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9811-046 (SFD)Y LICENSED CONTRACTOR DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions .of.:r 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 ' /� 66 /pr 12f3ii(It� of ate % `� r Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's Ii 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). , ( ) 1, as owr r of the property, am exclusively -contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). 4J () . I am-exepi-pt• rider Section B&RC. 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 andrill maintain a certificate of consent to self -insure for workers' compensation -'as provided for by Section 3700 of the Labor Code, for the performance 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: r`.arriar Policv No. .&IrA7 IS? 174t WAD 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 Sion 3700 -of the Labor rode, I shall forthwith comply with th.osg�rovisions.. ate:' / Applicant - f/!�C 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 information is correct. I agree to comply with,all City, and State laws relating to the building construction, and hereby authorize.represeritatives of this City to enter upon the above-mentioned property foe n�spegn,�urpose +�ignature (Owner/Agen) - G't3 ' Date l L C PERMIT# `BUILDING PERMIT �,.�. DATE' VALUATION S472.097.0� LOT TRACT : 4S � �17f1.4 . JOB SITE i 18451 1AxaAG OC TURN APN 770-36 -770-366-0213 6-0213ADDRESS OWNER CONTRACTOR / DESIGNER / ENGINEER' MIRC1(a " LI XPLA'l D rrr rrnjcti+ tir coNI,1vN r•'-u1o•tmT 49-760 VIA St' LANA 35-CN38 CAT lEDRi-, , t:,.;vNYON MVE LA QUINTA CA 42253 CA1111 URAL CRT ;(-'A 92.234 f7a`sp1321-i} �2 ti f Tii. 5525 USE OF PERMIT .Sr -D - PERMIT j O)OF.S NOT INCLUDE BLCjL';K WALL Olt IKGOL V T011OOi3STRIICRON 4,i'cU:tii} SF k� H41A I0 4+ a.t�c� S t� C: AJRA0)Y(,*AJt'c5ttf 'd i•.i41 SF -a 0M.I ...111 �.T AE..1i Ci 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 f ./ - Exhaust Fans O.K. to Wrap F.A.U. Framing S7 Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall 3 Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALi 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 !o Appliances Final COMMENTS: �G 3-xe-v; �i P5 Act / ply T sup t7odgE Gio A7 J6�es d7 e<—, �,uSJC� AlId e J P/Al A4r¢-7 ( 4,4* tel B(j -�qr� $T % "! : �� �✓y ((5 .Docoesr 6e - y g4 Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service '•S`'G Sub Panels Exterior Receptacles G. F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) i - Building (..0 � Address �� 11 -r�-�wALr�oG � 4 4Q" /I P.O. BOX 1504 /� 78-495 CALLE TAMPICO I T2�KJ/'/D�i LA QUINTA, CALIFORNIA 92253 mK 14)-X A /y Mailing ,4� [a+� r )A y ,p Address -� v/ p�ry City Fri p- (-A X253 Contractor,J.`, , + Address 55 1�(�ll G� 1�,1. raC- CC,1J 4k, City 7+ ltE ©IC,oCZip Tel. State Lic. City & Classif. .,_ Lic. # Arch9 Engr., t _ _ _ � G, CIFF1 /rr �r- `Desi ner� +�.�(,�'I I`"Yd AddressTel .� rLi rL l .%4_4(4J Z.C(li�`t 1 S�} 7 City Zip r,'�- (e State G� 4A Zip Lic. # G { O LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 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 Ihereby affirm that I am exempt from the Contractor's License Law for th0ollowing reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct• atter, improve, demolish, or repair any structure, prior to 'its issuance also requires the applicant for such permit to rile 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 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 live hundred dollars ($500). l; 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 sale. If, however, the building orimprovement 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 doesnot apply to an owner of property who buflds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) I'! I am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 1 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 f7 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 if 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., 11, atter 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 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 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 sof this city do enter the above- mentioned property for inspection purposes. Signature of aOplicant Date Mailing Address City, State, Zip � �-1 (- 0 -/� APPLICATION ONLY BUILDING: TYPE"CONST. V OCC. GRP. A.P. Number Legal Description" -"T roject Description Sq. Ft. Size Ne -11 GJ No. No. Dw. ` Stories ! Units Add ❑ Alter ❑ Repair ❑ Demolition ❑ PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT /ey o d d • 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 FINAL DATEINSPECT Issued by: R DatA. Permit . Validated by: OCT 2 6 1998 Validation: JIT Y OF Lk QUINI TA WHITE = FINANCE YELLOW = 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 2/3/99 APN # 770-300-028 No. 18323 Jurisdiction La Quinta Owner NameMichael and Linda Kaplan Per # ' r No. 78-651 Street Talking Rock Turn Log # City La Quinta '` zip 92253 Study Area Tract # Lot # Square Footage 5,720 Type of Development Single Family Residence Comments No. of Units 1 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 5,720 or $ 11,039.60 the property listed above and that -building permits and/or Certificates of Occupancy for this square footage in this proposed project niay�now <be issued; . Fees Paid By CC/Bank of America/D.W. Jhonston Construction Tel phone 321,9135 Name on the check T. B Dr. Doris Wilson Y Superintendent Fee collected /exempted by Juanita Green Payment Received $11,039.60 /4/ - Check No. 201403371 Signature NOTICE: Pursuant ofVfm embly 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 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 rolled them on the Dis('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 a-vivdrUlf rY 11t;14lueslea tib �Ifst American Titfe Comvapv scrow No. 30108 --TC Loan No. WHEN RECORDED MAIL TO: Michael Kaplatl Lind, G. Kaplan 48-260 Via Solana !,a Quinta, CA 92253 4 40'7412 ' FIIgVED FOR RECORD AT 8:00 AM SEP 2 4 1995 DOCUMENTARY TRANSFER TAXS.....I............................................... ...... Computed on the consideration or value of property conveyed; OR ... Computed on the consideration or value less liens or encumbrances remaining at time of "I". � GRANT DEED P000eal�r �� _ Son 11111— SPACE SPACE ABOVE -THIS LINE FOR RECORDER'S USE L the un granto Signature of DacIArM or p6.11 determiningtax — Firm Name FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Michael B. Kaplan and Linda G. Kaplan, --' Husband and Wife as Joint Tenants hereby GHANT(S) to Michael R. Kaplan and Linda G. Kaplan, Trustees of the 1994 Michael and Linda Kaplan Trust the real property in the City of La Quinta COLInty of Riverside State of California, described as See Exhibit "A" Attached hereto **This Grant Deed is being recorded for. the sole purpose of correcting the Vesting.. Dated _aril 6_, 1998 STATE OF CALIFORNIA }ss. COUNT',' OF } On n f _ before roo, personally appearedt.-L�,i`�2.��1_ _ a.�1C�... �..r,� ter°_��,,.�..�,-;�._��1.�..1�..�.---• personally known to me (or roved to majW the basis of satisfactory evidence) to be the person Kwhose nam re subscribed to the within ins ant and acknowledged to me tha h he/they cuted the some in is/ r/their authorized capacity,(W, and that 'by�er/their signa- ture n the strument the person(*�OT the entity upon behalf of which the perso�ctetl, executed the instrument. , WITNESSY hand a offi ial seal. Signature MAIL TAX STA MENTS TO: ft Am"n"10 Mow No Now k� ,,let Ow pwo Sit WV (This arP.a for o'}i * nOW101 98111 tn.12 (I j94) TITT/TL -vr.- Dear Builder. - PUBLIC WORKS CLEARANCE LETTER FOR CUSTOM HOME LOTS 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 rough 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 are complete, or sufficiently advanced to warrant building permit issuance. 3. Prepare an engineered grading plan that provides for on -lot storm water retention, and have it checked and approved by the Public Works Department . • Tract 26524 (Estancias) • Tract 26769 (Mountain View Estates) 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 it checked and approved by the Public Works Department. • Tract 28034 (South Valley Estates) FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT TRACT: :)Lgq_�o _2__ LOT: jzziu" "�& l PUBLIC WORKS AUTHORIZATION DAkE FAPWDEPT%DOCS\FORMS\PW CLEARANCE LETfER.ss COMMENTS: INS US lt; va 31Ui. Ub:.19 i -AX 760 77Z 719:1 JON TANDY !,SPECIAL INSPECTION SERVICE�� REGISTERED INSP1ffCTnR11t wCcr1 v nco#%n r JON TANDY 37630 Medjool Ave. Palm Deaert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 X1002 EMED O REINFORCED CONCRETE q STRUCT. STEEL ASSEMBLYION D POST TENSIONED CONCRETE Q ASPHALTq OTnER ❑ REINFORCED MASONRY O FIRE PROOFING JOB IOCA �,_ lenr� � J • V QUlhl/�` TVPEOf STgyCTypE PIANIT No. A IaAT[ L CA Pf10N AMC WECT REPORT S[pUENCE NO• ODAV OF WEER MRS. CHARGED � l � Er- ` ENGINEER _j v4v ASSISTANTS 16 ASSISTANTS MRS -CHARGED INSPECTION BENEIML O oAtESw CONTRACTOR b„ • u j - Towwsoo CONTRAMOR PL_ WELO (N & 0 w�-S Go l'S 1 e Ti'A ret c o Cs-- c.� �.► �- a� CON N C- c C. L C e a ,tom COW SENT TO C►IEN CONTINy[O ON NEXT `AGE O oADE Of CERTIFICATION OF COMPLIANCE ��~ • _ I HEREBY CERTIFY THAT 1 HAVE INSPECTED.TO THE BEST OF MY L7� KNOWLEOGEALLOFTHEABOVEREPORTEOWORKUNLESSOTHERWISE SIGNATURE OF REGISTE INSPECTOR _ NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED a �. 9 7S PIANS. SPHCIFICATIONS. AND APPLICABLE •SECTIONS OF THE GOVERNING BUILDING SAWS. "Y DATE F REPORT REGISTER NUMBER 4 a• t.� .,� al... u., . dJ rh.� ,u IIS ! 1. J JuN, SS FA8�4'�rrr• Job Nays: N4 A N 1.,2,8 .btu �.i,c.CZ� s '— �°' &wD jbd Date. l H F,eA cr vwe-�s 'Ma►terials and weldmsnts Cpnfo= to Lits P and an4eifieations sad AtsC, anti AWS Dl.l Shipping ►lack 905 SHEL Special Deputy Irtsp, U UU1 A D D P AV! Oeat ASC A M.P. A Elul PEN E L13te (Ytt) Tol.240 MaW T Filets T (Symbol) N[E mere (ALC) E E )( te) (Ll3te) EIngoMH110 �fL Ni�ii�iiii F,eA cr vwe-�s 'Ma►terials and weldmsnts Cpnfo= to Lits P and an4eifieations sad AtsC, anti AWS Dl.l Shipping ►lack 905 SHEL Special Deputy Irtsp, U UU1 EIngoMH110 Ni�ii�iiii NaINIMammouism F,eA cr vwe-�s 'Ma►terials and weldmsnts Cpnfo= to Lits P and an4eifieations sad AtsC, anti AWS Dl.l Shipping ►lack 905 SHEL Special Deputy Irtsp, U UU1 JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 f 0-. w o� Office (760) 772-7192 INSPECTIONSPECIAL Fax (760) 772-7193 REGISTERED INSPECTOR'S WEEKLY REPORT Pager (760) 776-3338 TYPE OF INSPECTION❑ PERFORMED ❑ REINFORCED CONCRETE O STRUCT. STEEL ASSEMBLY O POST TENSIONED CONCRETE O ASPHALT ❑ OTHER ❑ REINFORCED MASONRY ❑ FIRE PROOFING JOB LOCA 0C K- t40 p �v �N (.H•�_ ('•► 1` [•01� REPORT SEQUENCE N0. TYPE OF ST UCTURE lal� PERMIT N(,O... 0 DAY OF WEEK MATE LQSCRjPT10N /� _ I, ARCHITECT IQ�$�f� HRS. CHARGED .� �' �' `� 0 ( ENGINEER ASSISTANTSHRS. CHARGED INSPECTION GENERALSUB V MW , � (�C)t j CONTRACTOR p� "� I �I DATE CONTRACTOR lV� l ,see--RTIA" C-tl SHOP uJct-&5 't euo RL -to L t4 c -- -r -S-A U ka--0 i O G aP- Lj 6 i C'� e 6-- p, ®1,4 V-tL COPY SENT TO CLIEN CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. SIGNATURE OF REGISTE±X INSPECTOR -�- z (' % DATE &F REP RT REGISTER NUMBER t ti S5 FABRICATMN REPORT pp Begin Late: S t3 Job Name: • A ( LJ %2 g No. Fab. Shop Epd Date: S S H A D D P ASTM Heat ALSC S.P. A M.P. A Full PEN T.A S E Des No. Tol . Size Date (Tn�r (AM) ilets T Filets T (ACC E (VIS) (Symbol)te) (Date), Remarks ��3 �� Bio *Materials and weldmentsconform to plans and specifications and RISC, and AWS D1.1 Shipping Mark 905 SFiEL Special Deputy Insp. mwo��u� WOMENni�i�� Bio *Materials and weldmentsconform to plans and specifications and RISC, and AWS D1.1 Shipping Mark 905 SFiEL Special Deputy Insp. ` � G� z�.� O� w _ �-otd�J 5��� Certificate -of -Occupancy� -r- Cit of La Quinta - Building, and Safety DepartnientoF -This Certificate issued pursuant'to the requirements of Section 109 of .the..'Uniform Bui/ding Code, y 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: 78-651 TALKING ROCK TURN Use Classification: SFD Bldg: Permit No.: 9811-046 Occupancy Group: R3 Type of Construction:- VN Land Use Zone: RL Owner of .Building: MICHAEL KAPLIN" Address: 48-260 VIA SOLANA " City:. LA QUINTA, CA 982253 By: STEVE TRAXEL Date: 02-29-00 Building Official POST IN A CONSPICUOUS PLACE