9906-053 (SFD)LICENSED CONTRACTOR DECLARATION , '•
I 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 # Lit. Class Exp. Date
D �A"44
Signature of Contractor, v
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I 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).
( ) 1, 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..
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,provisiens of S* of on 3700 ofrthe Labor
Code, I shall forthwith comply with•those rovislons./=
Date!+-� Applicant',"
pplicantr 1 JJ� �
�'��
Warning: Failure to secure Workers' Compensation coverage Is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation,.damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under.or pursuant to
any permit issued as a result of this applicaton agrees to, &_shall, indemnify
& hold harmless the City of La. Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work, is not commenced within 180 days. from date of issuance. of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State, laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for insp'ectionMpurposes.
Vignature (Owner/Agent) ` v.• Date
!o ! � f
PERMIT p
BUILDING PERMIT
9906-05.
DATE (j VALUATIONU76.208.&j LOT TRACT a ffL�••,4
ADDRESS 7• FsP�iA JOB SITE
APN j e31�3•;�b
OWNER
CONTRACTOR / DESIGNER / ENGINEER
a
R i'-(AEMES J�C
(3 111C'D% r1r'I rr, lA`rw) pNUSr
teuv 1 t., a e...
PO BOX H4:a
42 r�>c�c:>'tr:'zKYN
LA QU04Tt'a. CA 92753
P.A�r•1.�.v�t , rr'A
��gJCr�r CS�s#
y9�221 5393 n y
(7607 f.72-7626 (1.x'e.7.r9 .7393
r;
�t
USE OF PERMIT (�
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w,. .,v. -a^r.t :aa.. N" iJ YU•.Py1rLRa .�.a
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-
%FD - PFAME 1' DOTS NOT INCLUDE Ili.- >i' WALLS OR P001.
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7733
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fi<fgsCt•Tril�f$�.:t4c..P'tfs •'•; i•4f ti!lfd-�i23-�U �fl7:i ?.rit
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0 4S Ql:MgyCNG, IMO`LfN 9FT yES) tOk
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Ott"i' IN PUBLIC liD_►�t::l: $ - ld1✓ti3� I13� d�it(b-;. � 000 UW, n..
P'1k:V;"�,r`�SYA.pa �t��>,�"'r'~✓�t;ft . M{,�'t3�"
84 fit- f <YrA.C• CONS E'lU ,7P;('i 1 AND 'PLAN CHECK
$6, 174
LwPRE-PAID PUS'
00yy8
^•U �p4 1i1,i.k!}2
T'1,11'Y'.&L 62:i's'50.1{'9 T FEEN 00E NOW
•P%a.n d<�. �V4
RECEIPT
DATE
BY ' .tj�
DAT�•FINA ��-
IN R
INSPECTION RECORD
OPERATION 7F77DATE
I 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
GV (CiLr
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
Cit/
Drywall - Int. Lath
Final '
Final
o7J
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
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Slower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
x)
Encapsulation
Gas Piping
Gas Test
_ �J
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)
4`
�,yg-g9r
/,0/_Z'/,S 6
Building
u�l'ItiGv
� AJA P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
- W4
APPLICATION ONLY
Mailing
Address
BUILDING: TYPE'CONST. OCC. GRP.
A.P. Number
Legal Description t%. �Q_ 13 o "'
LT2_ 4
Project Description
City/ � ,/^
vi -M1'1
Zi
a
Tel.
'��"�.� 6 a 6
Coatractor /^ �"\
A,d ress
LIZ -IV
AMOUNT
C' y
p,ea .v
Plan Chk. Bal.
State Loc.
& Classif. .� Q
City
Lic. q
Sq. Ft. No. No. Dw.
Size Stories Units
Arch., Engr.
Designer f �� �AJ3[,
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address �+ _
_.el /
Cu't'e Mer A.)e
Z"71
���t Co -5x//93
Driveway Eno.
LICENSED CONTRACTOR'S ECLARATION
I hereby affirms' I a licensed under provisions �,ft6tta er 9 (commencing with Section
7000) of Divi on 3 1 Busin ss and rote io de, and my license is in full force and
effect. l'
S GNATU DATE
OWN R•BU LDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5.8usiness 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 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 ($500).
I." 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
of proving that he did not build or improve for the purpose of sale.)
I'1 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 builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
i 1 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to sell -insure, or a certificate of
Worker's Compef�sation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy NoCompany
7fZCopy is filed with the city. ❑ Certified copy is hereby furnished.
A \ 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.
Dale -Owner
NOTICE TO APPLICANT: If after making this Certificate of Exemption you should become
suDtlect to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. -
t+
'CONSTRUCTION LENDING AGENCY
hereby affirm that there is a construction lending agency for the performance of the
for which this permit is issued. (Sec. 3097, Civil Code.)
Ws Name
-
I ! This is a building permit when properly filled out, signed and validated, and is subject to
lexpiration if work thereunder is suspended for 180 days.
(!certify that I have read this application and state that the above information is correct.
JI a ree to comply with all city and county ordinances and state laws relating to building -
co struction, and hereby authorize representatives this city to enter the above-
( entioned property for inspection purposes.
Signature of ajiplicant Date
Mailing Address
City, State, Zip
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
ide Setback from Property Line
FINAL INSPECTOR
Issuej�JQQ() Date Permit
t
bv:
LAQUINT,
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
�p cr •. (' app ��2-
EstimatedValuation
Ziy2(o
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Eno.
Infrastructure
4�
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
ide Setback from Property Line
FINAL INSPECTOR
Issuej�JQQ() Date Permit
t
bv:
LAQUINT,
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated k"' I i 760-771=8515
CERTIFICATE OF COMPLIANCE
Date 9/29/99
No. 19392 Jurisdiction
Owner NameNispero Properties LLC
No.78895 Street Pina
City La Quinta zip 92253
Tract #
Lot #
Type of Development SFR Mitigation
Comments
Single Family Residence sq. ft.
APN # 769-610-044
La Quinta
Permit #
Log #
Study Area
Square Footage 1
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:
Under Mitigation Agreement
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Mitigation Agreement
in the amount of
628.00 X 1 . or $ 628.00 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
Fees Paid By CC/ 1 st. Bank /Rob Capetz Telephone 772-2626
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sylvia Carrasco Payment Received $628.00
Check No. 52498
Signature
NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90i1ay approval period in which you may protest the fees or other payment identified
above 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
rolled 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
Gvt�`56, 85s f?�AJA
c&ty1'4.4 Qum&,
Dear Builder:
PUBLIC WORKS CLEARANCE' LETTER
FOR
CUSTOM HOME LOTS
Prior to issuance of a building permit, you will be required to obtain clearance from the
Public Works Department for one, or more, of the following:
1, Verification that rough grading is complete, and the pad elevation certifications
prepared by a licensed surveyor, or engineer, are on file in the Public Works
Department.
2. Verification that infrastructure improvements and other required tract improvements
are complete, or sufficiently advanced to warrant building permit issuance.
3. Prepare an engineered grading plan that provides for on -lot storm water retention,.
and have it checked and approved by the Public Works Department
• Tract 26524 (Estancias)
• Tract 26769 (Mountain View Estates)
4. Prepare an engineered grading plan that provides for building pad grading in
accordance with the existing soils report and tract grading plan, and have it
checked and approved by the Public Works Department.
• Tract 28034 (South Valley Estates)
FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT
TRACT: a
LOT-
7 i
DATE
F:%PWDEPTIDOCS\FORMS\PW CLEARANCE LETTER.ss
COMMENTS:
557541
FAIRWAY HUMES
RECEIVED': FOR, RD
RECO
• Order No. Recording Requested By AT 8-00AM
Escrow No. First American Title Company
Loan No: p E C 23 199
WHEN RECORDED MAIL TO: pp�.d'�ry y�`rp t
iV4
I.
r{�
Nispero' P - patfi 6 �9, I.LL
. 50--755,-.Nispero lite CiO:F .R@pOP+d@1< SOD
La Quinta, CA 92253 ' Few
MAIL TAX STATEMENTS TO: "Spice, above this lufie='for Recorder's Use
DOCUMENTARYTRANSF,ER,IAX$ 2 2,�• C�(� J
Comp- %e theco_asuleraiioa�ervalue;6fproperty.- Sg
conveyed, ORY
SAME AS ABOVE .. Campi ted -on the consideration or valueless liens or
encumbrances remaining at.time of sale
THE UNDERSIGNED.GR? NTOR
Signature of Declarant or Agent.deteimining tax -Firm Name
APN: - 6 A9 - O zNV.
TRA: 020-051 GRANT DEED
FOR A VALUABLE CONSIDERATION, receipt of which is hereby. acknawledged,
4 CAPITAL PACIFIC HOLDINGS, LLC, a Delaware Limited Liability Company
`Q-
hereby GRANT(S) to
iV2Spm pROPE'RriES, i= • , a Ia nit2d l ability
the real property in the City of La Quinta
County
.
Country of _ Riverside e of California, described as
Lot 56 Tract No. 248904 (See Exhibit "A" Attached Hereto)
sk
Dated-0ctober 21, 1998 y
State of California )
0.
) ss. CAPITAL PACIFIC HOLDINGS,LLC,
Coon of C�� a Delaware limited liability company
On Veim.tor� » tads before me, 'BY: CAPITAL_PACIFIC.HOLDiNGS,INC.,
a'Df
aware corporal ,Managing Member.
personally appeared t S
b�BN
personally known to me R ' .
e,fi&"O) to be the persono whose nameo0,;Iare subscribed to he
within instrument and :acknowledged to ine thatelthe executed the
same in Onerltheir authorized capacity{, and that by ei/their f"
ature(4 on the instrument the person,( or the entity upon behalf of
which the person acted; executed the instrument.
WITNESS HAND AND OFFIC ' SEAL r iesn ^AMY.,
CAm+iVdon'Y 112rJt6
' tECtfeY Pubie.—
Si afore19.2M
Lte-,-, e�Tee6m1►:
(This area for official notarial seal)
Summit Structural Engineering
2283 Fifth Street
La Verne, CA 91750
August 24, 1999 (909) 596-0842
Sun Vista Development
P.O. Box 1144
La Quinta, CA 92253
Attn: Rob Capetz
Subject: Roof Truss Shop Drawings and Calculations
Lot 56, Citrus Course
La Quinta, CA
Dear Rob,
The roof truss drawings by "The Truss Company" for the subject project were
received by our office on August 20, 1999 and are approved. The submittal has
been reviewed for general conformance to the design concept of the project
structural plans. The fabrication processes, techniques of construction,
dimensions, and quantities are not a part of this review. Since the shop drawings
were reviewed only for general conformance with the structural plans, unless
variations from the structural plans have been clearly indicated, we may not have
listed them.. Our review of these drawings does not relieve the truss engineer
and the framing contractor from complying with the structural plans.
Yours truly,
SUMMIT STRUCTURAL ENGINEERING
Benjamin Herbst, P.E.
CC: The Truss Company
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Residential, Commercial, Industrial, Land Development