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SFD (0005-160)54020 Avenida Madero 0005-160 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. D to 526236 13 L r Date Si nature of Contractor/' - - --1-` — g 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). ( ) 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 EXEMPTiOIN 00111.1.5 Policy No. (This section need not be completed if the permit valuation is for $100.00 or less). ( ) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the woyykers"compensation laws of Califorrry'a, and agree that Sh ould become sy6ject to th workers' compensatio }4p, ns of c '6n .7 ofe-L-aborode, I dial fo th comply with t o$esio s. ate: Applicant `J « 7C,, ' V 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 benefitwork 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 f this City to enter upon th7e bove-mentioned property for inspectio pup -ops. 01 `11 Signature (Owner/Agent) t Date V I t •1 ° U BUILDING PERMIT PERMIT#` DATE VALUATION LOT TRACT .1,t3 2A 13LK257 JOB SITE APN ADDRESS .774 -193 -WI OWNER CONTRACTOR DESIGNER (NEER DICK SCOn PARADISE CONS'CR.UC°t 0141 P.9.3 030 101512 P C BOX 16006 PADS D&SERT CA 92255 POR'II ND OP 172: 0 - (503 'l i3U9.2527 CBL4 a7 7 3 f. USE OF PERMIT 51140LEFA1v9 LY.CiWML1N0 3FD = PERM T IDES NOT INCL DI? 3LQCK WALL, Oi POOL, 6 TRACT CONSfRUCTIO1d 1, KDO OF . CtAMAGE1ti ARPOU (SF) 10,172.40 5 FT. WOOD FENCE 200.00 LF iy ESTUOXD COW]* OV CONSTRUC f. N' i3S,S81,i 6D 1PX1W1'FW,T SUMMARY CONSTR.L?C" VON. f4' 101.-000-418-000 $390,00 PL,A.w C -HEC F - 101.000-439-318 $495.21 MECHANICAL 101-000-421-000 $53.50 EJ,EC TRICAL. ME ' 101.000-420-000 $129.60 PLUMPING ME 101-000-419-000 $110.75 STRO'NO MOTION FEE 4 RESM 101-000-24,1-000 $8.84 ORADINO FEE 101.-000.423-1300 520.00 I`iBVBLOPER IMPACT $1,907.00 PRECISE PI.AAN 101-000.44.1.34.5 ii00A ME DZPOSI`C 101 -00"39-31 a dS2a0.4U Sdr B_ (y1°AC, (XIYOMIRTICTION AND A7 ClCMrx $3,4.14.50 1XSS PRE -PAID MS 4250.00 RECEIPT DATE DATENA ED INSPECTOR INSPECTION RECORD OPERATIONDATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck 7 - 5 _ pp %-C Exhaust Fans OX to Wrap .. z—a-62 157 F.A.U. Framing 5 Compressor Insulation -pa Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath _ Final 177- F - 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 Encapsulation Gas Piping Gas Test Appliances Final: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole -GTI S T 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: , BuildingOZ Address 7 r 1 Owner '11(G y— G U Mailing Address Ro. I;no k 1Q /V 12 T4ht 4 P.O. BOX 1504 APPLI ATION ONL ' J 78-495 CALLE TAMPICO LA QUINTA,'CALIFORNIA 92253 nn vis . BUILDING: TYPE'CONST. OC . GRP. - [ Z 1 Z.Z. Tet. G Conti for o e ✓ l cC.e cw\ S Vt, e i'ti tJ A sGA P COV %N'rV 4, C( U(410 D Number A- I Description LOT mt Description CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I am license provisions of Chapter 9 (cc the g6jines rotes ' • o da,d my It, OWNER -BUILDER DECLARATION I hereby affirm that 1 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). 1'101, 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 buflding or fmprovemenf 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.) II I, as owner of the properly, 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.) 17 I am exempt under Sec. B. 8 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 r7 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 (8100) valuation or less.) I certify that in the performance of thg workk-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: 11- ager 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 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 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 W, No. f No. Dw. Stories Units Add ❑ Alter ❑ Repair ❑ Demolition ❑ >timated Valuation PERMIT AMOUNT Plan Chk. Dep. ,. .. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure r F 1 TOTAL REMARKS ZONE: A 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 FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION State Lic.City & Classif. 526 2 Lic. # p 1 Z3 Sq. Ft. Size Arch., Engr., Designer Lz Kcl , 6vby New Address ITel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I am license provisions of Chapter 9 (cc the g6jines rotes ' • o da,d my It, OWNER -BUILDER DECLARATION I hereby affirm that 1 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). 1'101, 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 buflding or fmprovemenf 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.) II I, as owner of the properly, 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.) 17 I am exempt under Sec. B. 8 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 r7 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 (8100) valuation or less.) I certify that in the performance of thg workk-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: 11- ager 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 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 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 W, No. f No. Dw. Stories Units Add ❑ Alter ❑ Repair ❑ Demolition ❑ >timated Valuation PERMIT AMOUNT Plan Chk. Dep. ,. .. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure r F 1 TOTAL REMARKS ZONE: A 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 FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Notice: Document Cannot Be Duplicated Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE Date 5/18/00 APN # 774-193-001 No. 20456 Jurisdiction La Quinta Owner NameDick Scott Permit #0005-160 No. 54-020 street Avenida Madero Log # City La Quinta zip 92253 Study Area Tract # BLK257 Lot # 24 Square Footage 1409 Type of Development Single Family Residence No. of Units 1 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 2.05 X 1,409 or $ 2,888.45 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/1st Bank/Dick Scott Telephone,, 760-408=3495 Name on the check ~ V - Y By Dr. Doris Wilson - s . Superintendent Fee collected /exem tea by Mary Ann L. Bora Payment Received $2 8,88.45,:. ; y til .t I Check No. 54932 Signature NOTICE: Pursuant of Assemblyllill 3081 (CHAP 548, 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 fmm 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 tcording Requested`By 41CAGO TITLE COMPANt RECORDING REQUESTED Bi': AND WHEN tRECORDED, MAIL TO: Richard Scott P.O. Box 10612 Palm Desert, CA 92261 774-113.00/*4 ASSESSOR'S PARCEL NO.' 77 93 oba S TITLE ORDER NO.: 207055605 oma- ops GRANT DEED Doc is 2000-121346 03/31/2000 08:00A Fee:G-N Page 1 of i Doe T Tax Paid Racerdad in Official Records County of Riverside Gary L. Orso Assessor, County Clark 8 Recorder 1 I I IIIIIIIIIIII II II1 I IIIIllll1111111111111111111 1 M $ u PAGE SUE DA PCOR R SMP MISC. lAGA R L COPY LONG REFUND NCHG EXAM The undersigned Grantor(s) declare that the DOCUMENT TRANSFER TAX IS: $ 48.40 County $ City ' xx computed on the full value of, the interest of property conveyed, or: -computed-on the full- value ler 'ss-the-vatue -of-liens oerrcumbrantes remaining thereon at the time of sale. OR transfer is EXEMPT from tax for the following reason: FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Rosemary M. Hezlep, Trustee of the Rosemary M. Hezlep Trust dated August 12, 1997 hereby GRANT(S) to Richard L. Scott and Claudia J. Scott, Husband and Wife as Joint Tenants all that real property situated in the City of La Quinta County of Riverside, State of California, described as: Lots 23 and 24 in Block 257, -of Unit- 24., -of. Santa.Carmelita_at Valela Quinta, as shown_ by Map on,file, in Book 19, page 44 and 45, Records of Riverside County, California. Dated March 7, 2000 STATE OF CALIFORNIA, COUNTY OF-- oN ' /T - before me Alke"01 Rosemary M. H lep, Trustee Notary Public, personally personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacit and that by his/her/their signature(s) on the instrument p(j$(. the person(s), e e it upon behalf of which the person(s) acted, executed 11162OQ the instrume WITNESS y ,and aofficial fe j) 'I (J MAIL(TAX STATgMENTS TO: Richa d Scott - P . Box 10612, Palm Desert, CA 92261 (This area for official notary seal) RC DISTRICT - PLANNING REVIEW FORM This form is to be used by CDD staff for review of single family dwellings in the RC (Cove:Residentid1) District, in order to determine the applicability of compatibility issues or need to require the fil ng'of Master Design Guidelines by the applicant. It shall be transmitted to the Building and Safety Department as your_ , y correction list. Please attach additional explanations as necessary. APPLICANT PARADISE CONSTRUCTION SITE ADDRESS 54-020 Avenida Madero APN / / - - 0 BIN NO.: Compatibility Review LEGAL: LOT 24 BLOCK CASENO.: - 2000-222 257 UNIT S.C.@V.L.Q. CHECKED BY: Leslie Mouriquand 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 Compatibility Review Case logged and number assigned Verify legal and APN information Consistent with MDG on file (as applicable MDG filing required (5 filings since 9/3/98) Consistency with street/surrounding area: Colors Materials Architecture Other Requirements. © • , A B E C gZ HIBIT SE 'NO. Certificate of Occupancy City ofla 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: SFD Occupancy Group: .133 Owner of Building: DICK SCOTT 54-020 AVENIDA MADERO Bldg. Permit No.: 0005-160 Type of Construction: VN Land Use Zone: RC Building Official Address: P.O.BOX 10612 City: PALM DESSERT, CA. 92255 By: GARY HARTMAN .. Date: 12-1-00 POST IN. 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