SFD (0005-023)51720 Avenida Martinez
0005-023
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
,(.Wi oter 9 (commencing with Section 7000) of Division 3 of the Business and
Protessionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
595754 131 C'9/( /, 06130120
Date "LSignature of Contractor +' n- #
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 1, 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
perfo mance of the work for which this permit is issued.
(t 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 OTAt'E FUND Policy No. 229-00 UNIT 0011000
(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 Sect n 3700 of the Labor
Code, I shall forthwith comply with those'vlsions. ((((((
Date: ' - ?t . &.00 Applicant 11. -
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 insp
ection purposes.
Signature (Owner/Agent) J 1 i r Date x.71 - zoa
BUILDING PERMIT PERMITyy//# y /
//l . j
( lfVtl7. -026,6,3
DATE # VALUATION LOT TRACT
f f1 p . 13E1 14 BLKI 13X12.
JOB SITE
ADDRESS 51-720 11.VE,t WA 1VS.Wx' NX7..
APN
773-142-011
OWNER
CONTRACTOR / DESIGNER / EN INEER
A?3'CTUSi"i]`fE & EVA PAZ
PAZ C0.NS'Ck?UC1709 CO
52«995 AVENNIDA I1+1END0 A
52-995 AVFMAl+/31i N D=A,
LA QUISNTA CA 922.53
LA ( pwvT, CA, 92253
(760)564.3023 C'BVI 5537
USE OF PERMIT
SINCE FA)VIll Y OWEl WO
S1r17at'IvRDOT DOES NOT INCLUDE BLOGrWAL S OR Pool:,.
TRACT CONST'RUCTICiN 1,397,40 SF-
PORCH/PATIO 46.00 Sp
0AR.ACEfCAI'PORT (SP) 10,172.40
5 FT. WOOD FENCZ 200.00 LR
X9TWW.1'XD COST OF CCaI<i12'17RIYU170K
$6,341.30
PFIRwr F E (ZtT•i1lWAY
CONSTRUCTION MIX 101.000.418.0001 $590.00
PLAN CHFC K KF 101-000-439-318 $493.61
MECHANICAL IEE 101.000-471.00+0 $53,50
ELECTRICA1. WE 101-000-420-000 $122.79
PLUMBIAtO FEE 1011.000-419-000 311016
STRONG MOTION FEE • MMD 101-000-211-000 $3.83
ORADIN } PRE 101-000-423-000 $20.00
DEo/_1"_OPLR IMPACT 11EE $1,907.00
PRECISE PLAN 1011.000-441.345 $100,00
FEE DEPOSIT 101-000-139-:318 =S2s0.0a
9TJB-[0TAL COMIZilCTION MYD PLAN MIC K
$3,406.47
11"S PRE -PAM 1"F'US
-$350.00
cTOTA-L .F'E. 1RA-Yf FFES .STA NOW
0.7 6 A 7
1 f
`
RECEIPT
DATE B
l
DATE FINALEDINSPECTOR
INSPECTION RECORD
OPERATION
t
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
p pp s-
F.A.U.
Framing
2 neA2S
Compressor
Insulation
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 P ROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Water Piping
Heater Final
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
-6pQ
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)
COMMENTS:
107,12
Ici
0(1 a # V
P.O. BOX 1504
78-495 CALLE TAMPICO
AAPPLICATION ONLY
Address
LA QUINTA, CALIFORNIA 92253 vis
Addressss •{ .. ") 7 ^ (.1,usZ 1 1;A,. t-t e,J,•s--
Owner
Mailing _
Address &Jaz 1
City lZip ITel.
P
Zip
State Lic.I City
& Classif. .0 i; ,., `- A Lic. #
Desig—. , y..,
ner
Address Tel.
T3L 4- io
City Zip State
I . I /T Lic. #
ILDING: TYPE'CONST. OCC. GRP.
rL.bb A.P. Number 11 -- 14,7-
Legal
4,7Legal Description _ T t Tt 1 y 1 \' OAA C; i Z
Project Description ' r . w` ;. 4 tAv! t-+I,r,
! S Sq. Ft. No. No. Dw. I
Size Stories ( Units
LICENSED CONTRACTOR'S DECLARATION
I hereby afflfrr{ that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Di/vf'(oQ 3 of the BuTess and Professions Code, and my license is in full force and
effect. lF / 1 , 2 t—Zie cra
SIGNATURE t ! I DATE
OWNER -BUILDER DECLARATION
I hereby ffirm 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
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
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.)
I II'
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 or property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
I'! 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: If, 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
1hereby 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.
1 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
New 9 Add ❑ Alter ❑ Repair ❑ Demolition ❑
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:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
-
itl1
Estimated Valuatio
PERMIT
AMOUNT
Plan Chk. Dep.
.L/-.--9 06
< Ci (/(%
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
)
Driveway Enc.
Infrastructure
7
1
TOTAL
t
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:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Notice:
Document Cannot Be Duplicated
Date 5/26/00
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
No. 20477 Jurisdiction
Owner NameAgustine & Eva Paz
TI Z
No. 51-720 Street Avenida
City La Quinta zip 92253
APN # 773-142-011
La Quinta
Permit #0005-023
Log #
Study Area
Tract # BLK113U12 Lot # 14 Square Footage 1397
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 1,397 or $ 2,863.85 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/Augustine Paz - Telephone 760-564-3023
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Mary Ann L. Borja
Signature
NOTICE: Pursuant of AssembllAill 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 Distdct('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
v < e
tet
.a
Payment Received ,
"$2,863.85
a
Check No. 216413:
NOTICE: Pursuant of AssembllAill 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 Distdct('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
rf
01/09/01 ,10,:25 FAX 17608049062
_ RECORDING REQUESTED BY:
AND WHEN RECORDED MAIL THIS DEED AND,
UNLESS OTHERWISE SHOWN BELOW,
MAIL TAX STATEMENTS TO;
William Thomas Buff in
Power Brokers
D.O. Boy; 134
La Quinta, CA 92253
............ _..._._._;
.... ......
COh1MONWEALTH TITLE
_._...._........._.._.............. ........
[a 002
SPACE ABOVE THIS LINE FOR RECORDER'S USE
The undersigned grantor(s) declare(s): Grant Deed A.P.N. 773-143-011
Documentary transfer tax is S-1-70 Ue. / %icde aa
( %y) computed on full value of property conveyed, or
() computed on full value less value of liens and encumbrances remaining at time of sale.
( ) Unincorporated area; ( ) City of
,and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
James & Eileen Patton
hereby GRANT(S) to David Ross Miller, a Married Man
as his sol.e and separate property
the real property in the City of La Quinta
Stale of California, described as
, County of Riverside
Lot 14 of Block 112 Unit No. Santa Carmelite at Vale La
Quinta, as per map recorded in Book Pages lbf Maps, Records ;of Riverside
County; California
Dated JUlY 11 2001.
Stale of California )
County of ) SS.
On before me,
personally appeared
James & Eileen Patton
personally Known to me (or proved to me on the basis of satisfactory
evidence) to be the person(s) whose name(s) islare subscribed to the
within instrument and acknowledged to me that he/she/they executed
the same in his/her/their authorited capacity(ies), and that by
his/her/their signature(s) on the Instrument the person(s), or the entity
upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signature
MAIL TAX STATEMENTS TO,
r--- AJw-
Signature of Grantor
James & Eileen Patton.
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
SITE ADDRESS
PACIFIC TRADES
51-720 Avenida Men
APN 773 - 143 - 011 CASE NO.: 2001-517
LEGAL: LOT 14 BLOCK 112 UNIT
S.C.@V.L.Q.
CHECK AND APPROVED BY: wally Nesbit DATE: 129c.4 ?-//9'/p/
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
Verify legal and APN information
Vtd/r7 /W((64rA-S 0.a.^1k2
Consistent with MDG on file (as
applicable
MDG filing required (5 filings since
9/3/98)
Architectural variety within 200 feet of
the surrounding area:
Colors
Materials
Architectural design features
it ouncil
PIT-ommunity Dev. Dept. 2 0
Initials
Case No. 200/-
Exhibit ...
6SWith Conditions .
6J
Mo'
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: 51-720 AVENIDA MARTINEZ
Use Classification: SFD Bldg. Permit No.: 0005-023
Occupancy Group: R 3 Type of Construction: VN
Owner of Building: AUGUSTINE & EVA PAZ
Building Official
Land Use Zone: RC
Address: 52-995 AVENIDA MENDOZA
City: LA QUINTA, CA 92253
By: STEVE TRAXEL
Date: 09-18-00
POST IN A CONSPICUOUS PLACE