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0005-022 (SFD)0 -I 1 kF'115?�LICENSED CONTRACTOR DECLARATION it hereby affirm under penalty ofperjury that I, a— licensed under provisions of „ wChapter9 (commencing with Section' -7000) of Division 3 of the Business and'>r Professionals'Code, and my License is in full force and effect -= ` .' License# ' `Lic.Class Exp.'Date Nair�r �r W9). Ir,.f.;.4 ` + �� 12n112( ,'Date= ry Signature'offContractor` 4,1 f` T' OWNER -BUILDER DECLARATION 1 hereby.affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: g (y) 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, Business & Professionals Code)., , O t as owner :of the' property, am exclusively contracting with licensed �y ct. ontractors to construct the project (Sec. 7044, Business & Professionals S;O 1 am exempt under Section B&P.C. for this reason 1 �l'.r 'Date Signature of Owner :WORKER'S COMPENSATION DECLARATION vl hereby, affirm 'under penalty of perjury. one' of the following declarations: a, r� 3,( ) .1 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. A I.haGe and will maintain workers' compensation insurance, as required by , $e tion � 3700'of the Labor Code, for the performance of the work for which this 'permdis Issued `My�workers',compensation insurance carrier & policy no. are: Carrier ' Policy No. , FU ETATR ND 229.00-002("714 (This section need not be completed if the permit valuation is for $100.00 or less). i)yl certify that in the performance of the work for which this permit is issued, r�: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 ,': Zbtect to the workers' compensation provisions �of Section 3700 of the Labor t Code,' l shall forthwith comply with those provisions. Date ? Applicant �'� / y Warning Faifu a to secure Workers' ompensat'.n coverage is unlawful and ' shall subtect an employer to'criminal penalties and civil fines up to $100,000, in n,.addition'to the cost of compensation, -damages as provided for in Section 3706 ,I of the Labor Code interest and attorney's fees. �IMPORTANT,Applieation is hereby made to the Director of Building and Safety Yfor� a�permit-subject to the _conditions and restrictions set forth on his i application t 1 Each person upon whose behalf this application is made & each person at: - t', whose request and for whose benefit work is performed under or pursuant to ;aanyIpermit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. t< ; 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 ofssuch rpermit;` or cessation'of,work for 180 days will subject permit to cancellation. . 1r 1 Y ;I certify that I have read this application and state that the above information is Mcorrect.'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 fonspection pur ' poses. Signature (Owner/Agent),/¢ ji'' "' Date % ` -I910a ri...- ---s;r3�rEt-0•e"µPERMIT#/,'i�+•• �.� . G! er �s'rh•+`!A'r„ `�•.acR+r r'• . ;;.. BUILDING PrERMIT. r. . rlip •St{:,,a ,�r1,„��4�4 .r• L , •t•. ' �r =1y. .�{:.2, 7�'•n t x;.��l74DV+„'iJLf” :.�. {i l,I"S'r '(•f .Y �i�.., DATE , ,VALUATION d �1�p��p LOT ?. ,r a: TRACT.'. ” t •ty'006i 735 .70 !N , • is 46 1 "' tri , "''• s � � ) �) ?v�kf JOB SITE , APN ADDRESS '1€l-•'7'&� P17�1r� x , 763 CN30 0116 � 4 OWNER CONTRACTOR / DESIGNER / ENGINEER )&SIPERO PROPS rens ulc 9tr2`t VISTA DEVELOPMENT C0RLP> -,� P, 0, BOX 1144 77899 W01 LA c�UJN',rA c� 92253 PALM I)Ir.'3�Rr C� 92260 (760)772-2626 = CBL4 s ;4393: , USE OF PERMIT ;{ , • b Y ."aY '1'T't�F� S1A7CiI.L F1'' DiiVR,d.1N0 SFD•PEIT DON.S'Nar fNCLUDR BLOCS: bV.AJA" S OR POO RML •t ..�. c .•�>, FG i . .;•M1��� 4Lt r i.A� . CUSTOM CONSTRUCTION 4806,00 S 1r�i^�� . PORCH/PATIO 1,395.00 sF `1 ., Nil ,, CfARA EIC,ARPOR`I'(SFj 17,844,80 r r4 PL ESIXUATt-D COST OF cO.I�i:�"ra�ucrlO.�r��1,�3'.�.7� PLIOWFEE GUAbMiAR �• a T ��.( y r�3� I ���•• Y, CONSTRUCTION FEE 101.00044184000 $24001 00 i; PLAIN CHECK FEE 101-000-239.318 rL9 DEP081T 101000.439.318 $2,00000,; ARECIiA1+lICALFI?L 101-000 -421-000 $179.0 ELECTRICAL FEE 101-000.4!20-000 $30347 PLUMBING MEE 101-000-419-000 STRONG MOTION FEE- RDID 101.000-7AI-000 $4839 s �,• �'�°� �, GRADINO FEE 101-000-423-000 ; '. $20 06:x: DEVELOPER IMPACT FEE $1,5 .00 ART IN PUBLIC PLACES`, IMSI1: 701-0300-255-000 :$721041, � �• i` ;� �- R4 bg b •. 'sem rtlr.. _ r {OLTP, -TOTAL CO$F'TRTJC TTOAI' AP313 pT SAT`C 'E: { . ; e i% ` AFS PT:t:EaPAID FM' s's i il>Jo _{��. A� �• +SiVp3y %mmICA.yp$6 B095�. 4 '�pq y�"p}(/ - l�y3J � ! r r<. � " trFc•,t .� y^+'f9`��it`�'�� ;a � y�-,x �% i 0 0 ' : � � � •+ �� S GJ y'r ,� t� � y J.>aMt� �4t}t.���- y�v�l�jpy�y�'1' j� - • Ft .v , sa, ..j'ti1 s, �+vi^.,r{ ^r4y jN�f�..iir6,!`T�T �i L� ���, ' '- ' %.t 1,..;i1 �p`p.�'`' ,a�i•1{t1K�� '�'���'��,`���f,..}}y`?l'+'p RECEIPT DATEil $Y ; .! DATE FINALED {Yts�sI �INw�SPEr#CTO�Ry 1W S/C1iW'%C INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs d U.S Underground Ducts Forms & Footings _ Ducts Slab Grade V_S� 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 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 Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines CSU 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 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) P.O. BOX 1504 APPLICATION ONLY Building/ �� 78-495 CALLE TAMPICO Address J LA QUINTA, CALIFORNIA 92253 Owner "lcS Z �-. BUILDING: TYPE'CONST. OCC./GRP. Mailin Addressv ! yG A.P. Number �%1 v//7 tyZip Tel. ? - — Legal Description - Intraetor /,. - Project DescriptionT- � . I r- e, JA r> , i r � CityLZ1_-P/_1a/)_S Tel �t)"� __77_;Z2 -;16a-6 State Lic. � City �/ % & Classif. / Lic. # Sq. Ft. No. No. No. Dw. Size UUU Units Arch., Engr.,+ Designer t /y New C�- Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address % l ` 1' Tel. r%A LSI/ Lic.Stat#CCAS `�3 !LICENSED CONTRACTOR'S DECLARATION - I hereby alfirm that -I arm licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of.Ure Bus' ess.and Professi9yyy�s Code, and my license is in full force and effect. �. / 7 1 A c—,a.,,.� ,�'' / 7 e n r) •t /V/ OWNER-BUILDER'DECLARATION I hereby affirm that I am exempt rom 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.penally 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 ofproving that he did not build or improve for the purpose of sale.) Il I, asowner 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 builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) 1-1 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION .I,herebyaffirm that I 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 opy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM, WORKERS' COMPENSATION INSURANCE (This section need not be completed itthepermit 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 IOwner 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 ame 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. 1 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 imated Valuation I PERMIT AMOUNT. Plan Chk. Dep Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Driveway Enc. Infrastructure r W TOTAL REMARKS • � l 1 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line't Rear Setback from Rear Prop. Line Side Street Setback from Center Line' Side Setback from Property Line FINAL DATE INSPECTOR Issued by: - Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK =BUILDING DIVISION r 7 T 3 Desert Sands. Unified School District',. 47-950 Dune Palms Road Notice: LaQil:iita,.CA 92253 • Document Cannot Be -Duplicated 7G.0-77,1-8515 ' . CERTIFICATE OF COMPLIANCE... Date 8/31/00 APN# 769-600-016 No. 20957 Jurisdiction' _ "La- Quinta Owner NameNispero Properties'LLC Permit#0005-022 No. 78=785. Street Pina Log # City La Quinta Zip 92253, Study Area ' Tract# Lot,#.. .Square Footage ',.I" . Type of Development SFR'Mitigation :. No. of Units 1 Comments STD is in the Citws c5806 sq. ft. 4 • At the present time, .the Desert Sands t[Jiiiticd School Drstnctr�loes not collect'•_ fees on ,garages/carports, covered patios/walkways, residential additions under 500 sgivare feet, detaohed'acce,s'sory stiirctures or replacement mobilehomes. r..: It has been determined the above-named owner is exempt t 6hf-paying school fees atthis time due to the following reason: Under M><tigation Agreement EXEMPTION:NOT APPLICABLE This certifies that school facility fees'imposed pursuant to Government Code; 53080, in the amount of 628.00 X 1 or $ 628.00 the propg4,1isted above anii'tlia't building . permits and/or. Certificates of Occupant}T for: this square footage in,this•proposed'projectmav, new be issued r,. Fees P.aid'By CC / 1st Bank /Rob Capetz 1C$16. hon 760=772-2526 Name on the check By Dr. Doris Wilson "�• l Superintendent Fee collected/exempted by Annette Barlow Payment Received $628.00 r — wCheck No. 56616 Signature f TICE: Pursuant of Assembly Bi11.3081 (CHAP 549, STATS. 1996) this w 11 serve to:notify you that the 90•day'approvalperiod inwhich you may protest the fees or other payment ider tified ove will begin to run from the date on which the building or installation permit for'this project is sssued or on whichthey are paid t`o the District(s) or to another public entity authorized to lled them on the District('s)(s') behalf, whichever is earlier. - - - Collector: Attach a copy of county or city plarrcheck 1)lication form to district copy for allwaivers. Embossed Original- Building Dept./Applicant Copy- Applicant/Receipt Copy - Accounting -�— .' h. .ate •Y�T� ' ?' �• x.o- So- � a t -n� �� i 07 PAIRWAY Orderivo• ��� r gt;est�d 9� RECEIVED F01fR F:" "' ': escrow No. First Amnrit:an Title C AT O:OOMA e Loan No. ornpany ,a; EPAID FEB 28 WIIBN RECORDED MAIL T0:Mr. Robert H111 nsfer Tax ,,78-855 lima .rr -•�La Qu1nta, CA 92253 Re00rder MAIL TAX STATEMENTS TO: Spacea e this line for Rec er's a DOCUMENTARY TRANSFER TAX 3�21 4LS - -.Computed on -die consideration or value of property{ q " _ `- eomeyed.OR SAMBAS ABOVE - �Con"ted on the consideration or value less lime or ertemnbrances remaining at time of sale THE UNDERSIGNED GRANTOR ' [` Signature of Declarant or Agent determining lex•Firm Nnme�. TRA 020.03 - I 8 NT DEED - GRA x - , 4`FaR A VALUABLE CONSIDERATION, receipt of which is hereby acknowlcdged, } "" N CAPITAL PACIFIC HOLDINGS, LLC, a Delaware Limited Liability Company A. berebyGRANT(s)ro Robert M. H111 an unmarried Man. 4 r the feel property In the City of IA Quina County of Riverside Sate of Caliromia, described as Lot 45 Tract No. 349"4 (See Exhibit "A" Attached Hereto) - al Dated: January 27, 1999 - 5 if �1 - Sate otCalitomia ) _ - "` ) U. CAPITAL PACIFIC HOLDINGS, County of a Delaware United liability r ✓7 _, On : h e y .: � be me, BY: CAPITA PACIFIC HOLDINGB,IN SrAlmlri-N- 0A t Personally appeared a De ware on, ManagGtg Member personally known to me (or pvo#W to me on the barb of atbhetory 4i. . ' � = evidence) to be the penon(s) whose name(s) Was subseribed to the within instrument and acknowledged to me that he sheither executed the I same in hWheNtheir authorized capecity(bs), and that by hWhedtheir E signature(s) on the instrument -the person(s) of the entity upon behaltot n + which the person acted, executed the instrument, r 9r.<- ;,Yl::� WITNES MY HAND AND OFF I IAL SEAL eeaaeeea..r.r�: Si g natureOOMil�l�l1 •• yy a a •� OF LA OUINTA cFyoFoa,� BUILDING & SAFETY DEPARTMENT ® 7777012 INSWCTION REQUEST LINE 7777153 Owner NISP•RO. PROPERTIES LLC Contrac�or"oSIUN VISTA DEVELOPMENT CORP ``� 0005-022 Permit Number POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES 78- 755-prN7v-- DRES l' WALLS OR POOL TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK 5 Gd FOOTING STEEL MAIN GROUND SYSTEM GROUND PLUMBING PRE-GUNITE DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB Q JOISTS & GIRDERS ELECTRICAL GROUND WORK DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS & GAS TEST HEATING & VENT -.A/C FIREPLACE ROOF BOND BEAM O.K. TO WRAP 02 GROUT ❑ 4' ❑ 8' GROUT -- FRAMING moi/ INSULATION PRE -ROOF COVER NO WORK UNTIL ABOVE HAS BEEN SIGN DRYWALL INTERIOR logl EXTERIOR LATH POOL PRE PLASTER POOL FENCE & GATE SEWER SEPTIC TANK FINALS ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING Cort, ificate of Occupancy chy of La Quin. -.`a 8-Uilding,�and Safety Department This'Cei `ificate issued pursuant. to the r'equirements•.of.Section .109 of the ' * F certifying that , the fime of._ ssuancew: Uniform Bui/ding Co -e . t/is structure was in compliance with the_ variocis ordinances. 6 the ;City regulating ,6ui/ctl ng., construction ,or use.: For the fo/%,wing; BUILDING wb "RESS: 78-785T11N Us:e Classification'._ ` SFD c .. :Bldg. Permit No.: 0005-022 Occupancy4 Group: R3 ..Type of Construction: VNI. Land Use Zone: RL Owner of Building: NISPERO.PROPERTIES'LLC Building Official Address: R.O BOX 1144 City: LA QUINTA.CA 92,253 By KIRK -KIRKLAND , Date: 6-5-01 3�� POST IN A CONSPICUOUS PLACE 4, JONITANDY 37630 Medjool Ave. Palm A Desert,, CA, -92211 'Office (760) '772-7192 �SPECIAL INSPECTION7- , Fax j (760) 772=7193 Pager (760) "776-3338 REGISTERED' INSPECTOR'S WEEKLY�REPORT,, tea. TYPE OF , ❑ REINFORCEO`CONCRETE L TRUCT. STEEL ASSEMBLY ❑ S INSPECTION ! O POST -TENSIONED CONCRETE ❑ASPHALT Y4� *OTHERo La (cr PERFORMED s ❑ REINFORCED MASONRY'' - # ❑'FIRE PROOFING 1.(/�►"'—' —JOB—LCqT REPORT SEOUENCE NO. TYPE STRUCTURE ' " -]PERMIT NO. a • '^' . •} Dq DAY OF WEEK MATERIAL DESCRIPTION S pt ARCHITECT„r > ti -+ ,. �I�' -)/Q(��/ �OR HRS. CHARGED. V l” �'1 ��✓ .��; -"• ENGINEER " r- - •• , ASSISTANTS HRS. CHARGED INSPECTION ,DATE GENERAL. CONTRACTOR T ,, ! SUB; L& —,A "' CONTRACTOR f rya �� .. s ' 1> ..� #- . � 2 "` � • .J y t yu t pt •. .1 COPY SENT TO,CLIENT O" ,:. a CONTI ON NEXT PAGE'.❑ , PAGE OF . � ' .., � ..'" ,� } W i I, � Y x `• V'���'..' i • 1 CERTIFICATION OF -COMPLIANCE f t: I HEREBY CERTIFY,THAT•I"HAVE'INSPECTED,TO•,THEDBEST,OF'MY SI ATU E-OF•REGISTERED I SPECT R ..KNOWLEDGE -ALL OF;THE ABOVE•REPORTED WORK UNLESS OTHERWISE �• NOTED I HAVE FOUND THIS WORK TO;COMPLY .WITH THE APPROVED' l,` (�� . PLANS. 'SPECIFICATIONS. AND APPLICABLE "SECTIONS 'OF ^THE r GOVERNING.BUILDING LAWS. ` r' . aTE F REPORT REGISTER NUMBER �z I :Job Name: L O Job [�b. -1 f 99 Begin ate: Fab. Step `77W A L i� Fid Date: Q �v S W Vis '( H A TT DP ASTM M.P. Al FUU PM Heat` ALSC Camber ;Filets T Filets j T (symbol) NCE �1arane PCS E De9irr No. Tal. .Size Date (In) QC , (AOD). -EA(C4t ' (YIS)(Ctate) (Date) Rc�r1e D ®.10=. = NINE cull =11M.1-1101110011101 100110101 0 NMI 111010111 *Materials and weldzients conform to plans•and specifications and RISC, and AWS D1.1 Shipping Mark 905 SHEL Special Deputy Insp. � ■� NMINMI NMI ME OR ®.10=. = NINE cull =11M.1-1101110011101 100110101 0 NMI 111010111 *Materials and weldzients conform to plans•and specifications and RISC, and AWS D1.1 Shipping Mark 905 SHEL Special Deputy Insp.