SFD (0106-013)51895 Avenida Martinez
0106-013
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 # y Lic. Class Exp. Date
Dat Z Signature of Contractor
- 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.
y ,(V );;•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 Policy No.
STATE mnav
(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, comply with thW. so-v S.
Date `
: - Applicant
""Warning: Failure to secure Workers' Compensationkcoverage is unlawful and
shall subject an employer to criminal penalties and civil finesyub 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
application.
1. Each person upon whose behalf this application is made & each pe
whose request and for whose benefit work is performed under or purs
any permit issued as a result of this applicaton agrees to, & shall, indtionis
& hold harmless the City of La Quinta, its officers, agents and empl
2. Any permit issued as a result of this application becomes null and
work is not commenced within 180 days from date of issuance o
permit, or cessation of work for 180 days will subject permit to cance
k`,
I certify that I have read this application,and state that the above inform
correct. I agree to comply ali'Ctit , Bnd State laws relating to the b
construction, and hereby aut _rize reprtsent'atives of this City torterppo /
the above-mentioned property fot-in*ection purposes.
V I
Signature (Owner/Agent) Date
BUILDINGPERMIT `PERMI''"' PERMIT+#L3` , x
DATE_ 1 p VALUATION LOT tD1 y j4ReTRACT
7
JOB SITE
ADDRESS
I4PN
OWNER
CONTRACTOR/ DESIGNER/ ENO INE ER
r-kcavic
PA( ,q CON'Srj tTCIfXON'
.4 WMANSIME, t`.A 92054
2 Ca 5RA1 f9iC, 92054
(160)967-o069 MIR 1955
USE OF PERMIT
IRMU? 1~ VfiMH.Y DWM.6NG
wfti3 . C.'i3f' )?ifi 9' 1JCk:?3f.CLJ , 1'i1CtL, i31. 7R% '''ii', 1'' '
Ai'.P)2OACHI. (PW MA5`i`li! R S4 PLAVI)
TRIAD' CO F"InfzbfC'T30N 1.421.00 3.%
PORMFrteTIO .40.00 SI'
GARA6: EMARk OZY (OF) 0199 i.00
5 lel. W'00D F04CL 200.00 L?
V—S U.1AY.{lkid.,A". ) CONT OF L.a/.LC67A 1. C311't!•19
1.9 i3s.10
9 /p''( y; •; r `y /
MARY
CO)AbI!,"TR.UC4`1ION FH5 301_0004418.000 $594.60
PIAN CHIM"Y`. "Irt 101-00a.-439-318 $300.12
MXCf11#l'33O,'d4L M 101-000-421-000 160100
i.?T,.!?..5 TRICk4L IFEE. 1131-000-420-000 $129.44
PLt1MI13IRI T3RE 101.000.4.19.000 1110171
STRUM%1 MOTIOM YZ s - R.RSID 101-000-241'-000 .$b.93
OR QW $11 F1q,E 101.000.42MW $160.00
1iT?v,RLC'ik'.EA IMPACT FLO-2
PMISE P144:8 . 10.1-000-441.-345 MOM
7132 MPOSIT 1,01-000,439-319 .$ 50.00
W
ims PR&PATI MIS
J U L = 2 2a
ITA
4250,01D
.FTk5I A:lY9S.t JL'. u8.G DUE A.9 Na+'!SCITY
OF LA OUIFINANCE
DEP
RECEIPT
DATE i0 BY
DATE FINALED i
INSPECTOR
1t;r:
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
0. K. to Wrap
F.A.U.
Framing
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
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final I I
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
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voftage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated 760-771-8515
CERTIFICATE OF COMPLIANCE
Date 7/2/01
No. 22201
Owner NameDavid Ross Miller
No. 51-895 Street Avenida Martinez
city La Quinta
Tract # BLK 117 Lot # 7
APN# 773-175-019
Jurisdiction La Quinta
zip 92253
Permit # 0106-013
Log #
Study Area
Square Footage 1421
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 1,421 or $ 2,913.05 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may.inow be issued
Fees Paid By CC / Mission Oaks National Bank - J.R. Rodriguez Telephone 760-967-006.9
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /ex pted by Annette Barlow
Signature
Payment Received
Check No. 10581
$2.913.05
40TICE: 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
:ollect 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
01/09/01 10•:25 FAX 17608049062 CWDIONWEALTH TITLE
RECORDING REQUESTED BY;
AND WHEN RECORDED MAIL THIS DEED AND,
UNLESS OTHERWISE SHOWN BELOW,
MAIL. TAX STATEMENTS TO;
William Thomals Buffin
Power Brokers
B.O. Boy; 134
La Quinta, CA 92253
SPACE ABOVE THIS LINE FOR RECORDER'S USE
The undersigned grantor(s) declare(s): Grant Deed A.P.N. 773-175-019
Documentary transfer tax is S
( x)) 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 _
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Griepsma, Ardith
hereby GRANT(S) to David Ross Miller, a Married Man
as his sole and separate property
the real property in the City of La Quinta
Slate of Califomia, described as
County of Riverside
Lot 7 of Block 117 Unit No.
Santa Carmelita at Vale La
Quinta, as per map recorded in Book Pages mf Maps, Records of River
County, California
Dated 1 2 0
State of California )
Courtly of ) SS
On before me,
personally appeared
th
Personally known to me (or proved to me on the basis of satisfactory
evidence) to be the person(s) whose name(s) islare subscrlbed to the
within instrument and acknowledged to me that he/she/they executed
the some in his/her/their authorized capacity(ies), and that by
hls/her/(heir 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,
Signature of Granloi
Griepsma, Ardith
2
, and
side
RECVD FOR PROCESSING
(0 E)
ASSIGNED TO
RC DISTRICT - PLANNING REVIEW FORM (IM ALS)
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 PACIFIC TRADES
SITE ADDRESS 51-895 Avenida Martinez
APN 773'_ 175 _ 019
LEGAL: LOT 7
CHECK AND APPROVED BY
CASE NO.: 2001-4.89
BLOCK 117 UNIT
Michele Rambo
DATE:
S.C.@V.L.Q.
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
Consistent with MDG on file (as-
applicable
p Q
MDG filing required. (5 filings since
9/3/98)
\9
O
Architectural variety within 200 feet of
the surrounding area:-
Colors
Materials
Architectural design features
I
` f
xxe v
Other Requirements:
CITY OF LA QUINTA
- BUILDING & SAFETY DEPARTMENT
cC fM OF Q 777-7012 _.
INSPECTION REQUEST LINE
777-7153
Owner -PACIFIC TRADES
Contractor PACIFIC TRADF,4 CONST —
Permit Number 106-013
POST ON , OI INCONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 51-895 AVENIDA MARTINEZ
SFD - PERMIT DOES NOT INCLUDE BLOCK
WALL, POOL OR DRIVEWAY APPROACH.
TYPE OF INSPECTION I , DATE, I INSP.
FOUNDATION & SETBACK 7 -7 Ol 1 7
MAIN GROUND SYSTEM O
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB /
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST%(
HEATING & VENT - A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP -
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH /- (jam
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK 7 . 91- "'v
FINALS
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
Certificate of Occupancy
City of LaQuinta
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: R 3
51-895 AVENIDA MARTINEZ
Type of Construction:
Owner of Building: PACIFIC TRADES CONSTRUCTION
d
Building Official
VN
Bldg. Permit No.: 0106-013
Land Use Zone: RC
Address: 1719 S. TREMONT
City: S. OCEANSIDE, CA 92054
By: STEVE TRAXEL
Date: 10-29-01
POST IN A CONSPICUOUS PLACE