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0206-216 (SFD)undLICENSED CONTRACTOR DECLARATION •° I.he�etiy:affirm er 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. Class Exp. Date 77�3f3 13 J f ! 0f313V 1 D'at x t ► Signature of Contractor/ � 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). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). F . ( ) 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 fo'r which this permit is issued. I have 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 permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier I-%FaT 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 provisions of Section 3700 of the Labor Code, I shall -forthwith comply with those�'provisions/ n Date;'l1 , Applicant { * ✓� Warni g: Failure to secure Workers!/Compensation coverage is unlawful and. shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety ° for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned propertyfor inspection purposes. f.� i 1E-� •� � Signature (owner/Agent,�r�J _ "� Date , BUILDING PERMIT PERMIT# 10 1116 DATE VALUATION ,,tttt II LOT gg TRACT 101-K F 9 J • B SITE ADDRESS :- AW Dc I= APN _ ^ OWNER CONTRACTOR / DESIGNER / EN INEER COVE, 19A1hWP& LMACY ROME S 7,A14 N.r LWEVOD SP -/ 5O.c✓6dJFF IRSEL 0228 ' 8 13 PX'1'A-A1qA CA LP. OY.MrA CA 92253 >L36U)564� 782 l CIRL6 02063 USE OF PERMIT S�`;Jr NOT FNC:LUDE 1, LO 9 V�A,F. LFL POOL) SPA QR DRIVEWAY APPROACH. H. TY+:.AC T CONS TRUCTIOW 1.01100 5F' �. OPIC1•f/P.,ATIO 44.00 S; G.&RA.OMARI'ORT 404,09 8I3 CON 3's°' AUCTION FILTII 101.000-418-000 ulftso PLAN i:HE4,,11K Jr" 051.20 FEE Dvlfoali 425100 My-r,CI31h$v1L^A1,,.1 ELF 1U1�t1 lQ J 9-at)t1 60.(Yf3 i',9..1 C'E I C'•AL FER 101.000420.000 fi1,'13,3i� P tiAJiDINU FEE 101-000-419-000 $136.00 r STRONG MOTION WE I2UID 101.000.241,000 sio.53 OXAiXHano. 101-000-423-000 PAC'T.F;EE tDFV'EIrO11R. ♦I171 R'3Twfabr�u7lwi'i.ci�eA'i :1'01 "6J idi9'^i�i• 1^:7=*vJ y�SX7.571f gUB-TOTAL C'.C)N:3IRUCTdOR AND k LANK., C -15 NOW i\ ,RECE D Q� o I.AY.77 FINALED INSPECTOR y .r INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs - - Q Underground Ducts Forms & FootingsDucts Slab Grade Return Air Steel Combustion Air Roof Deck �j Z /milli Exhaust Fans O.K. to Wrap F.A.U. FramingCompressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wail 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 Water Piping e // / '•D �-G�- Heater Final Plumbing Final Plumbing Top Out ? Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Sewer Connection 7 -.26,p lz_ ,— Pool Cover Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: - Final Utility Notice (Gas) G 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 (J Final tit Utility Notice (Perm) Buildintl • '' 4 e we3_ 4 "" c v P.O. BOX 1504 78-495 CALLE TAMPICO APPLICATION ONLY t'IINTA, CALIFORNIA 92253 �n / wne JDeo,t ! Q Z f v Mailing1 Addressa�/ IGI e Q City Zip Tel. �n �y 5 Contractor 6 Address five ?_J3/ State Lic 8 `� 2-6)0 (City & Classif. ® Arch., Engr.�n ��/� 1�V� Designer Address I Tel - City IZip I State Lic. # 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: 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 (8500). I'] 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, 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' 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.) i 1 1 am exempt under Sec. B. 8 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 certficate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company 1`7 Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i1 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., Il, 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 1hereby 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 Address This is a building permit when properly filled out, signed and validated, and is sibject 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. 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 a0plicant —Date— Mailing ateMailing Address City, State, Zip BUILDING: TYPE'CONST. OCC. GRP. A.P. Number 7) /// do3 Legal Description4-�11 �"i'�- Project Description ZONE: BY: Minimum Setback Distances: t Front Setback from Center Line t I Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION a CiTYOFLgQUIAIM — FI—CEDEPT. i Sq. Ft. / Q (— J Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ L49, uc/-z 7 7 Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. r S� Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure . . TOTAL REMARKS ZONE: BY: Minimum Setback Distances: t Front Setback from Center Line t I Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION a CiTYOFLgQUIAIM — FI—CEDEPT. i CERTIFICATE OF COMPLIANCE v��IEDsc Desert Sands Unified School District >q�o 47950 Dune Palms Road Q BERMUDA DUNES r Date 7/9/02 La Quinta, CA 92253 rn RANCHO MIRAGE d No. 23356 (760) 771-8515 �� INDIAN WELLS y PALM DESERT LAQUINtP�QIVT DDIOy�'� Owner- Cove Development APN # 774-111-003 Address 53560 Avenida Juarez Jurisdiction La Quinta City . La Quinta Zip 92253 Permit # Tract # Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 53560 Avenida Juarez 1851 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that 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 Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14 X 1,851 S.F. or $3,961.14 have been paid for 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 - Sharon Bills Check No. 62954 Name on the check Telephone 760/594-1598 Funding Residential 1 By Dr. Doris Wilson Superintendent Fee collected /exempted by Crystal Scott $3,961.14 Payment Recd Over/Under Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day 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 issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting NOTE SECURED BY DEED OF TRUST ESCROW NO.: 2.35963 INSTALLMENT NOTE .-- INTEREST ONLY � $607,500.00 PALM DESERT, CALIFORNIA ' APRIL 16, 2002 Jr. installments and at the time hereinafter stated, for value received, I/Weromise p to pay to Richard L. Deman and Monique Deman, Trustees, or Successor Trustee, under Declaration of Trust dated October 1, 1981. c is or order, az Palm Desert, California, or at place designated by the holders) hereof, the principal Seven Thousand Five Hundred And 00/100 Dollars ($607,500.00) with interest from APRIL 26, 2002 the amounts of principal retraining from time to time unpaid, until said p p� sum of Sir Hundred on per annum. Payable in monthly installments of INTEREST ONLY, or more, ornmenc ngdont the rate 26 0% per cent and every month, beginning on the 26TH day of MAY day of each APRIL 26, 2005 , at w` time the entire un aid �0 02 , and continuing thereafter until 1 shall become all due and payable. p principal balance, together with interest due thereon, This Note is subject to Section 2966. of the Civil Code, which provides that the holder of this note slialig ive writtenI the trustor, or his successor in interest, of prescribed information at least 90 and not more than 150 days before any balloon payment is due. notice to Payor reserves the privilege of prepaying this Note in part or in full at any time without prepayment penalty. y I In the event any payment is not paid within 10 days of the due date, Trustor shall pay to 'Beaeitci 1 6.00% of the payment due in addition to each payment due and unpaid. � a I TE CHARGE of "This Deed of Trust is given and accepted upon the express provision that should the property hereinbefore described, pan thereof, be conveved or alienated by Trustor, either ` or any voluntarily or by operation of law, without Beneficiary.'s written consent, thea all sums secured hereby shall, at Eeaeficiary's option, become imediately mdue and payable." . T Z-0 AV -E 0 <'VViv Partial reconveyancc(s) are to be issued upon payment of 537,500 per Lo . SAID LOTS TO BE RELEASED LN A SPECIFIC ORDERS �` 3-.� vp DSn��,o v i AS 3 6 '4''F"1 F/01 5: (�, ' Phase First ' of Lots reieased are Four 4 1 t S3 — 6 E X1.4-y,� O Singe ,ors APN 773-215-004, 22 - 774-075-007, 774-111-003 and ?-74-112-304. Second phase of Lots released are Three (3) Double Lots apn 774-073-005/006, I T2/ remaining individual lots to be released. and 774-095-0OSi006 774-t73-023/024. Then all other Each payment shall be credited first on interest then due and the remainder on principal sum; and inter cease upon the amount so the said principal. Should defauit est shall thereupon whole sum of principal and interest shall become d into es oe made in payment of any installment when due the I immediately due at the option of the holder i interest payable in lawful this note. Principal and money of the Uniccd States of America. Should suit be commer<ced to oilect this note Portion thereof, such sum as rhe Court may deem reasonable or anv shall be added hereto as attorney's fees. This note is sec re ' by a Deed of Trust to EI Paseo Financial, Inc., a California Corporation as Trustee, Lots Vacant Land n affecting La Quints, CA See attached as per EMBIT "A^ g the property located at:' 18 Patncic T. Dohertyr telly �l. Dcher&L Contimted.on Page) CITY OF LA QUINTA JOB ADDRESS_5L_� 'C-�dL:--1 PERMIT NUMBER SUB-CONTRACTOR LIST OWNER BUILDER This form shall be posted on the job with- the Build niuild g nlnl spection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. ion: ;:>::Trada::/:;.Classficat:: .... ......:.. C..:.::.::::.:........ _ ..... _.... .......:_. .Wo ensatlg�nsura nontractor :e:. § ;Ctt Bus ns u c Name Classi 'cation License Number Ex .Date C Carrier Namei � Exp. Date LicenPolicYNumberComPan seNumberE Date o Exp. Pnt A B C x xxxxx1 1xx/xx xx1 1e. . State -Fund, nd CalComP1 (Format Varies1-S1 14 1xx/xx xx1 1xxxx11e.9. 1xx/xx xx 11F ,�tR'THWORK, f� C%n ►�1:J � N 17� r i�- u lctq 3_63 d 3 CONCRETE.0=.8 :>»>><><`> H 1 C ( (c 1 , 03G /V1'>aq� OX -1 d 6 3 - - Ci fSTRU.GTSTEEL' `C'.=51>i'.> MASON:. ;::::�:::� — I � � �'a -i�3 Pte- /k.Giril{ G Z / 2x% 2 t 3 �6 3 ;PLUMBIN i .IC:=3.61 >' i.ATH.PLASTER.(C351.:..:' YI'l L �2— C� J%S3/�� ��6Z Ll3 Ca,426)"i waT. 64.'6. Z _ 'l a-� Z7 DRYWALL:(C:;9.1::::>::>:>:::<:>:::;<�•0 ZAP 116 AM �C 2_q aqp -O E ELElC/n C?O 0i 71I 209 'lL- F f (� SINEETMETA41:431 -7 -7 Alb CaW2n INSUUlT1...:N.:.I..0:2i.::..:...:::.::. -- ( % AW - - to l G 3L- G � 7� � �l� �I as t�aS$ C I L 3 l� �-L D( 1 � - D 3 3 SEW4(iE'DISP(C42)< 61016 (e a '.CERAMLCTILE(C=541;::;:::::;::::. ( 1, 11 l C c� t ti [< 114NDSCiRPtNG.(C=27:)'<< l kk Gl tL ct [ t l NOV-07-2002'10:05 PM .► P. f (,'ERTIFICATF OF FIELD 'VERIFICATION AND DIAGN STIC TESTING CF -4 Project Title Dale -�' 3-�s a .�t.�. ' ✓are L G? e.'! %'v, Prosect Address Builds ams _ 5,17es fid+ _ - 3,;ilaer Conta ,9 Telephone Plan Number 1JP"WC r,ERS Rater Telephone Sample Group Number , o x. C tying Signature V 10aite Sample House Number rrn G d- ,a5ac:. HERS Provider ATL 3�SS�c Street Address: y—d xrodzZoe Clty/State/Zlp: Ccpies to: Builder, HERS Provider HERS RATER COMPLIANCE STATQdJNJ Trio house was Tested ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form comply with the diagnostic tested compliance requirements as checked on this form. (r Distribution system is fully ducted (i.e., does not use building cavities as plenums or platform returns in lieu of ducts) Vwhere cloth backed, rubber adhesive duct tape Is Installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at ducat connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM If fan flow is calculated as 400cfm/ton x number of tons enter //�7 calculated value here L:� If fan flow Is measured enter measured value here 1 Leakage Percentage (100 x Test Leakage/Fan Flow) =, Check Box for Pass or Fail (Pass=6% or less) ❑ Pass Fail ,.,-i� t[THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent Yes © No Thermostatic Expansion Valve (or Commission approved equivalent) is installed and Access is provided for inspection ❑ Yes Is a pass Pass Fail CJ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT I✓ Yes ❑ No ACCA Manual D Design requirements have been met (rater has verified that actual installation matches values in CF -1 R and design on plan, 2 O Yes ❑ No TXV is installed or Fan flow has been verified, If no TXV, verified fan flow matches design from CF. 1R. Measured Fan Flow W ' O 0 Yes for both 1 and 2 is a Pass Pass Fail 0 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:. 53-560 AVENIDA JUAREZ Use Classification: • SINGLE FAMILY DWELLING Occupancy Group: R-3 Type of Construction Owner of Building: LEGACY HOMES Building Official Bldg. Permit No.: 0206-216 VN Land Use Zone: RC Address: 47-750 ADAMS ST., #228 City: LA QUINTA, CA 92253 By: KIRK KIRKLAND Date: NOVEMBER 21, 2002 POST IN A CONSPICUOUS PLACE