrjmt the pmoo/or OR rntity span behalf at 0ej*mmnmL"t%vj" the ijutrum"t. I MY HAND AND O"ICILAL SFA4 71 I ta; 1�?es . .4 dr , ,QFFKIAL StAL "ILIEt SH N a 113'"t;=14, 16:28 FARO ESCROW DIVISION 07;13/98 16:24 FAX 760 508 9728 FATCO P.D. :;Y UNNIRIVIA— TEL:760 360 3080 M or Tract 28470-1. L5 314Own bY mAP On rile to book 261 pages 76 through rMardS of Rivmide County, California, m DEEP IS MADE AND ACCEPTED 5vjjjEcT TO THE FOLLOWING: ,j.m _delinqUrnj rc-il Cstx1E LAXCS A$M All nisrim or record. Including without lirnitalMn. INI ceMAin DeclantiOfl Of Of EastMents for the Tradition Covcnan46 Cooditions, Restrictions ,.-mcorded August —eamMU3�ty, rmordqd on July 25, 1997 as InsTrwmcm No. 262677 andev 1"7 *3 Instrument no. 292176 both or Official records or Riverside Coumy, 4'... which is incorporated by refcm-nce herein as if fully sci forlh at lerigth (thc -main jothilectural a d n Thc,peclaMLion inr�judcs, yncrF MeeIr—plon eiler matters, cc gq,,.devjlay;jenj guidelines and restrictions which Will apply to the construction of a CM the jbo%,c-dvWrib-td lot. P. 00) Zl 003 'Tradition, July 15, 1998 Via`First Class Mail Mr. and Mrs. Bob Dixon 6457 James Road Bettendorf, Iowa 52722 Re: Lot 11, Tract 28470-1 Dear Mr. and Mrs. Dixon, The ARRC has approved the Construction Documents you submitted. Yc the construction of your home. If you have any questions or need additional information, please do not Thank you. �e Sharman for na J. Dores at Tradition Golf Club /cjd PC: Gary Lohman 78505 OLD AVENUE 52 — LA QuINTA — CA 92253-1120 — PHONE 760/564-3355 — FAx` 760/` Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 :Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 7/24/98 No. 17386 Jurisdiction Owner NameBod and Carla Dixon No. 78-611 Street Deacon Drive East City La Quinta Tract # Lot # Type of Development Single Family Residence Comments zip 92253 APN # 769-162-001 La Quinta Permit # Log # Study Area Square Footage 3300 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: I' r . EXEMPTION NOT APPLICABLE 1 �` This certifies that school facility fees imposed pursuant to Government Code 53080 in the,amount of 1.93 X 3,300 or $ 6,369.00 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 t Fees Paid By cc/Palm Desert National Bank/Bob & Carla Dixon Telephone Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Olivia Aguirre Payment Received $6,369.00 Check No. 73534 Signature 2!2e�. NOTICE: Pursuant fit 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 above will begin to (un from the dale 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 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 Certificate of Occupancy City of La Quinta €` � Building and Safety Department oFm 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: 78-611 DEACON DRIVE EAST Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9805-016 Occupancy Group: R-3 Type of Construction: V -N Land Use Zone: RL Owner of Building: BOB & CARLA DIXON Building Official Address: By: DANNY CRAWFORD Date: 6-7-99 POST IN A CONSPICUOUS PLACE STEPHEN E. SLOMSKI ASSOCIATES - CONSULTING CIVIL AND STRUCTURAL ENGINEERS 2422 EAST LYNWOOD CIRCLE MESA, ARIZONA 85213 TELEPHONE & TELEFAX 602.898.8898 MEMORANDUM PROJECT DIXON RESIDENCE Deacon Drive East La Quinta, CA .Jeff Lohman TO ANDREW PIERCE CORP. DATE•11Sept98 SUMMARY: FYI: At the corner post at the SW corner of the Family Room, two (2) HD6A's were shown on the fndn.plan; It is acceptable to this office to delete any one of the two HD6A's at that post. Shear panel nailing from both shear panels at the corner to the - post must be per the approved plans. If you have any questions, please call anytime. 51 C-28269 \U) Exp. 3/31/2002 ACTION REQUIRED: cc: Dale Pekarek, THE FINE LINE Henry Lenny,, AIA BY: R ec�caer� SEP, 1 4 1998 D e tgE— ". . ' I OCT 4 REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY ..�37630 Medjool Ave. Rev Office (760) 772-7192 Fax (760) 772-7193 'Psager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑ ❑ POST TENSIONED CONCRETE ❑ ASPHALT O OTHER ❑ REINFORCED MASONRY ❑ FIRE PROOFING JOB LOCATION j I ,(� 1 /� •'% 1 ` 1�-�7�CCi tel �� � . [.... /'� �V l ti�� REPORT SEQUENCE NO. TYPE _rnlE 0 ,` PERMIT NO. DA b DAY OF WEEK MATERIAL DESCRIPTIONARCHITECT —3 fl —s— ) INSP9CTOA HRS. CHARGED ? I T ENGINEER ASSISTANTS HRS. CHARGED INSPECTION GENERALSUB Q ` ����- S 6Q AA' -e wc, DATE CONTRACTOR N RT�(�' CONTRACTOR loll) r7J-�� i N • COPY SENT TO CLIEN CO NUED ON NEXT PAGE ❑ PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED THE BEST OF MY SIGTU OFR GISTERE INSPECTOR ^� KNOWLEDGE ALL OF THE ABOVE REPORTED WORKK UNLESS OTHERWISE Q/` NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. ATE OF q .PO0r R,EGISTER_ni,.u•-- - Andrew Pierce Corporation 44-835 Deep Canyon, Road, Palm Desert, California 92260 / P.O. Box 3420, Palm Desert, California 92261-3420 Telephone (760) 346-3228 Fax (760) 346-6263 September 17, 1998 The City of La Quinta Attn: Mark Harlold 78-611 Deacon Drive East Traditions Club To whom it may concern: This letter is reference to the above address, in regards to HD 6A. Referenced on plan in family room if you have any questions please call me at (760) 250- 8978.