9510-029 (SFD)LICENSED CONTRACTOR DECLARATION 1,
I hereby affirm 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
Date Signatureof Contractor
OWNER -BUILDER DECLARATION
I hereby affirm 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 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 with those provisions.
Date: Applicant
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 application agrees to, & shall; indemnity
& hold harmless the City of Indian Wells, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void -I
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
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
F,
A`°'
BUILDING PERMIT
PERMIT9510-02.9
DATE 1��� 1
VALUATION $346,799.361 LOT
TRACT
JOB SITE ADDRESS
APN
,j .55-190 INVERNESS
769-620-003
OWNER
CONTRACTOR
THt?;1L1i) &.1R,0BERTX(t3IN1CfT1ELLC
55.1130.1iN IVEIVN E SS
1.A tai, INTA. CA, 42253.
CB119
DESIGNER/ENGINEER
(
IIM CAST Efd,I:ZZ.
3930 ARSOidS'T.
�
USE OFPERNT.PA.WLYDW4L.L,ING
�re:iv i�i.v%, c� .✓i.,i.i
FEE DESCRIPTION
FEES
CUSTOM CONSTRUC"1't:*F 4,104.00U
it
i31Al2.EeM( Al2k>0RA' 725-00 �S
POR(.—A:00 969.00 SF
ES3'INATED COST OF CONSTRUCTION'
346,7".30
PERMITFEE E Si.fMM.ARY
CONSTP.t3f,°'iIO 101-040-418-000 V,504.00
it FC'IrLMCAL FEE 101-000-41.1-wo $98.59
:ECTR10kL ME 101-000.420.0100 5249.44
1 trt7Ml3,[1�(3 k'I""a 101-000-419.000 5169.50
91701NO MOTION FEE - RFs:S.M 100-000-241-000 $34.68
$-',,0-00
GR+�,P�:}T3�1(A�tGF"!i/vR
}/}]yO � }!j n10�1�-¢00a=�!^yA�()(A;O�
�IN E\AIS '�1.�itlffl4✓.i.1Si 2'iG,lj, �il+5l 000-4,i.i"3if4 so or37 oo
XtT 1N int BIJO .P ;MMS - R:rs31 '701-000.255-i1(2ft 5017.00
PLAN t'-TIECt<:,1 14.1-000.43;-318 $1,204.77
FSE 4250100
SU13=10TAL. C;O1+tS"1.'FdiJC"C'fON AND PLAN CHECK
$nr$98.G9
::P tS
LESS PRE -ib FEE
-$2.50.00
FE&S
,1OID6.1LP1G.liMI .DUE]NOVo"
:7f9`pV�i}�tI.T
NOV 17 1995 TUTAL PROACT PEIIR I a FEC -3
�~
REC P
DATE
BY
PA
INSPECTOR
INSPECTOR
N
t
X
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
- (,!i\
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
- [ !P
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 Wall Firewall
Exterior Lath
— [
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
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
Pool Cover
Sewer Connection
i
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
Final -
Utility Notice (Perm)
COMMENTS:
M�
G
U�.
6r✓"j-
P.O. BOX 1504
/7&105 CALLE ESTADo APPLICATION ONLY
-Addrress 55� ` LA QUINTA CALIFORNIA 92253 A" j
%6FIR IB47eJ-1fA- M I rc) it/h 1.(1? ( l o
Mailing "
Zip / Tel.Contractor
City Zip
State Lic. City
& Classif. Lic. #
Arch., Engr.,
Designer TlAk 4-U2z �¢
Address Tel.
3 u C s o/u
City Zip State
51l ti biE50 I% a // Lic. #
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, 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 the alleged 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).
IVI, 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 suchimprovements are not intended or offered for sale. If, however, the building
or improvement is sold within one year or completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
I 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.)
1-3 1 am exempt under Sec. -B. & P.C. for this reason
Date /0 Al /50wner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation gsurance, or a certifie copy there f. (Sec. 3800 Labor Code.)
Policy No. 0, Company f /Gr�
IPCopy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WO R KERS' 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 why h this permit is issued, I shall not
employ any pers9n in -any rpanner so as to become sybject to.the Workers' Compensation
Laws of California
( %/ - /{i
Date •Owner t 'C.E•fY,��(� hjGi>La' t10 (f/,1✓
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.Set. 3097, Civil Code.)
Lender's Name t I i B
Lender's Address K i I
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 Address
City, State, Zip
BUILDING DIVISION
JILDING: TYPE CONST. OCC. �GRP.
P. Number
Igal Description _407-3. a5.3 9�7
oject Description
Sq. Ft.
Size
New E
No. No. Dw.
Stories Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
mmalea valuation
PERMIT AMOUNT
Plan Chk. Dep. r J?
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 t
ValldatE
Validati
COACHELLA VALLEY UNIFIED SCHOOL DISTRICT
CERTIFICATE OF COMPLIANCE
(Government Code 53080)
Project Name: _
Project Address:
55-180 Inverness, La Quinta, CA 92253 PGA WEST
Project Owner's Name: Tom And Roberta Minii�hel 1 o Phone No.:
Project Description: SINGLE FAMILY DWELLING (One)
Building Type (Check one):
Commercial
Tract No.:
(Include No. of Dwellings)
Industrial
Lot No.:
(If tract, attach Schedule "A" of all lots by tract, square footage for each lot and total.)
Assessor's Parcel No.: 769 620 003 7
(If Schedule "A" is used show Assessor's Parcel No. for each lot if one exists or Assessor's Parcel No. for parcels before subdivided.)
Total square feet of Building Area:
4104 Sq.Ft.
Certification of Applicant/Owners. The person signing certifies that the above information is correct and makes
this statement under penalty of perjury and further represents that he/she is authorized to sign on behalf of the
owner/developer.
01
Dated: /l b 7 &1 S_ Signature:
City/County Certification:
(Signature) Optional
(Title)
SCHOOL DISTRICT REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE
SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING (CIRCLE ONE):
Gov. Code -Gov. Code Project Agreement Existing Not subject to fee
53080/65995 65970 Approval prior to 1/1/87 requirement.
Note:
Total Number of Sq./Ft. 4.104
Amount per Sq/Ft. $ 1.72
Amount Collected $ 7,058.88
School District Official : tOQ41 I lnS/S .1/ Title: Asst. Superintendent, Administrative Serv.
Foch "Tut" Pe is
Date: November 17, 1995
Phone: (619) 399-5137, Ext. 235
Note: AB 2926 and SB 201 fees are capped at $1.72 per square foot for all residential construction, and at $0.28
per square foot for commercial/industrial projects.
RECORDING REQULrSTED BY
AND WHEN RECORDED MAIL THIS DEED AND. UNLESS
OTHERWISE* SHOWN BELOW, MAIL TAX STATEMENTS TOt
NAMEI
Minichiello 1988 Trust
rSTRICT
ADon[ss
Cit ®
CITY.
STAY[
xlr L J
Title Order No ..543017 Escrow No ....13260.......................
RN
This space for Recorder's use
PARTNERSHIP GRANT DEED
THE UNDERSIGNED GRANTOR(s) DECLARE(s) 152.90
DOCUMENTARY TRANSFER TAX is S
❑ unincorporated area ® City of La Quanta
Parcel No.
r] computed on full value of property conveyed, or
❑ computed on full value less value of liens or encumbrances remaining at time of sale, and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
TWO LAKES JOINT VENTURE
A GENERAL PARTNERSHIP ORGANIZED UNDER THE LAWS OF THE STATE OF ILLINOIS
hereby GRANT(S) to
THOMAS MINICHIELLO AND ROBERTA G. MINICHIELLO
trustees of the Minichiello 1988 Trust dated June 30, 1988
the following described real property in the City of La Quinta
county of Riverside , state of California:
Lot 3 of Tract No.25397 as per map recorded in Book 218
Pages 20 through 25 inclusive of Maps.
TWO LAKES JOINT VENTURE,
an Illinois general partne
�Toma_sA.
R
Dated June 3,,-1992---- - General rartner
F 't'AtEF6flNirt=l1 noes BY: LLA�KgE DESERT PA9TNER
STATE O
an III3no3s General parEnership
COUNTY OF— v�-ar9!de Lake- j SS.
BY, ener a er
On 5/3/92 GGg 11 g V
before me, the undersigned, a Notary Public in and for said County 3tsaPlanaf,inQrgeneral Partner
and State, personally appeared
Thomas A. Rosenquist
--- Alan E. Richards
known to me General Partner
to be All of the partners of the partnership
that executed the within instrument, and acknowledged to me that
such partnership executed the same. OFFICIAL SEAL
n STEPHENIE G. NIEHOFF
Signature G ' ��'"� NOTARY PUBLIC. STATE OF ILLINOIS
MY COMMISSION EXPIRES 10/12/92
Name (Typed or Printed)
Notary Public in and for said County and State (Space above for official notarial wall
MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE
Name Street Address Cid a Sate
0
W a
~ Z
c a:
0
4�
This space for Recorder's use
PARTNERSHIP GRANT DEED
THE UNDERSIGNED GRANTOR(s) DECLARE(s) 152.90
DOCUMENTARY TRANSFER TAX is S
❑ unincorporated area ® City of La Quanta
Parcel No.
r] computed on full value of property conveyed, or
❑ computed on full value less value of liens or encumbrances remaining at time of sale, and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
TWO LAKES JOINT VENTURE
A GENERAL PARTNERSHIP ORGANIZED UNDER THE LAWS OF THE STATE OF ILLINOIS
hereby GRANT(S) to
THOMAS MINICHIELLO AND ROBERTA G. MINICHIELLO
trustees of the Minichiello 1988 Trust dated June 30, 1988
the following described real property in the City of La Quinta
county of Riverside , state of California:
Lot 3 of Tract No.25397 as per map recorded in Book 218
Pages 20 through 25 inclusive of Maps.
TWO LAKES JOINT VENTURE,
an Illinois general partne
�Toma_sA.
R
Dated June 3,,-1992---- - General rartner
F 't'AtEF6flNirt=l1 noes BY: LLA�KgE DESERT PA9TNER
STATE O
an III3no3s General parEnership
COUNTY OF— v�-ar9!de Lake- j SS.
BY, ener a er
On 5/3/92 GGg 11 g V
before me, the undersigned, a Notary Public in and for said County 3tsaPlanaf,inQrgeneral Partner
and State, personally appeared
Thomas A. Rosenquist
--- Alan E. Richards
known to me General Partner
to be All of the partners of the partnership
that executed the within instrument, and acknowledged to me that
such partnership executed the same. OFFICIAL SEAL
n STEPHENIE G. NIEHOFF
Signature G ' ��'"� NOTARY PUBLIC. STATE OF ILLINOIS
MY COMMISSION EXPIRES 10/12/92
Name (Typed or Printed)
Notary Public in and for said County and State (Space above for official notarial wall
MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE
Name Street Address Cid a Sate
ARCHITECTURAL/LANDSCAPE VARIANCE APPLICATION
1 t11 1 �Y • •
Please complete and include this request form, along with
four (4)sets of your proposed home improvement plans to:
PGA WEST RESIDENTIAL ASSOCIATION, INC
P.O. Box 1060
La Quinta, CA 92253
or, 55-940 PGA Boulevard
La Quinta, CA 92253
Attn: Property Manager
NAME: / U
ADDRESS: -
PHONE: !
PROPOSED STARTING DATE:
AP ,RJ;XIMATE COVPI•tE.TION DA
owner's Sianatu
DATE: /D %S
The following appropriate information should accompany your
completed application:
1. Four (4) sets of complete plans to include:
A. Improvements and/demolitions
b. Plot plan
c. All dimensions proposed
d. Relationship to neighboring units
e. Material and color scheme
f. Planned modifications of all external systems (landscape,
sprinklers, gas lines, electrical, etc.)
2.' Agreement and Covenant Running with the Land completed and
notarized. Two (2) original.
3. Conditions of Approval and Disclaimer form (signed)
4. Facing and Adjacent Neighbor form (if applicable)
5. Construction,Regulations form (signed)
ELECTRICAL [ ] Approved [ ] Disapproved
Signature Date
LANDSCAPE [ ] Approved [ ] Disapproved
Signature Date
ARCHITECTURAL CO TTEE* Approved [ ] Disapproved
i
Signatureffff
Date
ARCH/Rev 8/95 � _ 1
f0i�vb'sASTELLUZZO &ASSOCIATES • ARCHITECTS &PLANNERS
Tom Minichiello.
Re: Minichiello Residence
PGA. West
La Quinta, Ca.
Title 24. energy Calculations
Mr. Minichiello
In my teleconference with the-plan.reviewer for. the City of La Quinta, .I informed Mark that the building is
calculated based. on a prescriptive, compliance with Title 24. 1. informed Mark, that the glass area would not
exceed 16%, of floor area, that two water heaters were provided, and that I would add the required notes on
the plan. for the air conditioning system compliance.
Based on my calculations, the residence has 298 square feet of insulated glass sliding doors and 354 square
feet of insulated glass windows for a total glass area of 646 square feet. The maximum allowed under
prescriptive. compliance; is 656 square feet.
The plans will include the note. SPACE COOLING 10 CER" on the certificate of compliance.
The window schedule will be adjusted as follows-.
1. Change window no. I from - 3' x 2.' to 2'x 2' -
2. Change window no. 3 from - Tx T to 4'x 2'
3. Change window no. 4 from - 10'x.6.8" to 6'x 4' C
4 s'hwig��rree p3
5. Add window no... 15 at 2'x 2'
The Glass Area Summary is as follows:
Total Glass Door area
298.
Total Window area
328
Total Clearstory area
20
Total Glazed area
646 square feet
We hope this information will. satisfy the requirements of the City of La Quinta..
Sincerely,
James Castelluzzo
r
3930 Carson Street, San Diego, California 92117 9 (619) 274-9162
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LOUVERS
No. 660CT
Circle Top Louver,
No. 66ORT Rectangular �a...o•.
No. 660R-12
No. 660R-115 �\
No. 660R-18
No. 660R-22
No. 660R-24
No. 66OR-28
No. 66OR-30
No. 6608-36
No. 660R-42 �—
No. 660R-48
No. 660R-60
Round Louver
18" , 22" Q4" 28". 30", 3611, 42" , 48" 60"
Diameter: 12" , 15".
Projection: 1%"
Specify closed or open with screen.
41_
No. 660PR-20
660PR-27
r No. 6 4
Outside Diameter: 20", 27", 34"
Projection: 21/2"
Rim width: 4"
Specify closed or open with screen.
No. 660 QL24
No. 660 QL36
No. 660 OL44
Quarter Round Louver
No. 660 OR24
No. 660 QR36
No. 660 QR44
Quarter Round Louver
o -c,.- 24". 36", 44"
No. 660PR Round Louver.
Note: Louvers can be rabbeted
to receive siding. Specify.
No. 660 CT
Circle Top Louver
Projection: 17/e"
Specify closed or open with screen.
No. 660.12
No. 660-18
No. 660.22
No. 660.30
Octagon Louver
Diameter: 12", 18". 22". 30"
Projection: 17/e"
Specify closed or open with screen.
2"
No. 660 R -32R2
Round Louver
Outside Diameter: 32"
Projection: 2"
Rim Width: 2"
Specify closed or open with screen.
open
No. 660RT Rectangular Louver.
LOUVERS
No. 660CT
Circle Top Louver,
No. 660R-12
No. 660R-15
No. 660R-18 r
No. 660R-22 k
No. 660R-24
No. 660R-28
No.660R-30
No. 6608.36
No. 6608-42 �-
No. 660R-46
No. 660R-60
Round Louver n30 a
28 , , 36 , 4211, 48", 60"
Diameter: 12" 16" 18, " 22". 2410
Projection: 1'/e"
Specify closed or open with screen.
4"
No. 660PR-20
No. 660PR-27
No. 660PR-34
Round Louver
Outside Diameter: 2011, 27" , 34"
Projection: 21/2"
Rim width: 4"
Specify closed or open with screen.
No. 660 OL24
No. 660 OL36
No. 660 OIL44
Ouarter Round Louver
No. 660 OR24
No. 660 OR36
No. 660 OR44
Ouarter Round Louver
Rnriius: 24", 36", 44"
No. 660PR Round Louver.
Note: Louvers can be rabbeted
to receive siding. Specify.
No. 660 CT
Circle Top Louver
Projection: 17/6"
Specify closed or open with screen.
r..
No. 660.12
No. 660.18
No. 660-22
No. 660-30
Octagon Louver
Diameter: 1211, 18" , 22". 30"
Projection: 17/8"
Specify closed or open with screen.
2"
No. 660 R-3282
Round Louver
Outside Diameter: 32"
Projection: 2"
Rim Width: 2" en with screen.
Specify closed or op
+, %W
rta
or open
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