DEMO (0310-283)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
H Chapter 9 (commencing with Section 7000) of Dk sion 3 of the Business and
N W Professionals Code, and my License is if4 full force and effect.
O M License # Lic. Class Exp. Date /
iZ 6+> 2630 C2$ 17J31/?C
CS CS Z�Date Signature of Contractor �'j /� •' C
CD 7
J
I.—
C) OWNER -BUILDER DECLARATION
W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's
~ a'
N License Law for the following reason:
Z_ ( ) 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).
M() I am exempt under Section B&P.C. for this reason
N Date Signature of Owner
O N
CL Z WORKER'S COMPENSATION DECLARATION
CD CE I hereby affirm under penalty of perjury one of the following declarations:
U-) O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W compensation, as provided for by Section 3700 of the Labor Code, for the
O _ Q performance of the work for which this permit is issued.
m Q I have and will maintain workers' compensation insurance, as required by
O 0 Q Section 3700 of the Labor Code, for the performance of the work for which this
LO
d a)H permit is issued. My workers' compensation insurance carrier & policy no. are:
Z Carrier Policy No. s
coi`,Tt; lyI'O 1�24:Fd..S1 fB
C)
J (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
3 subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date: Applicant _',; K.
Warning: Failure to secure WorkerCompensation c; erage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
�\ any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
• correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) `' - Date - ,
BUILDING PERMIT PERMIT#
R_
DATE VALUATION' y LOT 0:510-223 TRACT
JOB SITE ��y+�� ;�wy
ADDRESS Kip 9 o°{1 0 Ail diAf:q.A
APN
OWNER
CONTRACTOR / DESIGNER / EN (NEER
T.D.
TOLW&S LAND CLEARNG
P,O. my" 17)
52-910.BEGKW,9DR
J.,tfi,QfJD" Ai s (11A. _ 9225
11RIKAL C.A. 92274
398-085 1; 2809
SI$il,;
USE OF PERMIT .w
1ft.F'hdUVAL, OF SI PT1Ci'YvSTr.M ,ARID I)E M40 TO ElAR FtPO?.Mn OF TWO
HOU109I1AND 2:tk1EN&
r
VeMOLIT100 FEE 101�t`,�Oi, Z3 00
OCT 428200:, -
8200:CITY
CITY OF LA QUINTA-Y
FINANCE DEPT.
SUR -TOTAL CON '1 1 *'!'i +1 A P1." CHECK
5.00
RECEIPT
DATE. /? ��/
BNS" '
DATE FINALED
INSPECTOR
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 & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
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
-dewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility (Gas) Gas
ELECTRICAL APPROVALS
Temp. Power 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:
/e Tv ;5 C
G.$�-r� Ice 0310 f
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111
Ci of La Quinta
Developers PM -10 Approval Form
Prior to the issuance of a Demolition Permit for the project listed below, Public Works
approval must be obtained. Please return this form to the Building and Safety Department
only after approval.
Project Address: 3. 9 o n r o� 5
Applicant Name/Phone#: ;1G ct h g % G ; 8� — � cd -5 �
Scope Of Work:
To limit dust at this jobsite I will:
Maintain Adequate Watering at all Times.
Prevent Trackout
p Tarp All Vehicles Removing Debris from Site
c� Limit Work in High Wind Conditions
I* 1`-£ y%w
.❑
Public Works Department Approval is Hereby granted:
John Freeland, Senior Engineer
Date
COUNTY OF jU VERSIDE
GARY L. ORSO
ASSESSOR -COUNTY CLERK -RECORDER
764210004-6
CORAL OPTION 1
79295 RANCHO LA QUINTA DR
LA QUINTA CA 92253
CC_'NTY ADMINISTRATIVE. CENTER
4080 Lemon Street, 1st Floor
P.O. Box .12004
Riverside, CA 92502-2204
(909) 955-6200
Website: VMW.AsrClkRec.com
Date: 07/03/2003 �/
Assessment ##: 764210004-6-YE,ei1F
Parcel ##- 764-210-004-6 G4
Base Year: 2003
Property Identification:
117.27 ACRES M/L I4 POR SE 1/4 OF SEC 27
FOR TOTAL DESCRIPTION SEE ASSESSORS MAPS
NOTICE OF PROPERTY ASSESSMENT CHANGE
The property referenced above has been reviewed by the Assessor's office For the 2003 assessment
year. The assessment has changed as a result of the following reason(s): 1) partly completed new
construction on the property as of January 1; 2) a value correction; 3) a change in the assessment
or parcel number; or 4) a reinstatement of Factored Base Year Value (Prop. 13).*
Assessed Values
Land 2,447,258
Structures
Trees & Vines 117,250
Trade Fixtures
Business Personal Property
Total Assessed Value 2,564,508
Homeowners' Exemption.
Other Exemption
Net Assessed Value 2,564,508
NO ACTION ON YOUR PART IS NECESSARY. The property tax bill you receive this fallWill be
based on the Net Assessed Value, Should you disagree with the value or have other questions,
please see the reverse side of this notice,
**Proposition 13 'Value means the value at the time you acquired the property PLUS an annual
inflation factor of no more than 2% per year. This value sets the tipper lin-1 t on your taxable
value each year.
James N. Hansson, Assistant - Valuation
ACR 744-AS3VS0 (Est. 0612003)
THIS IS NOT A TAX BILL
Please see additional iafotmation on the back of this page.
Rex L. Ja&ton, Assistant - Administration
004738
'Larry W. Ward, Anistant - Assessment Services
LO 39Vd NOIi0ndiSN00 SAdVdS LU8ZTZML Ztb:91 E00Z/L0/0Z
10/07/2003 15:42 7607711841 SPARKS CONSTRUCTION PAGE 02
RECORDING REQUESTED-bY:
Fidelity National Title Company
Escrow No. 1381 -MB
Thle Order No, 9770633
When Recorded Mail Document
and Tax Statement To:
Grady Sparks, President
Coral Option 1, LLC
79-295 Rancho La Quints Drive
La Quinta, CA 92253
D, tY � 002 Fa230037
Aiat,
;4a9a 1 of 2 Doc T Tax Paid
Recorded in,official Record%
County of Rivarsida
Gary L. prso
Assessor, county Clerk d Recorder
1111�i
111 I
IIN
IIIIII
1111
IIII
Ililll
1{i1�
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i PAGE SIZE aw Y.AR II I�sMv.
i
COPY IOkG PJFllll.'7 NCMG EY/.0
PN: FM (Y-0015 - 7 GRANT DEED
TRA 058-085
The undersigned grantors) declare($)
Documentary transfer tax Is S 1,650-00
X ) computed on full value of property conveyed, or
[ ) computed on full value less value of liens or encumbrances remaining at time of sale,
( X ) Unincorporated Area City of
EOR A VALUABLE CONSIDERATION, receipt of which is he
acknowledged, The Nussbaum Family Limited
Partnership„ a Limited Partnership
hereby GRANT(S) to CORAL OPTION I LLC, a Delaware limited liability company,
the following described "ACHED HERETO AND MADE ARPARTdHEREOFe of California:
SEE EXHIBIT 0
DATED: March 27, 2002
STATE OF CALIF NIA ,i .�
COUNTY OF before me,
ON
personally appeared
(or proved to me on the basis
satisfactory evidence) to be the person(A whose
name(O islaw subscribed to the within instrument and
acknowledged to me that he/eivefth y executed the
same in his/her�4helr authorized capacityfiss), and that
by hisEkl pAMir signatureks) on the instrument the
person*, or the entity upon behalf of which the
persone acted, executed the instrument.
Witness my hand ffic el seal.
Signature
The Nussba Family Limited Partnership,
By:
Brad Nussbaum, General Partner
dfFIC1Ar• SEAL
K. LAW
COMM #1268797
NotarY PUblic - rKelifarrtis
^' RIVERSIDE COUNTY
♦ Y Cornmixsion EXOT"
{ ;UNE 24, 2044
MAIL TAX STATEMENTS AS DIRECTED ABOVE
GRANT t)EED
ED -213 (Rev 7196)
10/0712003 15:42 7607711841 SPARKS CONSTRiUCTION PAGE 03
Order No. 9770633 - A
EXHIBIT "ONE"
The Southwest quarter of the Southeast quarter of Section 27, Township 6 South, Mange
7 East, San Bernardino Base and Meridian.
.,,=rv�_
2
RECORDING REQUESTED B-':
Fidelity National Title Company
Escrow No. 1380 -MB
Title Order No. 9770632
When Recorded Mail Document
and Tax Statement To:
Coral Option 1, LLC
79.295 Rancho La Quinta Drive
La Quinta, CA 92253
DOC = ^4 00-230®3e
r 1 IM 3S : 00A lree : W CO
I of Y Doc T Tax Paid
Recorded in Official Records
County of Riverside
Cary L. Orso
Assessor, County Clerk d Rooerdar
I
111111111111111111 IN 11X111111111111111111111111111111
PA
8
U
PAGE RISE OA - PCOR NOCOP SW MIC.
A
Q
COPY LONG REFLAM NCHO CXM
764-210-004-6 UK
TRA 058-085
The undersigned grantor(s) declare(s)
Documentary transfer tax is 94,950.00
[ X I computed on full value of property conveyed, or
{ I computed an full value less value of liens or encumbrances remaining at time of sale,
[ 'X I Unincorporated Area C -i$-
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, VENUS RANCHES, INC.,
A California corporation
hereby GRANT(S) to CORAL OPTION I, LLC, a Delaware Limited Liability Company,
the following described real property in the mei-Dicta
County of Riverside, State of California:
SEE EXHIBIT ONE ATTACHED HERETO AND MADE A PART HEREOF
DATED: March 27, 2002
STATE OF CALL ORNIA VENUS RAN HES, INC,, a California corporation
COUNTY OF
00,
ON before me, By:
C k ar c personally appeared Brad Nussbaum, President
Ad, 77
{or proved to me on the basis
of satisfactory evidence] to be the person(d) whose
nameW isAw subscribed to the within instrument and
acknowledged to me that he/s� executed the
same in his/lterAh& authorized capacity{1n), and that
by his#Afghsir signatureW on the instrument the
person(s4, or the entity upon behalf of which the
person (s.11 -acted, executed the instrument.
Witness my hand an official seat.
Signatu
�Bi'r-�i SkA1
9: LARRY
'OMM 01268797 Q
11
►uldlle - Californla +
0121403 D IP COUNTY
Idly Commlosion Expires
IUNi 24, 2004
MAIL TAX STATEMENTS AS DIRECTED ABOVE
FD -213 Mev 7)96} GRANT DEED
00 39bd NOIiondistAoo sAiivds TOSTIZZ09L Zt7:91 600Z/L0/0T
COUNTY OF id VERSI DE
GARY L. ORSO
.ASSESSOR -COUNTY CLERK -RECORDER
764200007-8
CORAL OPTION 1
79295 RANCHO LA QVINTA DR
LA QUINTA CA 92253
CC 'NTY ADMINISTRATIVE. CENTER
4080 Lemon Street, 1st Floor
P.O. Box 12004
Riverside, CA 92502-2204
(909) 955-6200
Website: www.AsrClkRee.corn
Date: 07/03/2003
Assessment #: 764200007-8
Parcel #: 764-200-007-8
Base Year: 2003
Property Identification:
59001 MONROE ST
T.iiERMAL CA 92274
NOVICE OF PROPERTY ASSESSMENT CHANGE
The property referenced above has been reviewed by the Assessor's office for the 2003 assessment
year. The assessment has changed as a result of the following reason(s), 1) partly completed new
construction on the property as of January 1; 2) a value correction; 3) a change in the assessment
or parcel number; or 4) a reinstatement of Factored Base Year Value (prop. 13).*
Land
Structures
Trees & Vines
Trade Fixtures
Business Personal Property
Total Assessed Value
Homeowners' Exemption
Other Exemption
Net Assessed Value
Assessed Values
815,752
37,880
853,632
853,632
NO ACTION ON YOUR PART IS NECESSARY. The property tax bill you receive this fall will be
based on the Net. Assessed Valtte. Should you disagree with the value or have other questions,
please see the reverse side of this notice.
*Proposition 13 Value means the value at the time you acquired the property PLUS an annual
.inflation factor of no more than 2% per year. This value sets the upper limit on your taxable
value each year.
James N. Hanson, Assistant - Valuation
ACR '744-A,S3VS0 (Est. 0612003)
THIS IS NOT A TAX BILA,
Please see additional inrormation on the back of this page.
Rett L. Jackson, Assistant, Adrninistratioit
004739
Larry W, Ward, Assistant - Assessment Services
90 39dd NOIiona1SN00 SAdVdS TOBITLL09L Zb:9t 600Z/L0/0T
Order No. 9770632 - A
EXHIBIT "ONE"
The Southeast quarter of the Northeast quarter and the Southeast quarter of Section 27,
Township B South, Range 7 East, San Bernardino Base and Meridian, as shown by United
States Government Survey excepting therefrom the Southwest quarter of the Southeast
quarter of said lands above described.
IIIIIIIf�YNI�IINImIN�IN�IIIIIINIIII ••`_``:� 2 =-
2
90 39Vd N01iD 16iSN00 SA6VdS IOBTILL09L Zb :9L 600Z/L0/0T
ENVIRONMENTAL
KLEAN-CSP
Contractors stare Uftfise #64979 • D05H 81595
NOTICE OF COMPLETION
THIS IS TO CERTIFY THAT AN ASBESTOS ABATEMENT
PROJECT HAS BEEN COMPLETED IN ACCORDANCE TO
SCAQMD, CAL -OSHA & EPA REGULATIONS AT:
American Date Gardens
59-001 Monroe Street
Thermal, CA
JOB #
EKU-203-160
Asbestos abatement and disposal of non -friable asbestos containing materials (ACM)
Approx. 351 sglft of gray penetration mastic, approx 700 sq/:fit of white 9" floor tile/ black floor
mastic (at 350 sq/ft) and approx 10 linear feet of transite pipe. Friable asbestos containing materials
approx. 100 sq/ft linoleum per, surveyed report number 90347
provided by Enviro-Test,dated September. 6, 2003.
DA'T'E
October 2, 2003
JOB NAME
Young's Land Clearing
Rocky Young
PROTECT COMPLETION WITNESSED BY
4(X)
Beve . Gann
P.O. Box 285 Mira .Loma, CA 91752
Phone (909) 685-5314 Fax (909) 681-5559
Contractors License #684979 DOSH #595
L0 39bd n>13 6595289606 96:bL E00Z/Z0/0Z
09/18/2003 12:09 9096815559 EKU PAGE 01
ENVIRONMENTAL
KL'Iffv--"JAN=UP
CERTIFICATE OF COMPLETION
THIS IS TO CERTIFY THAT AN ASBESTOS ABATEMENT PROJECT
HAS BEEN COMPLETED TN .ACCORDANCE TO S'TAT'E & FEDERAL
REGULATIONS
AT
Block Structure
southeast of 58* street & Madlsm Street
EKU JOB #
203-157
Abatement and disposal of friable asbestos containing materials, window
putty 8 windows.
DATE
September 17, 2003
av veM &Wgpment
PROJECT COMPLETION WITNESSED BY
Beverley J. Gann
P.O. Box 285 Mira. Loma, CA 91752
Phone (909) 685-531.4 Fax (909) 681-5559
License ##684979 ROSH#595
ENVIRONMENTAL
K.EAN-ETP
Coatwtori State LS4en&e "84979 • DOSH #595
NOTICE OF COMPLETION
THIS IS TO CERTIFY THAT AN ASBESTOS ABATEMENT
PROJECT HAS BEEN COMPLETED IN ACCORDANCE TO
SCAQMD, CAL -OSHA & EPA REGULATIONS AT:
Single Fancily Dwelling
W500 Madison Street
Tbermal, CA 92274
JOB #
EKU-203-152
Asbestos abatement and disposal of non -friable asbestos containing materials (ACM:)
approx. 150 sq/ft of window putty, approx 1,100 sq/ft of floor tile (kitchen/dining/living-room) and
approx. 30 sq/ft of gray penetration mastic per surveyed .report number 80249
provided by Enviro-Test dated August 7, 2002.
DATE
October 2, 2003
JOB NAME
Young's Land Clearing
Rocky Young
PROJECT COMPLETIO_ N WITNESSED BY
Beverl ann
P.O. Box 285 'Mira, Loma, CA 91752
Phone (909) 685-53.14 Fax (909) 681.-5559
Contractors License #684979 BOSH #595
Z0 39dd nA3 6999189606 96:01 600Z/Z0/01
10/01/2003 15:12 7607711841 SPARKS CONSTRUCTION PAGE 01
SPAMS
INC.
October 1, 2003
Greg Butler
City of La Quinta
House/Structure Demolition
RE: Coral Mountain
Dear Mr, Butler:
We hereby grant permission to Young's Land Clearing, Inc. to demolish/remove
the following houses and miscellaneous structures:
1) 2 Houses and 2 Sheds on Avenue 59 APN 764200007 00
2) Block building on Avenue 58 APN 764200001
3) Building on Madison Sheet APN 764200002 5 So 0
If you have any questions, please don't hesitate to call.
Yours truly
Coral Option 1, LLC
Nolan Sparks
cc: Young's Land Clearing
Fast Office Bcx 1716
La Qukta, C.aliforaia 92253 Telephone: (760) 771-1941
Fax: (764) 771-1841