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LICENSED CONTRACTOR DECLARATION
I heeN.,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
691405 , 6/30/00
y ate µr�J 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
performance of the work for which this permit is issued.
(;< I) 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:
Carrier Policy No.
S je T1s 1=t.NI D Orb -9i 00i)�579
(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
workess compensation laws of California, and agree that if I should become
subject to the workers' compensation provisions of. Section 3700 of the Labor
PKie' I hall forthwith comply wit those prop ions:`Gi�
VDate:, WApplicanntt�'
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
1. Each person upon whose behalf this application is made & each persona t�
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 props �yfor inspection purposes.
/Signature (Owner/Age t)��'�
BUILDING PERMIT PERMITX07-217 CONTROL#q
DATE VALUATION S22%,9(, E., -A) LOT 9 TRACT
VVV
11>1��•�r7
JOB SITE
ADDRESS % - 2 ff►�.1�� d � ! i�.
APN 769-362-001
O NER
CONTRACTOR/DESIGNER/ENGINEER
L)ONA.LD.L PUFNPI L
CLASSM BUILDEJIUS INC
1ivMAN WELLS CA 92210
(760)772-1.019 081.0 4999
USE OF PERMIT
ti))1iOLR FAWLY 1�Wk 1..1.1Nu
ffr) - NO BLOCK WADS OR POOL. COMPL.iANC' E WITH ALL ['i:l'3%.Ai.M, &:
S7'A'1`E LAWS,.INC LU131NQ "iHL END NGEkFl) SMFC11_;S ACt' OF 1'17: 0.6
U.S.C. § 1532, E. r 1A.-', ).) W A1wVUC-el13IX_IS kt#;QtJ7i.;'k LNl
CUSTOM CONST9cUCrICNd 3,05515.00 SF
PORCiIWATIO $a.l.ui) Sr
C1AKA(,.'01C;AItP0KJ' 543.06,%F
I1s1ST'UMA TED MST OF CONIS"L UICi"ION,
56.9(04M
CONSTR.W,710N.1:EE 101-000-41"00 11,I.t-po)
P . AN 014W iC vliF 101-04n-4' 9-318 %%70.72
FLY, I)r'SIT 10.1.0:30-439-315 -3750.00
1Lt73CHA.NICAL Tali[ 101-000-421-000 $y2.(if)
1:1. CTRWAI. F'ER 101-40U-410.000 $197.82
P1 t.il R1'NG T TF lei -000-09-000 3192.50
STRONG MOTION rLT, - RES1D 10.1-000-2,11-0010 $2:+,70
vRAD1140 trek 1.01_000123_000 $20.00
1NrKA8TRUC,T1jkE FEE 22N"-413-342 e5,595.57
ART 1N PI[rKIC PL.ACVS -12 SSC !01.4100-255-000
i as
E
0111-ix'MA-1, (:0N',"fA.fiC1.`.0N AND Pl..) N CKCK
�f�,t►7ti,fli
LE`10S 1; ;tE-PARM FEES
_V50.00
8j
Pl.d 'NOW
TOTAL PERMIX FCC.S DISE
S7,916.02
NOV 17 1998
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RECEIPT
AATEI,_J"o'a: %..kIW,
BY'
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Slab Grade $ 'r /
Ducts
Return Air
Steel
Combustion Air
_
Roof Deck
Exhaust Fans
_
O.K to Wrap 4
F.A.U.
Framing
Compressor
Insulation 2F QQ —
Vents
_
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
_
Exterior Lath
Drywall - Int. Lath
Final
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
_Z
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 _
Sewer Connection 7,4
Pool Cover
Encapsulation
Gas Piping
Gas Test
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.1.
Smoke Detectors
Temp. Use of Power
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Final
`Utility Notice (Perm)���.
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 11/16/98
No. 18005 Jurisdiction
Owner NameDonald L. Puente
No. 78-591 Street Deacon Drive East
City La Quinta zip 92253
APN # 769-162-001
La Quinta
Permit #
Log #
Study Area
Tract # 28470-1 Lot # 9 Square Footage 3,056
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 4,in`thelarnount of
1.93 X 3,056 or $ 5,898.08 the property listed abovP;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/Bank of America/Classic Builders Inc. e Telephone 772-1011- y
Name on the check �r CC:
By Dr. Doris Wilson y �
Superintendent
Fee collected /exempted by Juanita Green Payment Received $5,898.08
Check No. 2012644639
Signature
NOTICE: Pursuant of Affiembly 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 jVom 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
8
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Recordir;y r'e uested By
First American Title Insurance Company
6rder No. r 2084008—EL PAID
Escrow No. M10I OB Doo. Transier Tax
Loan No.
RIV. CO. RecoKW
WHEN RECORDED MAIL TO:
MR. MRS. DONALD PUENTE, TRUSTEES
055337
RECEIVED FOR RECORD
AT d:00AM
FEB 18 1998
V==
Raw"
Fosf
MAIL TAX STATEMENTS TO: Space above this line for Recorder's Use
DOCUMENTARY TRANSFER TAX S 1 ` O
�CX Computed on the consideration or value of property
conveyed; OR
- SAME AS ABOVE Computed on the coiisid'eratton or value less Mini or
encumbrances remaining at time of sale
The Undersigned Grantor
Signature of Declarant or Agent determining tax -Firm Name
APN: 769-162-001
TRA: 020-015 GRANT DEED
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
TRADITION CLUB ASSOCIATES LLC, a Delaware limited liability company
hereby GRANT(S) to DONALD L. PUENTE AND MIKELLE L. PUENTE, TRUSTEES OF THE PUENTE LIVING
TRUST UDOT DATED MAY 27, 1997
the real property in the City of La Quinta
County of Riverside State of C.alifomia, described as
Lot _ 9 Tract 28470-1 (See Exhibit "A" Attached Hereto)
Dated:* JANUARY 22, 1998
State of California )
!� ) ss,
Coun of
onbefore me,
t�✓
personally appeared
personally known to me (or proved to me 6A the basis of satisfactory
evidence) to be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they executed the
same in his/her/their authorized capacity(ies), and that by his/her/their
signatures) on the instrument the person(s) or the entity upon behalf of
which the person acted, executed the instrument.
WITNESS MY HAND AND OFF IAL L
a
By:
Its. OO&YI diiyit4 PA00DOW
Its:
r TERRIE MILLER
U Comm #1128852
TARY PUBLIC CALIFORNIA
RIVERSIDE COUNTY ci
Comm SKI) March 6 2001 -�
(This area for official notarial seal)
5533'
EXHIBIT "A"
Lot 9 of Tract 28470-1, as shown by map on file in book 263 pages'76 through 90
of maps, records of Riverside County, California.
THIS DEED IS MADE AND ACCEPTED SUBJECT TO THE FOLLOWING:
1) Nondelinquent real estate taxes assessments.
2) All matters of record, including without limitation, that certain Declaration of
Covenants, Conditions, Restrictions and Reservation of Easements for the Tradition
Community, recorded on July 25, 1997 as Instrument No. 262677 of Official records of
Riverside County, California, which is incorporated by reference herein as if fully set
forth at length (the "Declaration'). The Declaration includes, among other matters,
certain architectural and development guidelines and restrictions which will apply to the
construction of a residence on the above-described lot.
Jf, . �. _-____rte ..
(SPECIAL INSPECTION SERVICE
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
37630 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager (760) 776-3338
TYPE OF
INSPECTION
PERFORMED
❑ REINFORCED CONCRETE ❑ STRUCT. STEEL ASSEMBLY
❑ POST TENSIONED CONCRETE ❑ ASPHALT
❑ REINFORCED MASONRY ❑ FIRE PROOFING
❑
❑ OTHER
JOB LOCATION 1 / I ^ -A CO tA � P-
W1 ([` 4 �T L A u
'1`\JI'NC N
REPORT SEQUENCE NO.
T TRUCTURE
,„ / �, c
V Pw e- eGU
PERMIT NO.
DA E
DAY OF WEEK
MATERIAL DESCRIPTION
ARCHITECT
jiNSPECTOR '
MRS. CHARGED
c -e) Tr
ENGINEER
ASSISTANTS
HRS. CHARGED
INSPECTION
DATE-
GENERAL SUB
CONTRACTOR CIA(
s c - o (der' - CONTRACTOR 'SA 64A e- oc'K-
0-Leb (.GR -0 i 0 ig AS L j01.A
-j-0 GO N - .
e -'T1 od' (� ct✓' :�
ID K Co
COPY SENT TO CLIENT
CONTINU D 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.
i
IGNATURE OF REGISTERED IN ECTOR
DATE OF REPORT REGISTER NUMBER