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9809-267 (SFD)LICENSED CONTRACTOR DECLARATION I, erieby 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. Class Exp. Date 635535 13 % 2129/00 t e .P'...&tv tactor Date Signature of Contrractor 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). O 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. S'3 A`i'lr' 1� f,1`i�vf� •. 'sfZi?1S-fE00967.i (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 S4ction 3700 of the Labor/ Code, l shall forthwith comply with! those, provisions,/ -� Applicant ` v"°''t"'' V Warning. Failure to secure Workers' Compensation coverage i5;einldwf6eafrd shall subject an employer to criminal penalties and civil fines uprto $100;000, in addition to the cost of compensation damages as providedo46 in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby)Aade 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 toN, 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 anis state that the above information is correct. I agree to comply with all City, and State laws relating to the'building' construction, and hereby authorizerepresentativesof this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) t Date - BUILDING PERMIT PERMI T#'�� DATE VALUATION y2={��,1 Q LOT Zs TRACT : F3j.93 i11 Fc JOB SITE 53»7J1D AV _N10A .fU,A% FZ APN 774-454-003ADDRESS "OWNER CONTRACTOR / DESIGNER / ENGINEER 8361 WCf EES 9r, SUM. 30 8361 VICKERS S"1; SWITE 30 SAN :31030 CIA 32111 SAN 1: IEGO CA 92111 f,7fi0)Sr+4-1 6 CrRIA 11151) USE OF PERMIT AA ��qq[{ ■r jye}�(y'y j y�!�`( S[NGLE FAMLY 1/ a T L.IA, V .0 e1'''I3 - PF,.iZMIT .D4.T,S WT 114CLUIVE BLOCK WALL OR PO(YL 1 t(.�tL l l"sU1V�3 tCf/l Y'ASiIV + r s u e» .t1V S.r 100.00 IV, GARAGIS(CAAPORT '650j 3F 1s 711. WOW t+`Ei`SCR 200.00U �3,'.11.k 1hL1�A.i VCOS,�1 OF l.-OlYAY9i.14,1�hI6.YA� yy PVt °WX F, SUMMARY CQNN'fRLfCT10_N FEE 9oF t„I }; 1.)1�Cs )-4a - gSi57r .I&T-3CITAN1CALOis' x01'-fl00-4 x-000 .°ir66.104) S` ,9?C"1'WCAL E Ma 101-000-420.000Sl3C,.tiS PLUMBING FEe 101 -WO -419-000 51:3.50 1%f"iAJ4.14fOT! (IN JJI lKR-431403 )01-000 241!-00(l, $9.2.7 (IRADITNO F135 W-AASPRUCT(REFU 2.25-01X443-342 $2,617.40 1 REC:1,319 PLAil t01-0013 441-345 $25.00 101-000.439-3 t R -W9,00 1, '1?:'Ft"R'A{,, Cb4,PwC:''k"EON AND MAN CHECK �z,S 19.5R ' LEM PRE-.1�.�- D FEES -$250M Nov 1.2199a r(Yr f,, PERMIT F ENN W.U41NO%Y $1.20.58 or— RECEIPT DATE 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 LIV Return Air Steel IV Combustion Air Roof Deck Exhaust Fans OX to Wrap F.A.U. Framing S- - Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath — 2 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 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 gyp Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole p 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) Z 4 4 " �fmf-bl P.O. BOX 1504 APPLICATION ONLY Building�- - 78-495 CALLE TAMPICO Addres5 / �V A L.,P; f a,UE11NTA, CALIFORNIA 92253 A Mailing Address �, ✓c�X e�. (� Aaaress r, City Zip Tel. 1,G State Lic. City & Classif. • �, � Lic. # Arch., Engr., Designer Address CityI Zip I State I Lic. # ----. LICENSED CONTRACTOR'S DECLARATION - that I am licen 'ed under provisions of Chapter 9 ( ommencing with 3 of the Biusi/�rss and Professions Code, and in license is in full fi I hereby affirm thatEl, ami -exempt from theConiractofs Lice sn e•L-aw fcir the blowing reason: (Sec. 7031. S, Business and Professions Code: Any city or county which epuires a permit to construct, alter, improve, demolish, or repair any structure, prior to its suance also requires the applicant !or such permit to file a signed statement that he is Icepp ed pursuant to the provisions of pie Contractor's License Law, Chapter 9 (commencing wlth/Secflon 7000) o! Division 3 0! the Business and Pro/essions Code, or that. he is exempt Ihere77rom, and the basis !or the alleged exemption. Any vlolatbn o/ Section 7031.5 Dy any plicant !or a permit subjects Melapplicanl fo a civil penalty of not,more than live hundred dollars $S0 l.: I, as•ow�7ner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered fors le. (Sec. 7044, Bulsness and Professions Code: The Contractor's License Law does not apply�o an owner o/ property who builds /or improves thereon and who tloes sucA work himsel! rpr Through his own employbes, pro tled that such improvements are not intended or offered for sale. If, however, fhe building or improvement is sold within one year of completion, the owner -builder will have the burden o! proving that he did not build or improve for the purpose of sale.) 1'1 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 contractors) licensed pursuant to the Contractor's License Law.) 1-1 1 am exempt under Seca'- 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 Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company n Copy is filed with the city. ❑ Certified copy is hereby furnished. 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. Date Owner 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. BUILDING: TY_7` C OCC. GRP. A.P. Number 7 / < / ✓ I.&gal Description ? ?'- 'f7- j`l1 Project Description Sq. Ft.r �. 5-7No. No. Dw. Size Stories Units New d Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. SU. OU Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL G 5 d u REMARKS 1, CONSTRUCTION LENDING AGENCY 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.) •, Lender's Name L 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. I agree to comply with all city and county ordinances and state laws relating to building.I 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 `+- ZONE: BY: Minimum Setback Distances: r Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE Q-2 ? =t} INSPECTOR Issued by: —Date Permit SEEP z,0''IbZ;d Validated by: Validation:.__! e }� I WHITE = FINANCE YELLOW = APPLICANT 4 PINK = BUILDING DIVISION Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 11/10/98 APN # 774-151-003 No. 17990 Owner NameLendel Ventures No. 53-790 Street Avenida Juarez Jurisdiction La Quinta Permit # Log # City La Quinta zip 92253 Study Area Tract # Lot # Square Footage 1,487 Type of Development Single Family Residence No. of Units 1 Comments 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 1.93 X 1,487 or $ 2,869.91 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/Union Bank of California/Lendel Ventures✓` h �. :'Telephone 1564-1 866 Name on the check " _ A , By Dr. Doris Wilson �:. �• " Superintendent%! �. r I Y ' Fee collected /exempted by Juanita Green Payment Received $2,869.91 Signature (I _ �pp� Check No. 6167339 INOTICE: Pursuant of As#nbly 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 above will begin to run fr 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 collect 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 Commonwealth Land Title Company 72855 Fred Waring Dr., Suite A5, Palm Desert, CA 92260 Buyer's Settlement Statement_ Escrow No.: 98.7271KC Buyer: LENDE.L VENTURES,.INC., A CALIFORNIA CORPORATION Property: APN 7.74-151-003, LA QUINTA, CALIFORNIA 92253 Escrow Officer: Kelly Collier Date: 090898 TOTAL CONSIDERATION Deposits by Buyer PRORATIONS/ADJUSTMENTS COUNTY TAXES.... .............. 126.82 07/01/98 09/08/98 67 days @.70455 per diem LENDER CHARGES LOAN ORIGINATION FEE ESCROW FEES, TITLE CHARGES Settlement Charge DOC PREP ESCROW DISCOUNT(DOC PREP) RECORDING FEES, TRANSFER TAXES Record Grant Deed REFUND DUE BUYER a DEBIT CREDIT $10,000.00 10,300.00 47.21 215.00 25.00 -25.00 6.00 126.21 $10,347.21 $10,347.21 r, RC District - Planning Review Form This form is to be used by CDD staff for review of single family dwellings in the RC (Cove Residential) District, in order to determine the applicability of compatibility issues or need to require the filing of Master Design Guidelines by the applicant. It shall be transmitted to Building & Safety as your correction list. Please attach additional explanations as necessary. APPLICANT: - IMDIL VENT REs, DTC. PROJECT VI/ `/'u -t' e__ _ -7?�% ADDRESS: r `��e APN: `773-i �i-nn� r ?74 - I5 ( - W3 LEGAL: CK'D,BY: BIN NO: LOT* 22 ,.BLOCK 199 , UNIT , S.C. @ V.L.Q. Fred Baker 46 CASE N0. CR 98-14 CHECK DATE: Inform the assigned Building plan checker upon your assignment to this case. The CDD Executive Secretary maintains a log book to track applications and assign case numbers. II REQUIRED ITEM I Y I N I COMMENT/CORRECTION II Case logged and number assigned Verify legal and APN information Consistent with MDG ,on file las applicable) MDG filing required (5 + filings since 9/3/98) 8, Consistency with street/surrounding area: UNIT Colors Materials Architecture OTHER REQUIREMENTS: The zoning code, architectural and landscaping manuals, and/or assigned inspector should be consulted where uncertainties arise. The completed checklist shall be maintained in the Building & Safety address *file. 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: Use Classification: SFD Occupancy Group: R 3 53-790 AVENIDA JUAREZ Type of Construction: VN Owner of Building: LENDEL- VENTURES Building Official Bldg. Permit No.: ' 9809-267 Land Use Zone: RC Address: 8361 VICKERS ST. SUITE #30 City: SAN DIEGO, CA 92111 By: STEVE TRAXEL Date: 05-11-00 POST IN A CONSPICUOUS PLACE OUTHLAND EOTECNNC40 FOUNDATION ENGINEERS AND MATERIALS LABS November 20, 1998 Lendel Ventures,. Inc. P.O. Box 450 La Quinta, CA 92253 Attn: Skip Lench Subject: Compaction Test Results House Pad . Project: 53-790 Avenida Juarez La Quinta, California Dear My Lench: Project No: P98151 This report presents the results of density testing performed by a representative of' our firm on November 19, 1998 at the above referenced project. In-place density tests were performed at random locations by Nuclear methods (ASTM D2922-91 & ASTM D3017-88) at referenced locations on the attached sheets. The tests were made under the responsible charge of a registered civil engineer in conformance to the test method referenced. Approximate locations of the tests are presented by paced measurements. A total of two density tests were performed. A moisture -density relationship (ASTM D1557) for the soil is also summarized on the attached sheets. DISCUSSION • Before our personnel arrived at the jobsite, the surface of the pad had been placed and compacted. • The test results indicate that a minimum of 90% relative compaction has been obtained based on ASTM D1557 maximum density within the areas tested. • The purpose of the tests was to determine compliance with the minimum requirements of the City of La Quinta. 780 NORTH FOURTH STREET • EL CENTRO, CALIFORNIA 92243 • (760) 370-3000 79-607 COUNTRY CLUB DRIVE, SUITE 5 • BERMUDA DUNES, CALIFORNIA 92201 • (760) 360-0665 7975 RAYTHEON ROAD, SUITE 210 • SAN DIEGO, CALIFORNIA 92123 • (619) 467-4900 r Lendel Ventures - 53-790 Avenida Juarez ProjectNo. P98151 LEMaTATIONS The test results summarized in this report present the moisture and density only at the locations and elevations tested on the specified dates. The density testing was performed according to the generally accepted, geotechnical engineering standards of practice that existed in the Coachella Valley of Riverside .County at the time the report was prepared. No opinion is expressed as to the uniformity of the material, compaction, nor adequacy of the material to perform as intended. No guaranty or warranty of the contractor's work is made or implied. The test locations are approximate, determined by pacing and sighting from distinguishable field features. In doing our Work, we have relied on topographic and surveying information provided by others. With any manufactured product, there are statistical variations in its uniformity and in the accuracy of tests used to determine its quality. As compared to, other manufactured products, .field placement of materials usually presents large statistical variations in its uniformity and in the accuracy of the tests results. Thus, even with careful observation and testing, all parts of the constructed product; may not comply with the job requirements. Therefore, our opinion means that there is only a statistically -based probability that the densities obtained .comply with the job requirements. Native soils below the building pad were not investigated or tested by our firm. No warranty is made as to the stability/density of the native soils. This report is issued with the understanding that the owner or his representative has the responsibility to insure that this'report is submitted to the appropriate governing agencies. Please review the test results and contact our office with any questions or comments. Sincerely Yours, SOUTHLAND GEOTECHNICAL, INC. Karl A. Harmon Staff Engineer Southland Geotechnical, Inc. Page 2 SOUTHLAND GEOTECHNICAL COMPACTION, TEST SUMMARY (Sand Cone Method ASTM D1556) .Client: Lendel Ventures, Inc. Project: 53-790 Avenida Juarez Project No.: P98151 Report Date: November 19, 1998 LEGEND Maximum In Place Soil Type Description USCS Matr'I (%) 1 Gray -Brown, Fine to Coarse Silty Sand In Place Dry Relative Specified wl Gravel or Test Moisture Density Compaction Compaction Soil No. Location Elev. (%) (pcf) M (%) Note Type 1119-01 50'Wx20'N from SE FP 4.2 128.2 95 90 P 1, corner of lot 1119-02 30'Wx30'N from SE FP 5.3 128.9 95 90 P 1 corner of lot LEGEND Note: FSG - Finish subgrade BG- Base grade PZ - Pipe Zone TT Top of trench F - Failure NSG - Native subgrade FG - Finish grade MT - Midtrench FP - Finish pad . P - Passed Submitted by: SOUTHLAND GEO ECHNICAL Karl Harmon Staff Engineer .. C:\wp51\97cmprpt\P98151-n.19 Maximum Optimum LMoisture Soil Type Description USCS Dry Density (pcf) (%) 1 Gray -Brown, Fine to Coarse Silty Sand SM 135.5 6.5 wl Gravel Note: FSG - Finish subgrade BG- Base grade PZ - Pipe Zone TT Top of trench F - Failure NSG - Native subgrade FG - Finish grade MT - Midtrench FP - Finish pad . P - Passed Submitted by: SOUTHLAND GEO ECHNICAL Karl Harmon Staff Engineer .. C:\wp51\97cmprpt\P98151-n.19