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0211-002 (CONR)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 Professionals Code,,'and my License is in full force and effect. License # Lic. Class Exp. Date i➢x 94.5 09'13012( Signature of Contractor 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). ( ) 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 prr,� rmance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Sgction 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: CarrierO . T�;;f�'TJND • Policy No.10106-200 (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 Section 3700 of the Labor Code, I shall forthwith comply with those provisions./ , Date: > Applicant 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 representatives of this City to enter upon the above-mentioned property.forinspection purposes. Signature (Owner/Agentr Date r p. ... BUILDING PERMIT PERMIT# DATE 'VALUATION LOT '�'� TRACT ,. $77,%7.70 291994 JOB SITE ADDRESS � m{i a ,arm il r�� .R sor APN 617-02(% .012.405 OWNER CONTRACTOR/DESIGNER/EN (NEER ND LQ PAR71W.-AS, UX ALL PHASF, CONISTRIXT1011 KU €1.1 OCA Air)NUR 53 80.822 VIA.PAIX, RM a Z..A.QuwA CA 922513 1.n4TSiO C.1A 92201 USE OF PERMIT cow, 00 . 1 10114.F. GUARDHOUSPXWOOFOMIl lioh"! y' 2)flit»ti'1 4 T TNOl�i3Of� 19t"Rel'#i .A,V'O 921.00 O " AJC. -- COMT MCLAL. 1.00 F CMITRACT ,ANO41?d'T 50 a. JO 1w EMMATED CCA,S"V OF COt;VFsi*R'U�"$,�,�? % 77,367.70 01WRUCTION FUR 101 -000-4.18-000 U4044) vt.mf CHPICK TrdtrE 101-000-439-318 �T9DEPOSIT 101-000.439,316 4250.00 MM'HAa7CCAT, PP'.- 101-000-421-000 09,5 ► Ui?..%TR1CAJ, "FZw 101.000-420.0(" $S4170 PLUfMB*10FEEE 101 -000,419-000 $65.J0 - ST1tOUG MOTION r,RZ- COMM 190.000.241»000 $161B O'RakDiHa IMP ?_1 101 -000-423-000 $13.00 '0c4 ,Aa`'1vF.$1 .P.warFF. AL".o. PRECISE, PU1,114 101-000-441-34S $100,00 ART R4 PUW:,.1C PLACES - COM.? 270.000-445.000 SUS.44 Mme, 9M -TOTAL C0X8TkTJCn0KAND PLAN CEEWK $3,950,49 '9 PRRMPAXD Q D glI:UO D MAY. 14 2003 CITY OF LA QUINTA FINANCE DEPT. RECEIPT DATE BY DA I, INSP CTOR 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 40, Roof Deck Exhaust Fans O.K. to Wrap F.A.U. AJU Framing Compressor Insulation Vents Fireplace P.L. _ Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath�� 14 Final Q _ _ Final :D POO S -,SPA S BLOCKWAI, ArPVOVALS 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 — 1�_� — �f' �% Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole 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) Building G 7' Address 5 — 0 .� FLR Titivl 4 4 " P.O. BOX 1504 78-495 CALLE TAMPICO rel �T LA QUINTA, CALIFORNIA 92253 O t6l Q✓;11T A,t.e5 /- 1-C Mailing ' Address �� 3 CityZip Tel. di�✓7"� L'i4 "L 2.,5 3 260-777-74DO Address it Zip Tel. 3k06Ni3l AZ 1 "9502g 1 602.-756-/323 State Lic. I City & Classif. Lic. # Arch., Engr., �1 Designer 8 2.0fc / fFGrs Address Tel. 71 -TtWiyg Ali S7X 12o / q - 5g:t, City Zip State o 707-56!5( Lic- #C/ LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I 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. SIGNATt1RE DATE OWNER -BUILDER DECLARATION Ihereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit fo construct, alter, improve, demolish, or repair any structure, prior to its Issuance also requires the applicant for such permit to file 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 the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than live hundred dollars ($500). 1 ! I, as oner of the property, or my employees with wages as their sole compensation, will do the wowrk, 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 or improvement 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 as owner of the property, am exclusively contracting with licensed contractors to con. st_ cl 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.) 11 1 am exempt under Sec. B. & P.C. to: this reason Date U d2 Owner � WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Com/pensation Insurance, or a certified op thheereofG.l�Sec. 3 00, Labor Code.) Policy No. ®b y/g Company ��A6 / L�^��J fl 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 lhp 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. 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 �7 A Lender's Address- This ddress 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. 1 certify that 1 have read this application and state that the above information is correct. I agree to comply with ail city and county ordinances and state laws relating to building construction, and hereby authorize representatives sof this city to enter the above. mentioned property for inspection purposes. Signature of applicant Date Mailing Address _yon _ City, State, Zip „/i p (a ,a;ylaa �A r 2- d2J/-'ooz APPLICATION ONLY BUILDING: TYPE'CONST. V- N OCC. GRP. A.P. Number Legal Description 7-11aNTiAY;/s, 'Tr" ,'f lib. -gwgq Project Description (c-,fJA Rx> JAoos, ht .L- A POW -7f% -w of sF,G710r+ 4 lbovsWr.0 kl[AK Qiii % Elig7, SAP) l3dliMA2016J.0 Mt�D�N 1 N JCA Q ✓r Ntw . do ✓O V O� �J ✓L!a-f 11�t ST�i� O� CALr r� Sq. Ft. No. No. Dw. .� Size Stories Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑ �y�i4c % JQ vQF/ '222 f 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 FINAL DATE INSPECTOR Issued by:. Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Coachella Valley Unified School District P.O. Box 847, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 Project Name: _ Owner's Name: This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMM/MD. AMOUNT: DATE: RECEIPT: CHECK #: INITIALS: CERTIFICATE OF COMPLIANCE (California Education Code 17620) LLC Date: February 5, 2003. Phone No. Project Address: 53-000 Jefferson, La Qui nta, CA 92253 Project Description. Gatehouse APN: 617-020-026,028,029 Tract#: Type of Development: Residential Lot #'s: Commercial XXXXXXX Industrial Total Square Feet of Building Area: 1,011 sq. ft. Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized to sign on behalf of the owner/developer. Dated: _2— S (23 Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code Project Agreement Existing Not Subject to Fee 17620 65995 Approval Prior to 1/1/87 Requirement Number of Sq.Ft. 1.,011 Amount per Sq.Ft. $ 343 74 Amount Collected $ 343 37 Building Permit Application Completed: Yes/No By: Carey M. Carlson Asst. Supt., Business Serv. 'Certificate issued by: E1yi ra Mattson Signature: Ofice Technician NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. At such time as this Certificate expires, if a building permit has not been issued for the project that is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. MV:c/mydocs/devfees/certificate of compliance 09/30/02 3 17:15 FAX 602 992 8111 7 W M S PA C CONSTRUCTION INC. Wespac Construction Q002/002 February 12, 2003 Ed Randall City of La Quinta P.O. Box 1504 La Quinta, CA 92253 RE: The Hideaway Mr. Randall, Per our discussion, Rubin Urrutia will not be a signer for Wespac Construction, Inc. for perp) is through your. City. The permit forthcoming f,3r the gatehouse apparently has WCI°s name on it for the builder and we would like to ask for it to be removed. Should hither inforu ation or questions come up concer=. g this issue please feel free to call at (602) 956-1323. I appreciate your help in this master. Sincerely, eff Nicholson Project Manager cc: Wayne Bogan, WCI Dale Grubb, WCI Rubin Urrutia, The Hideaway John Gamlin, The Hideaway Steve Adelson, The Hideaway 9440 N- 26th Street - Suite 100 - Phoenix, Arizona 85028-4716 - 602-956-1:;23, — Fax 602-992-8111 - license #089945 0-1 Visit our Website www.wespacconstr000n com YOUNG ENGINEERING SERVICES Engineering Architecture -Surveying- Building & Safety Services Letter of Transmittal To: City of La Quinta Date: 1/29/03 Project: 53-000 Jefferson Attn: Ed Randall PC#: 0211-002(2 d Check) Tel No.: (760) 777-7012 Tract No.: We are forwarding: X By Messenger By Mail Your Pickup No. of Copies Description: 1 . Set of redlined plans/corrected plans 1 Set struct calcs 1 Set of truss calcs Comments: Plans are acceptable. Thanks This Material Sent for: Your Files Per Your Request Your Review x Approval Checking At the request of: Other By: Eric Frenzel Phone # 760-360-5770 77-804 Wildcat Drive, Suite C, Palm Desert, CA 92211 (760) 360-5770 Bronz Young Tom Tisdale Fire Chief RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the California Department of Forestry and Fire Protection 210 est San Jacinto Avenue . Perris, Ca I omia 92570 • ( 9 . Fax 940 -MO 13, 2003 chitects 20371 Irvine Ave, Suite 120 Santa Ana Heights, CA 92707-5651 Proudly serving the 11 Re:- Non -Structural Building Plan Review unincorporated LAQ-03-BP-001 / Hideaway C.C. — Gate House areas of Riverside County and the Fire Department personnel have completed a review of the plans you submitted for the above Cities of: referenced project. Please be advised the following conditions apply as a part of the conditions for the Banning issuance of a building permit. 4. Beaumont 1) The Fire Department is required to set a minimum fire flow for the remodel or construction of all ..- commercial buildings using the procedure established in the 1998 CFC. A fire flow of 1,500 gpm Cahmesa for a 2 hour duration at 20 psi residual operating pressure must be available before any ❖ combustible material is placed on the job site. Canyon Lake ' 4:' 2) The required fire flow shall be available from a (Standard/Super) hydrant(s) (6" x 4" x 21/2' x 21/211) Coachella located not less than 25' or more than 165' from any portion of the building(s) as measured along Desert Hot Springs approved vehicular travel ways. 4. Indian Wells 3) Prior to the issuance of a building permit, applicant/developer shall furnish one blueline copy of the 4. water system plans to the Fire Department for review. Plans shall conform to the fire hydrant Indio types, location and spacing, and the system shall meet the fire flow requirements. Plans must be ❖ signed by a registered Civil Engineer and/or the local water company with the following Lake Elsinore certification: "I certify that the design of the water system is in accordance with the requirements 44 prescribed by the Riverside County Fire Department". La Quinta Moreno Valley 4). Install portable fire extinguishers per Title 19, but not less than 2A10BC in rating. Contact certified •.*• extinguisher company for proper placement of equipment. Palm Desert .;. 5) Automatic gate operations are not a part of the Fire Department approval of these plans. Perris •:� 6) If address is required, the approved building address shall be placed in such a position as to be Rancho Mirage plainly visible and legible from the street. Building address numbers shall be a minimum of 12" for 44*�. building(s) up to 25' in height, and 24" in height for building(s) exceeding 25' in height. All San Jacinto addressing must be legible and of a contrasting color with the background. .;. Temecula Please contact the Fire Department Planning & Engineering staff for final inspection prior to occupancy. Board of Supervisors All questions regarding the meaning of these conditions should be referred to the Fire Department Bob Buster, Planning & Engineering staff at (760) 863-8886. District 1 John Tavaglione, Sincerely, District 2 FRANK KAWASAKI J1m Venable, Chief Fire Department Planner District 3 Roy Wilson, B y ak District 4 Walter Brandes Fire Safety Specialist Tom Mullen, District 5 HAPEZWPDATAWtQI11MATRQIECT=LDG_PCllAQ 3-BP-001.due EMERGENCY SERVICES DIVISION • PLANNING SECTION - INDIO OFFICE 82-675 Highway 111, 2nd FI., Indio, CA 92201 - (760) 863-8886 • Fax (760) 863-7072 r: U � r!a zOf AJ 6 ' c�MOFn°� MEM0RA..NDUrM To: Greg Butler, Building & Safety Manager To PWD: // • �� i From: Steven D. Speer, Senior Engineer I Building Permit Release (this is an approval to issue a Building Permit) The Public Works Department has reviewed the followin project: 9� Description:yA& j — Addressor general location: 3— Doo APN and/or legal description:------------ S{� i4�%i9cfsE� I The Public Works Department finds that: ... issuance of this Building Permit does not require; Public Works Department approval. j ...issuance of this Building Permit is approved by the .Public Works Department. i er, Senior Engineer f v Date y ��wJ OF Tom' To: Greg Butler, Building & Safety Manager To CDD: From: , Planning Due date: Status: Building Plans Approval (this is an approval to issue a Building Permit) The Community Development Department has reviewed the Building Plans for the following project: Description: GV Ae P s c: - j4 f�V,4 Address or general location:,,53 zr APN and/or legal description: (L -I-c,2-0 z� , , g o a9 The Community Development Department finds that: 0 ...these Building Plans do not require Community Development Department approval. these Building Plans are approved by the Community Development Department. Planning Date Tom Tisdale Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of: Banning Beaumont Calimesa Canyon Lake Coachella Desert Hot Springs Indian Wells Indio Lake Elsinore La Quinta Moreno Valley Palm Desert Penis Rancho Mirage San Jacinto Temecula Board of Supervisors Bob Buster, District 1 John Tavaglione, District 2 Jim Venable, District 3 Roy Wilson, District 4 Tom Mullen, District 5 RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the California Department of Forestry and Fire Protection 210 West San Jacinto Avenue . Perris, California 92570 • (909) 940-6900 . Fax (909) 940-6910 November 18, 2004 To: Hideaway Country Club 16 3-000 effe'-r 651St eet La Quinta Ca, 92253 Re: Gate House Gas Fired Columns. MAR 2 3 2005 D v qlL- The Riverside County Fire Department has reviewed the plans submitted for the gate house Gas fire columns. The following conditions Shall be applied and maintained to - the above named occupancy. 1) A minimum of not less then 10 feet from the column to the base of the tree. 2) A minimum of 15 vertical feet Shall be maintained from and palm leaf or portion of the trees. 3) Obtain an approved plan from the City of La Quinta for all gas devices, switches, piping and igniters. If you have any questions, contact me at 760-345-6954 Respectfully, Neal Stephenson Fire Systems Inspector Certificate of Occupa.ncy 444 INCOWORA � 5 C1OF�ti Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 53-000 JEFFERSON - Use classification: COMMERCIAL Building Permit No.: 0211-002 Occupancy Group: B Type of Construction: VN Land Use Zone: RL Owner of Building: ND LQ PARTNERS, LLC Address: 81-100 AVENUE 53 _ City, ST, ZIP: LA QUINTA, CA 92253 By: BILL GORDON Date: 10-22-2003 Building Official POST IN A CONSPICUOUS PLACE