0302-078 (SFD)I)
I—
N to
W
Ouch
d r
C=)- Z
�
0' 0
JV�
F-wa
U)
Z
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
79, `405 B Iffe
�..+^ ..R
/ate 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.
,V -)l have and will maintain workers' compensation insurance, as required by
Seotign 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:
Canier_�,7 Policy No. p
.tom. i�: a t.r/;,.�.r r' r C"r,"/. ✓ (~1 z' .7
(This seaion 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: ��- .f Applicant -" ` w'
Warnirig: 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 for inspect�grr purposes
Signature (Owner/Agent) . -'� Date
E
_.BUILDING PERMIT PERMIT#
ti
DATE �a jj VALUATION LOT TRACT
_UK 15ci
JOB SITE
APN
tt�t• �y �y �e
ADDRESS,i -` s-1�i!.i�b �i.all� (itR i1a
r'�`� •ted'3�A:
OWNER
CONTRACTOR/DESIGNER/ENGINEER
,akTL.AN' Te4"!KSMW 3'i x.11 0GP
A-MAINVAS, DW.)s'S: MC, -.M 1. 3OUP
53-10 AV7.:k�ITIA
i.AQVINITA (1p, IS11253
Li17,��i.JATYA CA 01U,31�
USE OF PERMIT
183i5.,r+ S11'D M 'MIT DOZSS NOT UNC•r`:.UM `z3I.C9t.i: lViVl I„, POOLaW�.
OR DRIV A )' :APPRC3AL'H
1' 3sti"33f;?��1'Ia.l 173,99 Sir
EM. K TM {:1:)17'.1 47F MMUIXTION.
1_161MAO
c�[[vet{{,,,���((�(.�•��gc��V�J�.�.�(.;I;��f/�4oay�,�{a.�+R.�t���p
I�f.I�iN O,I-!11.CK :�.E?r F�I,•ff�1f'•�{••a Jn �')�l• �.i6J.j3
FV1 DEPOSIT 1501-CID04 39» n S -WV100
I UM71'RIC,F CAL YM $127,36
PLIUMMID fr"ati: 101 -00-419-0,1* $1411 30
al.10140 V. 1.1014 FSS 1? VID 101-(}00441.000 M I A
3-000 S61 rf.1iv
�.:?f .F.;67y1dl3 P'i3 I -W0-4!A3-000
dIRV11'rS t PLAN 1(3 ), •�i�-�? 91 ^:��SS �s0t).vE1
C: 1111T,'Rr I (I°JI(ON ,at' PLAN e`'I�' My
Y, 3 PRE. -PAR, w J~°
19, 13 7. 17
JUN 3 0 2D03
CITY OF
LA QUINTA
FINANCE DEPT.
RECEIPT
DATE' Z"Z �,BY��.
D FI E
INSPE
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
p
Underground Ducts
Forms & Footings
f
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
t,
Exhaust Fans
O.K to Wrap
Framing
F.A.U.
Compressor
Insulation
_
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
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
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 z�_ eff
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) _} L�
COMMENTS:
Date 6/30/03
No. 24641
Owner Atlantis Investment Group
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515
APN #
��� FtEDIYCI
o
a MUDA DUNES r
V) RANCHO MIRAGE d
INDIAN WELLS
�i PALM DESERT .y
LA OUINTA
11 N0O `^
O •YJ
773-295-015
Address
51-105 Avenida Villa #202
Jurisdiction La Quinta
City
La Quinta Zip 92253
Permit #
Tract #
BLK 150
Study Area
Type
Single Family Residence
No. of Units 1
Lot # No. Street S.F.
Unit 1 1 52545 Eisenhower Drive 1837 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
Lot # No: Street S.F.
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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that 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
Education Code Section 17620 and Goverment Code 65995 Et Seq.
in the amount of $2.14 X 1,837 S.F. or $3,931.18 have been paid for 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 OC/Wells Fargo - Art Lambrose Check No. 0737703857
Name on the check Telephone
By Dr. Doris Wilson
Superintendent
Fee collectei
Signature
Funding Residential
$3,931.17
Payment Recd Over/Under
NOTICE: Pursuant to Government Code Section 66020(d)(1), 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 issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
JUN.-03'03(TUE) 13:01 FIDELITY NAT TITLE TEL:1-160-179-0394 P•002
RECORDING REQUESTED BY:
Fidelity National Title Company
Earrow No. 410162 -CB
Title Order No, R-217541-1
When Recorded Mail Document
and Tax Statement To:
Arthur Lambrose
51105 Avenida Villa, #202
Le Quinta, CA 92253
GRANT DEED
The undersigned grentor(sl dedare(s)
Documentary transfer tax is 8 City Transfer Tex is $
[ l computed on full value of property conveyed, or
[ I computed on full value less value of liens or encumbrances remaining at time of sale,
( I Unincorporated Area City of La Quinta
USE
FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged, Gregory T. Sherman and Trudy
Sherman, husband and wife as joint tenants
hereby GRANTIS) to Arthur Lambrose dba Atlantas Investment Group
the following described real property in the City of La Quinta,
County of Riverside. State of California:
Lot 1 of Block 150 of Santa Carmelita at Vale La Quinta, Unit #16, as per map recorded in Book 18,' Page 99 of Maps,
in the Office of the County Recorder of said County.
DATED: May 2, 2003
STATE OF CALIFORNIA
COON OF l (i6(1- Greg ry
iL before me,
c F personally ppeared
oval owrrto rfle-{or proved to me on the basis Trud Sherm
of satisfactory evidence) to be the persons) whose
name(s),W Msubscribed to the within instrument and
acknowledged to me that hom" fie executed -the
some i e authori:ed capacitylies), and that
by lhwhar eir signatures) on the instrument the
person(s), or the entity upon behalf of which the
person(s) acted, executed the instrument.
Witness my hand d luta) seal.
.. CAT►IFAINE
Comm; f Asoya
138N6
g0TAAY PWLJC_CAjMpfflA Yl
Alwnl& coaery
Ah C"'O' hom ffim21,InpD ►;
We hereby certify this to be a true and
Signature. Correct copy of the 0#nal.
BFIDIRM NATIONAL TITh 1N RANCE CO.
MAIL TAX STATEMENTS AS DIREC
FO -213 (Rev 7/96) GRANT DEED
JUN -2-2003 MON 11:54AM ID:ATLANTAS INVESTMENT GROUP
PAGE:2
b
Certificate of Occupancy
E
r
U
6
4
oF Building & Safety Department
C,
a
iC
�
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
I
construction and/or use.
k
BUILDING ADDRESS: .52-545. EISENHOWER DRIVE
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 0302-078
4'
gOccupancy
Group: R-3 Type of Construction: VN Land Use Zone: RC
3
Owner of Building: ATLANTAS INVESTMENT GROUP Address: 51-105 AVENIDA VILLA, #202
City, ST, ZIP: -.LA QUINTA, CA 92253
By: KIRK KIRKLAND
�^
Date: February 25, 2004
Building Official
ti
POST IN A CONSPICUOUS PLACE
u
c„9s,
Architecture, Interiors, Space and Land Planning
Structural Calculations
29 October 2003
The City of La Quinta
Department of Building and Safety
78.495 Calle Tampico
La Quinta, CA 92253
Project: Single Family Residence for:
Atl t Group
1,837 Sq. Ft. Single Fa ' esidence at:
52545 Eisenhower Drive
.to, GalifGfflia
Regarding: Project Observation and Field Revisions
To Whom it May Concern,
On this date I visited the noted project site to perform code required structural observations. At
the time I rioted only minor blocking, nailing and strapping issues that were resolved at the 4me of
my visit except for the following:
d Shear wall "E" segment had to be revised, at my direction to accommodate electrical
and service entrance boxes. I directed Mr. Arthur A. Lambrose of Atlantas Investment Group to ap-
ply a new, retrofit, holdown in order to provide an impenetrate shear wall segment adjacent to the
subject service entrances. Please see attached detail.
Shear wall "C" segment required a retrofit holdown applied to one end because a
holdown was not installed at the concrete pour. Mr. Lambrose was again requested to apply the
retrofit holdown in accordance to thle same attached detail.
I hereby state that after the noted retrofit holdowns have been installed the project's
structure is in substantial conformance with the structural design intent at represented in
the construction documents.
If you have any further questions regarding this project please do not hesitate in contacting me.
Charles D. Garland
Architect t
411 I i
I.a3
. ATE
74-854 Velie Way, Suite 5–b—V_Wrrr_996_tt, CA 92260 ❑ Phone: (760) 340-3528 ❑ Facsimile: (760) 340-3728