RPL (9909-176)52011 Avenida Madero
9905-176
06266
LICENSED CONTRACTOR DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of
'Crrapter 9 (commencing with Section 7000) of Division P of, th::-Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
Date 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:
NLA I, as owner of the property, or my employees with wages as their sole
co pensation, will do the work, and the structure isnot 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. . for.4his reaso rI
Date ir?4 ef Signature of Owner t7
WORKER'S COMPENSATION DECLARATION r
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 ` ose provisions.
Date: Z! Lkt. Applicant - ? .t //!•1
`
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 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, or inspection,purposes. f
Signature (Owner.. gent) / ` ''' /r Date
PERMITN4)tX)1i76
BUILDING PERMIT
DATE 05413/1" VALUATION '510,4:tit}.40 LOT TRACT
JOB SITE
ADDRESS 52-011.tWNIDAINIA lFRO
APN
- ;
OWNER
CONTRACTOR / DESIGNER / ENGINEER
t)WT`:EIt,1't ttl.t:i R
i2 -flit AVENIDA MADERO
I..A QUIN i A CA 922'i 4
USE OF PERMIT
KN L A tiIJ,'O Z PA
I'C A.fSPA Cit% IN Al PRE -KA:, t ER
INW+_k'1It IN
POOL ANI CQ SPA LS
N%TIMATM (XIST OF CONS2•tM--ION
10,000.00
t'I iZAUTF64,SFINIMA14%
IILAN CHECK i, h1% 101-(XK)-434-318 4.7h 0%
("C t4in i1M. 10N rf•T 1()i•i1fNf 41K-(9flt) *,11-7 00
1W1.11ANICAL I'll 1*0 4. 101.000 121-000 S:I 49)
la.Et-) 1110U. M 1?l: --1't uL 101-Gth)-4211-(K,0 S 13 ou
Itl.ti; IDINoI+h. -lkx)t, lot-CW-419-U0t) S27(K)
i
St 113-`I( )TAL C( )N.91R1 f -nON AN'0 P1 AN ('1117('1;
1, )W1 Act
1 LESS PRE- AID FEES
%000
101 At, PleRI1I f iti VWS D11IF, Ni 1W
5289.05
RECEIPT
DATE
BY 4
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return 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 8 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 Pibg. 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
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:
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/ Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under Stare
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quin , CA 92253
(760 7 -7012
F ( ) 777-7011
OWNER'S SIGNATURE/DATE
IF
PROPERTY ADDRESS
zms 1,
PERMIT NUMBER(s)
1.
Hurwitz & Flickinger 6193253354
05/01/2003 08:55 7607777011
U
X
A
X
LA QUINTP
P. 01
PAGE 01/01
Bin R
Submittal
City of La Quinta
Recd
TRACKING
PERIM FEES
Building a: Safety DivUjon
P.Q. Box 1504, 75-495 Calle Tampico
Plan Sets
Permit
Plsn Check submitted
La Quinti, CA 92253 - (760) 777-7012
Item
Amount
Building Permit Application and Tracking Sheet
Project Address:
Reviewed, reedy for eorrcetions
Owner's Name:
Plan Check Deposit
A. P. Number:
Address:
Legal Description:
Celled Contact Person
Cin•. ST. Zip'
Plan Check Balance
Contractor: Cf 1A LUIV
KTele horx; `?0 5
"' +=
Address:
Flood plain plan
Projcct Description:
Cit)•. ST. Zip: - M. ( Q
`[ 4
Subcontactor List
Telephone: a-7
-
Grant Dead
Plgns picked up S•hl.l.
State Lie. J
City Lic, #:
Plans resubmitted Grading
Arch.. Engr.. Designer:
"' Review, ready for correetlonsfissite Developer Impact Fee
Planning Approval
Address:
_ j jU ,5 Z
Date Of permit issue
City, ST. Zip:
School Fres
Telephone:
Ptd` Total Permit IF es
POtt•it° Pax Note7871 Date
Construction Tv pe: Occupancy:
Projcct rjpe (circle one): New Add'n Alter Repair
Demo
State Lie. IV:
Name of Contact Person: ole G
Sq. R_: jq X # Stories: # Units:
Telephone # of Contact Person: D S6
stimated Value of Prpitct ! Q „
I APPLICANT: DO NOT. WRITE BELOW THIS LINE
b
Submittal
Req'd
Recd
TRACKING
PERIM FEES
Plan Sets
Plsn Check submitted
Item
Amount
Structural Cales•
Reviewed, reedy for eorrcetions
Plan Check Deposit
Truss Catcs.
Celled Contact Person
Plan Check Balance
Energy Csles•
Pians PiClied up Construction
Flood plain plan
Plans Mubmitted Mechanical
Grading plan
2"a Review. ready for correctionsA5:ue lwlectrical
Subcontactor List
Called Contact Person Plumbing
Grant Dead
Plgns picked up S•hl.l.
H.O.A. Approval
Plans resubmitted Grading
M HOUSE_'
"' Review, ready for correetlonsfissite Developer Impact Fee
Planning Approval
Called Contact Person AXP -P,
Pub, Wks. Appr
Date Of permit issue
School Fres
Ptd` Total Permit IF es
POtt•it° Pax Note7871 Date
From`s
To From
Go./Dept. Co.
! i 7 n&
Phone a Phone p 760;4
Fax Njgg9ri.0.7-Y.ig700a-- -n-v5 % 17- 70Lt
tr1r1C t;Mkl,.d
982(al(15 41
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address):
57 y`FOR COURT USE ONLY
ROBERT J. McFADDEN, JR. (SBN 071883)
McFADDEN & ASSOCIATES
1111 East Tahquitz Canyon, Ste. 209
Palm Springs, CA 92262
20013 AUG 2U A,1''('j0: 36
TELEPHONE NO.: (760) 327-473 FAXNO.: (760) 327-6591
.CITY OF LA DUINTA
ATTORNEYFOR (Name): Defendants
CITY Cil:>". II S, OFFICE
NAME OF COURT: SUPERIOR COURT, COUNTY OF RIVERSIDE
STREETADDRESS: 46-200 Oasis Street
MAILING ADDRESS: Indio, CA 92201
CITY AND ZIP CODE:
BRANCH NAME: Desert Judicial District
PLAINTIFF/ PETITIONER: SABETTA
DEFENDANT/ RESPONDENT: BLECHEN
DEPOSITION SUBPOENA
CASE NUMBER:
For Personal Appearance and Production of Documents and Things
INC 036565
THE PEOPLE OF THE STATE OF CALIFORNIA, TO (name, address, and telephone number of deponent, if known):
R. "Kirk" Kirkland, Senior Building Inspector, City of La Quinta, 78-495 Calle
Tampico, La Quinta, CA 92253 (760) 777-7000
1. YOU ARE ORDERED TO APPEAR IN PERSON TO TESTIFY AS A WITNESS in this action at the following date, time,
and place:
Date: Sept. 3, 2003 Time: 8:30 a.m Address:Dept. 1B - 46-200 Oasis. Street
Indio CA 92201
a. F-1 As a deponent who is not a natural nPrsnn vnl l ora nrrin—A fn A—i.,nnfe. .
• - . - - -- - -- --• -- -- ---•,• • •..... ......v rci ave • W icaulr vl l yvui uCl ldll d5
to the matters described in item 4. (Code Civ. Proc., § 2025, subd. (d)(6).)
b. You are ordered to produce the documents and things described in item 3.
c. This deposition will be recorded stenographically = through the instant visual display of testimony,
and by 0 audiotape = videotape.
d. This videotape deposition is intended for possible use at trial under Code of Civil Procedure section 2025(u)(4).
2. The personal attendance of the custodian or other qualified witness and the production of the original records are required by this
subpoena. The procedure authorized by Evidence Code sections 1560(b), 1561, and 1562 will not be deemed sufficient compliance
with this subpoena.
3. The documents and things to be produced and any testing or sampling being sought are described as follows: Any and
all records, notes, notices and information pertaining to the property located
at 52-011 Avenida Madero, La Quinta, CA 92253, specifically, notices that the
= Continued on Attachment 3. swimming pool was not finallay permitted
4. If the witness is a representative of a business or other entity, the matters upon which the witness is to be examined are described
as follows:
= Continued on Attachment 4.
5. IF YOU HAVE BEEN SERVED WITH THIS SUBPOENA AS A CUSTODIAN OF CONSUMER OR EMPLOYEE RECORDS UNDER
CODE OF CIVIL PROCEDURE SECTION 1985.3 OR 1985.6 AND A MOTION TO QUASH OR AN OBJECTION HAS BEEN
SERVED ON YOU, A COURT ORDER OR AGREEMENT OF THE PARTIES, WITNESSES, AND CONSUMER OR EMPLOYEE
AFFECTED MUST BE OBTAINED BEFORE YOU ARE REQUIRED TO PRODUCE CONSUMER OR EMPLOYEE RECORDS.
6. At the deposition, you will be asked questions under oath. Questions and answers are recorded stenographically at the deposition;
later they are transcribed for possible use at trial. You may read the written record and change any incorrect answers before you
sign the deposition. You are entitled to receive witness fees and mileage actually traveled both ways. The money must be paid, at
the option of the party giving notice of the deposition, either with service of this subpoena or at the time of the deposition.
DISOBEDIENCE OF THIS SUBPOENA MAY BE PUNISHED AS CONTEMPT BY THIS COURT. YOU WILL ALSO BE LIABLE
FOR THE SUM OF FIVE HUNDRED DOLLARS AND ALL DAMAGES RESULTING FROM YOUR FAILURE TO -O -BEY.
Date issued: August 27, 2003
ROBERT J.. McFADDEN,, JR. (SBN 071883). . .
(TYPE OR PRINT NAME) (SIGNATURE OF PERSON ISSUING SUB ENA)
ROBERT McFADDEN JR.
(Proof of service on reverse) (TITLE)
Form Adopted for Mandatory UseJudicial l of Califoia DEPOSITION SUBPOENA FOR PERSONAL APPEARANCE al Code of Civil Procedure,
982(aX15.4)(New lJanuary 1, 2000] AND PRODUCTION OF DOCUMENTS AND THINGS SO ut 4ns §§ 2020,2025;
p-1 n , ,,, Government Code, § 88097.1
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Building 52„411 Madero
Address
Dean DavU
T4ty4 4 Q"
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address 3
MW
City Zip Tel.
La QuInta 92253 1
564-7468.
Address
Valley Plumbing
46-780 Clinton
State Lic. I City
& Classif. 273088 Lic. # 101
Arch., Engr.,
Designer
Address Tel.
City IZip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
effect- ivision 3 of the Business and Professions Code, and my license is in full force and
effec
SIGNATURE DATE
OWNEWBUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason (Sec. 7031.5,13s ness and Professions Code: Any city or county which requires a
perm to construct. alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to Me a signed statement that he is.licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with -Section 7000) or
Division 3 of the Business and Professions Code. or Nat. he is exempt therefrom, and the basis
for the alleged exemption. Any violation or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civipenafty of rot more than five hundred dollars ($500).
❑ 1, 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
braids or improves thereon and who does such work hinseff 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
or proving that he did not build or improve for the purpose of sale.)
❑ 1, 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 bul or improves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Company
❑ Copy is filed with the city. ❑ Certified copy is hereby fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' 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 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.
Date Owner
NOTICE TO APPLICAAIT: t, after makig 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 pem* shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby 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 abuilding permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certity that 1 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 Addr v
City, state, Zip
No. 06266
WILDING: TYPE CONST. OCC: GRP.
k.P. Number 773-202--012
Description
roject Description
Gaa line
REMARKS to
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 97/89 Permit
Validated by:
Validation:
Sq. Ft.
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
L
Estimated Valuation
! pp
T V0
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
$15.010
Mech.
Electrical
Plumbing
S.M.I.
.03
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS to
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 97/89 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. @ $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING,
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH) + '
METER LOOP
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SO. FT. @
GROUT
WATER HEATER
WALL SQ. FT. @
FINAL INSP.
DRINKING FOUNTAIN.
BOND BEAM
WATER SYSTEM
URINAL
SQ FT @
=$
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property lax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING:
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIREPLACE
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. @ c
BATH TUB
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE tL.CK.FEET
NST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING,
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) + '
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL 71