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SFD (0001-019)51905 Avenida Martinez 0001-019 LICENSED CONTRACTOR DECLARATION -.'I hereby affirm under penalty of perjury that I am licensed under provisions of . 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 425381 B OZ/3 Ut i, Date Signature of Contractors`' 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 exempfunder 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. N(.,) 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 17 102'Jll S. ;J3rpft 9u (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 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 18.0 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 propertyyffordnspection purposes. Signature (Owner/Agent)`- " ` ` ' Date—1 1( Vli BUILDING PERMIT PERMIT ` ji 04")1_019 DATE I J l J } VALUATION $92,,,9X7 40 LOT TRACT (11 V JOB SITE ADDRESS 51-90.qAVEN11DA (A"RTkN>It Z APN 773-175.024) OWNER CONTRACTOR /DESIGNER /ENGINEER . DA, 'IT r tei•7--V- ePCiIC+Ay CrVi 3iT 17I9'S T€{.EigOA'YT 173y S'.r'R.i'.N1C \Yt 5 OCEANSIDE CA 92054 S C)CEANSILIIf: CA. 9204 ` (74(3)917-0%9 C111..10 1955 USE OF PERMIT NNOI LE FAMILY i3"VEL.i:,1:NG SF%? - PERMIT IX)ES NOT 24CLUDE BUIC:k WALLS 0R POOL. (LQP _ '3fi 151 Mrk3'132it T 3 .AC;" CONST UC TION 1.492,00 317,PORC Ph>w 0 ".00 SF t. fA&Atl'WCAHFQI21' 463.00 SF S F f. W001).FFWJEi 'Y.. O.60 IX E,STIIO'1ATE, D COST OF CONSTRUCTION NZ 91.17.4 0 I"E, WRIff FRU SUMMARY 0014, l'.K(JC1IUN.FFX 101-000.419,-000 $AOK.Ots P'fAN C1XB:.C;K- FER,101-l30t)-4 t 3} g 5t x. 3 %UX_'`A JIC: LFEE ELECTRICAL FlstI IPIXIMB:ING q,.E 101-000-419401 $f It).? i 1 ..t...l STIRONC: M(MIC7A!°'Riv- - RES,") 101. -01N) -241 -ft) $9.30 GRADING FWe' 10.1-000-42'-000 $20.00 1?1?. C:t E fyLAiY 301-000-44.'1-345 :E7Ut3.U0 '" p T FIT. T.)R OSIT 101-000-4.19-318 SUR -TOTAL CONS` IMC _RONI AND PIAN CHECK aka $1,449 06 LESS PRE -PAID FETES -5650.00 TOTM, 1'k:RMIX 1i'ECS DUE NOVV $3,198.€I6 RECEIPT DATE BY ,! ` r -.L DA ^ED Q d-' INSPECTOR ` sd INSPECTION RECORD 4 OPERATION DATE * INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs J 7 Underground Ducts Forms & Footings Ducts Slab Grade (' Return Air Steel Combustion Air Roof Deck — T Exhaust Fans O.K to Wrap Z 4 HT1 F.A.U. Framing Compressor Insulation _ y. c 10 S Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath 3 - -7 -cvx;, S Drywall - Int. Lath 3=q _pd 5 Final Final POOLS - SPAS BLOC KWALL AP ROVALS Steel Set Backs - Electric Bond Footings Main Drain Bond Beam - coo 5-7 Approval to Cover Equipment Location Underground Electric J0 2- - e; Underground Plbg. Test Anal Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines _ C 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 ( (so aj Appliances Final COMMENTS: 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 o 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 1/11/00 No. 19896 Owner NameDavid Ross Miller No. 51-905 Street Avenida Martinez City La Quinta Tract # Lot # Type of Development Single Family Residence Comments APN # 773-175-020 Jurisdiction La Quinta Permit # Log # zip 92253 Study Area Square Footage 1492 No. of Units 1 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 1.93 X 1,492 or $ 2,879.56 the property listed above and that 4itdir7gtr: i permits and/or Certificates of Occupancy for this square footage in this proposed project may niyw be issued Sh r' Fees Paid By CK/Capital Bank of North County/David Miller CeBpt> one 2760-967-00E9 Name on the check By Dr. Doris Wilson "' Superintendent t 1 " Fee collected /exempted by Olivia Aguirre Payment Received $2,879.56 Check No. 16459 Signature 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 Distdcl('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 i 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 Building & Safety as your correction list. Please attach additional explanations as necessary. APPLICANT: PACIFIC TRADES PROJECT ADDRESS: 51-905 Avenida Martinez APN:. 77.37175-020 LEGAL: LOT 8 , BLOCK 117 , UNIT 12 , S.C. @ V.L.Q. CK'D BY: Leslie Mouriquand 61N NO:. CASE NO. 99-174 ..CHECK -DATE: Inform the assigned Building plan checker .upori..your..assignrrment to this case. The CDD Executive Secretary maintains a log book to track applications and assign case numbers. The zoning code, architectural and landscaping manuals, and/or assigned inspector should be consulted where uncertainties arise. The completed checklist shall be maintained in the Building .& Safety address file. DEC.16.1999 3:01PM COMMONWEALTH NO.633 P.1i1 RECORDING REQUESTED V: CHICAGO TITLE COMPANY, COMPANY 99.9NN451KCR 970578!29. pp qq WH RL QO Rqq I LOW"D' 1 0 A S E ,NT DAViA OSS I :tILi'F,R ', GRANT DEED E THIS LINE FOR RECORDER'S USE 51-905' AJa. µAen z The undersigned grantor(a) declare(s): Documentary transfer tax is $18,15 (XXX) Computed on fulfil value of property conveyed, or ( ) Computed on full value less lens and encumbrances remaining at time of sale. ( ) Unincorporated area: ( ) City of and FOR A VALUABLE CONSIDERATION, receipt of which, is hereby acknowledged, CATHERINE F, PAROTINO, hereby GRANT(S) to DAVID RM MILLCR, the real property in ,the City of LA QUINTA, County of Riverside, State of California, described as: - Lot a, Block 117, Uniit No, 12, Tract Santa CarMelita at Vale La Quinta, as per map recorded in Book 18, Fage(s) 78-80 inclusive of maps, in the office of the County Recorder of said County. Dated December 14, 11999 State of California County of RIVERSIDE; On DECEMBER 15, 1999 before me, KELLY COLLIER personally appeared CATHERINE F. PAROTINO personally known to me (or proved to me on the basis of patisfacg ory evidence) to be the person(s) whose nlame(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in hip/her/their authorized capacity(ies), and that by hie/her/their'signature(p) on the instrument the p rson,(s), or the entity upon behalf of which he person(p) acted, executed the instrument. n /-\ WITNESS Signatur'11-1-- MAIL TAX STA o;Pcial seal, CATHERINE F. P.AROTINO (EL O L1ER U comm .:1229428 ( v NOTARY PUBLIC -CALIFORNIA RIVERSIDE COUNTY n ,q COMM. CXPQJ-UN,v6, 2nn1 - (This area for official notarial seal) 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 ADDRESS: 51-905 AVENIDA MARTINEZ .Use Classification: SFD- Bldg.. Permit No.: 0001-019 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC Owner of Building: DAVID ROSS MILLER Building Official . Address: 1719 S. TREMONT City: SO. OCEANSIDE, CA 92054 By: STEVE TRAXEL Date: 05-15-00 POST IN A CONSPICUOUS PLACE