9611-038 (SFD)F1
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.
597975 13 - % 713i/a�fi
Date 1-� Signature of Contractor
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&RC. 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 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 P/ode, I shall forthwith comply with those provisions/
Date: L,2 r tr t Applicant— J-, -�
r ,
Warning: 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, 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 -for inspection' purposes.
/Signature (Owner/Agent) �. Date
PERMIT # CONTROL #
BUILDING PERMIT
��6��_���� 4613
DATE I!i 7/47 VALUATION r, $;3t Ca$ 10 LOT TRACT
JOB SITE
18
ADDRESS .170 HERMITAGE
APN 761-47"34
OWNER
CONTRACTOR / DESIGNER / ENGINEER
W il'1`1'Al:Ck.
d211Ni"[ICSCAE'Iti`il:AI<I(?f3 Vi".iat�H't�'D}1�:'`f
15761 E. ALTA. VISTA 'W AY
79687 CQUN`i'R, C: L(J13 DR,92ol
SAN JOS6 t;:A 951.27
(3.i?ltMCJDA.DUKEIS CA M01
( .19;►1f1`�-7755 C#ll ';t 1969
USE OF PERMIT
;3''I f
F311) - (x3:i3.�•ifr I: GE,8.. N6T lt�i�i.VUE'fs1:Cri Wr�6.i,. G�i2 C�t�0L.
CUSTOM -1 CC)itis'f It`U'C; 3`l014 4,730.00 -SP
0ARAQW(7,KRP0RX 8v
�
'�4
0011 IF CS���t910•
���.� f.ii!1SIMATED
C ON8'MUCT10N �� 10140)_41.8-000 S1,5is�.S.►
N A'N (71-IRCK 'fr1?
I LAN CHEC. Z:UECri" -11 <g1 �ftrf).trti
w
ilii C:YAPYtc:rti:l�:E 1� 101:�0(i0-am001ii.SG
�3.Cc".a`ktCr14..•.�k'1~:ti.. 1U1-t)(1t1.4'i0-t;CfO �'!7g,71.
r''f;iiat'1, WO FEFS 101-19419.000
S"V;UrivGMOT f014('RITS) 1..01-000-244-000 . 9.9 ,16
ORAl73.Na3 1 U l �t t3 -d -at)0 :Efi.il0
!.M1TF'I2A 3I't1t"'f't]_ft€s 225+01/0~443-342 $b.(t0j.00
,ART 1N IaUI LK,* (1z1 S) 701-040-255-000 $749,fJr
-NIJB3 TOTAL, C`0NVK C, 1.C)N :AND PLAN (�s� icK
$10,476 47
®®
PA LJ . Ltss PRr'2-RAID FEE
JAN 17 1997 rc;TAL PERNOT Fk,RS DUE NOW
$9.47667
ITY OF. LA QUANTA t
RECEIP'T
DATE �,
BY ;
DATE FINALED
INSPECTOR
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
1_
Ducts
Slab Grade
I 1f14Return
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 Wali Firewall
Exterior Lath
DWvall - IM. Lath
7-11
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location -
Underground Electric
Underground PI . 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
46Z907
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 3 -
Final
Utility Notice (Perm)
COMMENTS:
/� ' AAi%f 04 TD �/lGv/,G�s'A3.pu�G>
;,go
Coachella Valley Unified School District
P.O. Box 847, Thermal, CA 92274
(619) 399-5137, Ext. 235
Project Name: PGA West
This Box For District Ilse Only
CERTIFICATE OF COMPLIANCE
(Government Code 53080)
Date: January 17, 1997
Owner's Name: Whittaker - Rancho Capistrano Development Phone No.
Address: 80-170 Hermitage, La Quinta, CA 92253
Project Description: 1 Welling
APN; 761-470-034 Tract #:
Type of Developme : c Residentia - X Commercial
Lot #:
Industrial
Total Square Feet of Building Area: 4,730 Sq. Ft. .
Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this
statenlentement under penalty of perjury and further represents that he/she is atut sized to sign ou behalf of the gwner/developer.
Dated: January 17, 1997
Sign
SCHOOL DISTRICT REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE
SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING (CIRCLE ONE):
r5 308
Gov. Code Gov. Code
0/6 65970
Number of Sq./Ft.
Amount per Sq/Ft.
Amount Collected
Project Agreement Existing Not subject to fee
Approval prior to 1/1/87 requirement.
4,730
$ 1.84
$ 8,703.20
Note:
By: Foch "Tut" Pensis, Assistant Superintendent Administrative Services
Administrator in Charge
Certificate issued. by: ELSA F. ESQUEDA Signa
o�a.
Facilities Analyst
NCMC!E: Section 66020 oftlie Govenunent Code enacted as Assembly Bill 3091, set fordi as Chapter 549, Statutes of die state oft;talitbmia, 1996 effective Jan. I, 1997, requires that this school district provide a written notice to
die project applicant at die time ofpayment of school fees, mitigation payment or other exactions. 'flus notice is to advise you dim any protest ui regard to such amounts or the validiiy thereofiii accordance with section 66020
of Ute flovenuuent Code and outer applicable low, commences with such payment or perfomnmce ofany oilier requirement as described iii Section 66020 of die Govenunew ('o& Additionally, dus notice advises that the
protest diereofnnist occur widibi 90 calendar days thereafter.
Note: AB 2926 and SB 201 fees are capped at $1.84 per square foot for all residential construction, and at $0.30
per square foot for conunercial/industrial projects.
Dev. Fees Disk: Mise\Cert-Com.Sam (REV. 1/97)
DEVELOPER V EES ]'At U
AREA:
AMOUNT:
RCYT.p:
CIc. a:
casut
INITLILS:
DATE:
CERTIFICATE OF COMPLIANCE
(Government Code 53080)
Date: January 17, 1997
Owner's Name: Whittaker - Rancho Capistrano Development Phone No.
Address: 80-170 Hermitage, La Quinta, CA 92253
Project Description: 1 Welling
APN; 761-470-034 Tract #:
Type of Developme : c Residentia - X Commercial
Lot #:
Industrial
Total Square Feet of Building Area: 4,730 Sq. Ft. .
Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this
statenlentement under penalty of perjury and further represents that he/she is atut sized to sign ou behalf of the gwner/developer.
Dated: January 17, 1997
Sign
SCHOOL DISTRICT REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE
SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING (CIRCLE ONE):
r5 308
Gov. Code Gov. Code
0/6 65970
Number of Sq./Ft.
Amount per Sq/Ft.
Amount Collected
Project Agreement Existing Not subject to fee
Approval prior to 1/1/87 requirement.
4,730
$ 1.84
$ 8,703.20
Note:
By: Foch "Tut" Pensis, Assistant Superintendent Administrative Services
Administrator in Charge
Certificate issued. by: ELSA F. ESQUEDA Signa
o�a.
Facilities Analyst
NCMC!E: Section 66020 oftlie Govenunent Code enacted as Assembly Bill 3091, set fordi as Chapter 549, Statutes of die state oft;talitbmia, 1996 effective Jan. I, 1997, requires that this school district provide a written notice to
die project applicant at die time ofpayment of school fees, mitigation payment or other exactions. 'flus notice is to advise you dim any protest ui regard to such amounts or the validiiy thereofiii accordance with section 66020
of Ute flovenuuent Code and outer applicable low, commences with such payment or perfomnmce ofany oilier requirement as described iii Section 66020 of die Govenunew ('o& Additionally, dus notice advises that the
protest diereofnnist occur widibi 90 calendar days thereafter.
Note: AB 2926 and SB 201 fees are capped at $1.84 per square foot for all residential construction, and at $0.30
per square foot for conunercial/industrial projects.
Dev. Fees Disk: Mise\Cert-Com.Sam (REV. 1/97)
1 ♦'AL
` CITY
OF LA
JON TANDY
�U1L')ftG ANS 3580 Condalia Ave.
�'�i upca Valley, CA 92284
SPECIAL INSPECTION SE_RVICEJ (619) 365-5045
REGISTERED INSPECTOR'S WEEKLY REPORT
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY ❑
's
❑ POST TENSIONED CONCRETE ❑ ASPHALT OTHER ` _x'
❑ REINFORCED MASONRY ❑ FIRE PROOFING 'g- „�.) Vl`,
JOBSUN_ (9 0 m I lA &e-/ A Q U ���� Com-
REPORT SEQUENCE NO.
TV PE Of ST6TURE `���e�` /�PERMIT NO.
DBY_t
DAY OF WEEK
ERIAL DESCRIPTION ARCHITECT
-SZ�
INSPECTOR
!�4
HRS. CHARGED
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPECTION GENERALSUB SUB ! �`�
DATE CONTRACTOR Il\V6�\ � 0 p('&' -nQ(l� (q-0 CONTRACTOR �` 14 (� y
' 1 '
O 6 -Q (A: S 1 uS'G /-5: 5 uJe C.✓J t lJ 6-- q-
-FOC—o t4 l,► c c - t i o t -A -A--z�s l b
oa,(-y -T- s . cmc - a.�� KI x
�sc�tS.
alo�lc� � ems(
oc
COPY SENT TO CLIE
CO TI ED ON NEXT PAGE D
PACE 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.
SIG ATUR REGISTERED INSPEC\ R
DATE OF RI REGISTER NUMBER
03/31/1997 14:53
714-976-9926
VCA ENGINEERS
VANDORPE CHOU ASSOCIATES, INC.
CONSUL TING E'NGMERS
295 N. Rampart Street, Suite A
Orange, CA 92668
Ter' (714) 878-9780 Fax: (714) 978-9926
Richard Wasserman
RANCHO CAPISTRANO DEVELOPMENT
55-880 PGA Blvd,
LA Quinta, CA 92253
Subject: Whittaker Residence - Field Walk Corrections
Dear Richard,
PAGE 02
Since 1979:
Facility Planners
Code Consultants
Structural Engineers
Fire Protection Engineers
M
March 28, 1:997
3
Per your request, we performed a structural observation of the subject residence on 3/27/97. The
house framing looked good, with the exception of several minor deviations as listed on a reduced
framing plan which. was left with the framer, and a copy is attached to this letter. Also attached is
clarification of several issues which were brought to our attention at the jobsite.
I, See detail "A" for roof truss to ledger where hanger could not be installed due to
interference with steel column cap at the back of the family room.
2. See detail `B" for 2x4 rafter to truss connection at the garage where the truss top chord
was manufactured too short.
3. See detail "C" for field fix for mislocated CB at the back of the Master Bedroom.
If you have any questions please contact Benjamin Herbst of our office.
Very truly yours,
VANDORPE CHOU ASSOCIATES:
Robert Chou, S.E.
BH:bh
f:\jobfiles\0096\RCD 1239\Pield7, wpd
O,?gOFESSjO
��Q��S�'►EUNG'c 9l
V �Q y �,
r-
y�_.�
w p No, S 003518 i
i 113.31
tp
s
p
Ar
MAR -31-1997 15:00 714 978 9926 P.02
03/31/1997 14:53 714-978-9926 VCA ENGINEERS PAGE 03
CO)
t s
�.__........ ....._ -__ ... ---
AM -
Jot
af
it
I •'1 q .Z � �; , e 4,' 1'vt, � ,t `��. �'' •, Z � q iia °'tl �3 -
7 +•:..'= L 1 C' moi.. L-• i
w
cl
q
17
IL
ArN
1 - -- -- aR // \ �lK►�
_.r..
r' .rte__ _�I - �VC•G� i - i�.�+ a["' I •e�� �- � ` 1��:y
'-
i
c FF
... :"� .M�• K/`: JG _ •OKE
_
asr r�
-
'A'..r+`MMI.a.vw!'—......:wo:'aaf•.tir �y..:pr.. �. �� F� "t�NYi• .� �� �'
';.w•-.-_....:.[-.www.—�r�. _ _ ....� ._ _
-
..f
+MAR -31-1997 15:02 714 978 9926 94% P.O3
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: 80-170 HERMITAGE
Use Classification:
Occupancy Group
SINGLE FAMILY DWELLING Bldg. Permit No.: 9611-038
R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: WHITTAKER
Building Official
Address: 15761 E. ALTA VISTA WAY
City: SAN JOSE, CA., 95127
By: DANIEL P. CRAWFORD JR.
Date: 8/19/97
POST IN A CONSPICUOUS PLACE