SFD (0003-214)54530 Avenida Madero
0003-214
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
U) . ) Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
O M License # Lic. Class Exp. Date
r- d U-)
W r- 521795 AB IIIC. , q 12/31! t
oZ r-- /ate 4f • 11 - 04i Signature of Contractor
(fl 0
J U
C:) OWNER-BUILDER DECLARATION Ill
HLU I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
Z_ ( ) 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).
cr) () I am exempt under Section B&P.C. for this reason
ul
N Date Signature of Owner
ON
Q WORKER'S COMPENSATION DECLARATION
It mZ
CcI hereby affirm under penalty of perjury one of the following declarations:
r H O () 1 have and will maintain a certificate of consent to self-insure for workers'
X W L- compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
m Q U ( ) I have and will maintain workers' compensation insurance, as required by
C5 L) Q Section 3700 of the Labor Code, for the performance of the work for which this
LO
H permit is issued. My workers' compensation insurance carrier & policy no. are:
Z Carrier Policy No.
FREI:4ONT 11TAi99303994-31
p
J
(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
3 subject to the workers' compensation provisions of Section 3700of the Labor
C I shall forthwith comply with thoseprovision O0t2
t Q
e:y-, IP — Applicant a -
e, Warning: Failure to secure Workers' Compensation coverage is/unlawful and
shall subject an employer to criminal penalties and civil fines up o $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
thZreve-mentioned property- for, inspection purposes.
(Owner/Agent) F • d'- Date
+
<,
,• J
triVO BUILDING PERMIT - PERMIT#
DATE VALUATION LOT MM -214 TRACT
S1Q3,;478, ? 23 13LK272 U25
JOB SITE
7ADDRESS
54-530 A LMiA it!I i1 IMI
Y
OWNER
CONTRACTOR / DESIGNER / ENGINEER
JOE&c MARI& AVILA
ifi'l".B I;- 81NION CO.
PO BOX 1155
P 0 BOX, 10990
RANCHO Iv RACM CA 92270
INDIO CA, 9220_2
('150)34"1-5399 CL•1L.#, 61217
- ~
USE OF PERMIT
MOLE FAIU .'-Y I MI -JI aO
J
SYD-PERMIT DOES .NOT IN'CLU04 BLOCIC"WALLS OR POOL
TRACT GON CIaUC:TION 1,734,00 3I°
PORCH/PATICI 69.00 SIF
GARAtI);7CARPORT 439,00 Sty
5 rr, WOOO FENCE 200.00 LF
, WS'tT'it/i TED COST OF C;0Wn1ZUCf1OX
105,378.30
i'IERMI ' FEE SUMMAPEY
CONSTRUCTION FEE 101.000-418-000 $660.50
PI„SAN CHECK PEE 101-000-439-318 549:56
MF.,CI3ANIC.fX F'R.E 101.000.121-000 $53.50
XLL4;'TRICAI,. FEE 101-000.420-000 $132.ri
PLUMBING FE101-000-419-000 $122,75
STRONG MOTION FEE - ItES1n 10)-000-24,1-000 V 0.5i
C1ltr DIWO FERE 101-000-423-000 $20,00
DEVELOPER IMPACT ME $1,9r,00
PRECISE, PLAN 101.000-441-343 $100,00
.ART IN PUBLIC PI..AC&S - RESIE 701-000-255-000 $13.43
FEE; PiEPOSIT 101-000-439-318 4230.00
WE TOTAL CON:1'TRtICTION ASIA PLAN C1TECK
$3,570.2'.1
I.,ESS PRE -PAM FEUr
4250.00
TONAL PIMWTitEES DUR 11014I
3 20.27
RECEIPT
DATE
B // r/
D/ E IN L
`
INSPECTOR
fr
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
SBO
F.A.U.
Framing
Compressor
Insulation
S ?
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 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
57<
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
y
Encapsulation
Gas Piping
Gas Test
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) 751-1
COMMENTS:
P.O. BOX 1504 APPLICA ON ONLY
p
Building L _ 78-495 CALLE TAMPICO
Address 5 I 5 /r C A LA QUINTA, CALIFORNIA 92253 I 5.
Owner I A J
/ ..p Af" iWJIIl n 0.4 I
Address
City Zip Tel.
12AAA.A,.1 9W ?0 1 7k. 3ya . t.
Contractor
Address
57 ^ 3 S 7 •'T a t!/lim
City Zip Tel.
G `j22T3 7/ /13
State Lic. City
& Classif. A 1 1-n 12 t." Lia #
=ngr., Q
er ! A , C.vv. I r t A O
Add ess Tel.
Cit ` Zip State
Ch0-
ZS Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provision of Chapter 9 (commencing with Section
7000) of DlyysA of the Busi ss a. P ofession ode, and my license is in full force and
effect. e an
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 (5500).
1-: I, as oner 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
orimprovement 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.)
1 1 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.)
1 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 certif' Dopy thereof. (ec. 3 00, Labor Code.) C.
Policy No. Company*
4n +- V
Copy is filed with the city. n 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 (5100) 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, alter 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 construction lending agency for the performance of the
work for which this permit is issud. (Sec. 3097, Civil Code.)
Lender's Name !A j:
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 stale 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
ateMailing Address
City, State, Zip
BUILDING: TYPE'CONST.
GRP.
A.P. Number -1 -
1OCC.
-Z -
Legal Description L Q J,
-1/
Q U
Project Description Sr
Sq. Ft. c No. No. Dw. W ` ^
Size I- ! Stories / Units t- Sewe,,.
Newq Add O Alter ❑ Repair ❑ Demolition ❑
PERMIT
AMOUNT
Plan Chk. Dep.
OS -0 •'
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
i
Infrastructure
yy
J 2 Il111S!
1 4
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
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
00WWHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
; h; eG/ , o /z/ // i
G1a F_x /2/i/T
Y// z/Zv/ /999
Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated 760-771-8515
Date 4/18/00
No. 20310
Owner NameJoe and Maria Avila
CERTIFICATE OF COMPLIANCE
APN #
Jurisdiction La Quinta
No, 54-530 Street Avenida Madero
City La Quinta zip 92253
774-190-023
Permit # 0003-214
Log #
Study Area
Tract # BLK272 U25 Lot # 23 Square Footage 1734
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 1,734 or $ 3,554.70 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/Steve Holliday-Teliphone 760-347-4383
Name on the check
By Dr. Doris Wilson J "
f
r b
Superintendent
Fee collected /exempted by Mary Ann L. Boda Payment Received ',-$3,554'.70 .
Check No. 214373
Signature
NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment Identified
above will begin to run from the date on which the building or installation permit for this project is sssuad or on which they are paid to the District(s) or to another public entity, authorized to
collect them on the District('sxs') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building DeptJApplicant Copy - Applicant/Receipt Copy - Accounting
»afitGORDING R£
j'
WIWI
I
first Americ lii
f ?itle,ls r' c:
nND WHEN'%•RECOROEO'MAIL' THIS DEED AND. UNLESS
o,,
w
;,THERWISE SH OWN•BEI.OW,. MAILTAX STATEMENTS To:,
.. ._ .. ...
{i
I
(; ][
fy.
M—J
fV
•
h$k
NAM[1-
°`
M
- I
•.
STRECT Mr. `and Mrs. Joe Jesse Avila
p C!
W o
00
2'
r
ADDRESS
P. O. Bog 1185
4'
.
Q
W co
•Q
G
.
STrAIf Rancho Mirage, CA 92270
; it
> ►-
z_
J
* • 3486-T W
?'itic Order No ......:.....:..:......... I{ rem.' \
• this spoce for Recorder's use
PAR"I"'NERSHIP GRANT DEED
117 t ,aA sT()r. k •. I. I )I•r 1 a?;r• f`) T7
ARl l [CANSFI I'.1X i> c__26._40
l '--._ui,in, rl:nr.ilr:.l arc;r ]a City of—La--Quinta—
• ,on,la,rc,l ,m kill -Inc of property c•unveyed, ur
I r'u,l`utr,l
'n- full v,iluc Iesc.value of liens or encumbrances remaining at time of sale, and
FQR A VAL11ABIJ:-. CONS11)1:ItATI 0N, reccil>t of which is hereby acknowledged,
DC2 FAMILY PARTNERS, LTD., a Colorado limited partnership who acquired title as
CROCRETTT,FAMILY,PARTNERS, LTD.; a Colorado Limited Partnership
hrr"liv GRANT(S) Io
Joe Jesse Avila and Marina G. Avila, husband and wife as joint tenants
the lollu,s'init descrihcd real hnilivrly in lite City of La Quinta
rnunly of Riverside state of Califotnia:
Lot 23 of Block 272 of Unit No. 25, Santa Carmelita at Vale, La Quinta as shown
on map thereof recorded in Book 19, Pages 50 and 51 df Maps, in the office of the
County Recorder of said County. ,
1 '
f
Dal,d March 25, 1992
OF CALWORNIA
COL`N'f Y O,F' •'1 ) SS.
Lcfnre ill r;'tIle' undcrsirnidz'Ngi' v Public in and `fo
a -!.said County
nd Sttc. personalh a ,geared / N__ S: _
known to me
to be '
1-0 f the partners of the partnership
that c.rcuted the .within instrument, and acknowledged to me that
such partnership executed the same.
Signaturcy /
Name (typed' or Printed)
Notary Public in and"for -said County and State
DC2 FAMILY PARTNERS, LTD., who acquired
title as:
CROCKETT FAMI 11PATNERS, LTD.
ilii r><.• ti -
BY:
o ores ._ . roc IS
i
y; l:t1 lI
(Space above for official notarial seal)
MAIL TAX STATI?MI?NTS TO PARTY SIIOWN ON FOLLOWING LINE; IP NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVIs
Name
FORM ST1 ,G
Street Address
City & State
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 JAMES E. SIMON CO.
SITE ADDRESS 54-530 Avenida Madero
APN 774 - 262- 002 BINNO.: 7d CASE NO.: 2000-200
LEGAL: LOT 23 BLOCK 272 UNIT 25 S.C.@V.L.Q.
CHECKED BY: Fred Baker 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
BK
Consistent with MDG on file (as applicable
EXHIBIT
MDG filing required (5 filings since 9/3/98)
A NO.
Consistency with street/surrounding area:
Colors
Materials
Architecture
Other Requirements:
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:
54-530 AVENIDA MADERO
Use Classification: SFD Bldg. Permit No.: 0003-214
Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC
Owner of Building: JOE & MARIA AVILA Address: P.O. BOX 1155
Building Official
City: RANCHO MIRAGE, CA 92270
By: STEVE TRAXEL
Date: 10-23-00
POST IN A CONSPICUOUS PLACE
j
*01
Earth Systems -Consultants
IMM7/ ` Southwest
79-811 B,Country Club Drive
Bermuda Dunes, CA -92201 • (760) 345-1588
Client Name
Client Address
Client Phone
t
DATE
511 5100
JOB NO.
PROJECT
`7 Ll' n8 Avf
'A
'"'I A- J Cx o
LOCATION
LaOu, ,,,
REFERENCE CURVE
CONTRACTOR
OWNER
WEATHER
TEMP Oat AM
Oat PM
PRESENT AT SITE
TEST
NUMBER
LOT
,NUMBER
ELEVATION
FIELD TESTING
REFERENCE CURVE
MOISTURE
CONTENT
%
DRY
DENSITY
lbs/cu. fl.
MAXIMUM
DRY
DENSITY
%
MAXIMUM
DRY
DENSITY
lbs/cu. fl.
OPTIMUM
MOISTURE
CONTENT
%
3
F -F6
y
.
53
d V110 xtstit,,r
l c1E
Q /" .Loclt.w
o
REMARKS: 1C 1 S IV Lim I Yz--- a jlrlS
CLIENT REPRESENTATIVE SIGNATURE
BD -FS -001 (10/98) -
AFIELD REPORT
IANS SIGNATURE
I'! 4835