9908-108 (SFD)LICENSED CONTRACTOR DECLARATION -
r I hereby affirm under penalty of perjury that.1 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
764
Date r Signature of Contractor,4
OWNER -BUILDER DECLARATION.
I hereby affirm under penalty of perjury that I am exempt from the Contractors, %
License Law for the following reason:
(.) I, as owner of the property, or my employees with wages as'their'sol
compensation, will do the work, and the structure is not intended or offered fo"
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.
Se0 1 have and will maintain workers' compensation insurance, as required by
ction 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:
Cartier �� 1 Policy No.
�^J�Oi1a.%Jl:..i.Yr FAGME - YVir:.+ 1 a�7.14V
(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 n�ot"employ any person in any manner so as to become subject to the
worl�,ers' compensation laws of California/ and agree that if I should become
slpject to the workers' compensation:�rovrslons of�,Section 3700 of the Labor
Bode, it sF,ijll1fortHWith comply with those provisionss,•_• -
Date: c r / t. Applicant ' (// 6../'l -�
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 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 infdrmation is
corpect. I agree to comply with /all City, and State laws relating to the building
construction, and hereby auth'orize,representatives of this City to enter upon
the above-mentioned property for''ins�tion-purposes.
� i F j
Signature (Owner/Agent)';( % Date
BUILDING PERMIT PERM T#
y'!Ai3�b-1f4
DATE VALUATION %i t t LOT f TRACT i 33114 U 8
ADDRESS JOB 54••••ta25.d�.`�•I�.,i�IDA NELAt\r�,•,.A�
APN �%�—���Q�%
OWNER
CONTRACTOR / DESIGNER / ENGINEER
fIfIZY sI AIQ NNJc
Yt :'!'K •F 1�nC lAJ �.+ 1J .51 s C•U� ;+.....
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TAS i.fl"1lr1,f 4��'C,
Yy 0 N. AR1Z4+WF3E,1D,r1 E.
670 N, ARROW€ EAD.) VE.
S .N BEWARDINO CA 92401
SAN Bk;RNAKIDWO ' ` CA 92401
00 0 1 WR
USE OF;PERMIT - --
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LID
RECEIPT
RECEIPT
DATE
DATE
by
BY
DATE FINALED
T
INSPECTOR
INSPECTION RECORD
a OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APP OVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
��
Ducts
Slab Grade
y "
Return Air
Steel
Combustion Air
Roof Deck
Z- - (o _
Exhaust Fans
O.K. to Wrap -,a,
F.A.U.
Framing
V-11 _ oa
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wail Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
O
y- 13- CIO-
Drywall
Drywall - Int. Lath
y— / 7 — exp
_
Final
Final �(
BLOCKWALL A PROVALS
POOLS - SPAS
Steel
Set Hacks
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
Z
���
Heater Final
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
. Pool Cover
Sewer Connection
po 57
Encapsulation
Gas Piping
Gas Test
7;yO - 39 'r
Appliances
Final
Final /
Utility Notice (Gas) ll Be�- S�
ELECTRICAL APPROVALS
Temp. Power Pole ,2 'f , c9a .
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) g
COMMENTS:
RECORDING REQUESTED BY
Lawyers Title Co,
AND WHEN RECORDED MAIL THIS DEED AND. UNLESS
OTHERWISE SHOWN BELOW. MAIL TAX STATEMENTS TO:
Name FOUR SEASONS HOMES, INC.
Address 670 N. Arrowhead Avenue
city & San Bernardino, CA 92402
State
TT -100 (Rev. 1/99) 7�elq 0 2 00 1 S
APN No. 774-283-017-7
DOC a 1999-235129
05/28/1999 08:00A Fee:6.00
Page 1 of 1 Doc T Tax Paid
Recorded in Official Records
County of Riverside
Gary L. Orso
Assessor, County Clerk 8 Recorder
I IIIIII 111
M
S
U
PAGE
SIZE
DA
PCOR
NOCOR SMF MISC.
A
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L
L=L=
CPYO
LONG
REFUND NCHG EXAM
GRANT DEED .
Title No. 434687-23 Escrow No. 7093-K
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY TRANSFER TAX is $ 15.40 CITY TAX $
XX computed on full value of property conveyed, or
❑ computed on full value less value of liens or encumbrances remaining at time of sale,
E
AQ
❑ Unincorporated area: 44 City of La Quinta and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
LOYOLA MARYMOUNT UNIVERSITY, a California NonProf.it Benefit Corporation, who acquired title as
Loyola Marymount University
M '
herebyGRANT(s) to FOUR SEASONS HOMES, INC., a California Corporation
the following described real property in the
County of Riverside , State of California:
Lot 7 in Block 304 of SANTA CARMELITA AT VALE LA QUINTA UNIT 28, in the City of La nuinta,
County of -Riverside, State of California, as per map recorded in Book 19, Page 60 of Maps,
in the Office of the County Recorder of'said County.
Dated: May 5, 1999
LOYOLA MARYMOUNT UNIVERSITY,
a Califo iallonProf. Benefit Corporation
John R110ester. Vice President
State of California V
ss. 1
County of Los Angeles
1999
on May 17, before me, Wendy A. Wilson ------------------- (here Insert name) Notary Public,
personally appeared .lonn K. uester ---------------------------------------------
personally known to me to be the personA whose name,001 eresubscribed to
the within Instrument and acknowledged to me all thaISI/skae{t" executed the some Ir&het0heir authorized capacity>Q, and
that b hl herf#hwk signatureQQ on the instrument the persoriilp, or the entity u on behalf of which the personfiO acted, executed the
instrument.
WITNESS my hand and official seal. WENDYA. WILSON
C.on iribdorl # 1089264
1 A 1 - ,I 7 4PMVC=M 000 May 17=10
Signature
MAIL TAX STATEMENTS AS DIRECTED ABOVE.
affix seal within border
PC District = Plannin4 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: FOUR SEASONS
PROJECT'
ADDRESS:' 54-625 Avenida Velasco
APN:
774-283-017
. Y
LEGAL: LOT- 7 .,BLOCK 304 UNIT 28 S.C. @ V.L.Q. '
µ r
CK'D BY: Leslie Mouriquand
BIN N0: CASE N0. 99-115 CHECK DATE: 9 ' LZ -21
--lnform;-the -assigned -Building', plan-checker.upori-.y-our assignment to this case. The CDD
Executive Secretary maintains a log •book`to=track applications and assign case numbers.
REQUIRED ITEM -
Y < N
COMMENT/CORR ION
. •:.;:; •:logged
and number assignedy
ristent
legal and APN information
with MDG on file las applicable).
y�'O
)011
MDG filing required (5+ filings since 9/3/98)
;
Consistency with-street/surrounding area:.
Colors
e
Materials
Architecture '
3
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,Odcupancy
City of L.a Quinta
Building. -and Safety Department � �fV
This Certificate issued pursuant to the requirements of Section 109of 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:. 54-625 AVENIDA VELASCO
Use Classification: SFD Bldg. Permit No.: 9908-108
Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC
Owner of Building: FOUR SEASONS HOMES, INC Address: 670 N. ARROWHEAD AVE.
City: SAN BERNARDINO, CA 92401
By: STEVE TRAXEL
Date: 09-1.1-00
Building Official
.. POST INA CONSPICUOUS PLACE