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SFD (9801-033)77285 Loma Vista 9801-033 LICENSED CONTRACTOR DECLARATION 1 -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 Date'/ L"'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). O 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: ( )J 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. a f !: •S1tf,f'i' r Y''iJt V iJ di J.l6t yi,.; (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 with4hose provisions. iDate: pplicant !✓ Gr' : /F . / ' , . -,, - 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 coriditions 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 therabove-mentioned property for inspection, purposes. / l Aat (Signature (Owner/Agent)` `//f /I „ . • BUILDING PERMIT PERMIT+ °°NTR°`#';• ,i i)1-9ff DATE - 3 -.1v9i VALUATION S339,449.441 9.441 LOT. TRACT, JOB SITE ADDRESS 77-285% LRZ[i'IA VISTA JAPN OWNER CONTRACTOR/DESIGNER /ENGINEER JAY Q ,':E i:EV PO BOX 1938 5418.80 AVE. ALVAU.DO' ALPINE NY it 620 LA QEJ+NTA CA 922153 ( xJjS6f: PSai . CRL4 196.I - e USE OF PERMIT SFD •- P MWIT DOE s NOT 'i`7`zeM"U E BLOCIK WALLS' (iIt,Po()L ; C"TS, klCONSTfaUCTIOi ? 68.00 SF tac,,t'tC.t!l.CA.TACi [,0'J5.06.t j±' ' Gr1I2Ac}i !t ARtK i?'.!' 4%3.0 SF pg, •g !t A pY C 1. ' • ^e ♦est, 1 a tf g^wy ply US MA .' ..i,v -a .s •e,7 Q. Wa L.VI aY l Ewti.t'n. kf§.isi i 2 - i>4 . 2 ,i z A qI, t4 q • CO:NS7RUC1111.014.FEE 1.01-000.419-000 S1,4'+9.50 PLAN ir'K.C1 FLS MEC,'"f !X,,A 14 E 101•-000.420.000 PL[jM61NO FE 10,t OOU 1"t '[+ig() 522735 . ' 11if? di" xv C)'i'1(t' 7 i"ham RFTSID 1011e4DQ0fll-000) `G t ,R C ,. •'Lama C C1 AS C13Z1CTiJTd.E P- .1251-000443-342 $4,000.w ART IN PLY91 C -PLACES - BF -WE' 701 fi()t)-255-000 -VS0•11010 S1J8-"!'C FAJ1 f'0NST'RUC-r[c.P; AND PLAN C111-i:k h . ,` , , ". 4.1ESS PRE -PAID FE •1•01'A'L:P1,?RAI #J` fe US MI_t,=:1:.l4iOW Y ;Xtks.1' RECEIPT DATE BY - DATE FINALED - INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs I Underground Ducts Forms & Footings A Ducts Slab Grade Return Air Steel Combustion Air Roof Deck 9 Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation l 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 — POOLS - SPAS BLOCKWALL APPROVALS steel Set Backs Electric Bond Footings Main Drain Bond Beam j Approval to Cover Equipment Location [ C/ Underground Electric G 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 _ Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL 1.00 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 GG (Perm) . a r _ Desert Sands Unified School District ®. ,Notice: 82-879 Highway 111 Indio, CA 92201 Document Cannot Be Duplicated 619-775-3500 CERTIFICATE OF COMPLIANCE Date 3/11/98 APN # 631-810-006 No. 16709 jurisdiction La Quinta Owner NameJay Green Permit # No. 77-285 Street Loma Vista Log # City La Quinta Zip 92253 Study Area Tract # Lot # Square Footage 3968 Type of Development Single Family Residence No. of Units 1 Comments 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 or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE 7- This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount bf '; a vo 14 1.93 X 3,968 or $ 7,658.24 the property listed above and that 6uiilding f . permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issu Fees Paid B CC/Valle Independent BankCarrie Hamilton 44 By y p Telephone 564-4844 Name on the check By Dr. Doris Wilson Superintendent . Fee collected /exempted by Rosita Jones Payment Received $7,658.24 Check No. 158202 Signature 10TICE: Pursuant of AssemblyBill 3081 CHAP 549, STATS. 1996 this will serve to not' ( ) Ay you that the 90 -day approval period in which you may protest the fees or other payment identified 1 bove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to J o1lect them on the District('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting , vjtwx - >n_-. • . } •--r p...ylJ '`9 rr. Y(LRY+MIYYM r 10:39 From:GENERAL CIGAR HOLDINGS T-642 P.02/04 Job-600 -a. VEt7 FOR R~CO • 1. RECORDING REQUESTED BY : AT 2:00 Q'CLOCK OF.l,_VGE COAST TITLE C,0 PA -' 95.5324DT R-101074-3 r t > NOV 2 7 i9 WH9N RECORDED MAIL THIS REED AND, UNLESS OTHERWISE SHOWN BELOW, tiCBa151 TOX MAIL 'tAR STATEMEN'T'S T0: I 1)0c," JdKNSON taco!dd#+Oitkia}Ftra! : RA ci SiAroroids CeurS}r, calranl JA'i M. GREEN fiiv• CA- R ®s' Reccrr and RENATE GR F ;:N r P.O.. BOX 198 1{ ► ALPINE, * NEIJ JERSEY 07620 SPACE ABOVE THIS LIVE FOR Rl R-!RDER' S USE f:u The unda.>rJigned grarltor(a) dac.l-re(a j Documentary traTisfei: tax is 4'65.00 (,l}''« Ciomputed oil frill va'1.uk of proper Cy cc TVeyed, UT Compt'jue ? ll! fu].L V81,L1 - i- $` 11.et;S '1V C• ;C.UIt y)1'' T1G65 I ilR3 i iT111:S? _t t P.'-C Of t1? . • 5 Lltl ,Tlcd*'po?:ated .rwe ( j C,? try 0L 0: FOR A VALUABLE CONS YDI~"ATYC )ti ', _ c which, is here-by acknowledged, recelpr N' 15 INVESTMENT CO1 1'iRP_?1;)! , aiI ()t?'_o t:0rnorevi,or CITIZEN'S " here`;-, GR_kNT(S 1 co - JAY, i1, uREF'. and. RcY A:!'E-/i'ZEE'i. iusbi nd s.n i .1.fe as. Joint T'enanT s the real , ope:rb iii the City of LA QUI:C'TA; County of Rive si3u, Se: ,e of aii_or!tia, ,Yr described as: ! y- V :3L"F E I4Y.BIT "1" ATTACHED HERETO :ttv1D iryr)F A FART h2REC. Datad NoVa,7tb2R' r. " sta : : £' G il3.fo 'r1t C._.=ZE1S Iiit%L `l =r;7T COP0 ;`aTIC V C unty (if jv21:SlGee' C S. an Oh:G v ?:]nr3,i0ai L On v I"ovem,Lbd'cr 199 5 _. __ ----- — before me, _ the undersigned notary Public_ _ perso-nally appeave;' B wi111a1e .': ae%"and Fhill7_ , d'`-'llloyd. _ ' 5 -- -• , lth v:c x: asa;r rr T -:roved . ;-o ite G^ the basis o: sa.ti,factoiy 6vid6nca) to be `'ala! V X the i7ei'bCit(s) (:hose llallle(s) CJ E. :'J1Ljl2Tl 1.115LI U.11i T1 alld .3 L; :.:OWiE3<I eCl LU Me tl-,,at hev# tie%Clley e:;ecT.l"ed the salve m MILLER it r:: ^. Pl /thei.r au.thoT: i zr.G capaci t . (ic:s j , all COMM, 095a?. ,6 .; ?; ;+;.'a 'i^ hloiclry Plebiic tal;forrla Ul t aL by lrjsvA v&/chair si ilsru>'et;5 on the o ) 1 l ;S t: . RIVEi:SIDY COLIi'd?Y (/j 1!1Sril'iiilent. the persons) , U2 file entity utiCTl klyCO—ninionExpire5 a behalf of which the person(s) acted, execitLec'i Januory21, igah the instrument. WITNESS myacid official 5es1. S'igTiatLlr (This area for official iiotarial seal,) 0 iiiier t MAIL TAR E TS s FEB -06-98 10:40 From:GENERAL CIGAR HOLDINGS '1 T-642 P.03/04 Job -600 K 14 z PARCM 1. " Lot ' 26 pF Tract Ii,-). 25237, n the City of La (, U41tc , ('-% t' O1 '_ 'rSi. B, * to 9`i), inclusive, State of Cal;forn a, as ;tap 2'ecc rded in Booi,. 228, e of l ps, `in the 0-f ice of the Cot,.:.-tty Recorder of ,aid County- F,E'"7F' i i '. t% i': OT' ilp 't xlefit of Iit.C Z .' S S ?C:C .'-Ssol. • j1i interest. ZlI1 others, nonexclusive Qa c o for aocesS, in E=ss: E' ie s, r iiit+ _t3 7C.e, _ Y' ; =iir, dicliik C,P-., dt' for C tY,,ex. puzp.oses,. all as C 2:- ] iil :hQ 'TSG w'?"eii`"_1L i1 bYI' i 0 Belo;:. '• a7 res t 'rne%` '+ 1i"the 4ir L?C LCL .CJ aeS C , , richt to grant and ttamfe •all or a porIl ore of the same: }A• 1 1 1+1. Levipu yy ur-r aa cis r1•y;it ; 'r: in xa.1. r+i4rrlt'9 natu)-a i gas r hts d righ' ..J"• o 1 . C.I6 he. a: i Q,'i_'L"f-: R 'i T d7 L --ba 4.. 'v .L• name i 7L ::rl f tL. i G 1. },eat aTZd ' r alb x'CaClacts de?,-jv—_3 from, anv Cif the lEnregoing - - geoth.erma (collectively, "Sub. ur'face c-soLZ s" ; situ _ $. T?lc 1?r_liza_ 7;c, L i ^ ,•c x'.i , m i:ne; r ,.yrs •ar4 cper t produce, sr -ore and reeve. ar:y' of vthe St: bs,_ •face Rese -e - n cr _on said Wit, lncludzr CasYE a.1Qht -to Tej- a6t > pL" Cl -F'.i: iwnt+lly' i Y'1. DIY? T 11t? EZ'4in TlC? rather ' f 'Y t t 4 '' - St Yfa tn,a.n' said Lot 't,,'esll'' , 4 )..rx)els iiyl shafts into, n..oa.,l e .r acto.ar . bottom coa4 aj- alle3 4F31s, of said. Zo , an , to _!c -t Z.,L 7tcR: rea a ,zaxeti }a? d £tri to ti i l or its cif. saa_ -. Lot, a1 to Xt l'i , ?cCtirltle3., equip, Yrkq.t-i`1 .:a: , [o a.ira c'te 1:EYt. _arr3 operateciri - slrC'i. jw"eE S Or 7012IEa, but ivit:iGL+t _'rl Y ' i % . t 7 : ?ill, it L`l , E -y -) Ore, OI?t'Y 4 %, Y fes, -,tote off.` per renyove any Of ltie' l". "y t 2 t:E' aC:t: j'G iC l: tic G h' dor i Z i PSe_ stiti" s { Y' Vic? 11L5 five hur.jr 3 f t . aDU s - f the 1 lliiret.- p_. d, :i_,. PARCEO ,. y } t L '>; +,Y Sa, {J9c3 r'i ' C 3.r1I1,^?1 ca.r ct, cif; described A nonexclus.Ivu. as ir 7 £c f c"'I',.S 'd pp_s,_ i.cC o s rw'6 Tii G'zV; l ?On' Of Ln the Lk rlara-t:ion Eet nt5 recoxr. d Y 5prc ? 12, Zt: `,. tTti Tit PPRCF.! ; 3 ° .. and A ncYnexc:1u;5i.V:y f:.asamr int for clCi ,S, >?`y S a7 t' _ ;r s 7 CEJ; 1? tricr2 lar ptl*: icy 5 over those pr' v-a`e -1 xee s :ae czir : the 'iT'L't `l.ca .s ° and • "V T1tLl c rr Tt" ;ZCn CiS. # ciS c P.=aC.["? lI? ? t c'.:? a.in C ''AO:CeuTn ilt TaI? :GT 1lt O " 1 recorded on e_hrua y 25, 19$7 as jr*Lst.Y' z% nt. o. 52-39, 117 Non-exclusive E— 'a nts „ } a'!°f.iCid1 Records of 'eni.^Q. CQUYY1 Ca f nY ? is ("i;iS i G'Y'Ont ) f f 0 j. .. "_• .., r^... ..til. ...: "'t `[.,yM ,•. ... Nt '( . FEE -06-99 10:41 From:GENERAL CIGAR HOL'G.INGS T-642 P.04/04 Job -600 ' X1'4.1 r._.IrM1' i . .• rµ 1 At\:i .. 1. 'C x1Er_al and special. rear prapii y t&-es~f 0.r ti -Le c^urrani:i fiscal y =a_r " supplar: r t.a as sr t ?... ??j17• L 2. Cove, -,ants, cone-iti ons and rest ' - i rimionsy easem&Bentz-, resexvatiar ,' rigY:ts a3 of record. G,st,nt of a.>y ac.. xp am r ?.. d rc-c- .rdation. ' :- As dead, e cpl S!, J cry celatS, covenants and agrees to ?)e ki d by arra aslgm +fox r of : of the provlsio7s and'r. irrr: n fi6t orf<}1 in ' i]e` Use A reelDe-n'r_ 1Y` C? e > 1 <'a cti of . Covenants, Condit ione r Rem r v z©ns w, d. ? «servation of s n, -n om : for 'he r Enclave MoLiT:.air Fsba ea (,t 'rar'ci0H1) r6r.)rdc-d. on. March '1 62 as lrs-r2. giant No. 8210-8, its ,the C?r` _cia:l Rec—Ords c;f Rtve.:-S :32 Ceun-v, c liforrx ," e^7>]ich X r .t ,e r - e Y3Ci a of which proviso m :a reauircjrr ]ts are ack: 7o-wled .d 't.o. . eas a.a . , i., are a_ncorpOrare he reLn by txtis refe nca— r1"t—,i s . , i d upon ane ,.pez cJiance of such rcys`vicn + a c ; ± _ r . * G a t iLee ir,"'PG?mx: +. "!'r1 L7dG2 Eo1" : 1 •C:"! t ?Y Lo' s i11i rfl E?i : s 1 51_t Palt r L fY ii }ice dT 1i '. a 0;4 Z:S l 11Se c3rE fully set for ",I .h iein aT;td iT: '. 4 ns- -t1Cl; scY tic: Use.".P-g *ent, tc. 4.'IZi,ch this deed i5• re`:siy made. sem: b . R O B E R T H. R I C L I A R D I i r A. I. A. & ASSOCIATES ARCHITECTURE ENGINEERING PLANNING INTERIOR DESIGN May 22, 1998 Building Department City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 Re: Green Residence Framing Inspection To Whom It May'Concern: I Robert H. Ricciardi the Architect' of Record on the Green residence, 17285 Loma Vista, Mountain Estates, La Quinta California hereby testify that I visited the site and reviewed the framing and I found nothing wrong with the framing and all the required metal connectors shown on the drawings, prepared by my office,: seemed to be in place. If you have any questions please feel free-tojcall me. sincerel Robert H. Ricciardi Architect lid. No.'C3808 75-090 ST. CHARLES PLACE, SUITE A • PALM DESERT, CA 92260 TELEPHONE 619-346-2223 FAX 619-340-2693 J2P-1U-7Cill L0H Y V1 _.j Vi wJVCu hKiSll W. HANS.UN PAGE 03 Kim W. NAS SOM - ,. 1 rcl tecr 4O' 9 2 13 MY G I ACK KUAU PALMDESERT, CAUFORNIA 92200 (700) 776.1060 FAX 770.1066 September 9,1998 a. Desert Resort Management MarlOnne Adkins Alessandro f Pair" Desert, California 92260 . Re: Design Review Green Residence #° Dear committee Members: I have reviewed -the Submittal in Connection with the above- ;.. referenced appilcation. The submittal appears to be in accordance # with the Design Guidelines subject to the following condltlons: i . Location of"wall is approved. 2. Gates approved. Provide color sample for finish. If you have any, questions wits' rea3rd to these conditions, please feel free to call me at (760) 776-4068. . 6 i i is son - Y n ting Architect f -7-7- 9 17'y OF LA 01,.tsj i-FA APR 2 RECD JON TANDY BUILDING AND __, 3580 .Condalia Ave. :SPECIAL INSPECTION.SERVI CE Yucca Valley, CA 92284 (760) 365-5045 REGISTERED INSPECTOR'S WEEKLY REPORT TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE ❑ STRUCT. STEEL'ASSEMBLY ❑ ❑ POST TENSIONED CONCRETE ❑ ASPHALT ❑ OTHER ❑ REINFORCED MASONRY ❑ FIRE PROOFING JOB LOCATION f717_ a oimA T 0 L t]!V, ,PJERMIT REPORT SEQUENCE N0. T pS UCTURE 4 ` ^Qr . NO. DATE ' DAV OF WEEK MATERIAL DESCRIPTION / J/ - ARCHITECT ITNSP HRS. CHARGED -ION ENGINEER ASSISTANTS HRS. CHARGED INSPECT DATE GENERALS CONTRACTOR V e UB SUB CONTRACTOR __ _ l .e AJ!, l e-6 tR C. -su:Ob c vr-A N E4 -8"f- 4-11 -15 P Tom' 0 a o1A :r --...S• WVSS X %j: &aeB.e• Loio y - JI --3_ 3 w10y-It1-4 A /oY, 14, W -f ' t IAS• a. J.(10e4t- GRuz u+1atO-14-,a L.A. CLI -y L-1 C - COPY SENT TO CLIENT CONT D 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. i SIGNATOR OF REGISTERED I SPECTOR DATE OF REPORT REGISTER NUMBER Certificate. of Occupancy Cityof L a UintaQ Budding''and SafetY pDe artment_ 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: 77-285 LOMA VISTA Use Classification: SFD Bldg. Permit No.: 9801-033 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL Owner of Building: JAY & RENATE GREEN Building Official Address: P.O. BOX 198 City: , ,ALPINE, NJ 07620 By: STEVE TRAXEL U,ate: 2-1-99 POST IN A CONSPICUOUS PLACE a