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0104-285 (SFD)'+ LICENSED CONTRACTOR DECLARATION +" I h@re6y 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 768922 �Dafe 41 Signature of Contractor ✓ g- , OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt 1rom 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. ( 1 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 Policy No. d'rATZ FUND 15% 886-01 (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. s Date:, ''' AV Applicant," ✓ Warning: Failure to secure Wbrkers'•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..) 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 {J :i' .• T' r. Al .: �.r7 a1 1. BUILDINGPERMIT j PERMIT# i I, ti rye DATE VALUATION r LOT TRACT }� ' �i1.A€i•�'.Ittt^:I© P �"1�'�L� .i.�S 'IT,i t,,. JOB SITE ADDRESS TPNf xi 1L-905 AX.k Pta 013R14. 0trl 77.,4•4&�619 OWNER CONTRACTOR / DESIGNER / EN (NEER CABIV71bs1 BY F I:ISION WORKS I;two 81 .10 1 IN.D.10 BLVD. SIXTB DI 8 81101. I ,10 BLVD. WJ1'17.171 S IT D10 CA 92201 WD10 CA 92201 (760)342 113;3 M'I fil " Y:fg7 . USE OF PERMIT 3F D - PERMIT DONSS IMO T MIC1,UOY, 81,OCK. WALI.,B.F%00I.ISPA. OR APPROACH DPJVFWAY. f CUSTOM CON111TRUC"TICN 070.0 31? ... '; I"GbfCT*i6.A.I'IC9 M QO Sid a1¢1.d ,.CII?1�:04S3.I"Kjtt'I pq ("OW OV, C'ON1�'�'.I�U ,'%1014 E. I I:I3B�3iP�e�Qi ..'y • yg� 7,Q,,1�'7� 'j �I,S'I':)MWYI~,fl� .Y. e,7[9.1EE ' N• S1 9� 6i(.fA7PNAAR - r' C1DNSTRUCT1014 FE: 10) -000-416-000 4 f� PLAV CHECK b7% 0-1 -000-419-319 FEE DET103ff 101-000-439-318 ����,� • F1. IE+IE..CH A,:N ICAI> IiI7 101-00f"21 _000 6Q. Ufl ZLECTRICAL F 99 101 -WO -420 -OW $106,65 , M.F7;, 511.40 PEE 10 -000-419-'000 1113.25 STRe iNO MOTION T)%9 • KESID 1101-000-241-000 $111.34 0Rf%17JKf' G FEE 101-000-423••000 $20.00 ' [ D.WELOPER IM> A(. r FEE P1tF;CsEZP".10 101-000-4 i 3Q�i �IOO.t10 t •a A • _ r r ]• E�UC11014 AKD PLAN 4..'Hi?.C% 33,599.4-1 t n W LESS PRL; -'A1.1 TWO 4250.00 - D t.. I 1 ><':_�' P7—ES DICIEr HOW FfiNW,4 7 APR 2 5 2001 ' t CITY OF LA OUINTA ECEIPT Y DATE FINALED INSPECTOR , "=^'� •--•'� INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE j INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts { Forms Footings D_� � Ducts s Slab Grade _ _¢ f! % Return Air [ Steel Combustion Air Roof Deck _ ..�. 8( s Exhaust Fans [ O.K. to Wrap F.A.U. [ Framing "1•-3•d S T Compressor [ Insulation Fireplace P.L. Vents l Grills [ Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines { Party Wall Firewall I Exterior Lath Drywall - Int. Lath [ ' l _ Final /Q/244 ST' BLOCKWALL APPROVALS Final { POOLS - SPAS steel i Set Backs Electric Bond [ Footings Main Drain Bond Beam Approval to Cover Equipment Location { Underground Electric { r Underground Pibg. Test [ Final - ' Gas Piping 1 PLUMBING APPROVALS Gas Test [ Electric Final [ Waste Lines Water Piping _ _ �7 %3lGl Heater Final { Plumbing Final [ Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster t Sewer Lateral Pool Cover Sewer Connection �, ?>. d S7 Encapsulation l Gas Piping { Gas Test Appliances [ Final 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 Utility Notice (Perm) 7 COMMENTS: Building Address Owner maning Address g�-- Tw�t " 7 P.O. BOX 1504 Wow7UINT CALLE CALIFORNIATAMPIO LA QUINTA, ORNIA 92253 City , Zip ITel. Contractor State Lic., Q City & Classif.`7/' Arch., Engr., . AAnnCC Designer A AA,-_ .Tot City/ r� CA / Zip State 11��1..///) Lia. if f 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, after, 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 oner 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.) 1'1 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(s) licensed pursuant to the Contractor's License Law.) 17 I am exempt under Sec. B. & 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 (8100) valuation or less.) I certify that in the performance of ing 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, 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 Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is is (ec. 3Q9�Civil Code.) Lender's Name _ _� 94 3P 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 aQplicant Date - Mailing Address City, State, Zip APPLICATION ONLY BUILDING: TYPE'CONST. OCC. GRP. A.P. Number :7 ::1 ?�, t 63 © Iq' Legal Description L�oT (� b20 4�, I '% Project Description 77 Sq. Ft. --1 No. No. Dw. Size 13 I Stories Units NewcB—' Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT ' Plan Chk. Dep. 60 Plan Chk. Bal. lr Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS 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 ��A! A A N Validated by: MAP /11 1 cuul Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands. Unified SchooLDistrict . 47' 950: Dune; PalmsRoad Notice: F ' L",inta,YCA 92253. . . Document Cannot Be'Duplicafed 760 771-8515- -_ CERTIFICATE OF. COMPLIANCE Date 4/25/01 APN #:' 773-163-019 No. 21942 Jurisdiction La�Quiinta t O"er-NameKathryn Letellier Permit# No. 51-905 t ,'. A 4reet Avetuda:Obregon Log # City La,Quinta zip 92253 `4. ~Study Area Tract # BLK 35 U2 .Lof # 7 Square Footage 1,370 Type of Development Single' -Family' -Residence;' T No. of Units 1 Comments *Received''a cashier's ­check in th'e<amount of$6,027 00. ?r: At .the' present time; ;the Desert Sands Unified School Distract 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 ekempt�fiom paying school fees at this time due to the following:reason: EXEMPTION NOTAPPLICABLE.. This certifies'that school facility fees -imposed pursuant to Government'Code 53080 in the amount of 2.05 X 1,370 or $..2,808.50. the property 1l%f d above and that building permits and/or Certificates"of Occupancy for this "square footage in,thisproposed project now be issued Fees Paid By CC/ 1 st Bank - Dan Dryden Telephone 760 831` 1098 . Name on 1he check By Dr. Doris. Wilson:,, Superintendent Y _ Fee collected /exempted by Paula Ruiz Payment Received $2,808.50 Check No.: 58658 Signature ' NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996).this will serve to notify you that the 90-0ay approval penod m 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 bistrict(s) or to another public entity authorized to collect them on the Distriot(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 . a Copy -,Accounting RC DISTRICT- PLANNING-RtVIEWTORM This form is.to.be used -,by CDD.':staff for review -ofsingle family dWellin'ks,,in the RC (Cove Residential) Distric-t, in order to determine the applicability of compatibility issues ';o'r,need 'to require the filing of Master Design Guidelines I � by the applicant:' It shall be transmitted4o' the Building and'Safety Department as your I correction list., Please attach additional explanations as necessary. APPLICANT Dan Dryden SITE ADDRESS' -Lot 7 APN 7 7 3 163 014. BIN NO.: CASE NO.: 2001-419 7., LEGAL: LOT BLOCK UNIT S.C.@V.L.Q. CHECKED BY- Fred Baker DATE: Inform the- assigned Building plan checker`' -upon your assignment to'Ahis case. The CDD Executive Secretary maintaihs.a" log book to track applications and assign numbers. ?pp ns - .0 gricase REQUIRED ,ITEM Y'­ .,N­ ' -COMMtNT/CORRECTION Compatibility.Revi*ew Case logged. and numberassignedPMENTZEPT.. ffj) 'By tomm-UNITY DVELO Verify legal -and APN:ifif6'r'mation 7r Consistent with MDG on file (as.applicable MDG filing required (5 -filings since 9/3/ Consistency with street/surr6unding• area; .Colors Materials Architecture,: Other Requirements: '1�Yt�t•,.7�S'j`' tea, .,_ gra * `. '� ♦ rY' ;.�1 i.`•.. ti r w +C . aru„f,St7t'ti�.�a x,..•374 t a'�^' y .. a y a7 G .� � •t-� � `fr�V ..�z ! _- .� '•SIL k .. �1 i •.. ir.- . . l {�egi�osted y* Doc--" s®®s=®tee®aa .; BrtY etI>te/RNP N NR ►NIN.N "" ( ���(,.111 I1t11: r�111U f Palo I of 1 Dole T tax Paid RECORD INu IV:Oihd W e71 ! R'eeer3iN in offieiel Newde Ceunly N R/veraisie .. Ore* ` k Reaseser, cewty Clerk 1 R*eerder WHIN RECORDID NAIL T01 t I H Z+r;4 KATHRYN LETiLLIER ►;� 39339 Newcastle Drive M u """ "' = "v ` 1� I palm Desert CA 92211' _ NPAC 2 0 -Oa i d Silo—,- e * oo.. gar. �.wo Mcw uw ; p The undersigned Grantors) declare(•j1 Documentary transter tax Ls $ 25.30 """ flr A6OsrseoRrs PARCEL No. 77.1�1f3=019;s► •comlputcd on full value of property conveyed,}os �[?ITEC ORDER NO.t 2182706 ( ),.Computed on the full value less liana or GCROW No.1 210003RN encumbrances remaining et.the time of sale t 1 -!'OR A VALUABLI CONSTDIRATfoll, receipt of which is hereby acknowledgod# L/)1 r j ( JAK911 I.VLLMZAUx and JUNE MUI.t.l11NAVI,«;,husband God' Mlto y - 44 hers;by GRANT(G) to RATNRIN, LNTiiJ.IiR, AND PIERPE LEI hLLILk, Tkl'8Trr...4� f)1' THV .LT1r1,LTRR rAMILY TROST nATEn APRI1. 11, •2000 The• following- read property in the La Quanta, Riverside County, .Stati`ot* cali;forrt>tlile, t y' do ad malt Lot 7• 'in iilgrok 3S,,.oi "ala Carmelite .at'VaI L pu>inle, ;tIALt 'j2 a3K . p'ma� . *:..%x eoorded - La sooll 11; hgea -08• a' ad 86' of Nape;:. lleoAsl�e of Rigar3l�de ot�x ` _ Datec January S, 2001 COUNTY Or , ) NULLINRAU'l on N, 2 , 2001' fore -me, th« doreiq edt • •' I,-�" Personal Y PPeared personally known to ae (or proved to me on the basic __�_ 4: . ay"'= Of satisfactoryevidence to be the ` name(a) is/are subscribed to the withinsinstrumente =1 �.. •�- ` Y ' x and acknowledged to me that he/sho/they executed the , , l same in hie/her/their authorised cap%city(Les), and by his/her/their signatures) on the instrument the person(e) or the entity upon behalf of which the c —•— 3�IiK1Al SEAL person(s) acted, executed the instrument. RHEBA WEST COMM / 1123410 C) NO{a>ry PWIC C4100MIA 1 r t Witness my �atS/ f ti, Lal • 1. C7 RIVERSIDE COUNTY ,� 8ignatur* fEBRU^Rv 24, 2001 r .�2 ILI- p (This area for:official notarial goal) `�, } , ' MAI1: TAX ATATOUDITN 'POI 39519 Marcastie DiLve, Pala nesest CA 92211 MIR ' � i ' _�•� �, tiff Certificate of Occupancy City.of La,* Quin. ta � g Building and Safety' Department This Certificate issued pursuant to the requirements of Section 109 of the Uniform'Building Code, .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 fol%wing: BUILDING ADDRESS: 51-905 AVENIDA O.BREGON Use ,Classification: ' ,SFD Bldg. Permit No:.: 0104-285 Occupancy Group:. R 3 Type of Construction: VN Land Use Zone: RC Owner of Building: CABINETS BY PRECISION WORKS Address: 81-101 INDIO BLVD. #D 18 City: INDIO, CA 92201 Building Official By: STEVE TRAM Date: 10-24-01 POST IN A CONSPICUOUS PLACE