0203-272 (CONR)FI
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
768595 :B 08 WC� 9/30/03
Date ZZ -L -?0 Signature of Contractor
OWNER -BUILDER DECLARATION
V
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 ; TATg pU114D 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
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply withos
;the provisions.
Date: 5_&•.2,-a Applicant �. //, •.����'Fr��,�
Warning: Failure to secure Workers'Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on' his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter, upon
the above-mentioned property fojrlins1pection purposes. d
Signature (Owner/Agent) 4 /. ?',+ j1 Date � •_4 - -n 7
AKV
BUILDING PERMIT PERMIT#
DATE VALUATION LOT W03-2172 TRACT %
•if
%� . ,/_ _ r' ..: � SYS$ a€�9.�9 2! Q1
JOB SITE W.
APN
ADDRESS 47 747 G TRIMET. �R+'.AY
C49--030-045
CONTRACTOR/ DESIGNER / EN INFER
0RES.3P
DC�, _,!1 DEV.
aL?�UCfi,M-MAI-
74.760MCIETWAy.I 119200
78.1600ITICHMA:Y 1I I
IN;D'1'AN WELLS CA 92210
:ice CJUWfA CA 92253
(760)771.3345 CRV21SC
USE OF PERMIT
2VIV S.F C:IZU13HOU39 FACILITY
PORC HIPATIO i 663.40 �F
SPPJWK12,R 3,1,30.00 S?
AX -- COMMERCIAL U16.06 Sig
COW IT.AC:T AMOUNT 1-3
XS°8'WA: XD C:C)FT Z +.1t' C;'C)NIM:13,MOR
1,9110:29190
IFIR;TY.2 $LASMY
CCO'N@TRUCYION FEE, 101-00"116-000 S961..Ck
PLAN CHWK FEE, I 4100-439.31 j $959.fr;
MEC.`RA'NIC.AL FER 101-000.421-000 $110:00
ELECTRIC A1, [ME 1131-000-410-000 $134.40
PLi1M0IN.0 FE E 101 "000-419-000 $192:00
STkO7JO MOTION FEE � COMM M 100.000-2,41-000 X40.12
DZV'P:LOPItR IMPACT P H, 33,317A)
:4..11.1' IN PUBLIC PY-KCWS : COMP 270-000-44.1-000
S'UB-I'OT'A€.. C°f:1R&I'RxI'O'110M ,AND PUN CH KX:
$6,569.7:3
LEE I"RE,PAJD x:01:+`3
MOO
MAY 0 q 2002
� CffyOF4.AAlIIAY►q
FINANCEDE
RECEIPT
DATE =
BY
DI F ALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
—a2
Underground Ducts
Forms & Footings
Ducts
Slab Grade
— /.Z ` dZ_
Return Air
Steel
— : —
Combustion Air
Roof Deck
o• . o y sr
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Insulation 7!
cJ
Compressor
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
/
Z `r - a =—
Drywall - Int. Lath
/ —•0 2— 57
-
2-
_
Final
BLOCKWALL- A. PROVALS
Final
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
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
r —
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
_
/ • • a 3 S
Encapsulation
Gas Piping
Gas Test7.
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas) 7 B�
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
Final
Utility Notice (Perm) d
Standard Notice of Work Completed and Not Completed
NOTICE - All reccommedations may not have been completed. See below- Recommemedations not completed.This form is prescribled by the Structural Pest
Control Board, with whom a copy must be filed by license within 5 days after completion of work under contract.
THIS IS A NOTICE OF COMPLETION ONLY, NOT AN INSPECTION REPORT
ADDRESS OF BLDG STREET CITY: DATE OF COMPLETION
PROPERTY 47-747 Gertrude Way La Quinta CA 92253
INSPECTED: CO. CODE 33 08/29/2002
FARMER TERMITE CONTROL AFFIX STAMP TO
P.O. BOX 5155 BOARD COPY ONLY
BELLFLOWER CA 90706
(888) 340 -BUGS (562) 920-7571
FIRM LICENSE NUMBER PR1401 I COMPLETION STAMP NUMBER
Notice of completion
Sent To and date
Owner's Name and Address:
Copies sent to
This is to certify that the folowing recommendations on the above designated property, as outlined in STANDARD INSPECTION REPORT NO
, date : / / REGISTRATION STAMP NO: have
been and/or have not been completed.
Recommendations completed that are in accordance with Structural Pest Control Board's rules and Regulations:
Recommendations completed that are considered secondary measures under section 1992 of Structural Pest Control Board's rules and Regulations:
Recommendations not completed by this firm
Signature
Cost: $ 70.00
Inspection fee : $ 0.00
Others : $ 0.00
Total: $ 70.00
Estimated Cost: $
If you have questions regarding the work as outlined above,you should first contact the licensee noted above. Id satisfaction is not obtain you may contact
the Structural Pest Control Board at :
Los Angeles - 213-620-2255
Sacramento - 916-920-5323
You are entitled to obtain copies of all reports and completion notices on this property filed with the Board during the preceding two years upon
payment of a $2.00 search fee to: The Structural Pest Control Board 1422 Howe Ave.,Ste. 3, Sacramento,California 95825-3280.
AT20:4820030313
IN StiLA T IO`` CERTIFICATE IC -1
�!., Ad-ir',5s
Description of Installation
Prrrl: \!lnbzr
I. ROO;
;.. a:c r i al �c.�S E -a - � ti' _ ... _ , k;�'�-'!� `� �-l�c�f1 i '� t �..�-•�.
Thickness (ircIncs) \3/f T;:;r; ;': Rccsis:ante (R Value) .3
CEILING
Bat: o: B:ar.';crType tca-(> E.an, � Na -c "n Xl ot_U
Thickness (inch s` 22 " (� ) -�
(i.J l hart?:_. SiSt3r.0 1 slut
LooscFill Type )ka,)E Er-rid'OD:t'1��4-1
Contractor's rnir installed weight/f- �_lb �1;. i^' :-1tIli ckness tbyinches
Manufacturer's installed weight per square foot to zchievc T crmmal Rcsist`rce (R -Val`.:,-)
3. EXTERIOR WALL
A. i�„� L,->44t)ax(o-P�cwt o 3
Material P(L-� Brard Namc U0 Ali t _
Thickness (inches) _ _ Ther -mal Resistance (R-Valuc)
B . Exterior I,UC,-)� —
Material Btzr.d 'Name
Thickness (inches) 3' 0 T tier;: ai Resistance (?c -Value)
RAISED FLOOR
;✓: j!erlai
Thic'.kncss (inch. -s)
SLAB; FLOO.RuTERIMETER
N.aterisl
Thic'kncss (inches)
Perirnc!er Insulation Depth (inches)
FOUND. -.TION NVAT L
N1.alc:iai
Thi.lcness (ir.chcs)
Declaration
Tis ...,si R.sistanc (R-Valuc)
Brand- Name
T' crmnal Resistance (R -Value)
�yr' \±:-.`
T'.-e=a! Res;s.anc: CR-Valuc)
1 .1Cr.G} C.f ;f,+ t}13! l� 3-o%'C IrSl1I3tICn \v1i IG5:3iICd In t4. C_.!C.-._3..��J'._ !v^^d-3;iC❑ 11 CCrrC^ta; CC W1!`: L5. C'_, .n
Ererg�; Ejrciene�S for ruidenti]1 buil-ii:.,cs (Title 2-., °a- 5, Ca ..cnia COi.: as indiea�,--d ca the
Cc^t:i_atc C. Co -r c, u applicable.
P. C12' _r_,Da-, II' j:C1tr] C,Cr
(C3. Na OR
G r._. el Ce ;�:mr (Co. Nave) OR 0cc.
Date
Si, , D -,r,
Au-- 2 -Ji
1-,:allir.g Sub-onL-3cior (Co. \arc) OR
Cc ;cra1 Ccr.!rc:or (Co.'Namc) OR Ou•n_r
L-.s:a11i-� S: `cerawor (Co. Name) OR
Cu. -,:!:!3r (Co. Name) OR Our, ---r
A•,3.6
T-7
PRIOR SHALL INCLUDE PANIC HARDWARE
+LLED SHALL COMPLY WITH THE REQUIREMENTS OF UBC
HS MEMBER SHALL BE MOUNTED AT A HEIGHT OF NOT
r THAN 44 INCHES ABOVE THE FLOOR. THE UNLATCHING
!OUN05 WHEN APPLIED IN THE DIRECTION OF TRAVEL
WARDWARE TYPE, EXCEPT FOR THE MAIN ENTRANCE.
HAVE LOCKING DEVICE
0RS SHALL BE OPENABL.E FROM THE INSIDE WITHOUT
GIAL. KNOWLEDGE OR EFFORT. MANUALLY OPERATED
�LU544 BOLTS AND SURFACE BOLTS OR ANY OTHER TYPE
T01 CLOSE OR RESTRAIN THE DOOR OTHER THAN BY
. SSE SHALL NOT BE USED. PROVIDE SIGN ABOVE THIS
-D DURING BU51NE95 HOURS" IN P HIGH LETTERS WITH
ke'QUIRE A 10" KICK PLATE AT THE BOTTOM.
20'—O"
10'-1" Q'-11"
G
6'-5"
A
5'-8"
GENERAL NOTES
ALL DOORS SHALL HAVE A FLOOR OR A LANDING ON EACH SIDE
AS REQUIRED BY CHAPTER Il AND SHALL NOT BE MORE THAN A
1/2" LOWER THAN TH1= THRESHHOL.D OF THE DOORWAY.
LANDIN65 SHALL BE LEVEL EXCEPT THAT EXTERIOR
LANDINGS MAY HAVE A SLOPE NOT TO EXCEED 1/4" UNIT VERTICAL
IN 12 UNITS HORIZONTAL OR 2% SLOPE. GBG 1005.3.1.6.
EXIT DOORS SHALL BE OPENABLE FROM THE INSIDE WITHOUT
USE OF A KEY OR ANY SPECIAL KNOWLEDGE OR EFFORT AS
WELL AS THE UNLATCHING OF ANY LEAF SHALL NOT REQUIRE.
MORE THAN ONE OPERATION, GBG 1005.5.1.8.
ALL DOOR HARDWARE AND EXCEPTIONS MUST CONFORM
TO THE DOOR CODE SECTIONS WITHIN GBG 1005.5.1.
THE MEETING ROOM SHALL HAVE AN OCCUPANT LOAD SIGN
POSTED STATING MAXIMUM OCCUPANT LOAD OF 100 15 ALLOWED
(69'1 SQ.FT. / 15 SQ.FT. PER PER -50N) PER GBG SECTION 1001.2.6.
STORAGE ROOM 15 TO CONTAIN TABLES AND CHAIRS
FOR MEETING ROOM.
CONTRACTOR SHALL FURNISH WALL MOUNTED, BARRIER FREE
BI -LEVEL ELECTRIC, WATER COOLER COOLING UNIT TO BE
TUBE -ON -TUBE TYPE. MINIMUM COOLING CAPACITY TO BE
'1.5 SPH FROM 80°F INLET WATER TEMP. TO 50°F OUTLET
WATER TEMP. IN 400 AMBIENT, OPERATING ON 115V, 60 HZ,
A.G. COOLER SHALL BE: 5UNRO0- MODEL NWGA-B-BL, WITH
STAINLESS STEEL FINISH. SEE DETAIL 6M1.1
QENERGY CALCULATION LEGEND
TITLE 24 REPORT : CLUBHOUSE
FORM ENV -1 pages 2, 5 4 4
000"INDOW
DESCRIPTION TYPE
6LAZIN6 # / REQUIRED
AREA 5Q.FT. U -VALUE
/
EXTERIOR'l- STND BLIND INTERIOR
SHADE TYPE SHADE TYPE
5H60=0.16 51460=0.41
STND = STANDARD
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Standard Notice of Work Completed and Not Completed
NOTICE - All reccommedations may not have been completed. See below- Recommemedations not completed.This form is prescribled by the Structural Pest
Control Board, with whom a copy must be filed by license within 5 days after completion of work under contract.
THIS IS A NOTICE OF COMPLETION ONLY, NOT AN INSPECTION REPORT
ADDRESS OF BLDG STREET CITY: DATE OF COMPLETION
PROPERTY 47-753 Gertrude Way La Quinta CA 92253 08/20/2002
INSPECTED: CO.CODE 33
FARMER TERMITE CONTROL AFFIX STAMP TO
P.O. BOX 5155 BOARD COPY ONLY
BELLFLOWER CA 90706
(888) 340 -BUGS (562) 920-7571
FIRM LICENSE NUMBER PR1401 COMPLETION STAMP NUMBER
Notice of completion
Sent To and date : 03/13/2003
Owner's Name and Address:
Copies sent to
This is to certify that the folowing recommendations on the above designated property, as outlined in STANDARD INSPECTION REPORT NO
. date : / / REGISTRATION STAMP NO: have
been and/or have not been completed.
Recommendations completed that are in accordance with Structural Pest Control Board's rules and Regulations:
Recommendations completed that are considered secondary measures under section 1992 of Structural Pest Control Board's rules and Regulations:
Recommendations not completed by this firm
Cost: $ 70-00
Inspection fee : $ 0.00
Others : $ 0.00
Total: $ 70-00
Estimated Cost: $
Reinarks :
A soil pre—treitment wis performed •n this• •• • •.nce with Str 1.•. • regiflations.
Signature
If you have questions regarding the work as outlined above,you should first contact the licensee noted above. Id satisfaction is not obtain you may contact
the Structural Pest Control Board at :
Los Angeles - 213-620-2255
Sacramento - 916-920-5323
You are entitled to obtain copies of all reports and completion notices on this property filed with the Board during the preceding two years upon
payment of a $2.00 search fee to: The Structural Pest Control Board, 1422 Howe Ave.,Ste. 3, Sacramento,Califomia 95825-3280.
AT21:1120030313
IN'SULA T IOC CER-nFICATE IC -1
y
Descriptioii of Installation
1. ROOF
hICRnJ55 13 t r
2. CEILING
Per„I; Nunb2r
21,
gra-_
Tines-:'; Resis:ante (R-Va!ue) 3
Bat: or Elan'.;et T y p c lv7.lkt� Er' --d Namc cz., Mr, od(
Thickness Onc.`.:s' ��" Tte rr =: Frisistar.ce (R-'-'slec) C3%
Loose Fill Typc`Ct ,�t� Erand A QQ,nf4:b-z-�
Contractor's r'i- installed weight/ft: k— lb t.4ici. lb_ inches
Manufacturer's in -stalled weight per square foot to achieve T;.c.m„al Resistance (R-V!I'_e)
3. EXTERIOR WALL
Material Brand Namc Un in
Thielcrtess (inches) _ Therms! Resistance (R -Value)
B . Exterior LC c,&o rr
Material Brand Name Ln(t,�-L T
Thickness (ir.c' t: s) 3' Tterma: Resistance (R -Value)
RAISED FLOOR
:s!:�!eriel
Thic`.cncs3 (inC`.:s)
SLAB FLOOR/?:.RIME T ER
Mat�risl
Thicknc55 (incites)
Perimc!cr Insulation Dcpth (inches)
FOUNDATION ViALL
Niate.ial B.;na Na: -c
Thickness (inch --s) Ti-e=a': Resistance (:Z-V31uc)
Declaration
1 acrcby ccr:iCy that t:._ a`cc irsulat,en as ir;s!31'_d in c_:!=:-- 3 a`o.c iota::cn ... ccr'�cr-taacc w t. - cur.-..
ErerZ, E? C12.^.C� C:Or,��'.� f,r residential bui!^_'i ,gs (Title 2 5, Cs:i:Jnis Co�c : ReKuL;:ens) ss indie3I-d en the
Ct!1:3(c oFC1. aopi;eagle.
1 � ,� /%(�? ���F'i )�/�/�l o���i /cam//G�c,L• %✓,
S,i2
Cc,-,:. a[ Cort--3cror (Co. Nave) OR Ownt:
B, an Na..._
T t1C:^r:at KC5i5fanCe (R-V3i'Se)
Brand. Na -me
Thermnal Resistance (R -Value)
T -c n . sna: rc, Datc 1- ._Ilina Scb:onz,,mctor (Co. Nanc) OR
Central Cer 2c.or (Co. N3mc) OR Owner
Sid .:!_rc, Cat. Irs:alli--, Sutcon-�,wor (Co. Name) OR
C c-�2! Ccr.tra.:Jr (Co. 'Nam".) OR Owner
A•3o
a
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: 47-747 GERTRUDE WAY CLUBHOUSE
Use Classification: SINGLE FAMILY ATTACHED
Occupancy Group: R-3 Type of Construction: VN
Owner of Building: MIRAFLORES, LP
Building Official
Bldg. Permit No.: 0203-272
Land Use Zone: CR
Address: 74-760 HIGHWAY 111 #200
City: INDIAN WELLS, CA 92210
By: STEVE TRAXEL
Date- 03-21-2003
POST IN A CONSPICUOUS PLACE