9196 (SFD)ep
Building t;
Address 52-010 f4f
Owner
D -m' ill -damn ' tAATrfQ
Mailing
Address 41-1865 Bog
City Zip
Palm Desert
Contractor
78-105
P.O.
8 1(P.O. BOXLLE 504 N o • 09196
t LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. - OCC: GRP.
4112 A.P. Number 7;73- .,2 0
Zip -I Tel.
State Lic. City
& Classif. 1349424 Lic. #
Arch., Engr.,
Designer
Address I Tel
City IzipState
I
Lic. #
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 Contractors 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 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).
❑ 1, 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, 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.)
❑ 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
Q Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(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 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: It, 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 applicant Date
Mailing Address
City, State, Zip
Legal Description
Project Description
Si Crl+eyar�A Iv DwA l l incl
Sq. Ft. 1ffQ�
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Pt'- FSY i A&)P£i
not Y_t7lCShide wall nr ruit l
Estimated Valuation
95 7291,40
PERMIT
AMOUNT
Plan Chk. Dep.
n fit,
Plan Chk. Bal.
24A
Const.
57 6 KR
Mech.
Ag Afk
Electrical
1 ' AC
Plumbing
j A.
S.M.I.
7
Grading
"!A 4A
Driveway Enc.
9 n
Infrastructure
I Ron Ai
TOTAL
REMARKS(M
Z:r aimiP7>ttl7
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEtS
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
CSAR. SO. FT. ®
CAR P. I SQ. FT.
WALL SO. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK '
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH) � /2
J
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
FINAL INSP.
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4c
HOUSE SEWER
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK 2 l��
/
UND PLUMBING
901 UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. O
I
GAS (ROUGH) � /2
J
/ ATER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ —plus—x$_=$
LUMBER GR.
FINAL INSP.
FRAMING 017 y g/ A
FINAL INSP.W2 elfz
ROOFING T/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING40 WAI 9/
MESH
INSULATION/SOUND /
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
h
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111.
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 5/2/91 Type of Permit I La Quinta
No. 10571 Permit #
Owner Name Log #
Paulden Evans
No. 52-010 street Montezuma
city La Quinta zip 92253 study Area 112
APN # I Tract # 'Lot # Square Footage 11600
Type of Development Single Family Residence No. of units
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 1.58 X 1600 or$ 2,528.00 have been paid to D.S.U.S.D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now be issued.
Fees Paid By General Construction Management Co. Telephone 340.4445
Name on the check
By Richard M. Beck
0114
Director, Facilities Planning & Development
Fee collected /exempted by Shelley D. Bennett
Payment'Received,I.t-0 -=%7
..•
Signature ` lr., Check No. 5305
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
0
F�FS4' 78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 .-. (619) 5642246
January 23, 1991 JAN
C1TY ®F
QUINTA
Mr. Steve Boyd Subject:
General Construction Management Setback -Adjustment #91-039
41-865 Boarkwalk #112 Location: Cove
Palm Desert, CA 92,260 �77=125 Durango
APN: 773=2'01=00`1
Legal: Lot 1, Blk 39
Dear Mr. Boyd:
This letter is to report approval of .your recent application
for a setback adjustment, pursuant to Chapter'9.188 of the City
of La Quinta Planning & Zoning Regulations. The following
setback adjustment has been approved subject to conditions and
in accordance with attached Exhibit A.
SETBACK ADJUSTMENT: 8.feet from side property boundary
(street side)
FOR: House
After review it was determined that:
1. This adjustment is.consistent with the intent and
purpose,of the zoning ordinance.
.2. There are -special circumstances applicable to the
property, including such'factors'as size, shape,
topography, location or surroundings that justify
,approval,of the adjustment. These special
circumstances are: this is a' small irregular shaped
lot, the rear property line only measuring 40.77
feet in length.
MAILING ADDRESS P.O. BOX1504 LA QUINTA, CALIFORNIA, 92253
LTRGL.104/CS. -1-
pamp4 a "Grail n LAIN I I I Li 1101/6, Y
� Ilwt! ra�rrwwlas:�rrrr:.:
Bt05 Pilo .Vires Lase
Itisftirside : CA 92301
=A ft 164�`3I tsiwte 2-11538
I LAND TITLE
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IL
X. Y...
1 ARWE AMW[ TIO tss
GRAFT DEED
773-201-961
IM UNDPAMNED GRANTOR(S) DECLARE(S)
ARY TRANSFER TAX 18 5 34.10
on ASG valve d property corwvtod, or
Computed on tuG value cess valve of Gena or anaxnbrarlcae remgtnhg at Ikea d gala.
Wr4orporam am
)(aar LA a NTik , AND
FOR A VALUABLE CONSIDERATION. rece4A d which Is hereby acknowledged.
FRANCIS KEVINS and EDITH K. KSVINS, Husband and Wife
hereby GRANT(s) to
PAVLDEN.BVANS and JONI 'K. EVAN8. Husband and Wife as Joint Tenants
the following dom bed real property In the City of LA QUINTA
Cowdy of RIVERSIDE . Slate of California;
LOT 1 IN BLOCK 39. SANTA CARMZLITA AT VALE LA QUINTA, UNIT NO. 3: AS
MAP RECORDED IN BOOK 18 nP MAp8, rAGS 59. Itt THZ G. KT_S OF TM2 COUNTY
RECORDER OF SAID COUNTY.
Dated Nov. 28, 1990
5V" OF CALfF�
ookwrfr OFy C S ct R ss
' On liam of �e_S,__.,____ . w, +ry tee►1e .
beton ma, Ig
AN ✓ Ms�udwsip11A a N"y PjbPjbkk h 04 br sed Stw.
Oer+oF--Het --.K_t-_ ��✓i�1d _
I •OsrsdORY known b me
00 fm 0,1 to be 0fe
POW _a:_ Idr*a Mrw v C twbwst.e to tm waft
bwvu M r;d admwWped to nn eW he If- sae.Md N.
rMiTiltiB RN WW mtt srtkfW "0.
uFRA1f1CIS KEVINS
EDITH K. KBVI.NS
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00.441 Inly "a AMC rAX STATEANW3 AS P AEC TtO AeOrl.
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This Certificate issued pursuant to the requirements of Section 306 of the Uniform "Building
s
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`7ADDRESS 52-01"0 Montezuma'
SFDUse Classification . No. 9196
Bldg.
! I
s
v Group R3 Type"Conet'iuction V.NFire Zone Use Zone SR
!
I ; i
Owner of Building Paulden •Eva ns - 41865 - Boardwalk Suite 112
Xf Address
City ' Palm Desert, `CA -92260
G By;- Mark Harold
j
Dote, 8/16/91
—
Building Official ,•' fi.f 't�.
^,09T IM.A'00NS?I000U9 PLACE
-40
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