0201-115 (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 # Lic. Classn Exp. Date,
Date � Signature of ContractorrP,•
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 theirlsole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044, Business & Professionals Code). N
( ) 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 penaltyl�oftperjury one of the following declarations:
() I have and will maintain a certificate of consent to self -insure for workers'
compensation, ase provided. for. by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
�6) I have and will maintain workers' compensation insurance, as required by
gection 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 PTATE FUND Policy No. 22.0-02-0020714
(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,pro'vision /61 Sect? .370 of the Labor
Code, I shall forthwith comply with,tl ose prove ions. ,�
Date: f r�.'e' / 7 APPlicant/�' fr
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 df 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 Safetj _
for a permit subject to the conditions and restrictions set forth on his'
application. i
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. e
2. Any permit issued as a result of this application becomes null and void if G
work is not.=mmenced 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 Ahe building
construction, and hereby authorize, representatives of°this City to enter upon
the above-mentioned property fdryl ispectibn,purposes.
Signature (Own er/Agefnt)' '" / F.•-..-� DatV_/111
JCf
d
-BUILDING PERMIT PERMIT#
0201-11.6
DATE 06 ��� VALUATION
vfi�1 LOT w 5 TRACT VMS
JOB SITE ADDRESS 52—IM TYXI CRAM 01 �
APN 770-3,+0-019
OWNER
CONTRACTOR / DESIGNER / EN (NEER
SUA !am;I3'i�!AIWAS LIX
u U111.1 AMA T:}E?'&UPIVENr C01M
IAi3i% T'lC'' _94S:3i1i:AQ),11'1N*T
A Ck 9VA3 ,
USE OF PERMIT°
ORNGL FA AIi.'sf 3 I d'c�s
3F01 DOMI' I[K WAIA-W:OOLIOR.I[i/EWA.X .f,1;X331, OA..CWCOMPLIAN-C '
W7:'}1 ALL .k"R:I?t3.AI: & .3`1'A E IA` S., INC",LU.001C D
SNEGIZ3 AC..'T OI< I9 -n IF Ar IpLay.Ars'LF,IS iR1f,C�iJIRP,,a
o
('11S.COM C'0.)MITTiUC710N 4,M 00 OF
P0R,f,H/I•A!rJ--O 15I.Q.00 SP
,
0MLA0jPtF;A(t'f )Wf ,MOO OF
l rMAA,;f'.E D Cog], OFCO.N-ViR1lCIRM
37004,4
CONSTROCTIOM A'4E 101-000.418.000 $1120A
PWN CHECk RK 101-000-439-318 $1,290.96
1<'f<tZ DEPOSIT 101-000-439,,3183 411000100
s�itl{.'..AtLii'V4 101-000-421-000 $06.00
mr,XTkRUAL R.F. 101 _000-420-000
P€.UN"BI- o FEE, 101-0004119-000
ITI R ,10 IvTOMN KER - RMID 101,.000.241-000 $37A
-
t?IB.li,DfHo FF -E 101-006.423-000 70.On r
DGMr'Z..OPER EIV PAC VI E
ART IN 'PUB13C VLAC;.S d 0013I.0 270-000-445..000
4 Ci 3:f- O AL C,"ON RUM"IOR ADD ?,'LA -1`Z 'MO
G LEUS 11RE-PAM FU
, X OM
YUMT XS NOW
Owl,
RECEIPT
DATEI J j
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
orReturn
Air
Steel
Combustion Air
Roof Deck
- o
Exhaust Fans
O. K. to Wrap
/
F.A.U.
Framing
-
Compressor
Insulation 1�0� �_� _
Fireplace P.L.
Vents
Grills
Fireplace T.O.
Fans & Controls
Party Wali 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
Sewer Connection
_�
46— -vL_ K�'�
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final .
Utility Notice (Gas)ti3 �GL
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
low Voftage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power 7
Final
Utility Notice (Perm)
1 �.rVri �,.r". 'G :-�::-.,jr.:r �•s y+b�r. t.^e "Itr ..�I rMt u � {V Atl� •` r�`"f,-..a'C F: M'+ta`4 i�,.�3Ci"�J .4.��.•,rA,�
_- . A
P.O. BOX 1504 APPLICATION ONLY V�r (.y
dess — Q `C� 7 78-495 CALLE TAMPICO
Addr? / q1
/ LA OUINTA, CALIFORNIA 92253
Owner
_ avv t° �1 f
Mailing Q / V `� BUILDING: TYPE"CONST. OCC. GRP.
Address C..J /7iO� lie �� SAA A A.P. Number 7 -7' 5 3 U ��
City Zip
Legal Description L`' tf b
Contractor<, t
�� }� Project Description ✓t � %�/ �'�� � �� r�
Address
v/T ( C)UiAJJ Zi_wa5 3 79�/-
a
State Lic. �� City
& Classif. �G�O Lic. #t��f 3 �3 Sq. Ft. % l % No. No. Dw.
Arch., Eng ., L
Size ' ' Stories Units
Designer U > t ¢-�,C i New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
/Pa �i/�r o� � 6338?ri
City Zjp.�) State
C -X A �`,)� �a Lic. #
LICENSED CONTRACTOR'S DECLARATION _
I hereby affirm that I am,licensed under provisions ofthapter 9 (commencing with Section
7000) of Division 3 of the usinds-9 and Professions CoTde, and my license is in full force and
effect. i j' // \ � L-
IG
SNATOR .r S,. I/��J""" 'I 1DATE
OWNER•BUI DERECLAIiAT10N Estimated Valuation
I hereby affirm that I am exempt from lh Contr@rctor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, after, 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 PERMIT AMOUNT
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 II +
for thealleged exemption. Any violation of Section 7031.5 by any applicant for a permit Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500)•
I21 I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.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, Mech.
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 Electrical
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- Plumbing
strucl 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 S. M. 1.
such projects with a contractot(s) licensed pursuant to the Contractor's License Law.) l
Grading
I1 I am exempt under Sec. B. 8 P.C. for this reason
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 certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
I7 Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REM A S
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 ZONE:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances.
comply with such provisions or this permit shall be deemed revoked.
Front Setba r m 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 this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
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 1 have read this application and state that the above information is correct. Issued by: Date Permit
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. Validated by:
Signature of a0pficant Date
Mailing Address Validation: -�
City, State, Zip
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISIOI,/
Summit Structural Engineering
2283 Fifth Street
La Verne, CA 91750
April 7, 2002 (909) 596-0842
Spates Fabricators
85-435 Middleton Street
Thermal, CA 92274
Attn: Truss Designer
Subject: Roof Truss Shop Drawings and Calculations
Lot 55 at The Tradition
La Quinta, CA
Dear Truss Designer,
The roof truss drawings by Spates Fabricators for the subject project were
received by our office on April 5, 2002, 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
No. C0W 93 -
Exp. 12131103
3Exp.12131103
Benjamin Herbst, P.E.
CC: Rob Capets, Sun Vista
BH
cA2001 jobfiles\sv-161 \161 _truss2.doc
Residential, Commercial, Industrial, Land Development
0
,Notice:
Document Cannot Be Duplicated
Date 5/10/02
No. 23207
owner NameSLM INvestments
No. 52850
City La Quinta
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
APN # 773-330-019
Jurisdiction La Ouinta
Street Del Gato Drive
Zip 92253
,
Permit #
Log #
Study Area
Tract # Lot # Square Footage 4438
Type of Development Single Family Residence No. of Units 1
Comments
Cashiers Check - $9,495.18
Cash - $2.14
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
2.14 X 4,438 or $ 9,497.32 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 Business Bank - Gisela Porter
Name on the check
By Dr. Doris Wilson
Telephone
Superintendent
s -
Fee collected /exempted by Crystal Scott Payment Received$9,495.18
Check No. ,"1.23615
Signature
lOTICE: Pursuant to Assembly Bill 3081 (CHAP 549, STATS. 1996) 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
Tradition
May 6, 2002
SLM Investment
c/o Lainperti Associates
1241 Andemm Drive S'«ite A
San Pq&el, CA 94901
Re: -32850 Del Gato Drive: Lot 55
Dear Mr. Lampert
The Tradition Archft_Gt aal Committee has reviewed your tetter regazding tlw waif
around. the M tr- n rr rer on -lots 54 arA S S. Thank you .for }tout follow ug oa this hem
We love also received c,)rrespondence from Sun Vista regarding the screening of the
garage windows. We tuderstand the garage windows facing the street will be savened
-,% ith an interior shutter.
We =, in receipt of the $5,000.00 Construction Performance Deposit. The Association
approves you to obtain , 6.building .Pen dt.. I Iook foY'vvWd to working With 7QU Ruder on
the developmeDt of this &OMe.
Six=-ely,
Mindy Grutierrttttm Property Manager
Tradition Community p- ssociatiOn
cc: Suit Vista. Deve:bpment:
PCIMIDESER7 RES -ORT PROPERTY MAINAGEI+tEXT C e1P.�X
POST OFFICE BOx 4772, PALM DI SERI, ZALWOM,11A 92261-4x2 . 73.5.50 AUSS-E NOR0, S:.TTE 5. P.ALat I3 SM- CQff0MJL-02260
PHONE: (760) 346-1161 — Fax: (760) 346.991$
Certificate of Occupancy
City of La Quinta
Building and Safety Department
-This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS: 52-850 DEL GATO DRIVE
Use Classification: SFD Bldg. Permit No.: 0201-115
Occupancy Group: R-3 U-1 Type of Construction: VN Land Use Zone: RL
Owner of Building: SLM INVESTMENTS LLC Address: 8 MONTE VISTA AVENUE
Building Official
City: LARKSPUR CA 94939
By: KIRK KIRKLAND
Date: 3-26-2003
POST IN A CONSPICUOUS PLACE
199S 10 : 21 At4 FROKI F'_
RECORDING REQUESTED SY:
Fidelity National: Title Company
Escrow No.. 4083 -CAH,
Titie Order No: 9782069
When Recorded Mail Document
and T;ix Statement To:
Diablo Holding, LLC
1241 Anbersen dr.
San Rafael, CA 94901
TRA 020122
DOC = 2001-2.40 3°33
04/0412081 88:eep Fae:26.ee
Page 1 of 1 poo T flax paid
Recorded in Offielal.Reoords
CaunEy,of Riveredde
Gar. y L. Orso'
Amsessor, County CistbR 4 kacorder
DADR SZE I DA pCOR N'
Low --Ft& r� E%vnt
GRANT DE
The trndersigned grantorts) declare(s)
Documentary transfer tax is 5544.50
[ X l computed on full 'value ofproperty conveyed, 'or
[ l computed on full value less value of liens or encumbrances remaining at time of sale,
[ 1. Unincorporated Area City of La Quinta
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Tradition Club Associates, a
Delaware ;Limited Liability company
hereby.GRANT(S) to. SL?,ff ZnvestiReuts; LLC
the. following .described .real property in the City .of .La Quinta
County of Riverside, State of California:
Lot 55 of Tract 2885.7, in the City of La Quinta, as shown by Map on file in Book 275, Pages 69 through 78 of
Maps, in the Office of the County Recorder of Riverside County.
DATED: February 7, 2001
STATE OF CALIFORNIA
COUNTY 0 1,t•.E'1J
dN, .. before me,
lr IS bnally appeared
personally known to me a
} to be the person(s) whose
name(s*isl"subscribed to the within instrument and
acknowledged to me that fze/she4144 - executed the
same in hisff+e4t#►eir authorized capacity(ies), and that
by hisA riOieir signature($} on the instrument the
person(*, or the entity upon behalf of which the
personts) acted, executed the instrument.
Witness my hand. and. official 4o
Signatur
aware Limited Liability
David Chapman, Managing Member
CHRIVINA J. DOR85
Commission*.. 1127459
Notary Publto - CQlifomin
Riverside County
Nty C�rirn, Ekes Feb?, alp T!
MAIL TAX STATEMENTS AS DIRECTED ABOVE
FD -213 (Rev 7/95) GRANT DEED
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE STRUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE 1 ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
0 S
❑ OTHER—I
6
JOB LOC
/, /` _
REPORT SEDUENCE NO.
TVP F TRUCTURE
� �T � �
to
PERMIT NO.
DO�TE� �
CLJ
DAV OF WEEK -
MATERIAL DESCRIPTION
^
fo 9)0
ARCHITECT
I OR
NRS. CHARGED
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPECTION
DATE
GENERAL\ - L&
CONTRACTOR V
V V
SUB
CONTRACTOR
Lis
�L
ID
X14
'S Ve,es-
�
$ba
COPY SENT TO CLIENT ❑
CONTINUED O T PAGE O
PAGE
OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS. SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS
9G A OF REGISTERED IN.SSPECTO
DATE F EPORT REGISTER NUMRFR
it
IMMENNIMMIMI
INEEMEMM101
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
O REINFORCED CONCRETE
❑ POST TENSIONED CONCRETE
❑ REINFORCED MASONRY
❑ STRUCT. STEEL ASSEMBLY
❑ ASPHALT
❑ FIRE PROOFING
❑
ER
1/ _
JOB LOC �r�-�j1 at, O�
\ V
L� u `
REPORT SEQUENCE N0.
TVP OF STRUCTURE '�►�.J
.16 _:Su
PERMIT NO.
DAY OF WEEK
MATERIAL DESCRIPTIONARCHITECT
rK,
S
IN EC OR
-a
HRS. CHARGED
ENGIN
O.�
ASSISTANTS
HRS. CHARGED
IN;PE
DATE CTION _ _ - CONTRAGENECTOR v U d �S
CONTRACTOR
art
l C�•
L)jl 1
h
w .
:S OA-
-
-X
COPY SENT TO CLIENT O
CONTIN ON NEXT PAGE O
PAGE OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
PLANS, SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
GOVERNING BUILDING LAWS.
TrRE OF R`EGIS�T REcD�-I� PpECTDR
o
DAT F RE ORT REGISTER NUMBER