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9908-106 (SFD)LICENSED CONTRACTOR DECLARATION -w 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# Lia Class ;f a Exp. Date - 764551 r `:ikJ130t D C�' t ' Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Con actor's License Law for the following, reason: ( ) I, as owner of the property, or my employees with wages as t eir'sole' compensation, will do the work, and the structure is not intended or offered, fo,r 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 forworkers' compensation, as provided'for .by Section 3700 sof 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: Cartier Policy No. G(9.1X7N RAGLE is `NIC: 552211; 5-V0 (This section need not be completed if the permit valuation is for $100.00 or less). ( .) Icertify that in the performance of the work for which this permit is issued, �J 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 withthose pro Iu dons. -Date.'""' t a i Applicant ,� ; r✓/ _ /i . :, Warning: Failure to secure Workers'' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $1100,000, in addition to the.cost of compensation, damages as provided for in Section 3706 of. the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work, is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issuedas a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property, or•inspection p(irposes. (/ S 'Signature (Owner/Agent)/'�✓ v/Date // f NF'F PERMIT# PERMIT ,BUILDING DATE J ,! VALUATION-.y:�.�w: n� .LOT 16 TRACT'JOB SITE ADDRESS ,11.9�3?':A�✓1`"� IDA, I�y'!f�/Si4$EZ APN �74-�:Tli'•�.)W� OWNER CONTRACTOR / DESIGNER / ENGINEER X70 N. A,#iWCMVAD AVv's.' 670 N. AW)WREAL.; VE, SAN BE1NAI3DINC) (.,A 92401 �1!��wAN^A3tbAiT O CA i.' /�yyfryry+N y�!)y241).1 5fy{J� 7_0221.. J CLIE.hT' gi,t(a; USE OF PERMIT S iNG.E FAMI.LV UWES..i..ING, £i 1 •• PERM i' ii063 NO3 INCLI )L 13A.O K Mr'�LLS .RT(?O:L. i RAo T CION �= s'I� UC"aa ION 1,218.00 S 1? �jRC111'PA'a'1u 165.00 SY (JAR&ClWi',t RPORT 473.00 W, 6+ 'Thr,N.LA ±:J3 C".y°'i•Tf OF CUNST 77,602.70 P14,,RlS'$ITi FEE SUAM iiAR f:;t>WB!'tt.4lL!'1C7fJ e�'EsF� !(D2-•©()t)••A�}'.t3"+E18f3(4 �54f1.":t? • PL ANC1'M KF '1 thCHA NICAL E 101-ilU1) 421-f300 $.�?3: $t9 irK.irc: 43�i�',t11... � �e B t)1-f1tJr�-�si3-1ii3t? $t Fs.:i9 : . 161--000-419-M) KT RC 1Nn hA'CyS I[O F-0317 - R f';Il:!? 3014W-7411-000 C3:t'id\!'afNQ !'f 1- IC J-(1(10- 2 .flb)9) 320.00 !°�tC'l;�trl'f..rlle nuI-(�OC9<•4<83-{4�S SlB60:f7tI �➢!i'�r�:1.:Oaali4C f€�tiYAC: i' 1~'4:JE• $l,5►{1"?.£s'17 . FfT;. tYFPCWI i SUM-It'YaAL CC)NS'['M UCTION /1ND PLAN CHECK K $ 3,A.34 02 U, S, PR1w-4'AID FIC 3S 1.61FAI.. PERMIT FSla.f;S OVENOW YB:Agi4f44t,m RECEIPT DATE BY 1 DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts I Forms & Footings D'099 Ducts I Slab Grade Return Air I Steel Combustion Air 1 Roof Deck S 7 Exhaust Fans 1 O.K to Wrap F.A.U. I Framing — s— Ov V Compressor 1 Insulation 14 — fz .- c,0 Vents 1 Fireplace P.L. Grills I Fireplace T.O. Fans & Controls I Party Wall Insulation Condensate Lines I Party Wall Firewall I Exterior Lath Drywall - Int. Lath Y / q Oo ! { 1 Final 1 Final POOLS - SPAS BLOCKWALL A PROVALS steel I Set Backs Electric Bond f Footings Main Drain [ Bond Beam Approval to Cover i Equipment Location 1 . Underground Electric ! Underground Plbg. Test ! Final Gas Piping { PLUMBING APPROVALS Gas Test ! Electric Final I Waste Lines Heater Final 6 Water Piping Plumbing Final f Plumbing Top Out Equipment Enclosure i Shower Pans O.K for Finish Plaster E Sewer Lateral Pool Cover I Sewer Connection Encapsulation ! Gas Piping 1 Gas Test 04 f Appliances ! Final t COMMENTS: f t 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) pa a.A Y/ ,4 W P.O. BOX 1504 ~ Building + + 78-495 GALLE TAMPICO Address 53-890 Av_ ' Ramirez LA.QUINTA, CALIFORNIA 92253 • Y Owner I Four Seasons Homes, Inc: Mailing Address P.O. Box 749' City Zip Tel. San Bernardino 92402 (909)889-022.1 Contractor Four Seasons,Homes, Inc. APPLICATION ONLY UILDING: TYPE '.CONST. i OCC. GRP. ,P. Number, 7 `7 /&Z 00 9 ?gal Description' OT l (o ( LOC t 2-340 Llfa CT ZZ 'ojectDescription Address 670 N. Arrowhead Ave. REMARKS. - WORKERS' COMPENSATION INSURANCE City San Bernardino Zip 92401 Tel.. (909)889-022.1 or less.) , State Lic. & Classif. 7 6 4 5 51 B City tic. # 5 818 Sq: Ft. No. No. Dw. Size Stories Units Arch., Engr., _ Designer Frank A. Moreno New'r Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address 52-950 Av. Mendoza Tel., '(760)564-1282 Date Owner City La Quittta Zip 92253 - State Lic.Ill. subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: " LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section' 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect - [ SIGNATURE DATE 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: Anycity 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 4s licensed pursuant to the provisions of the Contractor's License,Law, Chapter 9,- (commencing wlth•Sectlon 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 (8500): L-: 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 ivho 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.) FI I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Seca 7044, Business and Professions Code: The Contractor's License Law. does not apply to an+owner of property.wno•builds or improves thereon; and who contracts for:. such projects with a contractors) licensed pursuant to the Contractor's License Law.) .. 1-7 I am exempt under Sec. B. & P:C.•for this reason Estimated Valuation '' PERMIT AMOUNT a Plan Chk. Dep.. - ' Plan•Chk. Bal. Const. ' Mach. , Electrical Plumbing S.M.I. Grading Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION - I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a ce ified copy Cher of. (Sec: 3800, Labor Codg� Policy No% WCSSZ3JS•AE),mpany (�O�ediV_ it— INS ave. _-Issued by: Date Permit 1 agree to comply with all city and county ordinances and state laws relating to building - t r construction, and hereb authorize re a iv of this city to enter the above- n Copy is filed with the city. ❑ Certified copy is hereby furnished.' TOTAL CERTIFICATE OF EXEMPTION FROM - REMARKS. - WORKERS' COMPENSATION INSURANCE (This section need not be completed If the permit is for one hundred dollars ($100) valuation or less.) , I certify that in the performance of thg work. for which this permit is issued, I shall not employ any person in any manner so as ,to become subject to the Workers' Compensation- - Laws of California. Date Owner NOTICE TO APPLICANT: If, after making thisCertificate - of Exemption you should become 'ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: " Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING'AGENCY- , Side Street Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the ' - work for which th1 perm'(i issue_ d. fSey. sga� .civilcode.) Fi(-- S C`•i�% Cb'rj. Side Setback from Property Line Lender's Name--�':�) C:axc� i-1 1 _ - Lender's. Address$'S A FINAL DATE .INSPECTOR This is a building permit when properly filled out, signed and validated, and issubject to expiration if work thereunder is suspended for 180 days. - I certify that I have read this application and state that the above information incorrect. _-Issued by: Date Permit 1 agree to comply with all city and county ordinances and state laws relating to building r construction, and hereb authorize re a iv of this city to enter the above- - mentioned property for inspection p - Validated 6y: Signature of aoplic t Date Mailing Address Validation: City, State, Zip WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION RECORDING REQUESTED BY LawVerrs iiti® CO. AND WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW. MAIL TAX STATEMENTS TO: Name FOUR SEASONS HOMES, INC. Address 670 N. Arrowhead Avenue City & San Bernardino, CA.92402 State TT -100 (Rev. 1/99) � c-;)2- OU /-5 GRANT DEED APN No. 774-162-009-6 TRW No. 434686-23 Escrow No. 7093-K THE UNDERSIGNED GRANTOR(s) DECLARE(s) DOCUMENTARY TRANSFER TAX is $ 15.40 CITY TAX $ XX computed on full value of properly conveyed, or computed on full'value less value of liens or encumbrances remaining at time of sale, ❑ Unincorporated area: X1 City of La Quinta DOC 98 Y 9S J— 2 3 5 1 2 8 05/28/1999 08:00A Fee:6.00 Page 1 of 1: Doe T Tax Paid Recorded in Official Records County of Riverside Gary; L. Orso' Assessor, County Clerk 8 Recorder III VIII I I IIIIIIIIIIII IIIIIIIIII 111111 M $ U PHAGE SIZE DA PCOR - NOCOR SMF MISC. A R L COPY LONG REFUND NCHG EXAM FOR A VALUABLE CONSIDERATION, receipt of which ti�srhereby acknowledged, LOYOLA MARYMOUNT UNIVERSITY, a Californiat GorprbVUU o%e%tiScquired title as Loyola Marymount University hereby GRANT(s) to FOUR SEASONS HOMES, INC.,- a California Corporation the following described real property in the County of Riverside State of California: ,and Lot 16 in Block 236 of SANTA,CARMELITA AT''VALE LA QUINTA UNIT 22, in the City of La nuinta, County of Riverside, State of California, as shown by Map on file in Book 20, Page 24, of Maps, records of said County. Dated: May 5, 1999 V LOYOLA John Oester, Vice President it State of California \' County of Los Angeles ss. 1� 1999 OnMay 17, before me. Wendy A. Wilson ------------------ (here insert name) Notary Public, personally appeared John R. Oester --------------------------------------------- personally known to me ( o be the, persong whose names,wsubscribed to the within Instrument and acknowledged to me *all that 'sbeA# 4 executed the some,jn,6 s authorized capacl%CW, and that b hi /Faeµtliek signature Q on the Instrument the personK, or the entl up n e al o.Y h ch h so 'i a to executed the Instrument. WITNESS my hand and official seal. WENDYA. WILSON Commbston / 1089264 •� Notary PdAp — Ca9dm1a Wr Angeles County ,� Comrri. DWaeat May 17=W Signature MAIL TAX STATEMENTS AS DIRECTED ABOVE. affix seal within border R ~ pi ri Pl nni vi • This form is to be used by.CDD staff for -review otsingle-family dwellings in the RC (Cove Residential) District, in` order to detefm ne-the' applicabitity .of compatibility issues or need to require the filing of Master Design Guidelines by the t applicant I f shall be ,transmitted to . Building &Safety as your correction list; Please attach' additional explanations as necessary. APPLICANT: FOUR SEASONS PROJECT 4 ADDRESS: 53-8-90 Avenida Ramirez APfV:. 774' 162.,,009. LEGAL: LOT 16 BLOCK 236_. ; UNIT 22 -S.C. @ V.L.Q. CK'D BY: Leslie Mouriquan'd 81N N0: CASE NO. 99-111 CHECK. -.DATE:, inform the assigned Building -plan -checker .upon-youur_assignment'to .this case. The CDD Executive Secretary -maintains. a 1169 book: to=track-applications=and-assign case numbers. The zoning code, architectural- and landscaping manuals, and/.or assigned inspector should be consulted,.where uncertainties arise..j completed:.checkftt shall be maintained in the Building .& Safety'addrdss-*file. Jt. Certificate of Occupancy City 0''If La Quinta Building. and Safety Department Zhis-Certificateissued pursuant to the requirements of Section 109 of the Uniform Bui/ding Code, certifying that, at the time of issuance, this structure was in comp/iance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS: oma„ Use Classification: SFD Occupancy Group: R 3' Type of Construction: Owner of Building: FOUR SEASONS, HOMES, INC i Building Official Bldg. Permit No.: 9908-106 VN Land Use Zone: . RC Address: 670 N. ARROWHEAD AVE. City:' SAN ;BERNARDINO,,' CA 92401 By: STEVE TRAXEL Date: 07=05-00 POST IN A CONSPICUOUS PLACE MIM