9811-117 (SFD)f� LICENSED CONTRACTOR DECLARATION
'fes - •-!2M- 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
04 W Professionals Code, and my License is in full force and effect.
O =) ch License # Lic. Class_ Exp. Date �
w 4732I�� 1(,,� v;(,
Z ate /0-1lxSignature of Contractoript1
r'- ~ C:) OWNER -BUILDER DECLARATION
Wa I hereby affirm under penalty of perjury thi t l am exempt from the Contractor's
U) License Law for the following reason: f
Z_ ( ) 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).
c'') () I am exempt under Section B&P.C. for this reason
LO
N Date Signature of Owner
O0
U Q 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.
IV) I have and will maintain workers' compensation insurance, as required by
S'dction 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.
%�"'�1ta'1iON, T INS Cts
"(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 Sectio 3700 of the Labor
Code, I shall forthwith comply with those provisions' '
Date:! --e Applicant / r
i
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 of compe'nsatio`n, damages as provided for in Section 370 1.6
of the Labdf.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 property for inspection purposes.
gnature (Owner/Agent) 1 • — Date% -A2
77/
BUILDING PERMIT PERMIT#
DATE VALUATION ILOT 5 TRACT R74, C�1O
1-2 Q- (76
JOB SITEY r A /�
ADDRESS 5.2-140 A..VEIrtXIDA `��ii�kiSCO
APN C
77�-,i�3-p34;i
OWNER
CONTRACTOR/DESIGNER/ENGINEER
BUILDWO ffORl7ONS
3011: SrrK0 C';,`PJS`r1;.UCT10f!
42-600 COOK STkEFr SUTfER.20
78-545 STARyorr LANE
PALM OC SE RT CA. .02211.
BEAMUDA DUN ES CA M01 �
t7fiEi)3t+U-Sl i8 C'SL# IM2
USE OF PERMIT
>f'Ai�1ii 5' 11V+TELi. Ib,a
�,41WCILEAr
%7D.. PWOWT DOE 'a' NOT INC LUDE Dl.omi WALL OR POOL I �
�A
`DEC
10 1998
A!<tll.! �.'I�JiV II�iJIlLtJlV l,VJtl.tJC/ti:1P'
PDXC IPPA IC) 11.00 SI.
_ _
UARAWCAtt(`OR 1' 461.0 S.ir
L Vz
(XM.T 0r, �.`C NS I'la�iC"-I0..N,
�`•.3ft'�i3",.1l.l�I
Myyy� k �Y�1 �j .,jlpt�j[ {H� � �lq'i,�i'D
PIP.RY
C:QI4&r1t1iG.V10N FM I0.1-000.418-000
.
-/�i�/(�1/t��-eq4��';�i R/r
y!/El�!
(R�
39-3
At�i;[:f�.MiC:.AI, .�Z� i U i �Cift�-d2 fl-ii(hi $5�. tai
f!Lk'i?` R1C'AI. F1".Y 101 -tit 420-000 5131.32
ul,rffvl yT•fc t�"f•t. 1014Y -419-000 gt7� ►
;1 t�r�►�ty lbiCY "IC�t1 F'Iaa • 13 :tC) lot -000.241-000 $1..0,W
t;1tAi�:llui� .Irtir;is 10 i-fiG(I-9 i�-�� �.2u.wl
iNFR.AS'1JtU(73 rRJ- FFE 2254M-443-342 52.2418.51
PRE'CI; FPf:.gM f 4-(}(3f1•".1_34S $iiTi)Iff1
A..R'r .IN PUBLIC PLACES - R2E SIC- ".0I-000.255"-000
S1,TW!'CFf'A , CON-SIAUCTION AND P'f,.AN CH f:C K
84 ;" 5
LESS PRE -P r,i`�:FEES
4250.00
TOT. Ai„ .i.'IN.iIiM# C FEES DUB NOW
Sr3.607.15
' e
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
Return Air
Steel
Combustion Air
Roof Deck —( — -
Exhaust Fans
OX to Wrap
F.A.U.
Framing
Compressor
Insulation 3_
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final6-4
—
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 f ff 917
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 sV 2,112
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels k
Exterior Receptacles a
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm) —( —
COMMENTS:
IIED
°O`acs
j w RANCHO
OMIRAGE r Desert Sands Unified School District
RANCHO MIRAGE
` INDIAN WELLS a 4j_g50 Dune Palms Road • La Quinta. California 92253 • (760) 777-4200
PALM DESERT
♦ LA pUINTA �a
�O INDIO L�
October 21, 1998
Joseph R. Sitko, Executive Director
Building Horizons
-•42-600 Cook Street,. Suite 120
Palm Desert,. CA'92211 '
Dear Mr. Sitko:
Desert Sands Unified School District hereby waives the payment of Developer
Fees for the Building Horizons Project located at:
52-080 Avenida Velasco, La Quinta APN. 773-225-004
M1..,'.a•.•
52400 Avenida -Velasco, La Quinta APN 773-22,57005.
:. 52-120 Avenida Velasco, La Quinta APN 773-225-006
If you have any questions and/or concerns, please don't hesitate to contact me
at (760) 771-8516.
Sincerely,
PIT 40 -
Peggy Reyes
Director of Facilities Services
RECORDING REQUESTED BY
Lawyers Title Deed recorded November 19, 1998.
AND WHEN RECORDED MAIL T0:
Building" Horizons, Inc.
42600 Cook Street fl• 120
Palm Desert, CA 92211
Space Above This Line for Recorder's Use Only
• A.P.N.: 773-225-005-9 TRA #: 020017 Order No:: 03-429313i20 Escrow No.: 2-26790
1} 3 Ot123
GRANT DEED'.'
THE UNDERSIGNED.GRANTOR(s) DECLARE(s) THAT DOCUMENTARY TRANSFER TAX IS: COUNTY $11.00
X ] computed on full value of property conveyed, or
]compute -'d on full value less value of liens or encumbrances remaining at time of sale,
unincorporated area; [ X ] City of La Ouinta and
FOR A VALUABLE CONSIDERATION, Receipt of which is hereby acknowledged,
KAREL NOVAK; Trustee of the Kids Trust U.D.T. December 4, 1997
hereby GRANT(S) to
BUILDING HORIZONS, INC., A CALIFORNIA NON-PROFIT PUBLIC BENEFIT CORPORATION
the following described property in the City of La.Quinta, County of Riverside State of California;
Lot 5, Block 74 of Santa Carmelita at Vale La.Quinta, Unit #10 -as per map recorded in book 18, page 70 in the office.of the
County Recorder of said County.
✓• c!.6°��
co?
IGI�y,7(0 BF
• p o
Karel Novak, Trustee of the Kids Trust U. D.T.`December 4, 1997 B ' ' FS E F�eppyoF
Y 0 , INC,
Document Date:. November 12, 1998
STATE OF CALIF¢�NIA )SS
COUNTY OF ���25
On before me,
personally appearedvete,
e (or proved to me on t basis of satisfactory evidence) to"be the person(s) whose name(s) is/arc-subscribed. to the'within instrument
and acknowled d to a .that he/skeltli ecute he me in his/herftheir authorized capacity(ies) and that by his/herklukr signature(s) on the instrument
the persons) o e ry-/upo half which th ers n(s) acted,, executed the instrument..
WITN m at ci seal. 1'
Sig ature
L. LAINgE "pFQLOQAN
offlGYtArI3tar�149 ''nn
vl NOTARY PUBGC CALIFORNIA VI
Riverside County
My Comm. Expiree Aprll 18, 2000
Mail Tax Statements to:', SAME'AS ABOVE" or Address.Noted Below
Certificate of Occupancy 1%
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
ol%wing:BUILDING ADDRESS: 52-100 AVENIDA VELASCO
Use Classification: SFD _ Bldg. Permit No.: 9811-117 -
Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC
Owner of Building: BUILDING HORIZONS
Building Official
Address: 42-600 COOK STREET # 102 .
City: PALM DESERT, CA 92211
By: STEVE TRAXEL
Date: 7-19-99
POST IN A CONSPICUOUS PLACE
CertainTeed 0
Builders Statement
InsulSafe°4
Fiber Glass Blowing Insulation
InsulSafe"'4 has been installed with the THER,1AAL PERFORMANCE—ATTIC BLOWING APPLICATION
manufactuer's recommendations to In accordance with the chart below, you must install the minimum number of bags
N? N? vide a value of R �usin per 1,000 sq. ft. of net area for each R -Value listed.
bags of insulation to covert The, maximum net coverage must not exceed that specified for each R -Value.
square feet of area at a minimum g p
thickness of nches. The installed insulation must be at or above the specified minimum thickness for
ZZ–C,, each R -Value. -
• Failure to install the required minimum weight per sq. h. of insulation at or above
ll taller Cont ctor Is' n).-.. the minimum thickness will result in reduced R -Value.
Tlis product should not be mixed with other blown insulations or, the thermal
Compny Name ;5 a _claims will become invalid.
or -/0
Date
Builder (sign)
Company Name
Date
Batts and Blankets
R -Value
Insulation
Thickness (in)
38
10, 12
30
8'/., 10
25
8
22
6'/,
21
5y,
19
6'/,
15
49
13
34
11
3'//
Fiber glass batts or rolls have been
installed in accordance with the
manufacturer's recommendation to
provide an R -value of. ' in the
ceiling,, --2L in the exterior walls,
in the. or or cr 1 space perimenter.
I scatter Co tractor (sign)
Company .Name
6 -io - 99
Date
Builder Isigni
Company Name
I),Ilc'
Coae No. 30.24.233
R•VALUE
BAGS P
1000 SQEFT.
1;�AXIMUM
SQ. T. PER BAG
MINIMUMMINIMUM
POUNDS PER S1Q. T.
THICKNESS
Tu obtain a
Thermal Resistance
(R) of:
Bags per
1000 $q. ft.
of net area:
Contents of bag
should not cover
more than: (sq. fl.l
Weight per sq. ft. of
installed insulation should
not be less than: (lbs.)
Should not be
less than:
(in.)
60
36.5
27
0.986
»
49
.29 .6
34
0.800
44
26.4
38
0.712
161L
38
.22 .8
44
0.615
14'/.
SO
18.0
S6
0.485
12
26
15.5
65
0.418
10'/:
22
1.1.1
77
0.353
9
1911.1
90
0.301
7y,
13
7.7
129
0.209
II
6.6
151
0.179
44.
R -values are determined in accordance with ASTM C 687 and 518.
Complies with ASTM C 764 as Type 1 insulation.
"R" means resistance to heat flow. The higher the R -Value, the greater the
insulating power. To get the marked R -Value, it is essential that the
insulation is installed properly.
DANGER: RECESSED LIGHT FIXTURES—TO PREVENT OVERHEATING,
DO NOT INSULATE ON TOP OR WITHIN 3" OF SUCH
DEVICES. DOES NOT APPLY TO TYPE IC LIGHT FIXTURES
OR TO FLUORESCENT FIXTURES WITH THERMALLY
PROTECTED BALLASTS.
FLAMING ADJUSTMENT
To compensate for framing members the number of bags per 1000 sq. rt.
of net area should he reduced as follows.
loist Size
frn•1
Bags to deduct/lobo sq. ft.
foists 16" O.C.
Bags to deduct/1000 sq. it.
foists 24" O.C.
1 t 4
11.5
0.1
2z('
0.8
0.5
2 c N
1.0
0.-
2 10
I.:S
11.9
1998 Cenaineed Corporation 10/98
BOY2 and GIRLS CLUB
Client: BUILDING HORIZONS
Joe Sitko (760) 340-474-8
Project: SINGLE FAMILY RESIDENCE
Address: 52-100 Avenida !VOW=
La Quinta
Job-, 96-178
Date: 18 November 1998
lIg'Iny 01uffre-4-4
STRUCTURAL AND CIVIL ENGINEERING
DENISE R. POELTLER, INC.
73661 Highway 111 • Suite G • Palm Desert, California 922
TEL. (760) 779-0405 • FAX (760) 779-1317
- �_