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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
`760595 D CS Eli(,
Da et jJ Signature of Contractor
OWNER -BUILDER DECLARATI N
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).
( ) 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 have and will maintain workers' compensation insurance, as required by
c
A 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:.
Cartier 31'A.`!'E, KIND 1 Policy No. 169Yd6.41
(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 Fo6is ons.
Date: '? 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. 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 forinspectionpurposes.
Signature (Owner/Agent) •.. Date =
BUILDING PERMIT PERMIT#;
DATE % / VALUATION LOT 041-3.13 TRACT
w
JOB SITE oo / o u E
APN
ADDRESS
79-730 DESIM, Mii.LOW
- -
OWNER
CONTRACTOR / DESIGNER / EN (NEER
I)t'7 '.0EVFJ,0P M4+3 T.11IC
V DIVIVELOPML 6'].',INC
7 B-6001310.17WAY i I I
18-00 3°WH`►'4AYA I I
.L."', QUIN'I'A. CA. 9225:'
Lk QUWA CCJk 92253
/,'
(1.60)771.3345 C13Vf 2180
;s
USE OF PERMIT `
CC1I`�T�, WIAL
f17�19t;CA2i�tr�llrvr>t��f~�tt�.��rt�urt� S"�tw1LPTY •
FORM PATIO I i1.nf13p
Ct31.1'1'RACT Ata443EfAf"a 3,35:f.613 I.S
1s'IM..X03) C01;f CIF C0NNIR CITON
i,248.60
POI NYy. qamlpR
C.' N,13oT13.1. 0101^4 FEE 101-000-418-000 MAM
PLAN C'HYXX31 E 101••000-439-11£1 W06.03
t•.
Mr.0 1 ANICAL M—Z � 101••000.42.1-000 SIMOO
.
94:X'f TICAL YEE 101-000-42.0-000 $36.9?
P1.L1MF31 O FEE 101.000-419.000 $.I r/.30
V"rRIONG M01101,1'M 100••000-241-000 v3..ti3
'
G.k.ADIN 0 Fit 101-000-42',1-000 $4.00
A?Cr JW PL1J L)C PLACZS - 0431!'17 2.913-000, '4145-000
SM-TMAL-COMXJ _-710N AM P,I_AW E..Ht...C�1�.
$415.66
FETS DAIE NOW
MSA.*S
ap 0,
RECEIPT
DATE /�
BY �;_��.�
DA N``AL 1
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
-
Underground Ducts
Forms & Footings
Ducts
Slab Grade
.- Z
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
'
0. K. to Wrap
5 - /-
F.A.U.
Framing
-j' _
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
s
Final
_
Final - -
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
2 _
Set Backs
Electric Bond
J 70
Footings
Main Drain
Bond Beam
- Z
Approval to Cover
_
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Waste Lines
Gas Test
Electric Final
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
Appliances
Final
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)
COMMENTS:
Ot
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`" # „
City of La Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
t/, f /awBuilding Permit Application and Tracking Sheet
Permit #
71--)3 0:t>
Project Address: L�.�j- fii� .� C
Owner's Name: C,
A. P. Number:
Address: j
Legal Description:
Contractor:— L
City, ST, Zip:
Telephone: 1 l.• 3 �5
Address: i�i-730 U,L�-(,,��
Project Description: C tai t -r P00t— L. -C
City, ST, Zip:
Telephone: 5
b 8
State Lic. # :
Citv Lic. #:
Arch.. Engr., Designer:
Address:
City. ST, Zip:
Telephone:
State a
Name of Contact Person:4 d S
.
Construction Type: Occu aneN•.
Project type (circle one): . Ne Add'n Altar Repair Demo
Sq. Ft.: a L-7 # Stories: # Units:
Telephone 4 of Contact Person: L 1
Estimated Value of Project: 10. p oD, Do
APPLICANT: DO NOT WRITE BELOW THIS LINE
4
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
ZPlan
Sets
Plan Check submitted
) 1/7Item
Amount
Structural Calcs.
Reviewed. ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
// /s
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d Review, r dy for corre ons/issue
'01f%
Electrical
Subcontactor List
Called Contact Person
Qi/ %
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
11
ailed Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Notice:
Document Cannot Be Duplicated
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 1/29/02
No. 22868
Owner NameDesert Cities Development
N0.79730
City La Quinta
Street Desert Willow
APN # 649-030-043,044
Jurisdiction La Quinta
Permit #
Zip 92253
Log #
Study Area
Tract # Lot # Square Footage 217
Type of Development Commercial Addition No. of Units 1
Comments
Pool Building 217 sq. ft.
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
.33 X 217 or $ 71.61 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/ First Community Bank - Patrick Bird Telephone-
Name on the check
By Dr. Doris Wilson _
Superintendent - s
Fee collected /exempted by Nicola Wong Payment Received
Check No. 104796
Signature
0
NOTICE: Pursuant to 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
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 DistrictCs)(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
i CC>,44 vj7y -�>C
City.of La Quinta
Developers Project Approval Form
CONSTRUCTION PLAN/S APPROVAL
Prior to the issuance of Building Permits for the project listed below, please return this form and
plans to the Building and Safety Department . Contact applicant for resolution of conditions
preventing or delaying approval.
Project: Desert Cities Development
Community Pool Building
79-930 Desert Willow
Applicant Contact: Joe de Coster: -
OFFICE: (760)771-3345
Circulation Date:
unit DevF
Christine di Iorio,
Public Works Department
Manager
Steve Speer, Senior Engineer
11/07/2001 ER q/l,
This is for approval of the Building plans as per the SDP
Ed Randall
Building &Safety
11C)�
ate
Date
edrdinq Reques' I By
First American Title Company/
Recording Requested By And
When Recorded Mail To:
DC & TC, LLC
71084 Tamerisk Lane
Rancho Mirage, CA 92270
Attn: Michael Shovlin
Mail Tax Statements To:
Same as above
DOC a 2000-420072
10/25/2000 08:00A Fee:9.00
Page 1 of 2 Doc T Tax Paid
Recorded in Official Records
County of Riverside
Gary L. Orso
Assessor, County Clerk 8 Recorder
11111111111111111111111111 IN IIIIIIIIIIII 1111111111111111
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SIZE
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LONG
REFUND
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EXAM
f�c mGr1+11 Trw'►S{er7oyc'i5rta+madea o �}fj�'t
[EXEMPT FROM REV. & TAX. CODE § 480.3 PER REV. & TAX. CODE § 5081
GRANT DEED
FOR VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
the undersigned, LA QUINTA REDEVELOPMENT AGENCY, a public body corporate
and politic ("Grantor"), hereby grants to DC & TC, LLC., California limited liability
company ("Grantee"), that certain real property in the City of La Quinta, County of
Riverside, State of California legally described as follows:
LOTS 1 THROUGH 12, 19, 41 THROUGH 86, AND LETTERED LOTS A, B,
D, E, AND H THROUGH R,INCLUSIVE, OF TRACT NO. 28601-1, AS
SHOWN BY MAP ON FILE IN BOOK 278, PAGES 86 THROUGH 90 OF
MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA
together with any and all buildings and improvements located thereon (the
"Property"), subject to easements and non -monetary liens and encumbrances of record,
and current non -delinquent real property taxes and assessments.
Dated: /4 , 2000
394/015610-0026 _
105685.03 a10/13/00
LA QUINTA REDEVELOPMENT
AGENCY, a public body corporate and
politic
By:
Nalne: Thomas Genovese
Executive Director
-1-
9
ES
STATE OF CALIFORNIA )
ss.
COUNTY OF RIVERSIDE )
On "�/l t- 12-0a o ,2000 before me, .a notary public, personally
appeared THOMAS GENOVESE, personally known to me (itwbasi-,
to be the person whose name is subscribed to the within
instrument and acknowledged to me that he executed the same in, his authorized capacity
and that by his signature on the instrument the person, or the entity upon behalf of which
the person acted, executed the instrument.
[SEAL]
WITNESS my hand and official seal.
11111111111111111
111111 IN 111111111111$ 113319.1020520 £0e$�eOR
394/015610-0026
105685.03 a]0/13/00 —2—
7
City of La'Quinta
Developers Project Approval Form
CONSTRUCTION PLAN/S APPROVAL
,..he issuance of Building Permits for the project listed below, please return this form and
plans to the Building and Safety Department . Contact applicant for resolution of conditions
preventing or delaying approval.
Project: Desert Cities Development
Community Pool -Building
79-930 Desert Willow
Applicant Contact: Joe de Coster:
OFFICE: (760)771-3345
Circulation Date:
Community Development Department
Christine di Iorio, Planning Manager
Works
Steve Speer, Senior
1110712004 ER
This is for approval of the Building plans as per the SDP
Ed Randall
Building &Safety
Date
1117 Id S
Date