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0010-214 (SFD)LICENSED CONTRACTOR DECLARATION .1 I hereby affirm. under penalty of perjury that I am licensed under provisions of I,– V Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 6� L) Professionals Code, and my License is in full force and effect. O ce) License # Lic. Class Exp. Date r-- Cf LO LUi oZ � Date- i � �° � Signature of Contractor Atli' 2V-11 () r Y U OWNER -BUILDER DECLARATION W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's ~ d License Law for the following reason: Z( ) 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). ( ) 1, as owner of the property, am exclusively, contracting with licensed contractors to construct the project (Sec. 7044,6 Business & Professionals Code). co () I am exempt under Section B&P.C. for this reason O N 'Date Signature. of Owner rn EL Q WORKER'S COMPENSATION DECLARATION p Cc I hereby affirm under penalty of perjury one of the following declarations: Lo H O () 1 have and will maintain a certificate of consent to self -insure for workers' X W LL compensation, as provided for by Section 3700 of the Labor Code, for the O � Q performance of the work for which this permit is issued. m Q L) ( ) I have and will maintain workers' compensation insurance, as required by O � Q Section 3700 of the Labor Code, for the performance of the work for which this Il LO Z permit is issued. My workers' compensation insurance carrier & policy no. are: Cartier Policy No. J (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 provjtionsf Date'. d. Y ., Applicant 1,16arning: 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. 7 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 for inspe//coon pu .. ossees" (t Signature (Owner/Agent) 7%�^`!"l�'-��t:�,•�,' .�t�`fe}pr"Date �tlr`-x�`9� BUILDING PERMIT PERMIT# DATE j VALUATION LOT 0010.9114 TRACT I :`.� c�. .Ca �7. 1 JOB SHE APN ' ADDRESS 52,940 ,t+t.VENWA ':6ZIRF" 7r3-325-01 1. OWNER CONTRACTOR /DESIGNER / EN (NEER T+3ilCffd.'IMMONS HOWNS P 81 f.,ONITl.�'ti1.TMON WC PO BOA{. 749 111 )RP 3 Y BUKDER- B SAID BIs R ARDINO CA 924.02 SAN BY"AI INO CA 92423.0! (909i9�•5�333 C:�+T:lf 1532 USE OF PERMIT 811.4I1.LE FAIWILT DIAM ..I G 3106 • Pk�"„�t:1v',a7 '%°5° P 13PRIT DOES Vp7` INCLI:01t,, 1sS40TWALMMOLrIP.A, OR DFUtt•MA•Y A.PPROAM TFACT C-014STRIJCi',ION 1,218.00 aft OP09RATIO 165,00 sr, 5 FT. WOOD FYINCE .20100 V fSitR AOX 473.00 SFS X&IMM i Cow. OF OO1�db" 111RU TRIM 791 tri 70. CONS RUC1`10H FER 101-000,408-000 &149, 30 PL&H CHEIC ;• 1 101••000#-4^a9-318 5467.15 101-000.421.000 393.60 ;�r..1�7`R;iC.4i,�"1a:1: �1133i��i�-�i20-•0�?�1 �d!S.3+t 1:'L1.1M.1 INO FR ` 101,•000-419v000 $1218.76 J'i?i.ONO MOTION FE9 . MID 101-000--241-000 $7,93 O A. NIG FEE 1€610000-423w000 $20.00 PR,1J 3199 PIM 003-0.00441-345 S100100 Fir�i�t iT 1201-000.439_318 N Q t7Lfd;Y^S`'+d l.•AA. i..ti/KV 6D�IJF.4b1..Ad� •f. l`V.'9F.I Jw'9lV l,.Ck[:'.+...•.59. ✓,349.62 . LEW PRE -PATO 1.P017.3 4230,00 3 0 201%, OCT Ve a n REC%PT DATE I BYt+, , DATE FINALED INSPECTOR VU INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS � I Set Backs ' Underground Ducts Forms & FootingsI _ y Q Ducts Slab Grade -f l Return Air SteelCombustion _.f7 Air Roof Deck J} - fi, Q ( Exhaust Fans O.K. to Wrap *3�, 8l F.A.U. . Framing Insulation [ 1-� Compressor Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wail Insulation Condensate Lines Party Wali Firewall Exterior Lath —,Z7, 0 Drywall - int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs �_ �p_3 e- o0 $"7 Electric Bond Footings Main Drain Bond Beaml(=3I".qgp 57 Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines _ _ Heater Final Water Piping v �( Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection ,9� 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.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) %��� Building Address L• 1`TCJ T� Owner Mailing Address City Zip Contractor �y Address City Zip State Lic. & Classif. Designer, y' ., 0I1(a -Q P.O. 4 /_ BOX 1504 APPLIC ION ONLa" Y 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE'CONST. OC GRP. A.P. Number I' J� © 0 Tel. Legal Description_ - Project Description t-« IV I �n City Lic. If Address Tele /IZ2 City Zip State Lic. # 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, 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 penalty of not more than five hundred dollars ($500). I: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) I 1 I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor($) licensed pursuant to the Contractor's License Law.) 17 1 am exempt under Sec. B. 8 P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 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. 0 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: If, alter 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 Ihereby 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. 1 agree to comply with all 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. Sq. Ft. —� Size New r7� No. No. Dw. `�/ Stories Units Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT 2 0- CDC) ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line FINAL DATE Side Setback from Property Line INSPECTOR Issued by: Date Permit Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Certificate of Occupancy City of La Quinta Building and Safety Department This Certificate issued pursuant to. the requirements of Section 109 of the Uniform BuildingCode, 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:. Use Classification: SFD Occupancy Group: R 3 52-940 AVENIDA HERRERA Bldg. Permit No.: 0010-214 Type of Construction: VN Land Use Zone:. RC Owner of Building: FOUR SEASONS HOMES Address City By .Date Building Official POST IN A CONSPICUOUS PLACE P.O. BOX 749 SAN BERNARDINO, CA 92402 STEVE TRAXEL 07-18-01 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 10/30/00 No. 21152 Owner NameFour Seasons Homes APN # . 773-325-011 Jurisdiction La Quinta No. 52-940 Street Avenida Herrera City La Quinta zip 92253 Tract # Type of Development Comments Lot # 16 Single Family Residence Permit # 0010-214 Log # Study Area Square Footage 1218 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 2.05 X 1,218 or $ 2,496.90 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 / Citizens Business Bank / Michael Stubbs Name on the check By Dr. Doris Wilson Superintendent Fee collected /exe ted by Annette Barlow Signature Payment Received Telephone Check No. 375610 %2.496.90 40TICE: Pursuant of Assembly 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 Move 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 :ollect 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 RECORDING REQUESTED BY .Lavers We 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 San Bernardino, CA 92402 city & State TP ozoo TT -100 (Rev. 1/99) APN No. 773-325-011-3 DOC N 1 9 9 9— 3 7 6 8 1 7 08/23/1999 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 Ilii III III IIII I II VIII M S U PAGE SIZE OA PCO NOCOR SMF MISC. 1 A R L COPY LONG REFUND NCNG I EXAM GRANT DEED Title No. 436934-23 Escrow No. 7227-K THE UNDERSIGNED GRANTOR(s) DECLARE(s) DOCUMENTARY TRANSFER TAX is $ Tv CITY TAX $ �X computed on full value of property conveyed, or ❑ computed on full value less value of liens or encumbrances remaining at time of sale, ❑ Unincorporated area: X-� City of La ouinta FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, DRAGO C. VINSKI and MIRA VINSKI, husband and wife hereby GRANT(s) to FOUR SEASONS HOMES, i INC. , a California Corporation i the following described real property in the County of Riverside , State of California: 0 T AM ,and Lot 16, Block 160•of SAN CARMELITA AT -VALE -LA QUINTA, Unit No. .16, in the City of La Ouinta, County of Riverside, State of California, as -.per -map recorded in Book .18, page 99 of Maps, in the Office of the County Recorder of said County. Dated: June .18, 1999 V Drago C. V nski. Mira Vinski State of California _( 1. o �C •- 4 (l�{i� ss. County of On -7 L3, q °� before me, /tom r -8. (here Insert name) Notary Public, personally appeared5�- personally known to me (or pr ed to me on the basis of satisfactory evidence) to be the person(s) whose name(s) Is/are subscribed to the within Instrument and acknowledged to me all that he/she/they executed the some in his/her/their authorized capacity(les), and that by his/her/their signature(s) on the Instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the Instrument. WITNESS my hand and official seal. : Andrew B. HDlmes3 0 Comm. *1133008 nn (� '• S NOTARY PU8LtC CALIFORNIA" i LOS ANGELES COUNTY 0-• Comm, Exp. April 6.2001 Signature ` - atHx seal within border MAIL TAX STATEMENTS AS DIRECTED ABOVE. 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 the Building and Safety Department as your correction list. Please attach additional explanations as necessary. APPLICANT PSI Builders SITE ADDRESS 52-940 Avenida Herrera APN 773 _ 325 _ 011 BIN NO.: CASE NO.: 2000-332 LEGAL: LOT 16 BLOCK UNIT S.C.@V.L.Q. CHECKED BY: Stan Sawa 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 N COMMENT/CORRECTION Compatibility Review Case logged and number assigned V Verify legal and APN information Consistent with MDG on file (as.applicable MDG filing required (5 filings since 9/3/98) Consistency with street/surrounding area: Colors Materials Architecture V Other Requirements: yhq�. 0* A an p (avt5 g1K9JL `t e3" 115 Y� L 4e A- • -r_VAi 1y- 4o -b 4- W' 410 t Y�GoI'Y7$G'�• �� r l ov►MD�i �I l!'DV1 •�GJtP �v � �.►wrf� i�(�� 7 C1191 24 October 2000 City of La Quinta Department of Building and Safety 78-495 Calle Tampico La Quinta, CA 92253 Project: Single Family Residence for: Four Seasons Homes The Rose Plan "A"& "B" 52-930 Herrera and 52-940 Herrera La Quinta, California Re: Review of Truss Manufacturer's calculations To Whom It May Concern, CHARLES D. GAR LAN D Architecture, Interiors, Space and Land Planning Structural Calculations I have been supplied with a copy of the truss manufacturer's calculations prepared by Spates Fabricators Of thermal, California, for the project noted above. Upon review of these calculations I find, them to be in substantial conformance with the design intent of the construction documents. If you have any other comments or questions regarding this or any other matter pertaining to the project noted above please do not hesitate in contacting me. Hrcrineci 35-325 Date Palm Drive, Suite 151-J - Cathedral City, CA 92234 - Phone/Fax: (760) 324-7146