SFD (0107-165)51860 Avenida Madero
0107-165
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
i
'257474 5p. on 5
Date. Signature of Contractor •c
OWNER -BUILDER DECLARATION
I her 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:
Carrier Policy No.
C.PAY, COMP Yd' PRI 130493
(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 provisions. f
Date: ..- , ' ,c Applicant -*"fir
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 )%'P %' ' " '' Date ll
BUILDING PERMIT PERMIT#
LOT (01(17-163 TRACT
DATE VALUATION yy,y
yy gy.a q y !
19 BW
JOB SITE
APN
ADDRESS 514-M AVE.L DA J. ANDM .i
773' -M -OCA
OWNER
CONTRACTOR / DESIGNER / ENGINEER
M..+ , T. i7:AKs.'R.Frl` ER-1,°S.[7%'CIS
IA i. BAJA 7AER IN YMMi-S
187 _5 11111 0101133 =YrKR DrOwle
1875 LAYARPAMM ('INTEIR DOVE,
SAN .SJ '4i•,[ `A"all..td.6C• O CA 92408 .
67ANT-t`•,iiV,MAwCl+DWO CA 92408
)r oq)w-,7ul. LIMA 4706
USE OFPERMIT
ulfiga1IM3xyyUXT
SFD. DOFUS N67 INCIAJOE HL,XX WALLA POOL, ; IR DIt,IIVYWAY
APPROACH, iMY.;d 9TFi2N01Z?I-SLfVATIO14 0f .%PLJVHtk'IaTWK H%".Dr
RZOUCJTXON FOR li OLTIPIX PERMITS OF.SlA its PLA34 `i",l§',":c
PORCHIPATIC 52,04 SF
GARAO " ARPOI C. f 451-90
Ms'".l. x171) COST Carr C,C?NLwTRUrMOkl
1,.M423.Q
'PrMa 101f;2. SUMMARY
1-/Q tgltti-+3+1 x$6500,04
(11C MSD '%vv'lUCjT[FE N :FEE 101
8-0 00
PIAN CA iX1*K FUR t/ Y'\,l4A J`^' J 3"'..3 7 L? $1.f V. l4
FEE DIa` OSIT 101.000.439.318 42:I0190
MEL IA I( A.a.1?,K 101•000-421-'000 $66.x0
d+:LECTRIC 1, PEE! 101-000-420-000 6117.41
Pf..:i3PJBMIOl•fYF I 3-QiX) X41 -t Sf ? 6.00
V '.t) ,XJ MOVON ITTE - RMID 1,01-000,441-000 $10 24
ICl9x1Cr1$ 20.00
PY8y.0Y1&R IMPACT R -E
FIumnsI, PLAN 101-000-441-345 $I.aU.9Ct
SW. '1WAL CO r ' '111 , 1 A •CIL
A 1G 1
f
k,^ d"Y4.Lr 3
,Dk t e'S. V4
RECEIPT
BY f {
DATE FINALED
INSPECTOR
INSPECTION RECORD &0
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings pt
_
Underground Ducts
Ducts
Slab Grade
d,
Return Air
Steel
t
Combustion Air
Roof Deck
( _ p I
S7
Exhaust Fans
O.K. to Wrap
_ ,r O (
2
F.A.U.
Framing
Compressor
Insulation +
V
Vents
Fireplace-P.L.
/
_
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
'Z 1% O/(
!APP(((ROVALS
_
POOLS - SPAS
BLOCKWALL
Steel
Set Backs
-
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
p/ /Heater
57
Final
Water Piping
L/ L/
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
4F 8 -d/
S7
Encapsulation
Gas Piping
Gas Test
/
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL
APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
BG 4-1-02
„,n,A,r,. ,... s iM:}{r ., 1Y•” :ltil AaC«r tT'-'s7s: r:af J/ L
L/ P.O. BOX TAM
J 78 495 CALLS 1504 O
, A LA APPLICATION ONLY
Buil In QUINTA, CALIFORNIA 92253
Address
Owner
Mailing
Address J$ -7!eS> t e > .x li
City Zip L' Tel.
Contractor
weal -0 .T VIRkw 51,1-t
Address
City Zip Tel.
State Lic. City
& Classif. S • - Lr Lic. #
Arch., Engr.,
Designer
Address Tel.
City( Zip ( State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7!X10) 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 70001 of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for
thealleged 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.)
I1
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 contractors) licensed pursuant to the Contractor's License Law.)
i J 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
n 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: d, 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 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
WHITE = FINANCE YELLOW =
TYPE-CONST.S--f tS OCC. GRP
Number
Description
Description
Sq. Ft. No. No. Dw.
Size oma` )Qij Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation J
PERMIT 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
F2 ATE 1OR
c::
I ^ _77
Permit
by:
CITY OF LA QUINTA
FINANCE DEPT
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. 22390
owner NameNeal T. Baker Enterprises
No. 51-860 street Avenida Madero
City La Quinta
Tract # BL31 U2 Lot # 19
Type of Development Single Family Residence
Comments
APN# 773-154-005
Jurisdiction La Quinta
Permit # 0107-165
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 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 1,710 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, ow be issued
Fees Paid By CCB of A - Rick Webb Telep,ione 909-424-8912
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Juanita Green Payment Received $3,505.50
I 4 Check No. 2009865336
Signature
NOTICE: Pursuant otjAssembly Bill 3081 (CHAP 549, STATS. 1998) 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
WHEN RECORDED MAIL r0:
r,,il....EAL T. BAKER ENTERPRISES, INC
1875 Business Center Dr
San Bernardino, Calif 92408
ESCROW NUMBER: 1765–K
ORDER NUMBER:
MAIL TAX STATEMENTS TO:
NEAL T. BAKER ENTERPRISES, INC
1875 Business Center Dr
San Bernardino, Calif 92408
.I
v
0 c
J
4r W l(E 00
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a
(L DZ Nn 0
ui o2 2 J cv w
> •1 Q 4l e 2
3 cr
W 3t c v
Ir
SI'AUE A110VE IIII' LINE 17011 HEGURDER'S USE
DOCUh1ENTARY TRANSFER TAY, St -...`.3s—' Z,_ -
X ... Cnnll`nlr`11 alil- rr 11—of plod^.rly c,mvn`,nrl: OR. .
... (;nngnlln•I nn Ihn ,,nr:itlrinfit'll rn :•nlr.rn hsc lirn r rncn,ul•ranrng
r„111:`1'1111(1 11 ti,,Jn r`r cnlr.
quP• lilr,• nl U•., In nul nr Arl^.nl II •i.., mi ,illrl Ing rinn tlnmq ..—'_._. _.
G11ANT 1)EED
FOR A VALUABLE CONSIDERATION, leceipl of which i!-, hereby aCl-nowled(led.
:1 I JOHN REGINALD MURPHY
l
Nhereby GRANT(S) to
NEAL,T. BAKER ENTERPRISES, INC., A California Corporation
M•
the real property In the City of
La QUirita
county of Riverside Stale of California, described as
AS PER LEGAL DESCRIPTION ATTACHED HERETO AND MADE A PART HEREOF:
2v Ls
La-
I
Dated_d.uky-42,-4J988
SrATE OF CALIFORNI/ I
COUNTY OF',An/ s
/•EG( __
On
before me, the undersigned, a NotaryPublicIn and for said State, per-
sonally appeared QI ! _ if'C i 91
' fGZz/ , _
/JOHN REGINALD MURPHY
-v r xvlrry
---------- -- -------- --— OFFICIAL SEAL
—3,BAROARA MCCULLEY ;
personally known to me (or proved to me on the basis of satisfactory
evidence) to be the personylj whose name Islme• subscribed to the 0 '1 h rl;Y f i!pm-ffdJFONNIA
r ?"ICIPAr ort -ICE IN r
within Instrument and acknowledged In Ile Ihal hrlsheilhPy execuled SAI1011:130 ColiNIFY "
e
the same. Aly Commission IMP. SepL 10, 1990 ;
WITNESS my Band and official se I.
71
Signature `r% Z%1 G /Jw Cr Irrr<., ,I„r,.rnsi,ll,mali,r< n
FORM NOI GO 400 (1183)
MAIL TAX STAIEMENIS AS DIRECTED ABOVE
r '
t LEGAL UESCRIP'riON
;O
C1
i -
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
i 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 III:
n Lots 3., 15, 17, 19, 20 and 2l 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
Lots 20 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
PARCEL VI:
Lots 1, 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 AIJG u 4 1931
LA QUINTA PROPERTY LEGAL DESCRIPTION
PARCEL III
LOTS 3, 15, 17,19, 20 AND 21 OF BLOCK 31 OF SANTA CARMELITA AT VALE LA QUNTA,
UNIT 2 AS SHOWN BY MAP ON FILE N BOOK 18, PAGES 55 "AND 56 OF MAPS, RECORDS OF
RIVERSIDE COUNTY
LOT 3
51825 AVENIDA JUAREZ
PARCEL #773154015-9
LOT 19
51860 AVENIDA MADERO
PARCEL #773154006-1
LOT 20
51840 AVENIDA MADERO
PARCEL #773154005-0
LOT 21
51820 AVENIDA MADERO
PARCEL #773154004-9
I
C
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 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 51-860 Avenida Madero
APN :V 3 - - 00(. CASE NO.:
LEGAL: LOT 19
BLOCK 3l
CHECK AND APPROVED BY: wally Nesbit
2001-464
UNIT Z
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
nitials
Y
N
COMMENT/CORRECTION
Verify legal and APN information
✓
Sic wc ,-s-nom►oto
Consistent with MDG on file (as
applicable
/
(
MDG filing required (5 filings since
9/3/98)
r1 S
Architectural variety within 200 feet of
the surrounding area:
RECVD FOR PROCESSING S o
(DATE) Colors
ASSIGNED TO
INITIALS) Materials
Pc4-s tig Co 5//.7 /01
Architectural design features
v1
-2
A4us T Us£ c,s +s s, •vrtac.cr't.S
uirements: Date e
. 'u
Planning Commission
City Council
Community Dev. Dept. 2
se No/1c2o.0 /
,JkVUith Conditions _._e-0=_ccp 0^'. s , —
June 12, 2001
City of LaQuinta
Dept. of Building & Safety
Re: Baker House
The undersigned Engineer of Record (EOR) has reviewed the truss design criteria for the
above project for conformance with the project requirements. The EOR was not in
responsible charge of the truss design, but does approve the design criteria to which these
components were designed.
E
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:
BUILDING ADDRESS:
Use Classification:
Occupancy Group:
SINGLE FAMILY DWELLING
51-860 AVENIDA MADERO
Bldg. Permit No.: 0107-165
R-3 Type of Construction: VN Land Use Zone: RC
Owner of Building: NEAL T. BAKER ENTERPRISES Address: 1875 BUSINESS CENTER DRIVE
lr>tn
Building Official
City: SAN BERNARDINO, CA 92408
By: RICHARD KIRKLAND
Date: 07-15-02
POST IN A CONSPICUOUS PLACE