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0001-269 (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 04co \ `Professionals Code, and my License is in full force and effect. W*�` License# Lic. Class Exp.. Date cZ � Date Signature of Contractor O� H0 OWNER -BUILDER DECLARATION F- L) d t1 -I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: Z_ (V) 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). CY)O I am exempt under Section B&P.C. for sones f= LO U N DAe - In DG Signature of Owner Q WORKER'S COMPENSATION -DECLARATION < Z I hereby affirm under penalty of perjury one of the following declarations: n p () 1 have and will maintain a certificate of consent to self -insure for workers' K w �= compensation, as provided for by Section 3700,of the Labor Code, for the D � Q performance of the work for which this permit is issued. n QU ( ) I have and will maintain workers' compensation insurance, as required by j Section 3700 of the Labor Code, for.the performance of the work for which this U L H permit is issued. My workers' compensation insurance carrier & policy no. are: ? Z Carrier Policy No. (This section need not be completed if the permit valuation is for $100.00 or less). (Q - 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 shall forthwith comply with those provisions."=-^ D te: 1!''Applicant l Warning: Failure to secure. Worker's'-Cdpensation coverage is flaw u1 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, indemnity & 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 inspection,purposes--" r Signature (Owner/Agent) W- Dte� BUILDING PERMIT PERMIT004 264/ DATE�4/o VALUATION LOT TRACT JOB SITE 5I-49.5 C.ALL11.. 11,01t o APN 7694 14-024 ADDRESS C OWNER CONTRACTOR/DESIGNER/ENGINEER LVA '31-14DION FRANZ Y11111,1101,14 IRp is 1i PALM D Sii:RX CA. 92255 USE OF PERMIT SVD - MUMOT iXJLiS NOT JNC LUL) t3L0C &-WALi.•° 01k KJOL k110//S i lav0F0 e4! 120efii r "RItCl C,,2TiUC..iGN I,4%'sM.3i ai PIOKICIVPIA�rlo 33,00 SIF 4.;AtdAC4lVC:Ak-1?0 T 53:1.00 wlr' fi'k f.'. WALL 11.00 L� 31"T. 'WO0,T,3 I^ ENCS 00.00 "LF INTI, D COS. OF CONSTRUCTION 90.317.91? gg ,n y;1;t�t, ,Cw y„ �g a L&STIt', :4 91+�U7 IT Y.' ER, aPITAIli'SiSIA V . C'ONST'KUJt',"i`TON FLM 1111-W-4184,UU S599.00 Pl At4 CREC'K. FRY." 101.f)W—A39-1 3.� $5611 ! a • , 1 M1 2 11 ��F:-��e..�-(i{)u ELEC: TIRIC,ML FEE PLUA481NO ME 1.01000-419.o0i 5- - NOVItON01 (Yl'rot4'Pi'7R.,Y2sKM tflt 4. j 1 cr.AOING F03 i01-000423.000 3,20,00 C1 PRECASE 3't..AN 101.009-441-345 sloo uo . - ;-I �:I� I�t�s�St-�� 1f11-fN.DU-A%�l-3xR-S?��►,�n � i.� . _ ...C3 .„J 843111-7 MAI ONSi'3 IX: ETON A1:PLANC"yF;K $�,43110 LESS 4250.0101 `1'OT A1.,1'1;A3f IT VCW.'9MJ14, N0W 63;181.:50 RECEIPT DATE BY� DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE I INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings �7 Underground Ducts Ducts . Slab Grade Return Air Steel Combustion Air Roof Deck 5 J i %&p 57 Exhaust Fans O.K. to Wrap -Flo--moo F.A.U. Framing _ y(o Gb 7 Compressor Insulation _ ? _ cW IJ7 Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall -Int. Lath r Final Final BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping 3 ld Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Ste^ - .on cU ��i Encapsulation Gas Piping �% Gas Test Appliances Final COMMENTS: ! Final 1 Utility Notice (Gas) QO ELECTRICAL APPROVALS Temp. Power Pole -31cv 7 crfl 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) tw P.O. BOX 1504 APPLICATION ONLY Buildingn tt tt 78-495 CALLE TAMPICO Address 51 _I 5 Colic is 1144:) �1 O LA QUINTA, CALIFORNIA 92253 Owner ►_�A:l,,Oy► FI -A v,2 Mailing Q Address o J I �r �t 1Jb x � j (� City Zip el. V I I� �a 5� "T� _4.73 o c� Contractor Zip State Lic. City & Classif. I Lic. # Arch., Engr., Designer Address City IZip I LiState # LICENSED CONTRACTOR'S DECLARALON I hereby afflrm that.l-amtlicensed ud�,J�der provisions of,, h ter 3 (commencing with Section effect. of Division /3 of�p e'Busines %bred Pr, ofe@stores Cod Ji se is in,(full orae and SIGNATURE J DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors 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 thal 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 thealleged 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 dolers ($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 sae. If, however, the building or improvement is soldwithin one year of completion, the owner-irrilder will have the burden of proving that he did not build or improve for the purpose of sale.) Il I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: TAe Contractor's License Law does not apply to an owner of property who builds or improves theeon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's Lcense Law.) 1-1 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 self -Insure, or a -certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company r7 Copy is filed with the city. ❑ Certified copy is hereby furn'shed. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed 0 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 become subject to the Workers' Compensation Laws of California. - Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemptionyou should become subject to the Workers' Compensation provisions of the Labor (ode, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby 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 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 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 �+ WHITE - FINANCE YELLO BUILDING: TYPE'CONST. OCC. GRP P. Number Description Project Description Sq. Ft. jZJ3/t Size / / V No. Stories No. Dw. Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading -- Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINKDATE 11 A ; M s 1" INSPECTOR fSri ,. 4...i r— ..•� __ Issued by: Date Permit I cif 3 Validatetl 6y: - Validations W = APPLICANT 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 3/6/00 APN # " 769-114-024 No. 20116 Jurisdiction La Quinta Owner NameLyndon Franz No, 51-495 Street Calle Iloilo City La Quinta zip 92253 Tract # Lot # Permit #0001-269 Log # Study Area Square Footage 1432 Type of Development Single Family Residence No. of Units 1 Comments t By 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 1,432 or $ 2,763.76 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 Check/Wells Fargo Bank/Mrs. Franz Telephone.- 760-772-4300 Name on the check Dr. Doris Wilson71 Superintendent µ Fee collected /exempted by Mary Ann L. Bora Payment Received 42,,763.76 Check No. 7377001502 Signature NOTICE: Pursuant of 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 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 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 ORANGE COAST TITLE CO. RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: Lyndon Wayne Franz and Kristi Kay FranPAI D 42151 Sandy Bay Road ED)c. Tra-rater Tax Bermuda Dunes, CA. 92201 Ift . Co. Recorder 556973 SPACE BELOW FOR USE OF RECORDER ONLY RECEIVED FOR RECORD AT 8:00 AM DEC 2 3.1998 d �hOWA* McondK� 1p,ama MAIL TAX STATEMENT TO: Documentary transfer tax 13.20 _ Name:] Computed on full valu( of property conveyed, or same as above � Computed on full value and encumbrancs DR Address: remaining thereon at time of sale. "'City & State: I n •- 1 JI Signature of declarant or agent determining tax -firm name Parcel No. 769-114-024/Code No. 0a00/(,9 PERSONAL REPRESENTATIVE'S DEED As Personal Representative of the Estate of LEO ( LEE) LANCASTER GUERRERO deceased, ® and pursuant to the Order of the RIVERSIDE County Superior Court, dated 11-12-98 ® confirming sale of real property, which directs this conveyance, and for value received, and pursuant to full authority under the Independent Administration of Estates Act. .JACOB A. ROTHMAN r\ Personal Representative, HEREBY GRANTS TO: M LYNDON WAYNE FRANZ.and KRYSTI KAY FRANZ, husband and wife, as joint v` tenants _ O all right, title, and interest the decedent had at death and that the Estate may have acquired subsequently, in the real property (N,,, situated in City of La Quinta, Riverside County, California, described as follows: Lot 12, Block 4, Desert Club Tract, Unit 2, as per Map recorded in Book 20, Page 6 of maps, Records of Riverside County, California Q . Continued on Attachment Assessor's Parcel Number: 769-114-024 STATE OF CALIFORNIA count yof RIVERSIDE �ss. On before me, a Notary Public in and for said State, personally appeared JACOB A. ROTHMAN personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument, and acknowledged to me that he/sMeMey executed the same in his/Xer/-Veir authorized capacity(ies), and that by his/ DBr/lMeir signatures on the instrument the person(s), or the entity on behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. MAIL TAX STATEMENTS AS Dated: JA A. ROTHMAN MALIKA FATIMA HASSAN v, COMM. #1184340 ` NOTARY PUBLIC - CALIFORNIA to RIVERSIDE COUNTY My Comm Expires May 22. 2002 (For Notary Seal or Stamp) T,&�t4 PUBLIC WORKS CLEARANCE LETTER FOR i CUSTOM HOME LOTS P Dear Builder:. 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 Trough 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: ^ Y' tr are complete, or sufficiently advanced to warrant building permit issuance ' "3. Prepare an engineered grading plan that provides for on -lot storm water retention, I. r . and have it checked and approved by the Public Works Department r 3 • Tract 26524 (Estancias) • Tract 26769 (Mountain View Estates) rw 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 if , checked and approved by the Public Works Department. • Tract 28034 (South Valley Estates) FOR UITERNAL USE BY PUBLIC WORKS DEPARTMENT+• TRACT: KtJ\ r 1- 2i LOT' Z,�Octi� r� / , X, /-i,,,)h .0a P B C W&KeAUTHOPATION I bATE F:IPWDEPi1DOCSTFORMSIPW CLEARANCE LETIER.ss t COMMENTS: ki ASSESSOR'S PARCEL NUMBER COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY - DEPARTMENT OF ENVIRONMENTAL HEALTH PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM - APPLICANT. Submit this form with four copies of a SCALED plot plan (1-20 SCALE) drawn to County specifications as indicated on the attached check list. A. non-refundable filing fee is required when the application is submitted. Check must be made payable to the County of Riverside. Approval of this applica- tion shall remain valid for a period not to exceed one year from date of payment. LMS # #' l Agent, Contractor, Contact Person Address City State Zip Telephone a Owner 4m49oxf Address ,, & Telephone ZZ Job Properly -Address S�LCE �CO/�0 City LAdt11;✓14 Zip U ULJ Lot Size / So /X l00 Water Agenc CpACµECCA �«Ey Use of Permit, P/P SUP, PUP, etc. XEBWicD �E�a,�a��v .✓s Legal Description LoT ,Qco�/� St D, Mr r 6k. tee riucT f(, Dwelling, I� Site.Prep retc. .�a 4/4// r y#I- p'Z Signature of Applica t z#/A/Ep �,/ fi3.y0/` Date A2 6 — 40 v CHECK BOX IF REQUIRED If any box is checked, this application shall be considered rejected until Q' Detailed Contour Plot Plans Required (1 to 5 foot interval) the information is provided and the fee paid. Resubmittals later than 90 days after date noted below may require repayment of fees. ❑ Staff Specialist Lot Inspection Required m ❑ Holding Tank Agreements Completed, Thomas Bros. Page i Grid Z � Certification of Existing S.D. System Required ❑ Date Lot Inspection Completed: Initials �~j ❑ WOCB Clearance Required WW (Attach for DOH -SAN -007, Santa Ana Region Only) Remarks: ❑ Soils Percolation Report Required Q Special Feasibility Boring Report Required ❑ Maintenance Booklet Provided ` '�. r- ❑ Final Inspection by Department of Environmental Health is required. ❑ Rereview Required Initials Date Please call 24 hours PRIOR to inspection. ,O/�``er,, � U cAN4 / / /��* C/42 / Seits•Reroelatiom.Boriog Report byl?O&A7, l�liNfn/ (CObSi11y(J7et c/P-rojecU# 39(O b70 Date ^�Y/J 0U Soils Map Page Soil Type Approved By Date No of Systems EX•itQ6 Txype of System(s) l Holding Tank ❑ Replacement No. Dwelling Units 1%MAk , Bedrooms, Fixtur fills (1) Septic Tank Soil Rate A'x/lTiV6 Grea;e Sand Grease IntFp/Unt Trap (� New ❑Addition �r -6isting kFA 4l� 3 BDA X3.4>•4*7U4L f 1J/aA0 / Gal. I' 0 cJ Gal. Sq. Ft. Total Linear Sidewall Allowance L f 0 ReAwfoil VLeach Bed sq. ft. of -; Bottom Area � Ft. rock/ sq. ft. running ft. Inlet Tested Dept ❑ NA Install Lines –eft. long `ft. wide with Inst inches rock b�low.drainlines or B ttom Area U Proposed Bottom Tested Depth Z Leach lines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Inlet (BI) Seepage Pit Maximum Other: O � Applicab rj(ECr/lI/6 Ex KT• 16X11?, Total Depth Allowable Depth""" LU N/A Overbuy %tactor 10'. (— TD Well Review %0 �" Approved: Date• Well Drilling Permit # • SIGNATURE Grading Plan Approved: Date: L� , y SEMI c si�R ,, `�// /f 4). Sewer. Verification Approved: W, ,AGtTI Date: I 'r.6 '� nllyApproved: Date: Plan Check Onl� REMARKS: 01 lo� to" A� TlSis application isPROVED DENIED%for the.eMegor.y checke.�iw,'S= =11=1-1191Z.dOR. - FOR OFFICE USE ONLY r above�re arYding he design of a subsurface disposal system as indicated on the aoornpanied plot plan, using the requirements set forth in SECTION C above, A bu' d- ing permit,i� s necessary foc tba.iostallation�f the abgv �e_s)gf�ted+syst / p Q Revenue code ��J7.��0 Fee $ P/ • a structlon'Is nermltted In the required reserved 100% exRanslon area .: (1j Septic Tank must be 100' minimum from any wells. / 963 0 heck # (2) Leach lines must be 100' minimum from any wells, including expansion area. Date / `-1�26 -DD Initial 71 Z (3) Sewer lines• must be 50' minimum from any wells .11 0 (4) Seepage,pits must be 150' minimum from any wells, including expansion area. U w t r Signature of Health Official Date DEH -SAN -122 (Rev 9/98) ulstnDution: WHI I E—Otrice File; YELLOW—Applicant; PINK—Bldg. Dept.; GOLDENROL—Plans/Records !� County of Riverside Health Services Agency ' ,;✓ 1 Department of Environmental Health f r 4080 Lemon Street, 2nd Floor Riverside, CA 92,501 �f ATTN: Land Use Section ' ��,� -°fit j t–�..�..• 1. 'Certification of Existing Subsurface Sewage Disposal System. Date of Inspection: 1 /20/00 'a 161-495 CALLE ILOILO LYNDON & KRICTI FRANZ (Property Address) \ (Owner's Name) r (Legal Description and APN) \ ' FAILURE TO PROVIDE ALL REQUIRED INFORMATION SHALL PREVENT dWNER FROM OBTAINING ENVIRONMENTAL HEALTH SERVICES APPROVAL. 2. Show design and location (1 20' maximum scale) of the sewage disposal system in relation to attached dwellings, structuress, wells, etc. on required plot plan (see Item II of memo RE: Existing Subsurface Sewage Disposal). ; 3. a. I examined the existing subsurface sewage disposal system at the above location on 1/20/00, date r and determined that the septic tank capacity is1 200 gallons and that there is ---- sq. ft. of leachline bottom area. - b. There'are leachline(s), each ft. long. c. There are - ONE seepage pit(sI, each 6 in diameter, 40' ft. deep. d. The leachbed is ` ft. by --- ft., total sq. ft. --- of leachbed area. 4. a. Construction of septic tank (please check one of the following): oncrete =fiberglass steel MC NOTTINGHAM - other (explain): ' b. Internal dimensions of septic (length 7.5 % ft., width 4-3" depth 5 ft.) C. Condition of tank (pleaseanswer yes or no for each question): f Yes No Inlet Tee•,present? Outlet Tee Present? Two,�compartments? Tank structure deteriorated?' ;-.�If .Yes, briefly Iain and _indicate_;aPPro riate correctjon suggested: - - ,( 5.- a. While pumping the tank, did effluent flow back into tank from the .absorption system?`rLI Yes ONO N, �..; b. Prior to pumping, was the liquid level in the tank above the outlet tee? ❑ Yes Lt No c. Was the area around the lids oxidized? G Yes O No d. Is design of system gravity feed? ?Di' Yes :� No e. Were well(s) observed on this or adjacent property? O Yes No + If yes, -indicate distance of wellfrom: Septic Tank Leachlines —'—' ft. Seepage Pits _-- ft. f~. Distance from springs, lakes Septic Tanks ft. and natural drainage courses: Leachlines "— ft. / (circle appropriate item) Seepage Pits --- ft. g. Sewer is within 200 ft. of system and -abuts property line. ❑ Yes J'No f ADDITIONAL COMMENTS: 6. It is my_ opinion that the system appears to be in good working order and can be expected to function properly ` + with proper maintenance. Ye's :3 No �• i a;,, ' 1 � �"'y';I%� •ds*t`.:1.b "+�: Ja.ws`r,+w, P,-- � �� r••� .. -. ... r .�,yc« a,L• t � "-�-°' . •_ ;r. tn; ^iPr7 ter.. �asYa e !t-tlaeFe=aFe:arty-fuFther-:q.ues-tief s; lee x`760) . 398-554'4•50-305 HIGHEJAY III, COACHELLA,CA�A2236 t ,r Telephone Number t' Address / .- 4•� r .IYc lrtify und'' penalty Wperury the foregoing is true and correct:�,. 396698 5/31/02 "i ,,� Signature C.42 State License Number P' Expiration Date ROBRRT D. RICHERT Print Name DATELAND CONSTRUCTION CO. INC.. s- 1 Name of Pumper company and Receipt Number/Name of Company Holding C-42 License ti i NONEC 50-305 HIGHWAY III, COACHELLA , CA 92236 Address `'°' •1 /24/00 Date " GEN -SAN. 104 (R.v 12192) DISTRIBUTION: WHITE—Office PINK—Contractor YELLOW—Applicant_ ,T I CITY OF LA QUINTA SUB -CONTRACTOR LIST JOB ADDRESS PERMIT NUMBER 06,01 r 2g OWNER,O�/,l BUILDER This form shall be posted on the job with the Building Inspection 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 compietea Dy appncant. --un riie is not an acceptaoie response. ........... .:::.::.:. ...................... Business om :ensat�on:.Insurance.:::::......................................:::::::::...�t:::........._.........._........................ ..................:.......State::Contractor..s. L�cense...................................................................W0r.wrs.:C...:......................................................................................... «Fradl:<.C..lassif..�catio.n.;:.;:.;:.;.;;:.>:.:::::::::::::::::::.::::Contr..actoc::.::::::::.:::.:.:::::::..................................................................................................................................... P Exp..D License eN Number rCom Company Name me asDate er Name Number ate Exp. Date ationLicenseNumberEx . CarriPolic xx xx xx xxx 1 xx x 1 xx xx 1 a Varies) / / - ICom (Format s 1 e. .Sate Fund Ca 1 1 xx xx xx t xxxxxx / / ) 8 1 ( , (e.g.A B C 1 1 P IF i.4c.�2 C��./CITY OF LA QUINTA SUB -CONTRACTOR LIST R - y3ao JOB ADDRESS — _P_ M Tf NUMBER OWNER BUILDER This form shall be`posted-on-the job with the Bu_ilding Inspection 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. "Un I-ile•• is not an acceptame response. Company Name Classification License Number Exp. Date Carrier Name (e.g. A, B, (-8) W I (xx/xx/xx) I le.g. State Fund, CalComp) Policy Number Exp. Date License Number Exp. Date (Format Varies) (xx/xx/xx) I (xxxx) I (xx/xx/xx) nn IF :::::::............ , ��~F /� �J��.,�,14 i1 4k , 51�lz I G � 1 7vi 3�1 I s131 I�,�I F e.,�., I'�` W //� . I f 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 ollowing. BUILDING ADDRESS: 51-495 CALLE ILOILO Use Classification: SFD Bldg. Permit No.: 0001-269 Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC Owner of Building: LYNDON FRANZ Building Offici Address: P.O. BOX 11003 City: PALM DESERT, CA 92255 By: STEVE TRAXEL Date: 07-25-00 POST IN A CONSPICUOUS PLACE