SFD (0011-046)52190 Avenida Martinez
0011-046
LICENSED CONTRACTOR DECLARATION
','-hereby affirm under penalty of perjury that 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. Date
/'1U 1l'i
579,' i r ' 'C , ,
1 . /Date ^' 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
pert99'rA ance 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 Policy No.
CLA.fLE DON NAT IN IDiY i pD a=b41
(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 thatt if I should become
subject to the workers' compensation provisions of Sectidn 3700 of the Labor
Code, I shall forthwith comply with those`proVisions ,//
Dater ' z " ' ' Applicant ` % . / // /l r
i
Warning: Failure to secure Workers pensat7 ion 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 inspection purposes.
Signature (Owner/Agent) ='' Date
BUILDING PERMIT PERMIT#
DATE ( ; VALUATION LOT (X)11-,OdW TRACT
;1, ➢ f .. . N:t 9) ill
JOB SITE, (
APN
1L yy +D y / 9n t
ADDRESS gs , q AM
e36r.g.: ,g l:' .t.{ VA'h J.Y•i,L 6A,D.R1L ,il, '
't73-2 2-010
OWNER
CONTRACTOR/DESIGNER/ENGINEER
« ,y
. 7.0?7 C AL-TWI ADR
y irJ
`9'9 ,17'? C. I' )=ADA
PALM UZERT CA 92211
PALM M?Si:AT f"'A 92211
USE OF PERMIT
SV03'1 a PXIE'7ltJT 0003 N0T 1VC'1AID.'T'BL,0C:K; 'ti+it:ALt,y PC?OL .,!t. SPA OR
DRIVOWAYAPPROACH
/
,r
r
TRACT i."O11S'lR.UC:TIt)N Sig
POPICF5+.1t.`T O 60.00 S:?
0AR ACEX-ARPORT (BY) 9,790.40
Fi'. 'lTd Crv 3 4tt.".t~ i .iitj L,N
x9mi "F;D COST OF (410-'3&1"l YCITIOINI
97,473,90
MO.a1TITE WC04RY
i"C3NOT )l.UC,")'1ON FEE 101-000-419-000 $`30,50
PLAN CHECK lit?, '101-000-439.318 $5;islo
MIOCMAICs° L PPF: . . 101-000-421-000 162.00
t,L ECTRIC:,AL FEE. 101-030-420-000 0.420-000 $11121
s`AI.IiAfI THiCS 4i 101.000 419-CK10 $1105
Sry' 1•'9R `& R Ira 101-IQS 00-2141},-/f 1 C t+In)
101•SI I:C `;MOTL104
c RADIISc# I'" E 0 f°l+VV YZJ kiW. AVott
Lf,%? L0PS1: IMPACT FXZ s),9v.Ct0
P fis'C:ISL WiFebsi 100,«! 00.441-M5
Ke REPOS -IT 101-000-439-318 +$150,00
S. L, -TOTAL CONr . r,.lr CHOMARDPIA1 14
Vi483,01
a a :Is-.pCt r6 .9rt7 C
t.i3f li3 .c".c4r✓.C-f,"yi,►s b'1:n7 tJ
"d d511 t41,
TUML . 11YRNU R. wEN DVE NOW
RECEIPT
DATE
! U
BY y
;. > .
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms 8 Footings
Slab Grade /
l
Underground Ducts
Ducts
Return Air
Steel
Combustion Air
Roof Deck
- I -S . 6
Exhaust Fans
O.K. to Wrap
. 13-01
F.A.U.
Framing
Compressor
Insulation
, a .p C
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 Hacks
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
Water Piping
—/_
(�% GD s,
Heater Final
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
/4ou S
Encapsulation
Gas Piping
Gas Test
• O
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole - ?.?i• d/
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)
Y V
11h -
4 4 Q"
see
P.O. BOX 1504 APPLICATION ONLY S
Building 7UINT CACALIFORNIATAMPIO ^
Address 2 %i LA OUINTA, AIORNIA 92253
Owner,,..^'" /?
6-3;LAJ Iv BUILDING: TYPE'CONST. ' a OCC. GRPMailing I
. `
Address/ 0 7 7 /A 4/Y=N0 _RO I/( ^^J
A.P. Number
City: Zip/z/ Tel. Q -- %
/ „ .-9rl l Legal Description Lo C IWZ? /
Contractor, J ® Project Description
Address G
City Zip Tel
State Lic. City
& Classif. %l Lic. # Z:943 Sq. Ft. No. / No. Dw.
Arch., Engr.,
Size Stories Units
.,....
Designer New Add O Alter O Repair ❑ Demolition ❑
Address a JTel.
/. 4 7
/T
Cityip +7 State
Lic. #
LI. ENSED CdINTRACTOR'S DECLARATION
I hereby affirm that I am licensedJ.y.Yryrynder provisions of Chapter 9 (commencing with Section NOV O C no^n
7000) of Division 3 f llll,gusiness'.and Prof setons Code, and my license is' 17'uII force and IV V L uu
affect & ! ih Vu.$ , / ` 7 _ 7
V - f 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
subj
e
cts the applicant to a civil penalty of not more than rive 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
or improvement 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 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 contractors) licensed pursuant to the Contractor's License Law.)
fl I am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Worker's Com ns tion Insuran a/ or a cert If- d copy he f..)/Sec. 3800 Labo o e
Policy No. + 2 Zpany &
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 the workforwhich 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.
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 insp. ti . pose // v0
Signature of adplicant Date
Mailing Address
City, State, Zip
JI'
J
itimated Valuation _IA, t"tli It
PERMIT AMOUNT
Plan Chk. Dep. 2 55550
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
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:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Noti'• 1
Do ent Cannot Be Duplicated
,/Date 12/27/00
No. 21405
Owner NameJames J. Molnar
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760471-8515
CERTIFICATE OF COMPLIANCE
No. 52-190 Street Avenida Martinez
APN # 773-232-010
Jurisdiction La Quinta
City La Quinta zip 92253
Tract # BLK95 U11 Lot # 13
Type of Development Single Family Residence
Comments
an official check for $6,469.80.
Permit # 0011-046
Log #
Study Area
Square Footage 1578
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
2.05 X 1,578 or $ 3,234.90 the property listed above and thai building
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
Fees Paid By OC / Washington Mutual Bank - James Molnar Telephone 750=34.5-956e
Name on the check
By Dr. Doris Wilson. -
Superintendent ti
Fee collected /exempted by Annette Barlow Payment Received $3,234.90
Check No. 225093208
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 Districl('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
W—W
t.
A y' :d:: AST TITLE 00,
L•'
RECORDING REQUESTED BY:
WHEN RECORDED MAIL TO:
JAMES J. MOLNAR
77027 California Drive
Palm Desert, CA 92211
Doc a 2000-334178
08/25/2000 08:00A Fee:8.00
Pape 1 of 1 Doo T Tax Paid
Recorded in Official Records
County of Riverside
Gary L. Orso
Assessor, County Clerk 3 Recorder
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged: 7TI
s
BUILDING HORIZONS INC. A NON PROFIT PUBLIC BENEFIT CORPORATION
hereby GRANT(S) to JAMES J. MOLNAR, A MARRIED MAN 2 ^ ( A
The following real property in the La Quinta, Riverside County, State of California:
described as: Lot 13 in Block 95, of Santa Car>melita Unit 11 as shown by Map on file in
Book 18, Page(s) 75, in the Office of the County Recorder of Rive si a County.
Date: July 25, 2000
p BUI I G RIZONS INC.
STATE OF CALIFORNI f&
COUNTY OF )
on bef re tuji4ersigned,
Persona ly appeared d
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 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(B) acted, executed the instrument.
witness my hand and official seal.
Signature
JUWM ROGERs
MAIL TA% STATEMENTS TOt 77027 California Drive,
(This area for official notarial seal)
Palm Desert, CA 92211
_SPACE
G R A/ N
T
/( /
7'/2 A Da 0 d !
1 LV
01500
A
R
l
COPY
LONG
I REnX0
NCk10
EXAM
The undersigned Grantor(s)
declare(s):
Documentary
transfer tax
is $ 16.50
ASSESSOR'S PARCEL NO.: 773-232-010(X)
computed on
full value of
property conveyed, or
TITLE ORDER NO.: R-188249-1
( )
computed on
the full value less liens or
ESCROW NO.: 206507JR
encumbrances
remaining at
the time of sale
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged: 7TI
s
BUILDING HORIZONS INC. A NON PROFIT PUBLIC BENEFIT CORPORATION
hereby GRANT(S) to JAMES J. MOLNAR, A MARRIED MAN 2 ^ ( A
The following real property in the La Quinta, Riverside County, State of California:
described as: Lot 13 in Block 95, of Santa Car>melita Unit 11 as shown by Map on file in
Book 18, Page(s) 75, in the Office of the County Recorder of Rive si a County.
Date: July 25, 2000
p BUI I G RIZONS INC.
STATE OF CALIFORNI f&
COUNTY OF )
on bef re tuji4ersigned,
Persona ly appeared d
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 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(B) acted, executed the instrument.
witness my hand and official seal.
Signature
JUWM ROGERs
MAIL TA% STATEMENTS TOt 77027 California Drive,
(This area for official notarial seal)
Palm Desert, CA 92211
u
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 Molnar Construction
SITE ADDRESS 52190 .Ave Martinez
APN 773 - 232 - 0'1`b BINNO.: CASENO.: 2000-344
LEGAL: LOT 13 BLOCK' > UNIT %/ S.C.@V.L.Q.
CHECKED BY: Greg Trousdell DATE: 11/7/2000
it
Inform the assigned Building plan checW! n our assignment to this case. The CDD Executive
Secretary maintains a log book to track alpp iic ns d assign case numbers.
REQUIRED IT 6'O
N
COMMENT/CORRECTION
Compatiq ity w l
e
R 10 e ssivaed
c y J f at
S6"v - L
Co sa ORh file (as.applicable
MDGr ' wired (5 filings since 9/3/98)
Consistency with street/surrounding area:
1 . Colors
Materials
a Architecture
6
G
Other Requirements:
" ov<-t
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: 52-190 AVENIDA MARTINEZ
Use Classification: SFD Bldg. Permit' -No.: 0011-046
Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC
Owner of Building: JAMES J. MOLNAR
!7C/4-1
Building Official
Address: 77-027 CALIFORNIA DR.
City: PALM DESERT, CA 92211
By: STEVE TRAXEL
Date: 09-26-01
POST IN A CONSPICUOUS PLACE
I