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13348 (SFD)Building Address 53-500 Owner P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address 73-373 COMMY CLUB DR. CityZip Tel. PALM DESERT 92250 1 773-0967 Contractor ress City State Lic. I City & Classif. Lic. # Arch., Engr., Designer SME AS ABOVE Address Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section lot of Division 3 of the Business and Professions Code, and my license is in full force and effec 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 sUD' cts the applicant to a civil penalty of not more than five hundred dollars ($500). JAI, as owner of the property, or my employees with wages as their sole compensation, will do he 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.) O 1, 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 `1�ihl Z e5w'ner ! .C..2i _ A,111 t . 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 ❑ Copy is filed with the city. ❑ 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 ($100) 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, 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 permiIW hen properly filled out, signed and validated, and is subject to expiration if work thereunder isuspended 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. yl Signature of applicant— Date Mailing Address City, State, Zip No. BUILDING: TYPE CONST. OCC. GRP.: A.P. Number 774-101-005 Legal Description Lot 5 Block 195 Project Description SPD 13348 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear.Prop. Line Side Street Set -6 ck from Ceriter Line Side Setback frc, m Proper tyvine FINAL DATE �� lA*PDF,i, Issued by: 10- y`\ Validated by: Validation: Sq. Ft. 2090 Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit does not include block walls Or pool. Estimated Valuation $120,224.00 , PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. 348.89 Const. 713.00 Mech. 62.00 Electrical 150.30 Plumbing 1.44.00 S.M.I. 12.02 Grading 20.00 Driveway Enc. .00 Infrastructure 2,705.04 Arts in Publ,LC Places 5 75 6 'recise Plan 25.00 TOTAL 4,481U.—Ul 4,230.161 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear.Prop. Line Side Street Set -6 ck from Ceriter Line Side Setback frc, m Proper tyvine FINAL DATE �� lA*PDF,i, Issued by: 10- y`\ Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING F%eS IST FL. SQ. FT. p $ UNITS SLAB GRADE 2ND FL. SQ. FT. p YARD SPKLR SYSTEM POR. SQ. FT. p MOBILEHOME SVC. BAR SINK GAR. SO. FT. p POWER OUTLET ROOF DRAINS DUCT WORK ROCK STORAGE DRAINAGE PIPING CAR P. S0. FT. p METER LOOP WALL SO. FT. p OTHER APPJEQUIP. DRINKING FOUNTAIN SQ. FT. p URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER _$ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FRAMING 7v2a .,A/ LL 0 LAUNDRYTRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. p c BATH TUB SO. FT. p c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID p 11/a c SEWAGE DISPOSAL SQ.FT.GAR p 3/ac HOUSE SEWER GAS PIPING PERMIT FEE MESH 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 GROUND PLUMBING S�r-qjdq 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. , GAS (ROUGH) A, ez;_ METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE A GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. 10-12-C79re GRADING oncu. yd. $ plus x$ _$ LUMBER GR. FRAMING 7v2a .,A/ LL 0 %/ FINAL INSP. —/0--1 [ O la [ ROOFING / REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWAL LATHING MESH INSULATION/SOUND l-7 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL :d DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated 619-775-3500 Date 5/5/94 1 Type of Permit I La Quinta No. 112810 Permit # Owner Name John M. Ivancich Log No. 53600 Street Avenida Montezuma city La Quinta Zip 92253 Study Area 111 APN # --, Tract # Lot # 0 Square Footage 12000 Type of Development Single Family Residence No. of units 0 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 1.65 X 2 000 or $ 3,300.00 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 -John M. Ivancich Telephone 773-0967 Name on the check By Dolores A. Ballesteros Superintendent Fee collected /exempted by Vickie J. Durrett , Payment Received, 17, Signature Z Y185 Check ��lo. Collector: Attach a copy of county or city plan check application form to district copy f -r all,waiver_s.. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Acc6unting� No COR Fff" AND Tawa7e arooMusa MAs< T1810 OWD AND. uwt-asa OTMd Not avna a••oww aaaaw. IMM. TAR OTAT220130" TO, Ivancich `q .••r Mr. 3 Mrs. y N 7453 Lost Canyon Circle Salt Lake City, UT 84121 t— � Bide Order No. 543036 E/rrow No. 13279 SPACS ANOVE THIS u roR IttOOno[R•s� GRANT DEED j 20.90 and is 1 The undeTaigned dedun that the documentary transfer tai is i ❑ computed on the fall value of the interest or property eoeveTed, or is 13 computed on the full value less the value of liens ur encumbrances remaining thereon at the time of sale The land. tenements or really is located in Le Qulnta ' ❑ tmincorporated area 13 city of ..._.._.._. and Yui; .. vALUABLE CONSIDERATION, receipt of which isherebT acknowledged. T. William R. Riley, an unmarried men V hereby GRANT(S) to John M. Ivancich and Nel 0. Ivancich, husband end vife as joint tenants ► the following described real property in the city of La Quince county of Riverside . state of C�lifornis- Lot 5. Block 1y5. of Santa Careelita at Vale La Quinta, Unit /19 as per mp recorded in Book 19 Pages 33 and 34, records in the office of the County Recorder of said County Dswd MaY 8. 1992 t el �6e_ - William R. Riley . STATE OF CAURNINIA SS. " ODMry Of Riverside -- on tlas M 18th ft'of —ma7. 19 9L 1Mtoa ma to vdwsi4ra. a Notary Pok 1n and for said Oma" and Stab. PwsrwaT OFp•w•a —. William R. Rile? FOR NOTARY SEAL OR STAMP �H.N••NN••HHHH•11•IIa1Ns - orvn+r GMCiAL SCAB to m1a or Vsvd to o an Ow basis of aaastaraar avtesee b d b 01101 SItLUA isaresnOsAbMwla+ams�nrnr A •O WTANT mut person he IIDTAar saw Futo IN OKI _wraaasONsaan+a. Net*=Comm ay t]oddsa Esti• APER 22.1994 •H••..••.• .............. . V Assessors Pared No..____-_._.._.._.._.._.._.._.. MAIL TAX SfATEVF.!fT3 Tel PAM 91M" O!t FOU Wt- U!tt:: IF .t0 PAK" �O SHOWN. MAIL ASMRLCZ4]1AS0\'F. Nr - - --• ' -' 9Hwr� A/k�. pr/ ♦1 Sire G1.LCT As• am T4hf 4 �wQ�rw 78-495 CALLE TAMPICO — LA. QUINTA, CALIFORNIA 92253 - (619) 777-7000 FAX (619) 777-7101 February 2, 1994 Mr. John M. Ivancich 73-373 Country Club Drive Palm Desert, CA 92260 Dear Mr. Ivancich : SETBACK ADJUSTMENT: 94-228 LOCATION: 53-600 AVENIDA MONTEZUMA 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: Reduction of side yard setback from 5 -feet to 32 -feet. FOR: Mechanical room for single family residence. CONDITIONS: 1. Obtain a building permit from the Building Department. 2. The requirements of the S -R Zone shall be met. 3. Mechanical door shall be painted to match adjacent exterior wall color. 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: narrow lot width. 3. This adjustment will not be detrimental to the health, safety, and general welfare of the community or be detrimental to property in the vicinity of the parcel for which the adjustment is requested. MAILING ADDRESS - P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253 ♦, LTRGT.183�� If you should have any questions, please contact the undersigned. Very truly yours, JERRY HOMAN DEVELOPMENT DIRECTOR IT: OUSDELL rate Planner of Attachment: Exhibit A cc: Building & Safety Department 61 LTROT.183 0 Cl) V) CD 00 C = TY O F LA QU I NTA Cont racto ►�/ Ovine Address Job Address 152 401610u. m p7rZ V �/�JA This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. It is the responsibility of the General Contractor or the Owner/Builder to monitor the sub -contractors that are on this list are the same persons performing the work. Any changes of this list must be approved by the City of La Quinta Department of Building and Safety prior to work being performed by a changed sub -contractor. Failure to comply will result in a stoppage of work and/or the voidance of building permit. TRADE SUB -CONTRACTOR NAME CONTRACTOR'S LICENSE NO. WORKMAN COMP. NO. ON FILE CITY BUSINESS LICENSE NO. EXCAVATE r, NeVJi35VF(seTz \m' PIPELINES CEMENT/ FOUNDATIONS �C�%j� CEMENT/WALKS & DRIVES ASPHALT FRAMING w '4"� '(� / �j 77 7 STEEL/ STRUCTURAL MASONRY FT� /V � //LL ff�/� 4 44 11A C7 PLUMBING =.� V O �rG"'1 LATHING DRYWALL AA PLASTERING �,��{ 4.�W (5 / �' �/ 4-G HVAC A/C ELECTRICAL . ROOFING DU F C. SHEET METAL , FLOORS GLASS/ GLAZING V��� W OG►� . INSULATION y� Sc rye( V, SEWAGE DISP PAINTING/ DECORATING V/i /1 1 ► }O.I /Q /_ i� 2 r/,�j�j TILE INSTALLATION ORNAMENTAL METAL FENCES/ BLOCK WALLS LANDSCAPING t�__ OTHERS