0308-269 (DEMO)LICENSED CONTRACTOR DECLARATION
reby affirm under. penalty of ReF:/ry that I am licensed under provisions of
te "9 (commencing with Section 7000) of Division 3 of the Business and -
ofessionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
653945
Date� *'r �� 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 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 ST.A'1'EFUND Policy No. 19106-211103
(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 provisions.
Date:`i 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
& huld harmless the City of La Qulnta, 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 inspection purposes.
Signature (Owner/Agent),%` - ' Date'.
BUILDING PERMIT PERMIT#'„�'
DATE f / VALUATION .LOT - TRACT 29894-2
JOB SITE J APN
ADDRESS
OWNER CONTRACTOR/DESIGNER/EN (NEER
ND LK C TJDT"tA PAR ..4U..B UC
C
81:1 Ota AMIE 53
LA QL1TN A CA 92253
USE OF PERMIT
DETl9:01,1C1°ION
ALL PHAM C01417MITMON; RU
82-822 VIAPALERTAO
D0.10 CA 92201
(760)275.7721 CBT.9 4298
CO. M P1 TX DEMO OP KKISTI D MrO TO 8A It, iAOtf TO.
RIMMED (MU 0.1r Ct NS-IN13'CTrON
1: EMOIXF1CR1. FEF, M-000^423-000 545,00
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MB -IAL CON—S:MUCTION. PLANCT'[I+ _ $45. NJ
LESS PRK-PAWIFHES $0.00
RECEIPT DATE
BY JN E J JS INSPECTOR
Olc 1"v %ssvE pe� X A
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall 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 Plbg. 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
Underground Conduit
Rough Wiring'
Low Voltage Wiring
Fb(tures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
HIDEAWAY
August 18, 2003"
Hand-delivered
Greg Butler,
CITY OF LA QUINTA u
P.O. Box 1504
La Quinta, CA 92253
RE: Hideaway/Demolition of Prestwick Models
Dear Mr. Butler:
As Ruben has mentioned, our partnership has made the decision to demolish the model homes
that were begun by a builder who is no longer involved in the project. Title to the property and
improvements is vested in ND La Quinta Partners, per the attached copies of grant deeds.
Also, ND La Quinta Partners is the Declarant of the Hideaway Association and retains control of
the board of directors at this time. Therefore, the Association also supports the request fora
permit to demolish the subject structures. If there are any questions, I may be reached at the
number below.
Sincerely,
ND LA QUINTA PARTNERS, LLC
JoAm
-Develop e
Enclosures;
C�
PO BOX 1540 81-100 AVENUE 53 LA QUINTA CALIFORNIA 92253
PH: 760.391.5072 • FX: 760.398.5788 • www.hideawaygolfclub.com
DISCOVERY LAND COMPANY
04-23-2003 06:26am From -Fidelity Title Builder Services +606 6371636 T-063 P.001/004 ' F-714
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f RECORDING REQUESTED BY AND ;Gee P10Aef
WHEN RECORDED RETURN TO: a, a
Morgan, Lewis & Bockius
300 South Grand Avenue, Suite 2200 Doc iii ' 2002—s i s 328
Las Angeles, California 90071 eailsrt11es 112:9112 Fee=38.119
Attention; Anthonyiasu, papa I of 4 Oce T Trac Paid
y lli�• Recorded in Official Records
I County at Rlveslde
jj dery L. Or&*
Assessor, County Clerk 6 Recorder
• MAIL TAX STA'IF.MENTS'Ib:
Nb La Quinia Partners, LLC,
375 North Front Street, Suite 200
Columbus, Ohio 43215
. 1
(Space Above this Line
Tra Dao 3�.
GRANT DEEB
FOR A VALUABLE CONSIDERATION; receipt of which is hereby acknowledged, NRI.LQLP W
GOLF PROPERTIES, LLC, a Delaware limited liability company ("Grantor") hereby grants to
ND LA QUEITA PARTNERS, LLC, a Delaware limited liability company, that certain real
property located in Riverside County, State of California, which is more fully described in
Exhibit A attached hereto, and hereby made a part hereof,
SUBJECT TO all covenants, conditions, restrictions, rights, rights-of-way, easements,
encumbrances and -other matters of record, or of which a survey or inspection of such property
would give notice, as of the date hereof.
Date&- September 2002 2002 NRI-LQLP GOLF PROPERTMS, LLC,
a Delaware limited liability company
By: Nationwi ity Investors. Ltd.,
al t__
liabilit o any; .
itsber
• i� By
Briallis
President and Chief Operating Officer
• 1� •
Description: Riverside, CA Document- Year. NOD 2002.511325 Page:1 of 4
Order: pt Comment:
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'04-23-1003 08:26am From-Fidelity Title Builder Services • +AOA 6371636 - T-063 P-002/004 F-714
STATE OF i IQ
COUNTY OF L
On this lu ' day of W0002, before me personally appeared I0.K = E i
pamonally, known to tri (or proved to me on the basis of satisfactory evidence) to be the person
whose name is subscribed to the within insmment and acknowledged to me that he/she executed
the same in his authorizod capacity and that by his/her signatune.on the instrument the person,"or -
the entity upon behalf of which the person acted; executed the instrument
S to hand and offtci al.
d AL"t
Notary blic /�c AB8IM0.tU�A09 .
swam I FOR 7C
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. 2882-511325 .
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Description: Riverside, CA Document- Year DoclD 2002.511325 Page: 2 04
Order: pl Comment: y
04-23-2003 08:26am ' From—Fidility Title Builder Services
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