9909-107 (SFD)LICENSED CONTRACTOR DECLARATION .
I hereby affirm under penalty of perjury that I am licensed underprovisions 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
6_1353,`5 B 02/29/1201.
Date 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:
( ) 1, 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).
(?t) I, as owner of the property,..am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
() ami/empt/under Section B&P.0%for..this reason
ate . `CI%I 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.
( ) 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:
CartierS('ATti f Policy No.r�}��I.i
(This section need not be completed if the permit valuation is for $100.00 or less).
Qr 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
subjeoYto the workers' compensation provisions•of Section.3700 of the Labor
C,pde, I shall forthwith comply with thos "provisions +
Zate: /f/7 .t t, Applicant—
Warning:
pplicant Warning: Failure to secure Workers' Compensation coverage is unlawful and
Shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, Interest and attorney's fees:
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date 'of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation:
I certify that I have read this application and state that the above information is
correct. (agree to comply with all City,, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for'inspection"purposes.
Signature (Owner/Agent)—Date y
:r\ %••sem*:-.»—,,a'� r
1 K
BUILDING PERMIT PERMIT"09-141.7
DATE 111/241 99VALUATION S93,aiW59 LOT TRACT 0,i�-
1
JOB SITE FA -410 oXNE+J1t A DIM
APN 774-234-007
ADDRESS
OWNER
CONTRACTOR/DESIGNER/ENGINEER
ARL•'ND BU TIMERS
LENDE fir: t�i'IA.li'T'S
2,645 &-URJ A pisu Dp,
54 -NO AVENIDA '4'IIIA
AASSICM ViEJ J CA 92692
LA QUIRIA CA 92253
(","t�i0)561.1 F46 E;RIA 8_110
USE O`F/PERMIT
fS.I.t��Sl.�''k•.t;•;d'll.ld ,! 1,l VY I..Ji1.J9�V
- .
�w
- :i�s:t�fv#3 a 1�1� � NJ�%` t:c�C.�•lil Yy�G`4"� lti'r��,. fiR i;�+:>Oi,.
TRA;,.7 00NI SMC'CT 014 1,50.430 133
PORICIWATIO 518.00 STY
0AI$JAUFJCA RJX))s i' 463013.➢^
Q'.I:T, W40711) T'iNM 200.00 Lf
ESTIMATED :4.OSI [SIF CONSTRUCTION
93.030.5D
PERMIT FRESCIUNMY
C(YNT)rY TC'.t"f,C'N k d : t�',k-ttY)tD- 'i. �742t� aGiZ. U
PLA'X CHECK OEM V'4145
MEC` -T.A X`AT '� ,O
:i- '> �(t(3�k $$60,04..f
�'R!#,.AL FURi,. i.4-s-f7f iZ-,t2tD a?Gil 3131.A)
101:100-419-000
Ce.'r�L'9l iC 101-000-423-000 'O.tf.0
i)EV ET fi PER :OAPAC U 174: ;51, `+t27.t1ti
C ONSIMU(,"t ON ANDx 3rANY CUE CK
V3,4644.31.
E -PAID FEES
.00
p$�'�"r.�aL'11,k���IT'i�'�;ES 31.} )' (�!O'1'�''
x:'1.214.4
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
_
l Z r�
Return Air
Steel
Combustion Air
Roof Deck
3♦ -
ST
Exhaust Fans
O.K. to Wrap
�_(o - BG
%�K
F.A.U.
Framing
`_( —90
97
Compressor
Insulation
/- / L - &oS
r
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
/
Drywall - Int. Lath
Finales
_
Final
POOLS - SPAS
BLOCKWALL 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
G
_
��
Heater Final
Water Piping/
T
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
�_y7 . c�
S�
Encapsulation
Gas Piping
Gas Test
/
Appliances
Y
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.
VSmoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
V
v Irl
4.4 Qakt d
P.O. BOX 1504 APPUCA ON ONLY
Building , / ^ 7UINT , CALIFORNIAE TAMPIO
Address t� � � LA QUINTA, CAORNIA 92253 ,
Mailing +
Address z�, �� �/�' ('I"` �. V P
City Zlp
Contractor
Address
City, Zip Tel... f
State Lie. City
& Classif. ✓ Lie. # ::;,C T
Designer
Address Tel.
CityI Zip I State I
Lie. #
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.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby 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 to construct, after, 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 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 dollars ($500).
1; 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
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
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
does not apply to an owner of property who builds 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. 8 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
n Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars (5100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employany person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: 9, 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
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 a0plicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE'�7CONST. OCC. GRP.
A.P. Number �i +L� . • tom' /
Legal Description
Project Description �= `'� �' 4 �+`�= iL i '-' / I? Y: •,:...
Sq. Ft. 1,4 7 No. ' No. Dw.
Size Stories Units
New 0' Add ❑ Alter ❑ Repair ❑ Demolition ❑
i SEN.
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 bv:
Validation:
WHITE = FINANCE YELLOW = APPLICANT
is ;kZ"ytr•..
PINK = BUILDING DIVISION
0
Al Y Ui U/ vjUIN l+,
stimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
!' rjo
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.1.
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 bv:
Validation:
WHITE = FINANCE YELLOW = APPLICANT
is ;kZ"ytr•..
PINK = BUILDING DIVISION
0
Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated 760-771-8515
Date 10/28/99
No. 19522
Owner NameArend Builders
CERTIFICATE OF COMPLIANCE
APN #
Jurisdiction La Ouinta
No. 54-410 Street Avenida Diaz
City La Quinta zip 92253
Tract # Lot #
774-234-007
Permit #
Log #
Study Area
Square Footage 1.501
Type of Development Single Family Residence No. of Units 1
Comments
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 1,501 or $ 2,896.93 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 cc/Wells Fargo Telephone
Name on the check
By Dr. Doris Wilson f' ' +• „.. `
Superintendent
Fee collected /exempted by Juanita. Green Payment. Received $2,896.93
Check No. 0503003315
Signature dZa/k7r_A'
NOTICE: Pursuant of Aspmbly 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
Sent,By: SPRINOMTN ESCROW;
909 699 3905;
Oct -26=99 10:57;
Page '2/4
IN FEE
THE LAND REFERRED TO IN THIS REPORT IS SITUATED IN THE STATE OF
CALIFORNIA, COUNTY OF RIVERSIDE, CITY OF LA QUINTA AND I5 DESCRIBEI)
AS FOLLOWS:
PARCEL 1:
LOT 18,° BLOCK -263 OF UNi7 NO 24 OF`-SAN'PA';-C-ARMELITA-.AT VALS LA
QUINTA; ASLSSOWN--BY MAP--ON–F-ZT E__I-I-BOOK 19- PAGES -4 7A =4-5 OF MAPS.,
RECORDS OF RIVERSIDE COUNTY, CALIFORNIA.
PARCEL 2:
LOT 12, BLOCK 77 OF SANTA CARMELITA AT VALE LA QUINTA, UNIT NO. -10,
AS SHOWN BY MAP'bN FILE IN BOOK 18 PAGES) 70 OF MAPS, RECORDS OF
RIVERSIDE COUNTY, CALIFORNIA.
AT THE DATE HEREOF EXCEPTIONS TO COVERAGE IN ADDITION TO THE
PRINTED EXCEPTIONS AND EXCLUSIONS CONTAINED IN SAID POLICY FORM
WOULD BE AS FOLLOWS:
1. GENERAL AND SPECIAL T71XES'FOR THE FISCAL YEAR 1999-2000, A
LIEN NOT YET DUE OR PAYABLE.
2. MUNICIPAL IMPROVEMENT BOND, 88-1 FILED. IN 'THE. OFFICE OF THE
TREASURER OF THE CITY OF LA QUINTA.
NOTE; INFORMATION ON THE BOND REDEMPTION AMOUNT IS .AVAILABLE UPON
WRITTEN REQUEST TO THE BONDING AGENCY, THIS COMPANY WILL WRITE FOR
THE IMFORMA'I'ION, UNLY UPON YOUR W]RI'1.VEN REQUEST TO DO SO.
MUNICIPAL IMPROVEMENT BOND, 91-1 FILED IN THE OFFICE' OF THE
TREASURER OF THE CITY OF LA QUINTA.
NOTE: INFORMATION ON THE BOND REDEMPTION AMOUNT IS AVAILABLE UPON
WRITTEN REQUEST TO THE BONDING AGENCY. THIS COMPANY WILL WRITE .FOR
THE:INFORMATION, ONLY UPON YOUR WRITTEN REQUEST TO:DO SO.
Page 2
8
Sent By: SPRINGMTN ESCROW; 909 699 3905; Oct -26-99 10:58; Page 314
Omer No.. 2144287
DISCRIMINATION 'BASED ON RACE, COLOR, RELIGION, SEX, HANDICAP',
FAMILIAL STATUS, OR NATIONAL ORIGIN TO THE EXTENT SUCH COVENANTS,
-
CONDITIONS OR RESTRICTIONS VIOLATE 42 USC 3604(C), WHICH PROVIDE
THAT A VIOLATION THEREOF SHALL NOT DEFEAT OR RENDER INVALID THE
LIEN OF ANY FIRST MORTGAGE OR DEED OF TRUST MADE IN GOOD FAITH AND
FOR VALUE
NOTE: THE FORM OF POLICY OF TITLE INSURANCE CONTEMPLATED BY THIS
REPORT IS:
ALTA RESIDPNTTAT, POT.TCY (6-1.-87)
r t a
EFFECTIVE JULY 1, 1999 AT 6:00 A.M., THE WIRING INSTRUCTIONS FOR
FIRST -AMERICAN TITLE INSURANCE COMPANY RIVERSIDE OFFICE ONLY:
FIRST AMERICAN TRUST -COMPANY
SANTA ANA BRANCH
421 NORTH MAIN STREET
SANTA ANA, CALIFORNIA, 92701
ABA 122241255
CREDIT TO FIRST AMERICAN TITLE. INSURANCE COMPANY DEMAND ACCOUNT
ACCOUNT NO. 18012
WHEN WIRING, PLEASE REFERENCE OUR TITLE ORDER NUMBER AND THE TITLE
OFFICERS NAME.
PLEASE WIRE THE DAY BEFORE RECORDING.
PLEASE NOTIFY THE TITLE OFFICER OF YOUR INTENT TO WIRE.
NOTE:
GENERAL AND SPECIAL TAXES FOR THE FISCAL YEAR 1998-1999.
FIRST INSTALLMENT: $153.48, PAID.
SECOND INSTALLMENT: $153.48, PAID.
CODE AREA: 020-015-
A.P. NO:: 774-234-007-6.
Page 5
RC District.- Planning 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: LENDEL VENTURES
'r �. �
PROJECT
ADDRESS: 54-410 Avenida Diaz 1 NOV:2 1999
774-2.34-007. CITY OF LAQUINTA
APN: 1 N RTMENT �.
LEGAL: LOT' 13 , BLOCK 26.3 , UNIT . S.C..@ V.L.Q.
CVD BY: Greg Trousdell
BIN NO:. CASE NO. 99-124 CHECK -DATE:
Inform the assigned Building plan checker upon. your. assignment to this case. The CDD
Executive Secretary maintains a log book to track applications and. assign case numbers.
REQUIRED ITEM
y .
MENT/CORRECTION
10
-
Case logged and number assign Q�1
Verify legal and APN informatio .(
Consistent with MDG on file las a bl!
0D
MDG filing required (5 + filings since 9/3/98)
c�v (n ,- 3
Consistency with street/surrounding area:"
Colors
Materials'�`'�"�
'Architecture
��
G '�
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.
BA -1
PLAN BA -1 / BRAUCKMANN-AREND BUILDERS
ELECTRICAL LOAD CALCS
DESIPTI®N` = rV®LTS`"UNITS
CKT
MMP.S,,,
a N®®F
�%®LTSAMPSf}}gTOTAL
PERUNIT '
VOLTSAM�PS°
120 V. MULT OUTLET CKTS
GEN LTG @ 3 W PSF 120 15 1,50.1. 3 4,503
SM APPLIANCE CKTS 120 20 2 1,500 3,000
GRI CKTS 120 20 11 1,500 1,500
SUBTOTAL 9,003
120 V SGL OUTLET CKTS
DISPOSAL120 20 1 2,400 2,400
DISHWASHER 120 20- 1 2,400 2,400
LAUNDRY 120 20 1 2,400 2,400.
HOOD 1201, 31 1 .360 360
SUBTOTAL.'. 7,560
FIRST 10,000 V—A @ 100% 10,000
BAL V—A @ 40% ! 2,625
r
SUBTOTAL :..... 12,625
RANGE
2301 401
1j.. 9,200 9,200
A/C (LARGEST FAU OR A/C)
2301 301.
1 '.. _` . =.;,:::6-900,1 6,900
TOTAL V—A 28,725
PLAN: ,BA -1. (BRAUCKMANN/AREND BUILDERS)
ATTIC VENTILATION
ATTIC AREA: 1,501 SQ FT .
,
463 SQ FT
TOTAL 1,964 SQ FT
1,964 SQ FT / 300 6.55 SQ FT REQUIRED
8 VENTS.. / 14" X 18" VENTS (1.17 SQ FTX 1.5 SQ FT)
8 X 1.17 SQ FTX 1.5 SQ FT =
14.04 SQ. FT
LESS 50% VENTED AREA
7.02 SQ FT
ACTUAL NET TOTAL SHOWN
7.02 SQ FT
LENDEL: EXCEUMY DOMCALMATTIC BA-I-BRAUCKMANN
10/13/99
BA -1
PLAN BA -1 / BRAUCKMANN-AREND BUILDERS
'ELECTRICAL LOAD CALCS
r��it� 2i
�
1-7�
W-19owl-1,
:120 V. MOLT OUTLET CKTS
GEN LTG @ 3 W PSF 1201 151 1,501
3 4,503
SM APPLIANCE CKTS 1201 201 2
1,500 3,000
GRI CKTS 1201 20 1'
1,500 1,500
SUBTOTAL
9,003
120 V SGL OUTLET CKTS
DISPOSAL 120 20
2,400. 2,400
DISHWASHER .120 20 1
2,400 2,400
LAUNDRY 120 20 1
2;400 2,400
HOOD 120 : -3 1
360 360'
SUBTOTAL
7,560
FIRST 10,000 V-A @ 100%
10,000
BAL V-A` @ 40%
2,625
SUBTOTAL
1.2,625
RANGE 2301 401 11 9,200 1 9,200
A/C (LARGEST FAU OR A/C) 2301 301 11 6,900 1 6,900
TOTAL V-A
28,725
SELECT SER�%!CElZE'TQ*T�AL VA x `, 28,72`SY' `x124`9 P'MPS F
LENDEL: EXCEMY DOMCALCS\ELEC BA-I-BRAUCKMANN
10/13/99