15279 (SFD)Building
Adziress 77-'29
Owner
P.O. BOX 1504
78-495 CALLE TAMPICO
Calle Chihuahua LA QUINTA, CALIFORNIA 92253
Mailing
Address
Cityr
Zip
Tel.
La Quinta, CA
92263
1
Contractor
Double D Construction
Address
51-960 Avenida Herrera
CityTela
Zip
La Quinta 32253
771--2561
State Lic.
City
& Classif. 581012
Lic. # 323
Arch.; Engr.,
Designer
Address
Tel.
City IZip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapterr9 (commencing with Section
71000) of Division 3 of the Business and Ptofession;-Code, and m license is in full force and
A, A
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: 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 Ole 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 Ove hundred dollars ($500).
❑ 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, 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.)
❑ 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 self -insure, or a certificate of
Woiz=ZF
'e, or a certified copy thereof. (Sec. 3800, Labor Code.)
Polmpany
❑ Certified copy is herebyfurnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(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 the work for which this permit is issued, I shall not
employ any person in any manner so as to became subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: O, 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.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,D00), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
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.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 15279
BUILDING: TYPE CONST. V_N OCC. GRP. •R3
A.P. Number 773-311-013, 773-311-014
Lot 13, 14 Block 169
Legal Description
Project Description 5FD
Sq. Ft.
Size
New
No.
Stories
No. DIN.
Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
►rts in Public
IrA,n_'i RA Platy
TOTAL
REMARKS
AMOUNT
327.13
681.50
62.04
13.5.41
163.40
11.12
20.00
2403.72
28.05
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line—
Rear Setback from Rear Pro ',L 'ne,
Side Street Setback from 6�6 r _l
Side Setback from Prop . Ine=
FINAL DATE IN
Issued by:
Validated by:
r�,
CONSTRUCTION ESTIMATE ' NO. I ELECTRICAL FEES I NO. I PLUMBIW
IST FL. SO. FT. ® $
UNITS
UNDERGROUND
2ND FL. SO. FT.
COLL. AREA
YARD SPKLR SYSTEM
ROUGH PLUMB.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
FORMS r' / 9S
SEWER OR SEPTIC TANK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF. / 4
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SO. FT. ®
OTHER APPJEQUIP.
REINF. STEEL 7 / �f
WALL SQ. FT.
TEMP. POLE
DRINKING FOUNTAIN
SO. FT. ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
/r�
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
REMARKS:
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK /�
GROUND PLUMBINFI /�
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS r' / 9S
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. / 4
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL 7 / �f
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
.$-Plus-x$-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
?�
ROOFING ,{ �'/ Q�
/r�
REMARKS:
VENTILATIONv
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING Q 9�
MESH
INSULATIONISOUND
v ✓�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
EARTH SYSTEMS CONSULTANTS S.C.
79-811 B Country Club Drive
Bermuda Dunes, CA 92201 - (619) 345-1588
CLIENT NAME
CLIENT ADDRESS
CLIENT PHONE
DATE JOB NO.
PROJECT
G u► v
LOCATION
CONTRACTOR OWNER
�Oc,�ble
WEATHER TEMP TIME
PRESENT AT SITE
TEST
NLMBER
y�rfJe p
LOT
N:).
ELEVATION
FIELD TESTING
REFERENCECURVE
MOISTURE
CONTENT
%
DRY
DENSITY
Ibs/cu. it.
MAXIMUM
DRY
DENSITY
%
MAXIMUM .
DRY
DENSITY
Ibs/cu. it.
OPTTMUM
MOISTURE
CONTENT
%
S�.
/3,a
12o, o
J,
N
1
vt I ttv(4u
Q
"•� r "
REMARKS: Re�%I rn l ...rs Com u t ,'oie 4 U cxje- IO cl • i e9I'
LILN9 �. - �
CLIENT REPRESENTATIVE SIGAATURE
FIELD REPORT
TECHNICIAWSIGNATURE �� 8500
50O
)UN—W-1996 C'd:cb CR1STE, PIPPIN 3 GOLDS b1'J 'r'rb 441':),i r'.ofi
ontezuma
estee .
73-550 Alessandro Dr., Ste. 200
Palm Desert, CA 92260
May 28, 1996
City of La Quinta
Building Department
As of today's date, Montezuma Oeste, Inc. is replacing the current contractor, Mike Dietrick of
Double D Construction, on our construction projects at 77-290 Calle Chihuahua and 53-120
Avenida Juarez. Montezuma Oeste, Inc. will now formally assume the role of owner -builder on
the two properties. You are authorized and'requested to list Montezuma Oeste, Inc., on the
necessary permits and documents related to both construction projects.
In addition, please issue directly to our new construction supervisor, Dennis Melilli of D. Melilli
Construction (Lic. 275452), the current Building Cards, noted with all inspections to date, for
both properties.
Finally, if possible, please release directly to Dennis Melilli an extra set of stamped plans for
each property.
Thank yogi for your cooperation and assistance in this matter.
Sincerely,
Fred Wilson
Vice President
Montezuma Oeste, Inc.
cc: Irwin Golds
Dennis Melilli
Kris Wilson
malty FD ILL: Mar 01'96
''ltr-Z )RAI:-cs REOut- 11-.1) BY 1 furs
AND WHEN RECORDI1) MAIL W
Montezuma' Oeste, Inc.
c/a Criste. Pippin. do Golds
77!,564 Country Club Dr. Stc. 220
Palm Desert, Cs. 92260
A.P.N.: 773.311.014 TAA is 020 Ordcr No.:
12 35 No . 010 - P . 02
JUL 17 ice;
M..�otiw wc.a.
�aft"!
Atwim'Tha I.nc kw Itco,-ftrs Lac (Mly
Escrow Nw►
, GRANT DEED
TtI!tMERStOSIMGRANUOR(t)DUCIAlU/s)MINT I%( tit. sm,s no consideration
[ j computed on full value of property conveyed, of
[[ ]} computed on full value less value of tiers or encumbrances remaining at time Of .alc.
unincorporated arca; j X j City of La Ouinta , and
FOR A VALUABLE CONSIDERATION. Receipt of which is beteby acknowledged.
J. Frederick Wilson and Beth C. Wilson, basband and wife as joint tenants
hereby GRANT(S) to Mostnuma Otstt. Inc., a California C"ratioa
the following described property in the City of La (joints. County of Riverside State of California;
Lot 13, together with Lot 14, but excluding the west five feet of Lot 14 conveyed to Lots 15. 16. and
17, Block 169 of Seats Carmelite at Vale La Quints Vait No. 17, as shown by Map on flit to Book 19,
pall 19 and 20 of Maps. Records of Riverside County. California
n
J. Fre ilson Beth C. Wilma flORM NATIOM ME OWRANCE WhIPANY
NA$ RECORDED Tiff$ INSTRUMENT 11Y REQUEST AS
Document Date: July 11, 1995— AN ACCOMNOOATION ONLY AND NAS NOT EXAMINED
R FOR RECUEAR;TY Ano SUrvICIENCY pt! AS TO '
cwu[� t EFFECT UPON THE TME TO ANY REAL /Rp►ER4r
S -MO pp Riverside ��� MT MAY BE OESCRi8E0 TNEREm
oa July 11. 199S Wove etc. Diane Sedin
pe,�aHy sppr,� r Bete son and a son
petaoestly thorn to mt (or pewee to won tit ham ersatisfanoey evMCKV) to be the peraoe(&I WNW "Inds) it/arc si.bwnhcd to the within
imtrtaueat ttttd admoeledy.d to toe that faf tt/they esoneted the .ane in"t iWIVIt/their euthoeirw eapae;ty0es) and that toy a+sJlRr/ellen u�tatvret+I
an the inentintnt pnwn(s) or the entity upon behalf of wh.ctt the petaeut(s) meed. ewcvtcd the iestroa�eot.
U/fIwm my atfieNt mai.
A.
cats to:
z� Pea ft7 OlrKW nttliel:l seal.
OMNE SE UI,
(.haul a tiro • ty _
� v:a R4i)�.�•t Yl� h
A,(k's,
tY" 141
SAME AS ABOVE 'or Addtcss Noted Behow