SFD (0107-164)51840 Avenida Madero
0107-164
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
Date 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 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
6 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:
Carrier Policy No.
CAL COMP V?i 99)3 3f>#10
(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 Section 3700 of the Labor
Code, I -shall forthwith comply with those provlslons'
.✓`s,
Date:.G %-:.".- Applicant
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 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) f ''ate✓9 'w'' Dater'
BUILDING PERMIT PERMIT#
DATE VALUATION LOT t3'fD .,:1. 1 TRACT
$102I1-✓.:I<AG X131 U2
JOB SITE
ADDRESS
APN
OWNER
CONTPACTOR / DESIGNER / EN (NEER
g3g'.L .U.. T. . + s.: EWTE tY 'A7Y4it tCt. J y
A2 r111hA,y y' ,
q.
3 •C+1 f 5 :: V OTI MB815 S.0 R URTI bE,
{ A.L { i f .t•'P a1T. M} . fE7
1875 f 5 ULY.LSV ESPS M 14 .I..Lr/ R .A.✓RI "9E
(moi .. RxliAMINNO CA 92,408
S?kN EPERWARDYAO Chi .922 08
(:09)SP-7241 C 111-4 4706
USE OF PERMIT
MOLE PAM -111y DWE1112130-
170 ES P;OT IN£::I.t3i'1R HIM, r 'VA, ,:E 4;. P004 OR, 1'A?I4P v7,W/R a''
IZ;P't OC'i dC3N FOA MU'LAIPLE TsERM1TS OF aA'MP PLAN TYPE
RA,CT WKSTRUCTICM 4710.00 OF
PORC HAR TIO $2.00 P
wO9D L ` jr i.r NS1,L. & .2M1.^.IL.Ro
AVe6 d7 LnYa'
gg,, r y y9 a §.p + ryry g, MARY y/ * si:/9.d.:4d<,%l ,H-10'
P:C+++R'i:l 'iT MITI R '4 :.51i ti'.i.f ? FY
00HOTRAICTION 1rXV, 10) -000-4 18-000 W0.00
FLAW tiHVIX tluel 101-0041-439-13 18 $1'ih,1x
FC:S✓' D ,f ISIA`4' 101-000.439«318 4250100
bl11CH.fl141CA.t.. FYt -000 $68.5
M.&C1"(v.6t.;AI.. FRE 101-000-420-000 9117,41
M 8.7a.oxao mol/[ON W, " RFsi > {.Q 1 .0oV---IS'o41 -64l/ Y W.2..4 -
,f.
Ol AT ,1riCv.Ip`EI fi • ,.r „S ?(y 2.0,{N3
PL s^ l ' -3 y $100.00
l i 2001
1”.
. s 1-ViM 1F.lIt'{ .ld RUN CMD -INK
$3,143.33
FINANCE DEPT. : 1;f:50 PPR -PAM 1"fQX3
' 4250.00
I'tAMIA PT -IRMAT IM 1) VE now
ji
33
RECEIPT
DTE
irf - r 7 I; %f
BY
iLw '
DATE FINALED
,S - o Z_,"
INSPECTOR
r
INSPECTION RECORD P
OPERATION
DATE
INSPECTOR
OPERATION -
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings t
Slab Grade d3A
Underground Ducts
Ducts
Return Air
Steel
_
'
Final
Combustion Air
Roof Deck
t_(— Ol O 1
5.'11
Exhaust Fans
O.K. to Wrap
Framing
Insulation
Z 2
'/
—S-7
" !
F.A.U.
Compressor
Vents
Fireplace P.L.
(
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
/
Final
ELECTRICAL APPROVALS
Temp. Power Pole 8 r /O M
Underground Conduit
BLOCKWALL'APF` ROVALS
Set Backs
Low Voltage Wiring
Footings
Fixtures
Bond Beam
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Final
Smoke Detectors
PLUMBING APPROVALS
Waste Lines
Water Piping
Plumbing Top Out tt
Shower Pans
Sewer Lateral
Sewer Connection
Gas Piping _ G
Gas Test —Z OZ 1 -
Final
ELECTRICAL APPROVALS
Temp. Power Pole 8 r /O M
Underground Conduit
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) Eee
Steel
Electric Bond
Main Drain
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Te
Gas Piping
Gas Test
Electric Final
Heater Final
Plumbing Final
Equipment Enclosure
O.K. for Finish Plaster
Pool Cover
COMMENTS:
ri pll6}1 •.^rv`f ' " 'Y"NL', ' .€if'-, *'rf1 t'Sid` h''R/Tf ,',',' T t"T ' 7 /] % `I wernAvR'
P.O. BOX 1504 APPLICATION ONLY
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
rP4we .u.v.
Mailing
Address/9,_)S_ i
City Zip Tel.
SIP 0.1 Sa9iD9
Contractor
Address
/'g,'?y"
City
Sq. Ft. /G U
Size
Zip.
Tel.
State Lica ,
& Classif. 2' S
_ r
City
Lic. #
Arch., Engr.,
Designer
Address
Tel.
CityI Zip I State 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 Contractor's 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 ($500).
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.)
V) I, as owner of the property, am exclusivelycontracting 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 contractors) licensed pursuant to the Contractor's License Law.)
i7 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
f7 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, 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
Ihereby 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 1 have read this application and slate 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 aQplicant Date
Mailing Address
City, State, Zip
WHITE = FINANCE
LDING: TYPE'CONST.5 Pt OCC. GRP.
A.P. Number
Legal Description
Project Description " Lr'n 'r" 1 i +(/1-= r% / ,
r
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
DATE
CITY Of LA QUINTA
l FINANCE DEPT
YELLOW = APPLICANT PINK = BUII
rmit
Sq. Ft. /G U
Size
No.
Stories
No. Dw.
Units
New I—" Add ❑
Alter ❑
Repair ❑ Demolition ❑
• 1 t
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
r
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
r
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
DATE
CITY Of LA QUINTA
l FINANCE DEPT
YELLOW = APPLICANT PINK = BUII
rmit
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 8/17/01
No. 22389
Owner NameNeal T. Baker Enterprises
No. 51-840 Street Avenida Madero
city La Quinta
Tract # BL31 U2 Lot # 20
Type of Development Single Family Residence
Comments
APN# 773-154-005
Jurisdiction La Quinta
Permit # 0107-164
Log #
Zip 92253 Study Area
Square Footage 1710
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 ekempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE y
q
This certifies that school facility fees imposed pursuant to Government Code 53080 r -''in the aihount of
2.05 X 1,710 or $ 3,505.50 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 ccB of A - Rick Webb Telephone '90.9-424-8912
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Juanita Green Payment Received $3,505.50
J - Check No. 2009865336
Signature
NOTICE: Pursuant of Assqghbly Bill 3081 (CHAP 549, STATS. 1998) this will serve to notify you that the 9D -day approval period in which you may protest the fees or other payment identified
above will begin to run fro 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
WHEN RECORDED MAIL TO:
::..EAL T. BAKER ENTERPRISES, INC
1875 Business Center Dr
0 San•Bernardino,'Calif 92408
`t
ESCROW NUMBER: 1765–K
ORDER NUMBER:
MAIL TAX STATEMENT'S TO:
rNEAL T. BAKER ENTERPRISES, INC
1875 Business Center Dr
San Bernardino, Calif 92408
(W
CC LL 11., •
SPADE ABOVE IIII't LIRE FOR IIE(";Of1UEII'S USE
Q p
DOCUM17141Any InANSFFR TAY, 3 •...I. BS• a
X ... r:rnnlnrl wl •,n r,r —1— of prm,erly c ,w.-, o: on. .
r;:',...1-1-1 'm Ili- Ing.; linnc i,r 9 i!'nml•rnnr q
r••mninin(1 nl limn "! cnln.
G11ANT DEED
FOR A VALUABLE CONSIDERATION, receipt of v✓hicll is Ilaleby acknowledged.
:1 JOHN REGINALD MURPHY
l
Nhereby GRANT(S) to
4 NEAL T. BAKER ENTERPRISES, INC., A California Corporation
^_ the realproperty In the City of
La QUlnta
1 `
Couhty of Riverside
AS PER LEGAL DESCRIPTION ATTACHED HERETO AND MADE A PART HEREOF:
20
Lots
Dated _Juli► 12r 1--988 —...--......_.
STATE OF CALIFOIINIA A i EC7p ) ss.
COUNTY OF
On—
before me, the undersigned. a Notary Public In and for sald State, per-
sonally appearedIJO#A MA(
, State of California, described as
JOHN REGINAf.D MURPHY
OFFICIAL SEAL
'
( - .personally known to me (or proved to me on the basis of salislaclory [p ) ',. 13;!Rr ARA MCCULLEY
evidence) to be the personpO whose nirneA islrxesubscribed In the 'l+r`r ;7l jf:h!IFORNIA a
wlthln1nsUumenl and acknowledged to filo Ihnl 11clshelthPy exe(:Illnd Jr ;t SAII f111;G0 cf-'11!!Ty n
0
the same. Aly Commission (r.p. Sept. 10, 1990 ;
tv•.r!ti;.
WITNESS my hand and official se I.
Signature `:%n { C r/ rrr ; ,• , r,,, .,rr „r rr. n ,n
FORM NO. GD 400 (1183)
MAIL TAX STATEMENIS AS DIRECTED A130VF
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SPADE ABOVE IIII't LIRE FOR IIE(";Of1UEII'S USE
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DOCUM17141Any InANSFFR TAY, 3 •...I. BS• a
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G11ANT DEED
FOR A VALUABLE CONSIDERATION, receipt of v✓hicll is Ilaleby acknowledged.
:1 JOHN REGINALD MURPHY
l
Nhereby GRANT(S) to
4 NEAL T. BAKER ENTERPRISES, INC., A California Corporation
^_ the realproperty In the City of
La QUlnta
1 `
Couhty of Riverside
AS PER LEGAL DESCRIPTION ATTACHED HERETO AND MADE A PART HEREOF:
20
Lots
Dated _Juli► 12r 1--988 —...--......_.
STATE OF CALIFOIINIA A i EC7p ) ss.
COUNTY OF
On—
before me, the undersigned. a Notary Public In and for sald State, per-
sonally appearedIJO#A MA(
, State of California, described as
JOHN REGINAf.D MURPHY
OFFICIAL SEAL
'
( - .personally known to me (or proved to me on the basis of salislaclory [p ) ',. 13;!Rr ARA MCCULLEY
evidence) to be the personpO whose nirneA islrxesubscribed In the 'l+r`r ;7l jf:h!IFORNIA a
wlthln1nsUumenl and acknowledged to filo Ihnl 11clshelthPy exe(:Illnd Jr ;t SAII f111;G0 cf-'11!!Ty n
0
the same. Aly Commission (r.p. Sept. 10, 1990 ;
tv•.r!ti;.
WITNESS my hand and official se I.
Signature `:%n { C r/ rrr ; ,• , r,,, .,rr „r rr. n ,n
FORM NO. GD 400 (1183)
MAIL TAX STATEMENIS AS DIRECTED A130VF
NECEIVED AUG 0 4 198,t4
Ar
f
LEGAL DESCRIPTION
0
PARCEL I:
Lots 4 and 5 of
Block 29 of Santa Carmelita at Vale La Quinta, Unit 2 as shown by
Map on,file In Book 18, Pages 55 and 56 of Maps, Records of Riverside County
PARCEL.II:
Lot 10:of Block
30 of Santa Carmelita at Vale La Quinta, Unit 2 as shown by map
on file in Book
18, Pages 55 and 56 of Maps, Records of Riverside County
PARCEL 111:
Lots 3, 15, 17,
19, 20 and 21 of Block 31 of Santa Carmelita at Vale La Quinta,
Unit 2 as shown
by Map on file in Book 18, Pages 55 and 56 of Maps, Records of
Riverside County
PARCEL IV:
Lots 2200 and 24
of Block 32 of Santa Carmelita at Vale La Quinta, Unit 2 as shown by
Map on file in
Book 18, Pages 55 and 56 of Maps, Records of Riverside County
PARCEL V:
Lots 7, 8, 9 and
10 of Block 33 of Santa Carmelita at Vale La Quinta, Unit 2 as shown
by Map on file
in Book 18, Pages 55 and 56 of Maps, Records of Riverside County
PAkCEL V1:
Lots 3., 4, 20,
21 and 22 of Block 34 of Santa Carmelita at Vale La Quinta, Unit 2
as shown by Map
on file in Book 18, Pages 55 and 56 of Maps, Records of Riverside
County
NECEIVED AUG 0 4 198,t4
LA QUINTA PROPERTY LEGAL DESCRIPTION
PARCEL III
LOTS 3, 15, 17,19, 20 AND 21 OF BLOCK 31 OF SANTA CARMELITA AT VALE LA QUINTA,
UNIT 2 AS SHOWN BY MAP ON FILE IN BOOK 18, PAGES 55 AND 56 OF MAPS, RECORDS OF
RIVERSIDE COUNTY
LOT 3
51825 AVENIDA JUAREZ
PARCEL #773.154015-9
LOT 19
51860 AVENIDA MADERO
PARCEL #773154006-1
LOT 20
51840 AVENIDA MADERO
PARCEL #773154005-0
LOT 21
51820 AVENIDA MADERO
PARCEL #773154004-9
r 14
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 per Section 9.50.090 of the Zoning Code. Its purpose is to determine:
1) that the proposed house design does not duplicate the same architectural style of any
house within 200 feet of the applicant, and/or 2) if there is a need for the applicant to file for
Master Design Guidelines. If the applicant does need to file a Master Design Guideline, please
transmitted this information to the Building and Safety Department as part of your correction
list. Please attach additional explanations as necessary.
APPLICANT Neal T. Baker, Ent
SITE ADDRESS 51-840 Avenida Madero
APN - /VV - Ob.S CASE NO.: 2001-463
LEGAL: LOT 2
CHECK AND APPROVED BY:
BLOCK 3/ UNIT
Wally Nesbit
2 -
DATE: DATE:
S.C.@V.L.Q.
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
Verify legal and APN information
✓
q-iv^j Ivo r- -A120v1ot0
Consistent with MDG on file (as
applicable
MDG filing required (5 filings since
9/3/98)
Architectural variety within 200 feet of
the surrounding area:
RECVD FOR PROCESSING /01
(DATE) Colors
ASSIGNED TO lei
(INITIALS) Materials
P(. 3 ✓l4 co -!; /3-/01
Architectural design features
?
G.s t vve-s o r- r ro• +.
OAi" g1jP;;r*nents: Date
D Planning Commission
O City Council
PrCommunity Dev. Dept. 2
Initials
Case No.- Ac zaoz- 1/6
Reno
#
PrWith Conditionso;, ..,,...,,,.
Certificate 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:
BUJLDING ADDRESS:
Use Classification: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction
51-840 AVENIDA MADERO
Owner of Building: NEAL T. BAKER ENTERPRISES
Building Official
VN
Bldg, Permit No.: 0107-164
Land Use Zone: RC
Address: 1875 BUSINESS CENTER DRIVE
City: SAN BERNARDINO, CA 92408
By: RICHARD KIRKLAND
Date: 05-16-02
POST IN A CONSPICUOUS PLACE