0007-134 (SFD)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
778280 I3 I �;` 05/31lZt
Dated -^ ' ,,Signature of Contractdr
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.
(,,.)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 LrXIPT Policy No.
(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. t ,
Date:"• Applicanf `• ' '
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 hips
application. � t
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 a
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
y
vrSignature (Ownev geritj / + y. Date` •- "�Yf/r�
!.
y ,
BUILDING PERMIT PERMIT#
DATE VALUATION LOT QW7-134 TRACT `
08W $108, .21 3 BLIC.36
JOB SITE
APN
ADDRESS .5$-8W AVRWIDA OBI? rCs Ofq
OWNER
CONTRACTOR / DESIGNER / EN (NEER
RANDY & SHARON BILLS
IZGACY IiOWS
78-555 SAGUARO ROAD
78-555 SAGUARO ROAD
LAQUWTA CA 92253
LAQUR4TA CA 92253
(740)564-7820 CBY:#
USE OF PERMIT
BRINGZ . FAMILY DIVIELLPAG
SF'D-PZRMIT D01O, NOT 114CLUDE BLOCK WALL OR POOL.75% PLAN
CHECK FEE REDUCTION FOR MULTIP.LF. ISSUANCE OF SAME PLAN TYPE
TRACT CONSTRUCTIOPd 1, r8S,00 SF
PORCWPATIO 40.00 Sly
CIARACIElCA.RPORT (Iil) 9,564,$0
5 FT. WOOD FENCE 200.00 LSA'
> ynWA'1ED COSH" OF CONFfRUC`ff0N
10SAW3 20
P.ERA tT Ti's SUA9 ARY
CONSTRUCTION FEE 101.000.418.000 1 71,00
MECHANICAL FES: 101-000-421-000 362.00
ELECTRICAL FEE, 101-000-420-000 1120.84
PLUMBING FLOF 101-000-419-000 $122.75
STRONG WrION FE"E - I ESID 101.000.241-000 $10.89
OlLfiDING FEE 101-000-423-000 320.00
DEVELOPER IMPACT FEE $1,907.00
PR.ECtSI! PL4N 101-000-441-345 $100.00
` FEE DEPOSIT � 101.000-439-318 4750,00
PLa` N CHICK: FEE � ` 101-000-434-318 $134.08
$a
�UB=TOTAL CONSTRUCTION AND 1.)L AN CI-WX
$3,153.52
�. I. IX 33 FRE -PAID FEW
• $250, 00
TOTAL V_IT MS DUEE NOW
$2-1903,52-
2-1903,52RECEIPT
RECEIPT
DATE f
BY
DATE FINALED
INSPECTOR
0,
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings
Z7
�_
Underground Ducts
Ducts
Slab Grade
—�
Return Air
Steel
Combustion Air
Roof Deck
O.K to Wrap
_
l� —�
_
Exhaust Fans
F.A.U.
Framing
p 1.O -gyp
S"7
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Latham
5�
Final / S,7
l�
BLOCKWALL APPROVALS
Final
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
Water Piping
I ��
Heater Final
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral_
Sewer Connection
��.oj)
��
Pool Cover
Encapsulation
Gas Piping
Gas Test
2 �!�•�
j
Appliances
Final
COMMENTS:
i
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 4tp 5
Utility Notice (Perm)
c&t,,4
P.O. BOX 1504 APPLICATION ONLY
Building SOf� 78 495 CALLE TAMPICO
Address �' /T"� 'I`C LA QUINTA. CALIFORNIA 92253
Owner
U1 a AMOUNT
'/r
y 1 /-
Mailing 1
Plan Chk. Bal.
Address? ::; S
u f U
City
Zip
Tel.
fr�(l'%/t: 1•!fi
Electrical
Contractor
Plumbing
L L-�/I
Address !_
r_- / l
City,
el -I
"Zip
Tel, / - �
SG'% ars c�
State Lic.
& Classif.
��
City
Lic.
[
Arch., Engr.,
Designer
Address
Tel.
�,(/- / -
CityI Zip I 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�annddProfessions Code, and my license is in full force and
effect 's 1 - i '
f r .
SIGNATURE - r-. °'"` _.d'-` -=--••"" J �'-' 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 die 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 thealleged 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 (5500).
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 I 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(s) licensed pursuant to the Contractor's License Law.)
11 1 am exempt under Sec. B. 8 P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I 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. ❑ 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 thai in the performance of thg 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: 9, after 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
I hereby 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.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE'CONST. OCC. GRP.
A.P. Number�3�� L�d'tl� `tel
Legal Description t s; 7"
Project Description
C' fiJir) i�� f y%r7� C
Sq. Ft. No. No. Dw.
Size Stories Units
Nevy,2' Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
U1 a AMOUNT
Plan Chk. Dep.
A 6
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
t
Infrastructure
}
TOTAL
<61)
REMARKS
R
9
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
`Desert`Sands VfiifiW-School tD strict
47=950``Dune'Pa1m's Road
Notice:,
La Quihta,.CA 92V253
Document Cannot Be Duplicated i,604714'515':'
CERTIFICATE OF COMPLIANCE
Date 8/18/00 , APN # 773-164-003
No. 20905 zi Jurisdiction La Quinta
Owner NameRandy' &, Sharon Bills Permit # 0007-134
No. 51°-800 'Street Avenida'Obiegon Log #
City La Quinta . Zip 92253 Study Area
k.h
Tract # Lot # Square -Footage 1788
Type of Development Single Family Residence ' No. of Units 1
Comments
}
At the present time; the pesert Sands Unified-- School District doe'snot collect fees on garages/carports, covered
patios/wallcways"restderihal'addi6ons under 500 square feet, detached accessory structures or replacement mobilehomes. It
has been determined the above-named owner is exemptfrom paying skhgp fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility feesimposed pursuant to Governni en(,Code.53080' in the amount of
r ,x
2.05 X 1,788 or $ 3,665:40 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./•1st Bank./ Sharon BillsTerphone 160-564-7820
Name on the check
By Dr. Doris Wilson:
Superintendent
Fee collected /exembted by Annette Barlow Payment Received $3,665.40
- Check No. 55045
CianAtere �G//
NOTICE: Pursuant of Assem_b! Bitt 3081 (CHAP 549 STATS. 1996) this will serve to notify you that fhe 90day approval period in which -you may:protest the fees or other payment Identified
above will begin to run from the date on which the'bwlding or'installation permit for this project is sssued or on which they are.paid to the District(s) or to another public entity authorized to
collect them on the DistrictCsxs'),betielf,,whlcAever is eadier: "' ` P
Collector: Attach a copy of county or 'city, plan-checkappM tion %rm,to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy:: Applicant/Receipt 'Copy - Accounting
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_ OF -LA C�UIN-11•i , SUB -CONTRACTOR LIST w. /,7 f
N �, f �. Qfjle! ECG 1 OWNER__..._. e- Flo ees are authorized to work
IL t lr p�R�aT Nv�sER _— �Q6�— �e, t�nly persons app aring on this list or their emf Y
J08 AtDDRESS,_.._____ - --- ° p�— will result in n stoFipage of work andlor the voidance
er ..114 in ti
N TYris 1p shalt F�9S - 1° 1 +�11t.3h�$r lkn9 lU.4P tiDA�. _
changes to this list must be approved by the Building Division prior to commencement of work. Failure ti comp Y --_�
on this lob. Any 9 : liiable trade; :all information uested below must be completed bY_ applicant. on File" is not an_acceptabie reponse.
ermit, for irech aUU
m of buildin —
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trisutlnG
isatiurt - .
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ork
9YS`
r ✓� Pof%1r xh<xlxxl Ixxxr.} t
m Trade f Cbstilitatii►rr i ' ''?-_ 0 — Classification t.irtnse Numbet Exp. Date Cattier Name (Format Vanas) _ rE
ry Company (Marne xxxxxxl (xxlxrilxxl
leg. State fund. CaiComp)
le.g_ A. B. C-81 1 '
:I�
EARTOW3F 4t {CIy__
cQlic,E:fc$i t ' y ?5,3
FRAMING
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CERAIAIC"E.IG-51.
o'
DOCAB}( T5 IC 1}! t r5 " Ei 4'��° >w ..de llvp +of „ ��_•�{<. ^N t' 4 � _
OL
FENCiNQ SrS%-13} 4� ..i.., }�:�iS `• '� • ��Lk�� 1 f'�' 1%' �� ...
o { AN1pSG1spIPN4 EC ?71'.'---: w t�tsof _ _ L Z �.
-
.... = ..fit'" ...n.�.•.4J.� , i':-�;�Ls.. L�v .
RECORDING REQUESTED BY:
Fidelity National Title Company
Escrow No. 41657-C8
Title Order No.
When Recorded Mail Document
and Tax Statement To:
Mr. and Mrs. Randy Bilis
78555 Saguro Road
La Quinta, CA 9225
DOC N 2000-275153
07%14%2000 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
M S-7 U I PAGE I SIZE I DA ' POOR j NOCOR I SMF I mtsc7
APN:'773-164-003-9
I A I R L II I I COPY I E.
LONG t REFUNO I NCHG E
—17—o— 6 Zc�t•7, GRANT DEED _...__ ..__ . _ ....
The undersigned grantor(s) declare(s)
Documentary transfer tax is $18.70
[ X ) computed on full value of property conveyed, or
[ l computed on full value less value of liens or encumbrances remaining at time of sale,
[ ) Unincorporated Area City of La Quinta
�t FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Richard L. Swalve and Sharon
,v M. Swalve, Husband and Wife as Joint Tenants
r hereby GRANT(S) to Randy%ills and Sharonklls, Husband and Wife as Joint Tenants
the following described real property in the City of La Quinta
County of Riverside, State of California:
Lot 3, Block 36 of Santa Carmelita at Vale La Quinta, Unit #18, Pages 55 and 56 of maps, in the Office of the
County Recorder of.said County.
DATED: June 13, 2000
STATE OF -CALIF NIA--- _........._. _.
C0UN Y OF
N before me,
personally appears
_L 7
-personally known to me (or proved to me on the basis
of satisfaPaged
vidence) to be the person(s) whose
names) 'bscribed to the with'�strument and
acknowle tj that he'fsi`re� ee xecuted the
same in eir uthorized capacity(ies), and that
by signature(s) on the instrument the C•' "'l''" '�;� rOYt)
person(s), or the entity upon behalf of which the
person(s) acted, executed the instrument. , RNERRSIDE COUNT`(
y Cold1M. EX: NOV. 412002 'A
Witness my ha d a dofficial seal.
Signature
MAIL TAX STATEMENTS AS DIRECTED ABOVE
FD -213 (Rev 7/96) GRANT DEED
AK
!
RC DISTRICT PLANNING REVIEW FORM
This form is to be .used by CDD staff for reviewa� f single4amily 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 lista Please attach additional explanations as.necessary,
APPLICANT LEGACY- HOMES - LENCH'`DESIGN
SITE ADDRESS 51=.800 .;Avenida Obregon.
APN 773 1.64. 003,: BINNO.: CASE NO.: 2nnn-271
S7
LEGAL: LOT T BLOCK' d3 — UNIT S.C.@V.L.Q.
CHECKED BY: 'Leslie Mouriqudnd: DATE:
Inform the assigned Building-plan'.'hecker upon your assignment to this; case.. The CDD Executive.
Secretary maintains a log book to trick applications and�assign� case numbers.
REQUIRED ITEM Y., N COMMENT/CORRECTION
r.
Compatibility Review, :k
Case logged and number assigned j
Verify legal.and'APN-information
7.
Consistent with MDG on file (as applicable',*f
�.
MDG filing required (5 filings -since.9/3/98)
t.
Consistency with street/surrounding,area:
Colors-
Material94.
Architecture. t
Other Requirements:
wp