SFD (9903-123)52170 Avenida Madero
9903-123
LICENSED CONTRACTOR DECLARATION
I helreby affirm under penalty of -perjury that I am licensed under provisions.of
9 ornmencinb , (C with Section 7000) of Division 3 of the Business and
'
Professionals Code, and my Li6ense is in full 'force and effect.Lic. Class Exp. Date
06/300(
Signature of Contractor
OWNER -BUILDER DECLARATION
l,hb;eby affirm urider.penalty of perjury that'[ am exempt from the Contract&r'g'
License. Law for the . following reason -
1, 'as -owner of the. property, or my employees with'wages. as'their sole
compensation;
ompensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044, Business & Professionals Code).
t 1, as:oWner of -the j5rop'erty,:am exclusively contracting, with licensed
contractors .to construct the project .(Sec. 7044, Business & Professi6nals
I `arn,exempt under Section B&P.c. fo*f,this reason
Date"
Signature•of Owner, It
WORKER'S COMPENSATION DECLARATION
I Toy.-affieffi. -under penalty of , perjury. one of, the following declarations:
I. have."and Will maintain a certificate of consent to self-ins0re for,workers!
compensation, 'as, provided for by Section 3700 of the Labor Code, for the
performan66.ofl the work for which this'permit'is issued.
I
have, and will maintain workers' compensation insurance, as required by
Section 3706'61` the Labor Code, for,the performance of the work for which this
permit ii'1:S'S'Ued. M -workers' compensation n insurance carrier & policy no. are:
Carrier
rier, Policy No,
K) "I
Mrr 0 0
10
(This secti6n,neecl no't be completed if the permit valuation is for. $100.00 or, less).
I certify..that in the perfdrmance of the work for which this permit is issued,
i*ihall not4pmploy any. person in any mariner ner 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 .3.700 of the Lab6r
CAej'shall forthwith comply with those.provisions
%kYa. te; Applican . t
Warning: Failure'to secure Wbrkeis' Compensation Coverage is unlawful and
shall subject an e'moloy6rto criminal penalises and civil fines upto$100,0b0Jn*
adcliiiontothe cost of compensation, damage's -as provided for in Section 3706
P S
of the.Ldbor Code, interest and attorney's fees:
IMPORTANT Application is hereby made to the Director of Building and Safety
for. i" permit'• subject to the conditions - and 'restrict.ions,set forth on his
appj ication_
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, indemnity
&,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
,p4r it, or cessation of work for 180 days will subject permit to can6elfati on.
I certifythat I have read this,application and state that t ' he 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
. .1 '
the -above-mentioned property for inip, ection purposes.'
Signature (Owne'r/Aqeht) Date
BUILDING PERMIT PERMIT#
DATE. VALUATION $,I ot1 4-28;70 LOT 9 TRACT. '37., UA
9q
OB SITE
J ADDRESS 51-170 AVENWA MADERO
OWNER
CONTRACTOR/DESIGNER/ENGINEER
PAZ CGNSTRUCIXWCO,
PAZ CONSIRU(,110N CO
5-11 L, koss
511flE ROSS
EL CVW11,10 CA,
EL CEN IRO CA, 5 t2243.,
C131A -5537
USE OF PERMIT
,iNG1 - KLING
WF -D - P IMMIT DOFF. 140't DiCLUDG.HLOCK UTALLS ORr bdil*l
r.
7TOkc" 07 a 1RUCTION t,6513.00 S171
'14 . I
st
FSTV D COS Q, MCI WIN
E., MrAllf T OF, 0, N M.T."
180,428.7p,
pRalhOT, FOE SUMMARY
CONSTRUCTIC)N VEE, i0l-OW-418-000 $643,00
PJ AN CSWK K R -F. _3 9 $536-62
IM -000-139-318
&1.014,100-421-000 $47.00
, ffi;M WWAL r, E54
E.1.113,C-i'RICALFEE :10.1-000-420-000 $131, 761
03 19-000 $1X75
STROINC,'M CPTION F1311 - RP',STO .10.1-0004241-.000
GRANNO FrN. 101-000-125-000
I N 'R&S' iT tV C TF01 13 FHEl 222-(KXJ 443342 52,248,87
PRF . 1 8r, P.11 AN M! - W-441 345.
i -W TIN PUBLIC PLk"El - 'fdlmm 11701,_000-1765-000
SUB-TODA1, CON-517RUCITDN AN 01 P UN CTIECK
LESS ME-RAWFEES
4250-00
'raw., rf"RWICT FRIES 01411 NOW
53,636-814
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
A AUnderground
Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
—
Exhaust Fans
OX to Wrap
91 Zq_ &7
F.A.U.
Framing
S
Compressor
Insulation
o 7
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
BLOCKWALL APPROVALS
POOLS - SPAS
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
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection •
—Z/ —
Encapsulation
Gas Piping
Gas Test
,2 . 5
Appliances
Final
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.1.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
Desert Sands Unified School District r
47-950 Dune Palms Road
" Notice: La'Quinta, CA, 92253 k
Document Cannot Be Duplicated 760-771-8515 -
Date 5/7/99
No. 18703
CERTIFICATE OF COMPLIANCE
APN # 773-203-009
Jurisdiction La Quinta
Owner NamePaz Construction Co. Permit #
No. 52-170 Street Avenida Madero Log #
City La Quinta
Tract #
Lot #
Type of Development Single Family Residence
Comments
zip 92253
Square Footage
Study Area
1653
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:
J
. 0
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to' Government Code 53080 in the amount of
1.93 X 1,653 or $ 3,190.29 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 cc/Bank of America - Augustin Paz V Telephone "353=,9772
Name on the check
By Dr. Doris Wilson , y
Su erintendent`" y'
Fee collected /exempted by Ellen Patino Payment Received $3,190:91' g:M1'
Signature
j '
Check No. 2015831307
tOTICE: 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
ibove 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
.,tact 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
`Older No.
Escrow No.
Loan No.
WHEN RECORDED MAIL TO:
World Development, Inca
78120 Calle Estado Ste. 104
La Quinta, Ca.92253
SPACE ABOVE THIS UNE FOR RECORDER'S USE
DEED OF TRUST WITH ASSIGNMENT OF RENTS.,
(SHORT FORM)
This DEED OF TRUST, made February 23, 1999, , between
AUGUSTIN PAZ and EVA PAZ, husband and wife herein called TRUSTOR,
whose address is 52-995 Avenida Mendoza, La Quinta, California 92253 (State)
(Number and Street) (City)
EL PASEO FINANCIAL, INC., a California corporation, herein called TRUSTEE, and
WORLD DEVELOPMENT, INC., a California Corporation
herein called BENEFICIARY,
WITNESSETH: That Trustor grants to Trustee in trust, with power of sale, that property in the
City of La Quinta County of Riverside State of California, described as:
Lot 9 in Block 37 Santa Carmelita at La Quinta, Unit 3 as pe -r map recorded in
Book 18,. page 69 of Maps, Records of Riverside County
"Should the Trustor or his successors in interst, without the consent in writing
of the Beneficiary, sell, transfer or convey, or permit to be sold, transferred
or conveyed, his interest in the property, or any,part thereof, Chen Beneficiary
may, at his option declare all sums secured hereby due and payable."
together with the rents, issues and profits thereof, subject, however, to the right, power and authority hereinafter given to and
conferred upon Beneficiary to collect and apply such rents, issues and profits for the purpose of securing (1) payment of the
sum of s 7,750.00 with interest thereon according to the terms of a promissory note or notes
of even date herewith made by Trustor, payable to order of Beneficiary, and extensions or renewals thereof, (2) the
performance of each agreement of Trustor incorporated by reference or contained herein and (3) payment of additional sums
and interest thereon which may hereafter be loaned to Trustor, or his successors or assigns, when evidenced by a promissory
note or notes reciting that they are secured by this Deed of Trust.
To protect the security of this Deed of.Trust, and with respect to the property above described, Trustor expressly makes each
and all of the agreements, and adopts and agrees to perform and be bound by each and all of the terms and provisions set
forth in subdivision A, and it is mutually agreed that each and all of the terms and provisions set forth in subdivision B of the
fictitious deed of trust recorded in Orange County August 17, 1964, and in ail other counties August 18, 1964, in the book
(continued on reverse side) 1001001 (5194)
Page 1 of 4
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: AGUSTIN PAZ - PAZ CONSTRUCTION'..•
PROJECT
ADDRESS: 52-170 Avenida Madero -
APN: .773-203-009
LEGAL: _.LOT 9 ,.BLOCK 37UNIT 3 ,. S. C.' @ V.L.Q.; '
C K' D BY: LESLIE MOURIOUAND '
f 99-46: . •
BIN NO: See Boldin `OASE NO. CHECK -DATE:"
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-
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Case logged .and number assigned
Verify legal and APN,information
Consistent with MDG.on file las applicable)
i
MDG filing required ,15 + filings since 9/3/981
--- . Gonsistency--with': street/surrounding. area: '
Colors
Materials
Architecture f
OTHER REQUIREMENTS:
The zoning code, architectural and', landscaping manuals, and/or assigned inspector should-
'be
hould'be consulted where uncertainties arise. The completed checklist shall be maintained in the
' Building & Safety address file. -
Certificate of Occupancy
Cityof La Quanta
5
Building and Safety Pepartment', OF
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: 52-170 AVENIDA MADERO
Use Classification: SFD Bldg. Permit No.: 9903-123
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC
'Owner of Building: PAZ CONSTRUCTION CO... Address: 541 E. ROSS
City: EL CENTRO, CA 92243
By: STEVE TRAXEL
' Date: 12-6-99
Building Official
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