0007-070 (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
5137.333 [� Ai3 f�I 08!31/2(
D
to�5lgnature 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). 4
() I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirmunder 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 STATE FUIND Policy No. 1103231.99
(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
Cv'de I� hall forthwith complywi!fj o�se provisions.
Date: f 7 t Applicant --- ---�__ _
�f 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
�t/heDove-mentioned property for inspection urposes.
ature (Owner/Agent) �_ Date i '1
~�rU BUILDING PERMIT PERMIT#
DATE VALUATION LOT 0007-070 TRACT '
JOB SITE
APN
ADDRESS &.3-490 A NLT%A (D13ECJN
s .r
.OWNER
CONTRACTOR/DESIGNER/EN (NEER
A6womil,, INC.
1' Umul,,1wt^.
74-"0 JONI DRNI� U11M 2-I?
74-990 JOM DRIVB, MIT 2-D
PAW DESERT CA 92260
PALM DESERT CA 92260
(760)340.2726 CBIA 2526
USE OF PERMIT
SWGL E X'At C LY DW1n _WG
SFD• PERMIT DOES 140T LAICLUDE BLOCK WALLS OR POOL,.
TRACT CONSTRUCTION 1,543,00 SF
PORCK(PATIO 169.00 SF
0ARAQEICARPOAT (SF) . 9,427.60
5 FT. WOOD FENCE 200.00 L.L'
E91WA'M COST OF CONST RUMI TOLN
Pk'UW '.l: EE BOlbw"IRY
C014STRILICTION FKZE 101-000.418.000 $630,50
PLAN CHECK FEE 101-000-439-318 $321.45
MECHANICAL FEE 101.000.421.000 $53.50
a
EL ,.CTRICAL FEE 101-000-4.20-000 $112.30
PLUMBING FFS, 101.000.419.000 S10175
STIRONQ MOTION FEE - RESID 101-000-241.000 $9.74
(IRADINO FEE 101-000.423.000 $20,00
DEVELOPER IMPACT FEE: 1:1,909.00
PRECISE PLAN 101.000.441.343 3100.00
FE DEPOSIT 101-000.439-318
SIM -TOTAL CONFMUC HOM t 144 PLAN CHWIC
$3,171.24
Lm PRE-FAiD nwS
4250,00
JUL 2 7 2000
LAITY 0,F &QUINT,./
RECEIPT
DATEBir
y
DATE FINALED
INSPECTOR
r
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
_
$
4y
Ducts
Slab Grade
_
Return Air
Steel
Combustion Air
Roof Deck
O� pa
Ste%
Exhaust Fans
O.K to Wrap
pi( 5.-.0p
F.A.U.
Framing
'57
Compressor
Insulation
�� �_ ��m
-
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
!d. '(pD
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
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
m�
5z
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer Connection
�/ _ dp
Pool Cover
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Oa
$c7
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
'
Main Service
-
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
/' O/
57
Utility Notice (Perm)
Z - 1S 'C0
S7
,01n
60
Building S' 2 _ A.,9 o 0 ,QF.7,n,
Address J J T`�
Owner
I \,M
Mailing
Address Q Q ! of
4 4Q"
f7P.O. BOX 1504
6-495 CALLE TAMPICO
rS1LA QUINTA, CALIFORNIA 92253
fC1fly7 � I ZIR Tel.
Address
ty\QN �_,
ip
State Lic. 2 City
& Classif. 13 S32 33 3 Lic. q
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State I
Lic. N
LICENSED CONTRACTOR'S DECLARATION
I hereb affLUJAat I am tita�Ied under provisions of Chapter 9 (commyci ng �th Section
7000)for tv;;fon7o'f theBusfand Professions Code, and my licen�ss,in�force and
effect. �rl�/
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, 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 the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 or 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 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.)
1'1 I, asowner 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 contractors) licensed pursuant to the Contractor's License Law.)
I'] 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
(7 Copy is filed with the city. O 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 (E100) valuation
or less.)
I certify that 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: 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
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
ame -
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it 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.
. may r•": �.Y7R�.W�epCY�,.'.ri./'li`y),%G•c' : e!?yi,)�'f^"k' 1
JC4 .N�
APPLIC T O LY S
BUILDING: TYPE'CONST. _ OCC. GRP.
A.P. Number J � L4
Legal Description Lerr 2- � ` I Q p I
Description
V` C LA r—POM � � to � {_<Q t',
Sq. Ft.I No. No. Dw. '
Size o Stories 111 Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
1
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
—Rea r 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:
Signature of adplicant Date
"Mailing Address Validation:
City, State, Zip
s WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Desert'Sands Unified School Dist eictL
47 950.DunePalms_Road.
Notice: La Quinta; CA92253
Document Cannot Be Duplicated 760'1.11'8515
CERTIFICATE' OF COMPLIANCE
Date 7/27/00 APN # 774-075-012
m.
No. 20782 Jurisdictions la Qutnta..
Owner NameMuriibil, Inc.; Per 0007-070
No, 53-490 Street >' Avend'a Obregon Log #'
City La Qtiinta'.. Zips 9.2253 Study Area
Tract,#. Lot'# Square Footage _
Type of Development Single Fari ily.Residence No...of Units 1
Comments
*.
Y '
At the present time, -.the DesertSands Unified School District does not collect fees 'on, garages/carports, covered
_,
patios/walkways, residential additions-under:500 square,.feet,'detached' accessory structures or replaceineiimobilehomes. It
has been determined the -above-named owner is exemptfrom=paying schoolfeesat this time due to,the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility =fees imposed_pursuant to,. Governs ent Ctode 53.080 in the amount of
2:05 X ..1,548 or;$ 3,173.40, ,; .the property listed -above. and 64 Wing-
_ . , .. .. • . ' ..'.
permits and/or Certificates of -Occupancy for•thts7square footage idthis proposed project tri'a w be'7ssued
Fees Paid By CCNalley Independent Bank/Bill Howard . e�ephone;760 X40-2726
Name on the check
k t
By Dros Wilson sir
Superintendent
Fee collected /exempted_ by Annette Barlow Payment Received -$3;173.40
Check No. .225227 '
Signature
OT10E: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) this will serve to'notify you that the 90 -day approval•period in which you may protest•Uie fees or other payment identified
bove will begin to run from the date on which the. building or installation. pennd forthis project issssued or on. which they are paid to the-District(s),or to another public entity authorized to
ollect them on the Distdct('s)(s') behalf; whichever is earlier z l t'
Collector: Attach atopy of countyor city plan check application form to, district copylor alliwaivers.
Embossed Original- Building Dept./Applicant• Copy= Apphcant/Receipt ; "Copy -Accounting+
FIDELITY NATIONAL TITLE INSURANCE COMPANY
RECORDING REQUESTED`BY:
Fidelity National Title Company
Escrow No. 41501 -CB
Title Order No. 00538686
When Recorded Mail Document
and Tax Statement To:
Mr. William R. Howard
P.O. Box 10758
Palm Desert, CA 92255
3 �6 C>?
DOC a 2®®®-18®254
05%1272000 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 Recorder
t
PAGE SIZE DA
NOCOR I SMF I MISC.
LONG I REFUND : NCHG I EXAM
APN_: 774-0%6-T_12_-9_% } arAt.E AoUvt I r11J LINE
T(zA 020016 : GRANT DEED
&���
The undersigned
grantor(s)—clare(s)'
Documentary transfer:; tax is S16.40
( X ) computed: on -full value of property: conveyed, or..
I ) compyted, on .full value less value'of liens or encumbrances remaining at time of sale,
[ ) Unincorporated Area City of La.Quinta
w 1�
S USE
AS
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Gregory Howard Norquist, A Single
Man
hereby GRANT(S) to Mumbil, Inc., a California Corporation
the following described real property-in'the City' of'La'Quinta
County of. Riverside, State of'California:
Lot 12, Block 187, of Santa :Carmelita at Vale La Quinta, Unit #18., as per map recorded in Book 19, Pages 30 - 31
of Maps, in the Office of the County Recorder of, said -County.`
DATED: April 13, 2000
STATE OF CALIFORNIA
COUNTY OF
N -Y -/ before me, .
rtJE-:spersonally appeared
personally known to me ((or proved to me on the basis
of satisfactory evidence) to be ,the personof whose
nameK,gara subscribed to the. within instrument and
acknowledged to me that e_P#keA4@y executed the
same irQPher•/ 4&k authonzed capacitykv's1, and that
by �ir signature�si on "the instrument the
persons , or the entity upon behalf of_. ".which the
person (X acted, executed the instrument.
MAIL TAX STATEMENTS AS DIRECTED ABOVE.
GRANT DEED
Witness my d yandafficial seal
Signature
FD -213 (Rev 7/96)
Gregory Howard �Norquist
DANNY HAYNES
commonm�1z�1wNotary:Pubnc—C�ttornloCrrangeCo�1yJ�Q� My Camm;Exy�si+Aor.31,�1
RC"DISTRIC.T PL; ANNINGR
EVIEW FO
This form is -to, be use&by CDD stafffor review, of single�family_dwellings n the RC (Cove Residential)
District; in order to -determine tfie applicability,of compatibility issues or need -to require the filing of Master
Design Guidelines by the applicant It shall be transmittedto theyB'iiildng andSafety Department as your
correction list. Please attach additional explanations as. -necessary.,
APPLICANT riur?BZL.
SITE ADDRESS 53-4'30 .,`Obregon
APN 774- 075 - 012:.�ry BIN NO.:
CA'SENO.: .2000'-251
LEGAL: LOT 1, 2 BLOCK i. R �6 UNIT
CHECKED BY: Stan 'Sawa DATE:
Inform the assigned Building plan checker'^upori: your assignment to; this case. The CDD' Executive
Secretary maintains a log book toArack applirc`ations°,and assign case numbers,
REQUIRED;ITEM Y, N : "COMMENTYCORRECTION
Compatibility Review+
Case logged'and number assigned,,:-,,
Verify legal and AP information
Consistent with MDG on file'(as applicable_ �.:
MD.G filing required (5 filings smce.0, /98)
H.
Consistency<;wi.ih street/surrounding area:
Colors
Material's-' ;. ...
Architecture.
Other Requirements:.. Lam'
^ ^ .. ...., -t.�;. rev... �.n: �d •� .. � _
-. - --R�'�District.-Review�Check/ist <
s ,
-This<checklistJs to be used .for review of single family••dwellings in the RC (Cove Residential)
District. It'include's,..all .-requirements of the'RC: District and'' most buiIding-related City Code.
.. .. ., .�.
r
and "plan check req,uir�ements 1t also incl udes`other;appllcable z -"on ng code sections which
also'apply:in the,RC district.
APPLICANT:"
CONSTRUCTION,,
ADDRESS:
CHECKED BY: :PLANNER:
BIN" NUMBER: PLAN CHECK DATE" 3
IRE TEM:eA..,
r,COMMENT/CORRECTION
............................. ... .:• w:::. : nx .:..w: ::::: w:::::::. � w::: v: w. �:::::::::::::::•?"^is4ii'•i:{{C};{.};":.♦.'{'{{4ti:{{{: ♦;pv,.\;♦ •: x:4NO''{.`:: {..\\"': C^:ti `:v� '{: �♦• ` � \ � � � � ` "`�\\
:i tii:{•i:•u•i�..^��♦;�..:$i:.{{{y�.${r:{i{.:{v.{•ri4.i�::::{{;4{iiTiir ti'�'r:�n•i:" 4.♦!\ti0. \ `�•.♦�`; ��v
:: Li'.fx: • {•iii::+}:•'{••}'l,•,:.y;i{ :4:;: �:::.: v. }.:$'?{:•.:.v♦;'...:.::. {...\:.u; .,, rr'n,\♦.yy.�.`;®:..:\ ♦ .,
grog -m
Permit application,fotm-and'fee
Plan check deposit fee:;paid'
Proof,. of -title (Grant.Deedi or consent
APN. & Legal description'
Two;cornpletd'plari sets including:
�.
Site plan
Floor plan .
Landscape/fencin ., Ian`
Elevations
'Exterior color/materia[samples
Grading/drainage-,plain
,
ev, :.
Contractor's License provided?
'
Subcontractor's list .provided?:
Workman's Compensation Certificate?
City Business License provided?
CVWD connection -receipt?
School fee, receipt? .'
ITEM; v
N=
+REQUIRED ,.. { ,�:,ri ,
�Y= ,::'
�COMMENT/CORRECTION
;........,...::�w ,,.: ,.....,.........:....:.::
Gross livable area i 1,200 s:f. '-
'-
Bedrooms net -10'z 10 clear mirnmum':
Provide�required # of bathrooms
Garage net 20' x 20' clear minimum, with 4'
add.'I P fore ui men%areas
q t.
,
with:r'equ ed setbacks..for.
:Complies
Front (201
Rear (101
tin
'3.
Side 1'5'' in '0 side) '
y
Garage door, 25.)
,_Iswmg-up
Y <
Garage' (roll -up. door, X20')
Mechanical;egwpment;
ClayAor concrete tale -roof
Cement plaster extenor walls y -
Roof-'mounted.mecharncal,screernng�
Propane tanks screened by-fencehivall?
`Structure height <_ 117'
Fencing type,5location,.etc., per,manual
r
Irco-mbined retairnng/garden, wall height
{'
_'- ;3
_..... ,;,
A ,
'.:..._
.............................. rr::::. ::. �:::::. �::::: :..� -.::: �:::: •:v::.v•:
...... :.:'::. .. r...
i{i?.•}\•i}r'iw.4.•::::::::::::::::: .v: •.v\»}:}}}}
i j$r •:
3.::is�i!•{7i:ji..�i.?-Si:7'' 7w�'lrii:7:•::}::�:t:.:>...:::•:.
:f!1I
m.v:•:{•}}}}}:•}}}}..:}::}'•};.
� :4
CC.\Z:':'{,i`•h;v�'.yv
•.v}} 'y: :};:: x: ;r :- va} . • �... .v vv s•. »
v:n \ v'R �{.}•\\kta\' 'r':\+:<. .
%
.•}:.:.:} ::'}'
}�e.•:.`.'\:...................:.`.aaj::±:......o....... •..+:h.i.. .. •.::...w.....
-------- III
Complies wKs:
ith tendscape Manual requiremer.,
h
r
3.: trees.@ 1'/i caliper tkierior.lots);
5 trees : @ 1 '/_, caliper (corner., loots)
,.
Illuminated address numberin
ag.
E ctenorllightirig;complies with Outdoor Light
Control, Ordinance''
'
Complies with Section 9 50;.060, Architectural Prajacb ns
Chimney stack, vents, etc .don't•;�exceed
T -above .max. heigFit
#:::.
�.
' 4