SFD (0106-033)54015 Avenida Martinez
0106-033
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 # Lic. Class Exp. Date
Date " + Signature of Contractor
IILDER 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).
( ) 1, 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
1, 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.
( ) 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.
(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 witl1 t os*provisions. i
Date: 11 i Applicant S` 2
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application..
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officer's, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
v permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes. r f
Signature (Owner/Agent) Dat > %/ ' ' I
BUILDING PERMIT PERMIT#
DATE I f VALUATION LOT ()JL8& a& -J TRACT
j
/ o 2 251A10 7
JOB SITE
APN
ADDRESS
OWNER
CONTRACTOR / DESIGNER / EN (NEER
PALM : ENNI T CIA 92260
;1IA.1 m 151rM3' CA S42-260
(1600)m0 -2'i26 MIX 2526
USE OF PERMIT
8 ?, C+L'1.C? s =Q' INCLUDE BLOCKWAY,«L4' POOL 0R DR w°IlWr' Y
!e$pr -j
/' j.#JT
r0'
Awi"'d".ROd'➢014,
S 7111 WOOD WXCE 1.F
0ARUI'MYCARPORT 54S00 SF
1g01tfi1'fFt ATIO 1,46.00 SRS
T'1LAC°T CONS`1`RCtiE .1074 1,43f ,00 Jig
N91MMUKU COSI-9 0F CONSTRUCTION
.ftMWITER' SUMMARY
M 1~1rADUI°O 4250100
faL,tLt3? ef3,6°YC.' 1x1m, $;511.90
ICONS;("RUC'E'1CJN FIF9 101.000.418-000 SiTI%,3i1
kAW',{.th.Y41'C'A1.. FEE 101-000-421-000 $i ift.tll7
BLEC TRICA.L 1 :E 101-000-420-000 $123,19
P:f.,t]MBIND FU 101 -000-419-000 10"75
STRO INO MOTION FEE - 71 1D 101.000.241.000 $01:4
UM01,111401 1 ME 101-000-4.23-000 VC00
PRECUE PLAN 101-000-441-34S $100.00
8 :RV1T<LO-PER OA.P,fi:Cr PPI LO ; tt9flR 8
'9IJ `Y'-. .1 '` y•7 ,
I, l
JUL - 3 2001
s
CITY OF LA OUINTA I
RECEIPT r H V b? _
iBY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
s ?
(
Underground Ducts
Forms & Footings
Ducts
Slab Grade
_
��
Retum Air
Steel
Roof Deck
_ _
Combustion Air
Exhaust Fans
O.K. to Wrap
/ J _W
F.A.U.
Framing
/oj2-/d (
S_
Compressor
Insulation
l D IWO. (
O(
S
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
C�
Drywall -Int. Lath
J 6
Final �Z�S!
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
Gas Piping
PLUMBING APPROVALS
Gas Test
Waste Lines �J /2/ 1
S'�
Electric Final
Heater Final
Water Piping
( (�
Plumbing Final
Plumbing Top Out
Shower PansF-14
/
�(
`
Equipment Enclosure
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 Voltage Wiring
Fixtures
Main Service
�v
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
��
Utility Notice (Perm)
Notice:
Document Cannot Be Duplicated
Date 7/3/01
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
APN # 774-221-014
No. 22213 Jurisdiction La Quinta
Owner NameBill Howard Permit # 0106-033
No. 54-015 Street Avenida Martinez
City La Quinta
Tract # B297U27 Lot # 2
Type of Development Single Family Residence
Comments
Log #
zip 92253 Study Area
Square Footage 1450
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 1,450 or $ 2,972.50 the property listed above and that building' 1
permits and/or Certificates of Occupancy for this square footage in this proposed project may now' be issued _
Fees Paid By CC / Valley Independent Bank - Bill Howard Telephone1. 760-340 2726 "
Name on the check ' _
By Dr. Doris Wilson
Superintendent
Fee collected /exempt d by Annette Barlow Payment Received $2,972.50
(>7W ln4 Check No. 249649
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 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
JUN.:??- VRI) 0815 FIDELITY NAT TITLE TEL:1-619-119-0394 P.001
RECORDING REQUESTED BY:
Fidelity National Title Company
4scraw No. 42794 -CS
We Order No.
When Recorded Mail Document
and Tax Statement To:
Mr. William R. Howard
P.O. Box 10758
Palm Desert, CA 92256
'• ' „ �� + v' ~-� GRANT DEED SPACE ABOVE THIS LINE FOR RECORDER'S LITE"
The undersigned grantor(s) declares)
Documentary transfer tax is $32,45
( X ] computed on full value of property Conveyed, or
[ ] computed on full value less value of liens or encumbrances remaining at time of sale,
( l Unincorporated Area City of La Quinta
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Kathryn Ann Ladner, An
Unmarried Woman
hereby GRANT(S) to Mumbil, Inc., a California Corporation
the following described real property in the City of La Quinta
County of Riverside, State of California:
Lot 2, Block 297. of Santa Carmelita at Vale La Quinta, Unit #27, as per map recorded in Book 19. Page 82 of Maps,
in the Office of the pounty Recorder of said County.
DATED: June 4, 2001
STATE OF CAISIEPRNIA
COUNTY OF IV -_ ` 1 O
O 16 1 before me,
S`ELLfA � - - - personallyappeared
�
1
personally known to me (or proved to me on he basis
of Sa6(s
acto y evidence) to be the perso (j�whose
nam is/are.subscribed to the wit in instrument and
acknowledged t e that he/sh t ay executed the
same in his/h theirluthor' ed capacitEea and that
by his/heir he 0 signatur (sNn the instrument the
persoS or the entity upon behalf of which the
perso s ,acted, executed the instrument.
'SH13I@
LY RUF AMM
CWW&ticn 0 12V4 wa
Nofely pile -ft""
m CCKMh►
WON
MY rarr>:n. l�gii+es Oci, a ago
�.,
MAIL TAX STATEMENTS AS DIRECTED ABOVE
FD -2 12 (Rev 7/99) GRANT DEED
N
RECVD FOR PROCESSING l
( A)
RC DISTRICT - PLANNING REVIEW F®RIKDTO
(INITIALS)
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 MUMBIL
SITE ADDRESS 54-015 Avenida Martinez
APN 774- 221 - 014
LEGAL: LOT 2
CASE NO.: 2001-488
BLOCK 207 UNIT 27 S.C.@V.L.Q.
CHECK AND APPROVED BY: Michele Rambo
ULNA
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.
' R
REQUIRED ITEM
Y
N
COMMENT/CORRECTION
Verify legal and APN information
/
P Gaw_-L n w Sof
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
Other Requirements:
1 XA%,
0 1ti ' ~
O"
00
CQ'
Certificate of Occupancy
City of La' Quinta �
Building and Safety Department O.TME`
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: SINGLE FAMILY DWELLING
Occupancy Group: R-3 Type of Construction
54-015 AVENIDA MARTINEZ
Owner of Building: BILL HOWARD
Tom /4-%'
Building Official
vni
Bldg. Permit No.: 0106-033
Land Use Zone: RC
Address: 74-990 JONI DRIVE, UNIT 2-13
.City: PALM DESERT CA 92260
By: KIRK KIRKLAND
Date: 12/04/2001
POST IN A CONSPICUOUS PLACE