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SFD (0002-424)53785 Avenida Madero 0002-424 ~ LICENSED CONTRACTOR DECLARATION r j h reby affirm under penalty of:'perjury that I am licensed under provisions of r apter 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 9'1-1-54_ F3 C ltpf3(}120f Date R -7 }- I-9 'Slgnature of Contractor 1 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). _ 1. ( ) 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 ? -21 ­'ZiOCO Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under tpenalty, 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. (1 have and will maintain workers' compensation insurance,, as required by Ser tion 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 S1..ATL l.i;fND Policy No. '29©J tJ fi'1' Sh)11t?E(i 1 ' (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. Date: -?_, - Applicant 1. f r 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, 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 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) ll 'u ' Date 1-21-7—r. -, BUILDING PERMIT PERMI0002 424 VALUATION $1.04.239.660 LOT TRACT 1'J'J. TJ49 JOB SITADDRESS 3- % l v'TV f. f3a 14'iA 3LR i APN i74-142,-0$4 OWNER CONTRACTOR/ DESIGNER/ ENGINEER ` t 1 0 7 h' 'A R \ t7- N1T.'R G I f1 A'7 f4nT J T 'ef 7`11 -NN -0 ..1, VA. a l.,'i. PAL , .+ . 0, C., A....LJ V PO BOX 134 54.1 E ROSS r LA QUiNTA, CA 92253 EL CEWI R0 CA, 92233 (760)353-97`72 USE OF PERMIT SINGLU FMOffLY ,IJWl:i,,l.il G Wi-0 - 1'lst MI"1- i. 046 NO I' iNCLUI)E 13LCCk WALES OR POOL tI1f osmER "'1`.A.US") T -T/1' N O/ n ,5p R ' lsi:.i CCi.vSia+, J4a iiJl f 1,419V.Vi! :Sfa , CAicAG?eCAIWORT 533,00 RE i 1: V. WQ01 i) F'i:.NC1: 200.00 L t Can OF ConS'l ptua 6th 104,239.40 PERMIX FEE S(J111N1 RY CO-NKYRUC.IMN FEE 101 -WO -418-000 $657.00 W,nN 0-f-WCK {+'FSH, 101 -000 -439 -lits $553.517 NI CHA` ICAL TITE, !t}i- - 2-17:?i} $11431,00 `. 71 01,a RIC'.AL 1'kl ► PLUA119IN'G FEE 101-000-419-000 STraONO IVOTION ATE - RESfD CRAi{1<1 O PEG 10 1 - 0 0 V - 423 4X0 V, l EVELi PER iWACT i { , 1'P ►:r,,'1:`31 F{3.A.AN 1{1.I. -000-4E41-345 $lOf}.C>U :•-- . kRT IW NUWJC'PT.:A.("F . -,RFS1' 70J-00KII-255-000 SiJB-T .YI.'A .. CON,1RUf,:'%'tC1_N A_ iii i.f 1 T f Ile".C:K, $1,593,R6 TOTAL PClMU 'VI;E:► .l3C C NOW 53,393.86 RECEIPT DATE BY/ AJ./ !/ J D T INALE INSPECTOR i INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs GJ_57 Underground Ducts Forms & Footings _ / Ducts Slab Grade Return Air Steel Combustion Air Roof Deck —CSie9 Exhaust Fans O.K. to Wrap era%;,S F.A.U. Framing L Compressor Insulation • -00' 7Z2 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 2t ao BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs czp 9 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 Water Piping % Qa Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection+jo Encapsulation Gas Piping Gas Test —JDV 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.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: Building Address 5 — Owner rwr"raij r ua'�ct' C P.O. BOX 1504 78-495 CALLE TAMPICO QUINTA, CALIFORNIA 92253 Address P Q u34_ CityZip Tel. Contractor ti e�1 � - "nm ni � o t ICS C / vkr s Aaaress ty State Lic. City & Classif. I Lic. # Arch., Engr., Designer Ltzt-itjL Address Tel. City Zip State 1 � n ... _ _ /. G_ _ ,,- Lic. # LICENSED CTRACTOR'S DECLARATION I hereby affirm 1hat4Va'�m licensed under provisions of Chapter 9 (commencing with Sectlon 7000) of Division 3 dY'the usiness an Professions Code, and my license is in full force and effect. C a ` A" I L - 1! `�F,,rD1p SIGNATURESSS/ '7WXCDAATEE OWNER -BUILDER DECLARATION I hereby affirm th 1 am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5, usiness 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 for the alleged exemption. Any violation of Section 7031.5 by any applicant for a p subjects the applicant to a civil penalty of not more than five hundred dollars ($500). U] 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.) I I 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.) t! 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 (7 Copy is filed with the city. O 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 thF work for which this permit is issued, I shall not employany 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 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 it 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 sof this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip LDING: TYPE'CONST. OCC. GRP Number. :104 N.4 - Ca\ 4- 1 Description L.C7T Z-. 'Q, ux-v. - V9 N t—, l fj Ict Description r_G4 hi k I W—e'i -lam M � L� �4,OH t'`r Sq. Ft. No. No. Dw. Size /I ({p Stories Units New T Add ❑ Alter ❑ Repair ❑ Demolition ❑ to �P��OOO AMOUNT k J O� PanC a. � Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL =� REMARKS ZONE: BY:- Minimum Y: Minimum Setback Distances: t Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DA INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 Date 3/21/00 No. 20193 Owner NameLa Quinta Partners CERTIFICATE OF COMPLIANCE APN # 774-142-014 Jurisdiction La Quinta Permit # No. 53-785 street Avenida Madero Log # City La Quinta Zip 92253 Study Area Tract # Lot # Square Footage 1696 Type of Development Single Family Residence No. of Units 1 Comments WD - Permit does not include block walls or pool 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: ' ;a ti EXEMPTION NOT APPLICABLE ¢ This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.93 X 1,696 or $ 3,273.28 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 ccNalley Independent Bank/Agustine Paz Telephone 760 861-2872 Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Olivia Aguirre Signature Payment Received $3,273.28 Check No. 209783 NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to collect them on the District('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting -POC a 3998-481944 Recording Rag0estod 0y : llinitw. seaso or :V." CHICAGO TITLE COMPANY pa" Iof 2obee 7 `r r.lY 1 A>tOt)6tiJI1l0 A92 fYtTiD 1sY cw,y ♦r tllsfraida C3iICJ00 2'1742 C0IPAIP7 CONPART ( G►P L. tsv 99.9236)00 97057307 ir6b I t ■■Mr) cowir Clark t, Reaveo/ f wM "CWMXD X%n 7811) V= An, I 1111NIM0,1011118A i 76tO.M.89 B'w 10MOP1, WIL TAX ■TATAMCM !0, Jul RICMAttD SCOTT' r ■ a a ,00. nm■ r; u■ P.O. DODO 10612 I PALI OMRT. CA 90755 _ f ) 02,0`.0, GRANT • ■ ren ,v w r■r ww(lC DEED I lbs undarsi9nid grantors) Goclace (e) : Doeumehtery te"efor tau is 135.20 : (:Lal couputeQ on Lull Yalu: of praporty conveyed, or .. ( ) Carp teeaa on full value lana Ill an■ and encUUrencee ranaining at time of sale. I 1 Incorporated area, I ) City of and POA A VJkLUXW4 CN3T0BRATI011, receipt of Which in hereby acknovIedged, ' [SV]3 A. Eff , a siaau usa as to fat 1 and. ICB il1 >t. 101IC1QZR8CICKER end PAUL ZIr9Rta", CO-TRO8786S .Or TNS BRIG RIN)AY TRUST AGREe?18pT OF 1981 AND A$ AM=jcD NoMBER 13, 1983 is to Lot 2 hereby OR>`ar(sI to &1CtlARD L. SOM AMD CIAVDIA J. SCOTT, HUSBAND AND V1P6 AS JOINTTEHTS AS TO LO? 1 An VILLIAN THOMAS Bumm, M U101ARAIf9 NAH AS TO LOT 2 the real property In the City of iA OUINTA, County of-Rivereldo, State of California, described ass Lot (61 1 and 2, Block l9?t` uric 11o,DP9-,gr&Ct1Santo Cermclita at Vale La Ouinta. as per Boo* iige(P) amp recorded in 19, 33-30inclurive of maps, in the o9f4co of the County Recorder of Bald County, ' Vatad Ovtob" 4, 197! Rr 'C • stat: of Gltrornia County of C7 J S.S. BVI1 R'$4CXOFL; INDIVIDUALOn 1r- OGTaj W.F before aye, c r o elf. h V ( • P11itGf-fes.`, , prrsorol6/ appeared A(Jl 22 1, CO-TRUS4283 IrCViw/ A K = liiL K ECS 80SK.!<L _ for proved to eb on e14. ! the basis of setiseaetory evidancel to be A, CKBRB KBR, CO-'t1WSTVB the person 1%) : whose neaso (V) is/aw subscribed ' to the Within inctruaent and acknovledged to, ! roe that ho/*P-iWV P w(ocutsd the assn in i his/haz,/H.tr authorised espacity(4ai, and K44YMMMCiAMMO I that by him/has/their signaturt(04 on tho )40Co 0)16LW C 'or %WGon%A9vftjm2MM ► ' instrument the' pereonla,). the entity upon t— mois" , ►. behi{le of .hiCh the pereon(6) acted, executed tho i."tTVgont„ NlTVSC,$ ry )mnd d offieLal Deal,)7 SLgnature / (This area for official notarial meal) M xxxt 'rxx . SAME AS A1f0Yli t 1 t -T-65.:R6E . ZO,.-015 SEC' j2 020-m 050 Z5,60— 02-0- 060. 7 oZO-063*.10 020 ..... .... . R." -F-a CA c 4 Z 2 Vi. -: sp, z' Oro rpozo-ogg a Z-x4c /3'-4 ? -24 ll"4a 7., V J.: 7 - nZ 4 - 4 o. Z) - OtO -'0 - 5 0 ONLY'. LYj MEE, 4-M MU'- Rice m.nen era to sV •WSfled.merejygS eibn IF ' ce to streets arid O'her ! 1 6df- N r, t ,;Sum -a dpy r'easonOt iv..a Tli2ncehEreo,).,. V w CHA ON l RIM CALL -A a 4. 'ARMELITA."'--7 TUALETA I 4' ;SANM k g Ou, -`R/VERS/DE COUNTYa YL ."LiF u p ME, I E mi I- -; Ri -. .7 -00 1 . 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 the Building and Safety Department as your correction list. Please attach additional explanations as necessary. APPLICANT LA QUINTA PARTNERS SITE ADDRESS 53-785 Avenida Madero APN 774 - 147 - 014 BIN NO.: 148 C 2000-192 CASE LEGAL:. LOT 2 BLOCK 197 UNIT 19 S.C.@V.L.Q. CHECKED BY: Stan Sawa DATE: 3,a•OD 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 Compatibility Review Case logged and number assigned Verify legal and APN information Consistent with MDG on file (as applicable ti MDG filing required (5 filings since 9/3/98) Consistency with street/surrounding area: Colors Materials Architecture \4 , w*& gjol0 v -e zo ors BVI ► ( • V Other Requirements: 55p -d-1 PWLA Aoyoth, • ex+ Go 5 • V 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 ollowing: BUILDING ADDRESS: 53-785 AVENIDA MADERO Use Classification: SFD Occupancy Group: R 3 Type of Construction: Owner of Building: LA QUINTA PARTNERS Building Official Bldg. Permit No.: 0002-424 VN Land Use Zone: RC Address: P.O. BOX 134 City: LA QUINTA, CA 92253 By: STEVE TRAXEL Date: 08-21-00 POST IN A CONSPICUOUS. PLACE