Loading...
0012-141 (SFD)LICENSED CONTRACTOR. DECLARATION I hereby affirm under penalty of perjury that f 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 . ' 42538}. Date h %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 thestructure 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). O 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, fo . the performance of the work for which this permit is issued. My workers' comp nsation insurance carrier & policy no -are: Carrier Policy No. STATE FUND 1�Df��9P DO (This section need not be completed if t permit.4aluatiorris for $100.00 or less). ( ) I certify that in the performance of a 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' cornpensatioh provisions of'Section'3700 of the Labor Code, I shall forthwith comply with those provisions. Dater = -CApplicant 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 application agrees to, & shall, indemnify & hold harmless the City of La Ouinta„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) A Date BUILDING PERMIT PERMIT# DATE / VALUATION LOT 49012-1.41 TRACT W,.' MAG 9 JOB SITE , _. I - ' APN ADDRESS ..,/� 0 AVE4) WA '0DR1?:f.y0,Tq ` 774-242-W? OWNER CONTRACTOR / DESIGNER / ENGINEER PACIFIC4, 110009 � s OCTWIMCIEF. C11h 92054 8 C9CWI1�"�� E CM 92054 Q60)967-0069 CB1,4 1955 USE OF PERMIT Slr39 „ PERMIT, =PSNOT INC1,LJfl e DICK. W1#I,11}''O01JSP OR DRIVT+:WAY'.dif"i'1< OACH � y cill TRACT COiY�F0`1RUCTION 1,:-10.00 9p ' S OR -CE PATIO X40 9F 0A,R.A.e:3RMARSIORT (MF.) 10,OdM20 5 IrT. WWI D PT!INCIlz; 3t10.s3D .v lg r :A,SMt1'X:MD C7£�N'"i' 6. F OO�.tV'f`� 4a'OC.`�l�+C O :93r'si� PEW. rr 6'1 % OWMARY 3 . . WNSTRUC'-T101•F RE 101-000.4118-000 $612,50 pl,,AN C:HW 91i ks 101-000-09-218 $505.69 M EC HAN]CA1. -421-M S40.0 ty,1,Z" 2IC;AL.FEIt. Ioi-O'00�,120-000 $111:24 P1,iii1t4BUT10 FEE; :1>31.04JC9.4,1ax.C10C3 S110115 STkOlsdrl�,9iJ`f%:3'31�51.q'f�,Sdta 1.�yg.�+I20�?A1•Oi�J *9.:35 ,, GRADING FEE 520,00 ;Y . JDtV'FJ,,0PER IMPACT .IW PTtFC1 , FLAW 101.000.441.315 .. ffiIM0 101•.000-4301338 42150,00 Y SUB-TOTALCONST'ter 14,tl►tM YLAN CIMCK z a PRF_,PtJPFM-!3 4250,00 RECEIPT DATE BY r ` ti •-�. DATE FINALED INSPECTOR I �" -�� '�/� • �`f �J J Ver - INSPECTION RECORD OPERATION DATE I INSPECTOR OPERATION DATE I INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Slab Grade p �'� Ducts Return Air Steel Combustion Air Roof Deck 3 - -ol Exhaust Fans O.K. to Wrap , pt -C F.A.U. Framing t Compressor Insulation — lam_ o Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath -,Li 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 I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Water Piping 3 Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection - -p - Encapsulation Gas Piping Gas Test p Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole _ p L Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final 5.� Utility Notice (Perm) COMMENTS: Building r // Address `� i- ti-Sli, S,� V ITu r ,. P.O. BOX 1504 APPLICATION ONLY 78-495 CALLE TAMPICO C bml {p QA QUINTA, CALIFORNIA 92253 P Address t CityZip Tel. li _ A... t Address ty lZip State Lic.I City & Classif.�y��� 3 f Lic. #,�{ Desigy. ner , Address Tel. City \ (Zip (State I Lic. # LICENSED CONTRACTOR'S DEIJLARATION irm at I m licrrsed.under provisions of'C1 ter 9 (cb mencing with Section ion of th Busitess and Professions Code, and my lic rise is in full force and OWNER -BUILDER DECLARATION I hereby affirm that I aft exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Susine s 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 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). (_1 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.) II 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.) I1 I am exempt under Sec. B. 8 P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION Ihereby 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 r7 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 11 the permit is for one hundred dollars ($100) 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, 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 a0plicant Date Mailing Address City, State, Zip LDING: TYPE'CONST. OCC. GRP. ` . Number "Mr- -) 7 q \ C wItI —oo—) al Description ject Description - t 1 u >i C'C 5 t2 Sq. Ft. (�C) No. No. Dw. Size Stories Units New O Add O Alter ❑ Repair O Demolition O DEC 0 Estfmateo valuation I PERMIT I I AMOUNT / 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 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 12/18/00 No. 21361 Owner NamePacific Trades Construction . No. 54-410 - Street Avenida Obregon APN # 774-242-007 Jurisdiction La Quinta Permit # 0012-141 Log # City La quinta Zip 92253 Study Area Tract # Lot # 9 Square Footage 1500 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 1,500 or $ 3,075.00 the property listed above and that building 6,11 permits and/or Certificates of Occupancy for this square footage in this proposed project may ndik be�issueds , - Fees Paid B CC / Capital Bank of North Count �- y p Y Telephone r-,/60-967•-0069 r s. Name on the checkfi¢", • ;' By Dr. Doris Wilson Superintendent -r� _. Fee. collected /exempted by Annette Barlow Payment Received $3,075.00 664r_�_o Check No. 079522 Signature 40TICE: 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 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 District(s) or to another public entity authorized to bllect 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 - Applicant/Receipt Copy - Accounting Dec -04-2000 02:470" From -COMMONWEALTH LAND TITLE +7603413215 T-239 P.001/001 F-277 RECORDING REQUESTS 33Y S �- L( ORANGE COAST TITLE COMPACOMPANY . 10525KC r-192387-1 6 V V �lp . B, IUM RECORDED MAIL THIS DX= AND, I e MMFSS OTURRWIS! $$OWN BELOW, . MAIL TAX STATEMENTS TO: DAVID ROSS MILLER 1719.SOUTH TREMONT S OCEANSIDE, CA 92054 LSTRT9 7.TMP PAD DCe+nonvfl, ..n.' GRANT DEED "N; 774-242-007 The undersigned grantor(s) declare(s): Documenrary transfer tax is 520.90 (XXX) Computed on'full value of property conveyed, or (. ) Computed on full value less liens and encumbrances remaining ar- time of sale. ( ) Unincorporated area:.( ) City of , and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, WILL M. CARGILE and JUNETTA CARGILE, hereby GRANT(S) Lo DAVID ROSS MILDER, A MARRIED MAN AS HIS SOLE AND SEPARATE PROPERTY the real property in the City of LA QUINTA, County of Riverside, Slate of California,. described as: Lor. 9, Block 266, Unit No. 24„ Tract Santa Carmelita-at Vale La Quinta, as per map recorded in Book 19, Page(S) 44-45 inclusive of maps, in the office of the County Recorder of said County. Dated November 14, 2000 Srate of California !4 Cour.zY of j S . S . WILL M. CAROM.)✓ ;! On before me;' personally appeared JUNETTA CARGILE personally known to me (or proved to me on ,l cne basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to zi a within instrument and acknowledged to me that he/she/they executed the same in i his/ner/their authorized capacity(ies), and that by his/her/their signatures) on the instrument the person(s), or the entity upon behalf of whxch the person(s) acted, executed`;jl; rhe instrument. ''tip WITNESS my hand and official seal. Signature (This area for official notarial seal) !; MAIL TX STATE&W=5 T0: 41. f! i v Certificate of Occupancy City of La Quinta Building and Safety Department OFTMt° 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: k BUILDING ADDRESS: 54-41.0 AVENIDA OBREGON Use Classification: SFD Bldg. Permit No.: 0012-141 Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC Owner of Building: PACIFIC TRADES CONSTRUCTION Address: 1719 S. TREMONT City:. S. OCEANSIDE, CA 92054 By: STEVE TRAXEL Date: 05-09-01 Building Official POST IN A CONSPICUOUS PLACE