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0101-182 (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' Prgfessionals•Code, and my License is in full force and effect. License # Lic. Class if Exp. Date} /t tu Signature of Contractor F 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 ( ) 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 Setion 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. (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, ad agree that if I should become subj�t to the workers' compensation pro;I Ions) of Section 3700 of the Labor Code, I shall forthwith comply with those prss. VD&: •'k' \-!,\ Applicant—��IIIIII Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to .any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with a� City, and State laws relating to the building construction, and hereby author a representatives of this City to enter upon the above-mentioned property fo in4pection purposes. y `� VSinature (Owner/Agent'. Date .,� r it BUILDING PERMIT PERMIT# DATE VALUATION LOTTRACT JOB SITE ADDRESS '.`F APN fAj % yt 54.4015 AVMDA 0 0.N OWNER CONTRACTOR / DESIGNER / EN NEER C r 't /r'' r11'�►1 1 1G`% r CO3WRa?P0tRXrR,it' HOMEV ..Q'i`3:1i�1°,.�'�. CA 9'225: LA �Di�'1WTJ % 01h 92.253 ' (F60)564-1S5s52 C Lft 6255 USE OF PERMIT D • P%wl MIT DOES NOT .MCLUIDt PIL OC:K''WAL,XO FOOL &SPA. OR Dff2 3IWA,V AP.PR0,&C 14, graMA D,1 PLA`1.:�i c. `i`RAC`i' Cf,M!yR.UC T1014 POPItiHIPno ' k 90.Of SF l X1%-A1ATX,T),CQ;71, (YIP CONSINUMION 92.t987.40 FBI= Ir C:OMMXxCT.ION FtE, IQ] -WO -418-000 •�U:t1p PLAN CHECKFRIP 3)3i_00043.9-4o.".$fir"n.559 r e\!ANICA111 01M, 101-000-421-0m M,fJ9WTR XAJ, rEZ, 1131-000«12U-000 f'i4i. $ / F1,,UMBI<N01 iC • 101.000-x•419.000 9110175 ST.1 HO MOTION =1 N RES 3f5 1 (31,-000-241 -000 $9.39 ® N ORA.Y,'kjNC;i :FOR, 101_000w423_000 :i�;D�•��P%iS'li 9Si1.:(jd�!-4�'�-�31� •�ast�.Ofl i3 t?�-`'{i`1.`.1 C,Go'c�is." t3Li1C`�1� R'� 1':[ •(�1,T f mpm IMS PRE -W303, IrM 'f MAL PYUMIT I'M US LIVE NOW W06 RECEIPT DATE B.�' I / DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings Slab Grade • O �' s Underground Ducts Ducts Return Air Steel Combustion Air Roof Deck �%'�j, p/ �'f Exhaust Fans O.K. to Wrap Framing Insulation �d ,-p ( '��5 - �( �l sT F.A.U. Compressor Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wali Firewall Exterior Lath Drywall - Int. Lath y -.o ! S 7 Final I?•?f BLOC Al 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 _ / e Q7 Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Sewer ConnectionZ - �= D S% Pool Cover Encapsulation Gas Piping Gas Test ? . Zp • m S7 Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit l 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) - _!g P.O. BOX 1504 Awdg �Q C ��,/ 78-495 CALLE TAMPICO ressv ` p� / ►'v� �' �� LA QUINTA, CALIFORNIA 92253 n /I/ - L =- .1 - -,- Mailing r Mailing P� 0 y ` I Address o �, h /14:a Contractor SA :F I F" Zip I Tel. State Lic.�{ City & Classif. 13 (1 1:1 () I Lic. # g tngr.' Designer Desi ner c {/ • , Address Tel. ;ity Zip L State J' 1 ,` ` ��• Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I arp licensed under provisions of Chapter 9 (commencing with Section 7000) of Divisionof t e usiness and Professions Code, and my license is in full force and effect. V �1 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Susiness 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 iwsion 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit jects the applicant to a civil penalty of not more than five hundred dollars (8500). 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.) 111, as owner of the properly, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law doesnot 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 1 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. 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 (S100) valuation 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. Date Owner NOTICE TO APPLICANT: If, alter 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 it work thereunder is suspended for 180 days. Agftkl certify that I have read this application and state that the above information is correct. gree to comply with all city and county ordinances and state laws relating to building Wnstruction, and hereby authorize representatives sof this city to enter the above. entioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip V-2710 APPLICATION ONLY G6� ON I {, C 1, BUILDING: TYPE'CONST. OCC. GRP. A.P. Number 114 � q ( V' `l Legal Description L o Project Description A`14 60 / P>RFe2E Sq. Ft.T / a No. No. Dw. Size T Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ . Demolition, ❑ 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 Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan, Chk. Bal. Co"nst. ( Mech: - Electrical Plumbing S.M.I. Grading r, - Driveway Enc. Infrastructure P TOTAL ti " 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 Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District 47-950 Dune Palms Road ' Notice: 'La Quinta, CA 92253 Document Cannot Be Duplicated' 760-771-8515 ` CERTIFICATE OF COMPLIANCE Date 1/17/01 APN #. 774-241-019 No. 21517 Jurisdiction Owner NameContemporary Homes Permit# No. 54-405 Street Avenida Obregon Log # City La Quinta Zip 92253 Study Area Tract # BLK265U24 Lot # 8 Square Footage 1492 Type of Development Single Family Residence No. of Units 1 Comments 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 or replacement mobilehomes. It has been determined 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 Government Code 53080 in the amount of 2.05 X 1,492 or $ 3,058.60 the property listed above and that building � permits and/or Certificates of Occupancy for this square footage in this proposed project may nowUbe issued Fees Paid By CC - Union Bank of California - Robert Kellogg Telephone 760-564-1962 �f lz Name on the check 34 By Dr. Doris Wilson Superintendent Fee collected /exempted by Annette Barlow Payment Received $3,058.60 ` Check No. 7231795. Signature OTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified bove 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 District(s) or to another public entity authorized to ollect them on the District('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 - A' plicant/Receipt Copy - Accounting . ;:.. . Ci?1 f'gs ft RECORDING REQUESTED BY: CHICAGO TITLE COMPANY COMPANY 99.9036KC 97056898 WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW, MAIL TAX STATEMENTS TO: ROBERT B. KELLOGG and SYLVIA KELLOGG 47785 VIA TRIESTE LA QUINTA, CA 92253 M DOC 22 1999-389073 Recorded •in Official Records County of Riverside Gary L. Orso Assessor, County Clerk 8 Recorder _ III I illlilll I III�II IIII Iilll $ I U II PAGE I SIZE I DA I PCOR I NOCOR I SMF 1 I A I R I S 11 I COPY I LONG I REFUND II� NCHGGj�;!� ._ _.... ........ ....._ _.... _.. _.... _.._........._._ _ _._.... __ __ - ._. _. .. ..V'i GRANT DEED Th undersigned grantor(s) declare(s): Documentary transfer taxis $196.90 (XXX) Computed on full value of property conveyed, or ( ) Computed or. full value less liens. and encumbrances remaining at time of sale. ( ) Unincorporated area: ( ).City of and FOR A VALUABLE CONSIDERATION, receipt .of which is heraby acknowledged, JUDD MARMOR, TRUSTEE OF THE MARMOR REVOCABLE TRUST DATED APRIL 25, 1986 and JUDD MARMOR, A WIDOWER hereby GRANT(S) to ROBERT B. KELLOGG and SYLVIA KELLOGG, husband and wife as joint tenants DBA CONTEMPORARY HOMES the real property in the City of LA QUINTA, County of Riverside, State of California, described as: Lots 6 and 7 in Block 253 and Lots 8 through 14, inclusive in Block 265 of Unit No. 24, Santa Carmelita at Vale La Quinta, as shown by Map on file in Book 19, Pages 44 and 45 of Maps, records of Riversi- Dated August 18, 1999 State of Ca;iforngvp County ofS.S. On before me, BEVERLY WOODS -,a, cr na•� ..�-, .�r �.o o X02 personally known to me (or proved to me on the basis of satisfactory evidence) to be the person (,A whose name) is/-a•?b subscribed to the within instrument and acknowledged to me that(�she/they executed the same in /her/tr authorized capacity(i,e's , and –Chat by 6 . her/their signature(d) on the instrument the person(e), or the entity upon behalf of which the personae') acted, executed the instrument. WITNESS my hand d offici,l e Signature MAIL TAX STA S TO: BEVERLY WOODS m z O mission N 1140759 NoforV Pub@c — Colifornro. y Los Angeles My Cuinty omm. E:wirres J�n 22.2001 - (This area for official notarial seal) RC DISTRICT - PLANNING REVIEW FORM This form is to be used by CDD staff for review of single family 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 list. Please attach additional explanations as necessary. APPLICANT Contemporary Homes SITE.ADDRESS 54-405 Avenida Obregon APN 774 - 241 - 019 BIN NO.: CASENO.: 2000-384 LEGAL: LOT 8 BLOCK 265 UNIT S.C.@V.L.Q. . CHECKED BY: Fred Baker DATE: Inform the assigned Building plan checker upon your assignment to this case. The CDD Executive Secretary maintains a log' book to track applications and assign case numbers.. REQUIRED ITEM Y N COMMENT/CORRECTION Compatibility Review Case logged and number assigned Verify legal and APN information. Consistent with MDG on file (as.applicable PPROVEn By COM UNITY DEVELOPMENT DEPT MDG filing required (5 filings since 9/3/98) Al E ®`'/ Consistency with street/surrounding area: _. Colors Materials Architecture - - Other Requirements: 11 WCertificate of Occupancy City of La. Quinta 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 following: BUILDING ADDRESS: 54-405 AVENIDA OBREGON .Use Classification: SFD Bldg._ Permit No.: 0101-182 Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC Owner of Building:- CONTEMPORARY HOMES Address: 51-370 AVENIDA BERMUDAS Building Official City: LA QUINTA, ` CA 92253 By: STEVE TRAXEL Date: 08-21-01 POST IN A CONSPICUOUS PLACE