9912-0147 (SFD)54470 Avenida Alvarado
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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
6349.51 8 --^_ ) J1/204,Date ' .)Signature of Contracto C - : t ).
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.
( ) 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:
CarrierPolicy No.
GOLDEN ,EAGLE 1`41i. N144 Can 60
(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-Section3700 of the Labor
Code, hs ,all forthwith comply tyiih those,,pr"o iisio4j L4 -,
Date.
i J
Warning: Failure to secure Workers' Comp"ensation 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
the above mentioned property -for inspection purposes.
( r%
Signatures(Owner/Age-`- ' -'' ` '--- Date "'--?
L)
/hi') vs' BUILDING
DATE•
PERMIT PERMIT# •
9912-147
VALUATION $'92,926,20 LOT 13 TRACT JLt 5'1J24
ADDRESS \ 7!) AVENIDA E LVAR. .
APN 174441-0111
•
'OWNER'"
ROBERT & SY VIA .:410G
. 47-785 VIA RIESt°E
LA QUIN t'A CA 92253
CONTRACTOR / DESIGNER / ENGINEER
CORONELCOAa.7FC11.OaN .
51-540 EISEN1.1OWER,DR.
LA. (A/11\11'A . CA 92253
(760)564-4604 CF3L4 2262
USE OF PERMIT •
SIN.LE FAMILY DWELLING
rD-P.ERMiT DOES NOT INCLUDE, E, BLO K WALLS OR POOL
TRACT CONSTRUCTION 1,465.00 SF
PORCH/PATIO 203.00 SF '
Lt RAOE CARPORT 458,00 SF
5 FT. WOOD FENCE '2200.00 LF
ESTIMATED COW OF CONSTRUCTION
.9 2,,'- .26..`2'i
i.°,1,'.Rk':lT FEE SUMMARY
CONSTRUCTION FEE 101-000-418-000 $608,100
P!. AN 0.1.f_'CK FIT 101-000-439-31g $511,39
,.1TiCliANWAL, FEE 101.000-421-000 .60.00
7 .F,C,TRICAL Fa jut -000-420-000 $1.2Y.94
PLUMBING FEE 101-000-419.000 $1.16.75
1`!'R ONO MOTTON :FEE - RES 11 t 0 J -0(16)-241-000 $9.29
,
GRADING FM `,, 101-000-423-000 s e 00
D v'V-1.I.g1.PE(. IMPACT FEE $1,+Jt)7.00
._ --
PRECISE PLAN 101-0000-4441-345 , $100.00
,,,; • ,
FE'S f)r7PoSt•r p 01-000-449-31 8 -$250,00
,.
'
F 'Si"2
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t 3 1 ` '
.1 t; '11
;:jitvrOTAL CQNST1}UC.TION ANC))'.P11 AN rivEcftiK..
.: c.$3,46? ';7
t1
S.^ LESS .PRE-P.Aft) FEES
P ' -$250.00
TOTAL PERMIT V E;"Eb DI1; NOW •
$3,212.37
.
1111111111111111111111 13
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it
\ RECEIPT
DATE
BYE` 1/ .
DATE F , ALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
—
(/''
Underground Ducts
Forms & Footings
Ducts
•
Slab Grade
.'
Retum Air
Steel
Combustion Air
Roof Deck
"' 3e
Exhaust Fans
O.K to Wrap
0- G - QO
L-9
57
s7
sr
F.A.U.
Compressor
Vents
-~
Framing --4-44
Insulation
a - zo-p9
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
,2(0 - cAto
S r
Drywall - Int. Lath
- .3 -Cie,
$T
Final
Final
V744/44
POOLS - SPAS
BLOCKWALL APOVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
•
Underground Electric
Underground Pibg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines_Li-1 {
s
Heater Final
Plumbing Final
Water Piping
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
•
--.r
Pool Cover
Sewer Connection
ti _I `j -d
Encapsulation
Gas Piping
Gas Test
41/05e.
57
Appliances
Final
COMMENTS:
•
'
Final
/%
Utility Notice (Gas)
` 661
ELECTRICAL AP OVAL
Temp. Power Pole
l/ _V — ®b
sdr"
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
'Smoke Detectors
Temp. Use of Power
A.7Final
Utility Notice (Perm)
99/Am addtvg_o_6,„_
P.O. BOX 1504—f"-QC}—Y‘—
APPLIC,
78-495 CALLE TAMPICO
AN \j. \Iti i 1, LA QUINTA, CALIFORNIA 92253
Building
Address 1-i -
Owner
Mailing t
Address LA 7`i • t
City Zip Tel.
r
F-
Contractor
Address
City
1 ,-‘t
State Lic.
& Classif.r /
Arch., Engr.,
Designer
Zip Tel.
%till) Ikl iff
City -
Lic. #
BUILDING: TYPE -CO -NST. OCC. GRP. A
A.P. Number % ' %.-)!
Legal Description #_ (1 i -4); j N t.1 1 T
Project Description
-MWsTc2 Ys -z
/
Address
City Zip
Tel.
State
Lic. #
Sq. Ft.
Size
6,5 Stories
No.
tag' -
New 131./.. -- Add ❑
Alter 0
?pair 06 13
cpemolition 0
LICENSED CONTRACTOR'S 6 CLARATION
Ip pere affirm that I am licensed under grovisi sof Chapte7 9,4commencing with Section
epft )t ff%vision 3 of thg Businessand Pc•dfessi ns Code; and my license is,in•fyll force se
SIGI4ATUR9 1.... .C- -. %,.......,
DATE
OWNER -BUILDER DECLARATION
I hereby atf rm t I am exempt from the Contractors License Law for the following
reason: (Sec. T031.5,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 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 (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 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.)
11 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
l7 Copy is filed with the city. 0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i1 the permit is for one hundred dollars (5100) 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 it work thereunder is suspended for 180 days.
I certify that 1 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 aOplicant Date
Mailing Address
City, State Zip
Estimated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
AMOUNT
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
11111111IIIIIIII1111IIII 14 1
IE
PINK = BUILDING DIVISION
Thll[RllH5
E
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
Building & Safety as your correction list. Please attach additional explanations as necessary.
APPLICANT. CORONEL CONSTRUCTTON
PROJECT
ADDRESS:
• 54-470 Avenida Alvarado
APN: 774-241-011
LEGAL: LOT 13 , BLOCK 265 , UNIT 24 , S.C. @ V.L.Q.
CK'D BY: Leslie Mouriquand
BIN NO: CASE NO. 99-175 ..CHECK DATE: .jamD
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.
:�:n\::\: vi:•:: n.\..... C.: •v. :: .: \<:i::ii:•ia4i2i nL: n•� .^\����
•...
•
Wiks
Case logged and number assigned
Verify legal and APN information
Consistent with MDG on file las applicable)
MDG filing required (5+ filings since 9/3/98)
Consistency"with-street/surrounding area:.
Colors
Materials
Architecture
OTHER REOUIREMENTS:
APPBOVEI RY COMMUNITY DEVELOPMENT DEPT
BY '517/:. DATE -36 -90
EXHIBIT
CASE NO.
The zoning code, architectural and landscaping manuals, and/or assigned inspector should
be consulted where uncertainties arise. The completed checklist shall be maintained in the
Building '& Safety address 'file.
Recording Requested By
CHICAGC TITLE COMPAt'l�
RECORDING REQUESTED BY:
CHICAGO T: -,TLE COMPANY COMPANY
99.90361(C 97056858
WHEN RECO;i.DBD MAIL THIS DEED Ana,
UNLESS '>THERWXSE SHOWN BELOW,
MAIL. TAX STATEMENTS TO:
ROBERT B. KELLOGG
and SYLVIA KELLOGG
47785 VIA TRIESTE •
LA QUINTA, CA 92253
(c -o-:° („ s
The undersigned grantoris) declare(s):
Documentary transfer` tax is $196.90
(XXX) Computed on full value of property conveyed, cr
( ) Computed on full value less liens and encumbrances remaining.at time of sale.
Unincorporated area: ( ) City of , and.
FOR A VALUABLE CONSIDERATION, receipt of which is herby acknowledged,
II III III IIII 16
IE
DOC *I 2999-a389O7•a
081' 'X935 08:00A Fee:6.00
Pao . of 1 Goa T Tax Paid
Recorded In Official Records
County of Rive.rs4de
Gary L. 0rso
Assessor. County Clerk B Recorder
yMF
11111E1 II 111 ill In
NOC:R
MIs O.
GRANT DEET)
cots LONG
APN: 1311$
REAM HCM EXAM
JUDD MARN:OR, TRUSTEE OF THE PIARMOR. REVOCABLE TRUST DATED APRIL 25, 1986 and JUDD MARMOR,
A WIDOWEF.
hereby GFANT (S) to
ROBERT B. KELLOGG and SYLVIA KELLOGG, husband and wife as joint tenants DBA CONTEMPORARY
HOMES
the real property in the City of IA 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 Carmelite at Vale La Quinta, as shown by Mao on file in Book
19, Page,; 44 and 45 of Maps, records of Riversides Count liforaia
Dated P ig. ust 18, 1999
State of Cal,iforn
County of '5
Cn
before me, VERL.Y WOG
e=� } S.S.
//rergona.Y ly
v -/104e.._
,-, aD C> i Z Q K_ -..
personally known to me (or proved to me on
the basis of satisfactory evidence) to be
the person( 75 whose name, ') isAaPt subscribed
to the within instrument and acknowledged to
me that( she/they executed the same in
nl9/ler/ r authorized capacity (irt4'i , and.
at by( her/their signature s -S`) on the
instrument the person(%), Or the entity upon
behalf of whish the person ) acted, ezecu.ted
the instrument.
WITNESS my hand d official
Signature
BEVERLY vlOODS
NitlNrye. Commis P 1140759 2
eNotQN Pubit -- Colifornio
Lca Mgefes County
My Comm. Elp,re:.Jc:n 22.2001
(This area for official notarial seal)
Notice:
Document Cannot Be Duplicated
Date 1/13/00
No. 19902
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Owner NameRObert & Sylvia Kellog
11111111111,1[111111111111 17
APN # 774-241-011
Jurisdiction La Quinta
No. 54-470
City La Quinta
Tract #
street Avenida Alvarado
Lot #
Permit #
Log #
Zip 92253 Study Area
Type of Development Single Family Residence
Comments
Square Footage 1465
No. of Units 1
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
1.93 X 1,465 or $ 2,827.45
Government Code 53080 in the amount of
the property listed above and that building
t
permits and/or Certificates of Occupancy for this square footage in this proposed project may n$ww be issueds.
Telephone; 760`564-4604
Fees Paid By CC/Union Bank of California/ Robert Kellog
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Ellen Patino
Signature
Payment Received $2,827.45
Check No. 6528947
NOTICE: 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
collect 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
Certificate of Occupancy
City of La Quinta
Building and Safety Department
IIIIIIIIIIIIIIIIIIIIIIIII 18
IELs,
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: 54-470 AVENIDA ALVARADO
Use Classification: SFD
Bldg. Permit No.: 9912-147
Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC
Owner of Building: ROBERT & SYLVIA KELLOG
fee- ' % ARfoG
Building Official
Address: 47-785 VIA TRIESTE
City: LA QUINTA, CA 92253
By: STEVE TRAXEL
Date: 09-22-00
POST IN A CONSPICUOUS PLACE