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INSPECTION RECORD
OPERATION I DATE INSPECTOR OPERATION DATE INSPECTOR
Set Backs
BUILDING APPROVALS MECHANICAL APPROVALS
Underground Ducts
Forms & Foofings j _ Ducts
Slat? Grade Return Air
Steel �]` Combustion Air
Roof Deck Exhaust Farts
O.K. to Wrap - F.A.U.
Framing
Insulation
Fireplace P.L.
Fireplace T.O.
Party Wali Insulation
Part' WalI Fiwiall
Exterior Lath
Drywalf - Ini. Lath
Final
BLOCKWALL APPROVALS
Set Backs
Bond Beam
Final
PLUMBING APPROVALS
_Waste tines
1R+!Ws Pipin.R
Plumbing To Qtit
�.:
.311011,r Fans
Se.°.er Lateral
Sewer Z;cnn tii [3n
Gas piping
Ges Test - — —
Appliances -
Floral
U111irty Nclore (Gas) I —
ELECTRICAL APPROVALS^
Temp, Power Pole 3 -//—
Underground Canduft -
F:ough Wiring
Low Wine Wiring
Fixtures
!ialn Service
Sub Panels
Exterior Rece staclei
G.F.I.
Smoke Detectors
Tamp. Use of Power }
en s
Grills
Fins & Contrnis
Condensate Llnr
Final
Steel
Electric Bond
Main Drain
Approwa] to Cover
Equipment Lc atfon
tlride;ground >±lectrlc
Underground Plbg, Test
Gas A iing
Gas Test
E, tric Final
Heater Final
'IumLing Final
EcDAmeet Enclosure
O.K. for Finish Plaster
Foal Cover
COMf�ENTS.
POOLS -SPAS
Final
Utility Notice
fA
City y� I Zip
Contractor
Address
p
State Lic. I City
& Classif. Lic. #
_ Fall
✓ 5a -7�y R�
P.O. BOX 1504
TAM 0 r �,
Building r - > -,� � '� 78-495 CALLE AMPICO APPLICATION ONLY "1
Address , LA QUINTA, CALIFORNIA 92253 O \\O'�
Owner -
BUILDING: TYPE CONST. OCC. GRP. fJA
Mailing Address A-P- Number L
k Legal Description ■ 61
0 - -
Project Description S W
r
Arcflr,, tng r.,
Designs , U
Address _ Tel.
City Zip State
,� I F-1, Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereb affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70rlpj l-
of �ivletgn 3 of the Business and Professions Code, and my license is in full force and
eFfec
PATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the followlnI
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 (f500).
l7 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.)
I 1 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 properly who builds or improves thereon, and who contracts for
such projects wllp a contractors) licensed pursuant to the Contractor's License Law)
f! I am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of coneeni.to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy ['hereof. (Sec. 3800, Labor Code.)
Policy No. Company
f7 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
{This section need not be complatod if the permit is for one hundred dolem (11100) valuation
or less. J
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any,ppeersan In any manner so as to became subject to the Workors' Compensation
Laws of Cat,Tarnia-
Date Owner
NOTICE TO APPLICANT: 11. after making this Certificate of Exemption you should become
subject to the Workers' Compensation provpslons of the Labor Codo, you must forthwith
comply with such provisions or Ihls PUMP shelf be doomed 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 1 have read this application and stale that the above information 13 Correct,
1 agree to comply with all city and county ordinances and state laws relating to building
ronslruction, and hereby authorize representatives Hof this city to enter the above -
mentioned properly for lnspeCt[on purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Sq. Ft. No. No. Dw.
size l Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I- i f fl
Grading �►. ) j
Driveway Enc. r.
Infrastructure ¢,E� _ '°'"
r , �.._,
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 by: Date Permit
Validated by:
Validation:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Date
10/1 /02
No.
23678
Owner
Bob and Brenda Chaney
Address
City
Big Bear Lake Zip 92315
Tract #
24890-4
Type
Single Family Residence
Lot #
Unit 1 67
Unit 2
Unit 3
Unit 4
Unit 5
Comments
No. Street
50785 Nispero
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515
S.F.
4684 Unit 6
Unit 7
Unit 8
Unit 9
Unit 10
z o
Q BERMUDA DUNES r
RANCHO MIRAGE
� INDIAN WELLS
�:. PALM DESERT y
LAQUIo A
`�Q N`5
APN # 772-070-017
Jurisdiction La Quinta
Permit # 0110-204
Study Area
No. of Units 1
Lot # No. Street
S.F.
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, 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 4,684 S.F. or $10,023.76 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 OC/Cal Fed -Robert Chaney Check No. 400258162
Name on the check Telephone 760/772-3321
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Monica Guillen $10,023.76
Payment Recd Over/Under
Signature
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
01/15/2002 15:28 760-3403728 GLS GROUP
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PAGE 02
M�A F. MAKEY
.P,Q' WK6739
"t'G ]t L&W. CA
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M--d"Tax Scmvm0nr-- W' SAMM AS, ABOVE
REGISTERED INSPECTOR'S WEEKLY REPORT,
JON TANDY
78-194 Elenbrook Ct.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ RUCT. STEEL ASSEMBLY ❑
❑ POST TENSIONED CONCRETE ❑ ASPHALT N OTHER
❑ REINFORCED MASONRY ❑ FIRE PROOFING
JOB LOCATION
�� A �L
REPORT SEQUENCE NO
TYPE O�BIJC'T„i�,RE /�
/W`-�
r
PERMIT NO.H
O�
I``7�c��
DAY OF WEEK
MATERIAL DESCRIPTION
^
��J
ARCHITECT
1 2009
HRS. CHARGED
+� � � l.(/�
ENGINEER
ASSISTANTS
HRS CHARGED
L SUB
DATE INSPECTION GENECONTRACTOR CA(' 1` CONTRACTOR
SL)e
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e2 0 (1 Q t4 �-G( 0
LI.S [ u.e_ e- i�
COPY SENT TO CLIENT D CONTINUED ON NEXT PAGE ❑
PAGE 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
IG URE OF REGISTERED INSP TOFF
DATE REPORT REGISTER NUMBER