SFD (0106-030)LICENSED CONTRACTOR DECLARATION
I her.: ; 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 a_nd.effect. ,
License# Lic. Class Exp. Date
Date — - 4,f Signature of Contractor
x�-- «mow '01NNER=BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1' 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.
-(j)- 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 V
permit is issued. My workers' compensation insurance carrier & policy no. are:
Cartier Policy No.
:Y't'MIX3 FUND 4kda-0�-�1�A91��d
(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 agrewthat if I should become
subject to the workers' comperfs ion provisionslof Section 3700 of the Labor
Code, I shall forthwith comply with those .prov'isions.
Date: Applicant
1NaFning: Failure to secur6-Workers.Compensation gage is unlawful and `
shall subject an employer to crim�irial pen!Ities 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*lthis 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 comp ly,witfi all City, and State laws relating to the building
construction, and hereby'authorize representatives of this City .t9 enter upon
..� is ,-+✓' f
,the above-mentioned �prope rty,,for igspection,porposes,,� ' �!
Sianature (Owner/Anent) 1 �' ” Date
BUILDING PERMIT PERMIT#
DATE I VALUATION LOT 0106 -WO TRACT
JOB SITE ..' iDFD.7,a
') APN BMW ..
ADDRESS
OWNER ` ' " `" "r"6 ' J0"
CONTRACTOR /DESIGNER / EN INEER °J
,r
9740 iy IPP XC _6:.
5140 Rl"LEX'1':M DIX, YOM,, VAILTEY
i )REfiTf:3 V:ta;F;.T,:�" Y CA, 92557
RMIRUMPT. L.A. 92508
USE OF PERMIT F
Sna OOES ?,10T INC:Lf. M POOL, 2114ICIK a1iA1.L,% OR 19RIVFWA'1` �
1RCYCT frUM'TRUCT1014 4,78&09 eT
i:i:t. `i➢J3Ca°€'iC)
�4�!0.1110
(RM1GpA1ry R (W)
5111T.WOOD MINCE
EST�M) C`OSf OFCONYMUC170H
109M.A.20
Y301IMggTARi�yy4U��ppRX
f"IDI 3STRUCIi,"1Ot M,
MAN !CHECK, FIM
;t�'&'�1�'i1�I1C�.d,�t�'�� 1C11.a0tit1�421-t3;9Q � '�ba,Cs9
-
s"G1 101-000-420-000 2D.FA
2D..FA
11 LIMB040 RE 101.0:30 -iii 9.000
IT1iONO MOTION MOE.- i'�,,�'11.77 101.0
O+3Ai IWO V.99 101.00 A 3-000 V, 4
DZVW:&.f.' PMI IMPACT FRIE,
PRA1119 PLAN 101..00 . � 1e ffittl , .
n:,• P 12 2001
CITY OF LA QUINTA
FINANCE DEPT.
{�
Lim P12'ls",ml',1 P1?l
4250,00
DAT�rr
DATE FINALED
INSPECTORRECEIPT
J/1 1
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings p (
l
Underground Ducts
Ducts
Slab Grade
_n
1
Return Air
Steel
Combustion Air
Roof Deck
jL j_j/v
Exhaust Fans
O.K. to Wrap
Framing
/Z_�7/61/1
�l�
F.A.U.
Compressor
p
�`��
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
POOLS -SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I
Gas Piping
PLUMBING APPROVALS
Gas Test
Waste Lines
_
��_�/��
Electric Final
Heater Final
Water Piping
Plumbing Final
' Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover t
Sewer Connection
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)
3 • TiL-D ?�
rot
4tyl 4
53Jgso ,qv� �endaz�c P.O. BOX 1504 APPLICATION ONLY
Building^ / 78-495 CALLE TAMPICO
Address 3 9 Sy / f :11 "(GL �1 L� LA OUINTA, CALIFORNIA 92253
Owner
Mailing
Address ,
% X111
q City
�lVi:)IQG'OVGt��Jrl
I I Zip
12V5'-?
Tel.
Contractor
Address
I pp
City/ -Zip
State Lic.
& Classif. 1.r ` j -74
City
Lic. #
Arch.,,Engr.,
Designer–
I r
Address
Tel.
City (Zip (State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
t herebyy affirm thatd�am lice ed�oder provisions of Chapter 9 (commencing with Section
S7000) of Div'siorr3,of the Bus nes;and Professions Code, and my license is in full force and
IGNATURE -
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 thealleged 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).
C 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
or proving that he did not build or improve for the purpose of sale.)
I 1 I, as ownerof 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 contractors) licensed pursuant to the Contractor's License Law.)
17 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
f�Copy is filed with the city. ❑ Certified copy is hereby furnished.
�� 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 thg 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 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
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 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
LDING: TYPE'CONST. alZ. OCC. GRP.
. Number ' 1/. ' /)l
al Description � � L' �C `r< ,— C�
r
ject Description VA I
4 .I -I -,, C A i 1`t',I C
1 c)-- ! t
Sq. Ft. No. No. Dw.
Size Stories Units
INewX Add ❑ Alter ❑ Repair ❑ Demolition ❑
Valuation
PERMIT ! AMOUNT
Plan Chk. Dep. 7 71 7 t C.
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
Issued by:—
Validated by:
Validation:_
WHITE = FINANCE YELLOW = APPLICANT PINK =
1
CITY OF (A UUINTA i
FUM14CE DEPT i
Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated 760-771-8515
CERTIFICATE OF COMPLIANCE
Date 9/12/01
No. 22493
Owner NameW. R. Enterprises
No. 53-950 street Avenida Mendoza
City La Quinta
Tract # B249U23 Lot # 15
Type of Development Single Family Residence
Comments
APN# 774-173-010
Jurisdiction La Ouinta
Permit # 0106-030
Log #
zip 92253 Study Area
Square Footage 1788
No. of Units 1
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
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
2.05 X 1,788 or $ 3,665.40 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
i .
Fees Paid By CASH - Ed Whitson Telephone X909-485-8033
Name on the check
7 f
f.h • Af
By Dr. Doris Wilson '
Superintendent
Fee collected /exempted by Annette Barlow Payment Received $3,665.40
Check No.
Signature W W
IOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
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
ollect 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
r'
RECORDING REQUESTED BY
AND WHEN RECORDED MAIL TO:
WR ENTERPRISES
9740 RIPPLECREEK DRIVE
MORENO VALLEY, CA 92557
A.P.N.: -��_ .c
5 VIA L"�ar''-4 /
Space Above This Line for Recorder's Use Only
Order No.: 5244071-40 Escrow No.: 01 -1800 -DS
GRANT DEED
THE UNDERSIGNED GRANTOR(s) DECLARE(s) THAT DOCUMENTARY TRANSFER TAX IS: COUNTY $29.15
[ j computed on full value of property conveyed, or
[l ]] computed on full value less value of liens or encumbrances remaining at time of sale,
unincorporated area; [ ] City of LA OUINTA , and
FOR A VALUABLE CONSIDERATION, Receipt of which is hereby acknowledged,
STEVEN J. GORDON and JULIE I. BORNSTEIN, Husband and Wife as communit property and PAUL S.
WEINBERG, a Single man, each as to an undivided one-half interest as tenants in common
hereby GRANT(S) to WR ENTERPRISES, A GENERAL PARTNERSHIP
the following described property in the City of LA QUINTA, County of Riverside State of California;
LOT 15 IN BLOCK 249 OF THE SANTA CARMELITA AT VALE LA QUINTA UNIT 23, AS PER MAP
RECORDED IN BOOK 20, PAGE 25 OF MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF SAID
COUNTY.
CERTIFIED TO BE A TRUE
AND CORRECT COPY OF THE
ORIGINAL STATEMENT
GRANT DEED CONTINUED ON NEXT PAGE
JENNIFER WHEELER
Mail Tax Statements to: SAME AS ABOVE or Address Noted Below
Awk. P. N..
STEVEN J. G DON
JULIE I. BORNSTEIN
Document Date: April 18, 2001
CONTINUATION OF GRANT DEED
STATE OF CALIFORNIA )SS
COUNTY OF )
On before me,
personally appeared
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument
and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies) and that by his/her/their signature(s) on the instrument
the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signature
This area for official notarial seal.
CERTIFIED TO BE A TRUE
AND CORRECT COPY OF THE
ORIGINAL STATEMENT
BY o�
JENNIFER WHEELER
r'
�.� RECVD FOR PROCESSING
(DA E)
ASSIGNED TO 1`-t
RC DISTRICT - PLANNING REVIEW FORM (INITIALS)
This form is to be used by CDD staff for review of single family dwellings in the RC (Cove
Residential) District per Section 9.50.090 of the Zoning Code. Its purpose is to determine:
1) that the proposed house design does not duplicate the same architectural style of any
house within 200 feet of the applicant, and/or 2) if there is a need for the applicant to file for
Master Design Guidelines. If the applicant does need to file a Master Design Guideline, please
transmitted this information to the Building and Safety Department as part of your correction
list. Please attach additional explanations as necessary.
APPLICANT
SITE ADDRESS
W R ENTERPRISES
53-950 Avenida Mendoza
APN 7'74.- 133 - 010 CASE NO.: 2001-491 '
LEGAL: LOT 15 BLOCK 249 UNIT S.C.@V.L..Q.
CHECK AND APPROVED BY: Michele Rambo DATE:
Inform the assigned Building plan checker upon your assignment -to this case. The CDD
Executive Secretary maintains a log book to track applications and assign case numbers.
REQUIRED ITEM
Y
N
COMMENT/CORRECTION
Verify legal and APN information
x
LO
G°h^'`'S `'`�' S3_'700
Consistent with MDG on file (as
applicable
MDG filing required (5 filings since
9/3/98)
Architectural variety within 200 feet of
the surrounding area:
Colors
Materials
Architectural design features
'
APPROV
By E�eYC
gSNI el r OgOf VE/�PMEIV
oo O
`
Other Requirements:
LENIPEL VENTI7IlE19 INC.
May 31, 2001
Ms. Nickie J. Gormley
City of La Quinta Building Department
78-495 Calle Tampico
P.O. Box 1504
La Quinta, CA 92253
RE: W. R. Enterprises
Dear Nickie:
Please be advised that the following plans have been previously approved for use in the Cove
area of La Quinta by the Planning Commission. The firm of W. R. Enterprises has, my
permission to use the plans only at the following locations:
Plan: L Q Tower Ave Mendoza / Lot 14 Block 112
Plan: BA -1 51960 Avenida Ramirez
Plan: Malibu] 1 53950 Avenida Mendoza
Plan: BA -1 53340 Avenida Mendoza
�VR ! M, leff
If you have any other questions, please call me at 760/564-1866.
LENDEL/%FX JURES, INC.
A.P. Lench, II
President
APL:vI
P. O. BOX 450'' LA QUINTA * CALIFORNIA * 92253-0450
760/564-1866 * FAX 760/564-2627
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
May 29, 2001
Bryant Rugg
W/R Enterprises
9740 Ripplecreek Drive
Moreno Valley, CA 92557
RE: 'MINOR USE PERMIT 2001-292
Dear Mr. Rugg:
(760) 777-7000
FAX (760) 777-7101
The Community Development Department hereb_y_approves your request to establish a
temporary storage bin on the property south of-53-950_Ay_enida Mendoza pursuant to
Section 9.60.250 of.the Municipal Code, subject to the following conditions:
Mounted on the exterior of the trailer shall be a written notice (minimum 1" high
letters) providing emergency personnel your 24-hour emergency phone number
they can call in case problems arise that need your prompt attention.
2. Install one 2A10BC fire extinguisher inside the trailer.
3. The City may elect to add conditions to this application request to mitigate any
problems that arise not previously addressed herein.
The storage bin shall be removed prior to the issuance of a Certificate of Occupancy,
unless the Community Development Director grants an extension. This decision may
be appealed to the Planning Commission provided the necessary paperwork and filing
fee of $175.00 are filed with this office within 15 days. If you have any questions,
please contact me at 760-777-7068.
Sincerely,
JERRY HERMAN
COMMUNITY DEVELOPMENT DIRECTOR
MICHELE RAMBO
Associate Planner
cc:fanning Manager
/Building and Safety
Public Works
Fire Department