0211-110 (SFD)LICENSED CONTRACTOR DECLARATION
i,l hereby -affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Divisi6n 3,of the Business and
Professionals Code, and my License is in full force fafnd] effect.
License # Lic. Class Exp. Date
�;i 2 k3 I L1C
10/31/2-C
'Date � � � Signature of Contractor
OWNER -BUILDER DECLA5 ATION
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 t
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 Y Po icy NO.
(This section need not be completed if th permit valuation is for $100.00 or less).
( ) I certify that in the performance ofrpe work for which this permit is issued,
m
I shall not employ any person in any Ihne so as to become subject to the
workers' compensation laws of Califgr1hi , and agree that if I should become
subject tobe hrkers' compensation provisions of Section 3700 of the Labor
Code, i4 alllforthOvith Comply With those provisions.
,.Date: I Applicant "
Warning. Faure 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 j(QuintaN its. officers, agents and employees.
2. Any permit issued as`a result of this application becomes null and void if,
work is not commenced withi 180 days from date of issuance of such
permit, or cessation of work forri•80 days will subject permit to cancellation.
I certify that I have read this app icatio'n and state that the above information is
correct. I agree to compl�ith all ty, and State laws relating to the building
construction, and hereby a'uthon `e representatives of this City to en er'Jon
the above-mentioned property fofnspection purposes. �.
trbr
Signature (Owner/Agent) �' Date
UILDING PERMIT PERMIT#
�'� -��
DATE VALUATION LOT TRACT
2007
JOB SITE
APN
ADDRESS 53-M LATRC),I99 LAW
10`AW-021
OWNER
CONTRACTOR / DESIGNER / EN (NEER .
i a Gid{d DE"WE O ► <. i'
� A. �: `'i�3? �� ;£�a` CC322POR.A17014
7 i41 BRAIf DR_TVE'P.: i
110 BOX 3235 ;
LA QQ11MA CA 92253
PALM. DE Rr CA 92261
760)346-5976 CBLA 3333
zI
USE OF PERMIT
S:t3`i.>JFXG1.,t.TVZSWA.LLSIPOLH:d'l:EllX1?' t►d1Yi�P i�(7ACs3�tat�% I.1.€3 t°;.fW Ti17.fi'1�#
AM FEDERAL &OTds'li E i,,.laft1.A7CLUDI1' G THF ENt`!.AN+3ERED SPECI
.ACT OF 147311x' APPIACAB.L.-ft IS Ri !2J11P.PM
C.i1OTOM CONN TRUC TION N+„3E6,tza SIT
PORC:HPATIO 921.00 Sp
GABA MICARPC:'I1,T 1107.2.00 sty
ES T—COST 0"FCONYt"fiUC` OIN
467,429.90
r, U1, MWALRY
CONSTRUCTION FEER 1011.000-4I ri-,C}(30 $15927,50
PLAN CHFICK axe 101-41t30-439-318 $1,560.7A
FE11' DF—POSIT 101000-X939'3'18 41,0,00.00
MECHANICAL L FEE' 101-000-421-000 $490.0a
I:6ECTIUirAi FRE 101-000-420-000- MOM
I lIUMJ INO FEE 101-000-4.19000 $249.$9
STRO14 4MO�' ON FRE RESfD 101.000-241.000 546.74
GRAD1'} O ME 101-000-423- 00 4115.00
DWS Z,10I F.R IM'P eC T rr,,E 52,40:,00
- A kT .114 PUBLIC PUNCES a 0811270-000-445-000, $663SI
x RTTe"7 t1N1 AND PLA9 C*.i,Ca'tty
1XI 3s M.-PA7 PM14
D ®
,s54.i9
-sl,C3t3aoo
APR L 4 ,2903 PrWai "ES DIA,14OW
CIINANC;E DEPT. A
4. N
RECEIPT -
DATE
4 X10 0.,w
BY. 7
i 1
DAT FINALED
/ �% v
INSPECT
FM
INSPECTION RECORD
OPERATION
DATE
I INSPECTOR
OPERATION
I DATE
IINSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs I
Underground Ducts
Forms & Footings 6
Ducts
Slab Grade 7' ��
Return Air
Steel
Combustion Air
Roof Deck _
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing _ L Q
Insulation (�
Compressor
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wali 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
�'
sinalI
Gas Piping
:.
PLUMBING APPROVALS
Gas Test
Electric Final
Heater Final
Plumbing Final
Waste Lines /�t3 0 3 Wil/(
Water Piping ^' t
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection !iG�. �/3 �L�
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. Use of Power
Final
Utility Notice (Perm) G
YOUNG ENGINEERING SERVICES
Engineering Architecture -Surveying- Building & Safety Services
Letter of Transmittal
To: City of La Quinta Date: 1/31/03
Project: 53-025 Latrobe Lane
Attn: Ed Randall PC#: 0211-110 (2" Check)
Tel No.: ( Tract No.:
We are forwarding: X By Messenger By Mail Your Pickup
No. of Copies Description:
2 Set of redlined plans
1 Set of corrected plans
1 Old Calc
1 New calc
1 Drag truss calc (faxed sheet)
Comments: Plans are acceptable.
Thanks
This Material Sent for:
Your Files Per Your Request
Your Review x Approval
Checking At the request of:
Other
By: Eric Frenzel
Phone #
77-804 Wildcat Drive, Suite C, Palm Desert, CA 92211 (760) 360-5770
Bronz Young
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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that.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
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.14 X 5,586 S.F. or $11,954.04 have been paid for 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/Palm Desert National Bank - Curt Dunham Check No. 084529
Name on the check Telephone
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected
Signature
McGilvrey
$11,954.04 ' $0.00
Payment Recd Over/Under
NOTICE: Pursuant to Government Code Section 66020(d)(1), 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 run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
. Mc GEE SUR VEYING, INC.
79-301 Country Club Dr., Ste. 102 — Bermuda Dunes, CA 92201
Phone (760) 345-3828 — Fax (760) 772-5705
May 6, 2003 -
City of La Quinta
78-495 Calle Tampico.
La Quinta, CA 92253
Re: Pad Certification — Lot 17, Tr. 28867
:Pursuant.toyouur 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)
17 53-025 Latrobe Ln. 91.0'
�M
Si erely, �4p° $�9yE
��♦ V*Ea V '
Wayne .McGee s LSSM
L.S. 5479
.M
July 25, 2003
KNAPP & TANG STRUCTURAL ENGINEERS, INC.
408 So. Stoddard Ave, San Bernardino, CA 92401
Phone: (909) 889-0115 Fax: (909) 889-0455 Email: knappae@aol.com
To: City of La Quinta
Building & Safety Department
Re: Lot #17 N"0Z5 (ATnoAE CArjf-
The Traditions Country Club
x
On July 24, 2003, I performed a structural inspection on the subject custom residence. I found two
hold-downs missing or misplaced, one at the shear wall in the entry and one at the hallway next to
the garage. I am providing a detail for a drilled -in, epoxied Simpson "HTT-22" hold-downs.
At the outdoor room, north wall, add 4x6 blocking to the shear walls in line with low headers beyond,
and strap with Simpson "CS 16" strap or "MST -60" straps. These straps tie blocking in shear walls to
headers beyond.- At hall #2, exterior wall, add 4x6 blocking and straps as described above for
outdoor room shear wall. At both of these locations plywood shear should be added on 2x6 cripple
walls above openings in these two shear lines.
Once this work is completed the house will be in substantial compliance with our structural plans and
design intent. It will therefore be appropriate at that time to allow the contractor to proceed with
installation of finishes.
Respectfully submitted, ESSIpHq!
-Gst�
_ T
JNO' r"
yd
Exp. 3-31-04 �r
CMS-
Ceonard• C: Knapp
r
Engineer of'Record'
rig""' �: ��• its ;�" 2'} :��i r,}v "IC PG Zq'
Ji
Certificate of Occupancy
T'Vf oF 44ur«rw
Building. & Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 53-025 LATROBE LANE
Use classification: SFD
Occupancy Group: R3
Owner of Building: BENTON DEVELOPMENT
l
Building Officiaf
Type of Construction: VN
Building Permit No.: 0211-110
Land Use Zone: RL
Address: 78541 BEACH DRIVE EAST
City, ST, ZIP: LA QUINTA CA 92253
By: KIRK KIRKLAND
Date: 1-12-04
POST IN A CONSPICUOUS PLACE