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RPL (9810-164)54260 Avenida Martinez 9810-164 10812 10440 10411 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 74127 A 813U3.") ,/Date Signature of Contractor , _. f~ 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. ( ) I have and will maintain workers' compensation insurance, as required by Sion 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 with those, provisions. 1 Dater -a Applicant, ', . 4 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 inspection purposes. Signature (Owner/Agent) - -•- _ Date # CONTROL# BUILDING PERMIT PERMIT99 11110 64 DATE VALUATION S 12.900-410 LOT TRACT 4 4 8538 JOB SITE 54ADDRESS 'l,l Tl l d 111SY*I 11 1A' Ei - 7- OWNER CONTRACTOR / DESIGNER ENGINEER P IT(IA A'C FA r. -M ij// Stc.w v SUITE i4-260 AtNIDA MA UriW'Z 73011 COUNTRY CLUiB DR., 14 1A0-IN'lA .A 922.53 PA1NDESEWl' CA 92200 (760I461037C131.tf ym,t USE OF PERMIT Pt -7 L i1ND/O.R SPA POOL ONLY, ALA(2RWsAR1 IERS SHALL Qfr 1N AT PRE-PLASTM INSYEC;1'tc N. POOI. AiZXCIR SPA I« 9011.00 LS i'% RNU 1 PEP, SUMMARY 1 -LAN CHisCK FhE 10140) 439-3114 S93W) (Yl'Nq'I'RIXf 'rONVII- 11111-OM-A1>;.(M 114400 IRCHM-11CIM,117!M • POOL 101.000-421.000 S11 -I'm ( L I;Cr. tCAt. t RE --PC", 101-W-420-000 S4S.tiU 11i.t!h110N0 FFE -- I•'00L 1131 -0(X) -4t9 -0W .h • 911 r r r Sf _R-Ttn'AI, CONst'RUCTiC.• N AND PLAN (`'.31Ft1K. h(1 A j 1,1:::.`1 VRE-PAID 11:1:4 $000 OCT 2 81998 11Vfdkt, MKjti IT FMN 01)K NOW $333.64) !,r pQy y. 79 1 OF U. '% \C" "a. d J _A I RECEIPT DATE sy*' DATE FINALED INSPECTOR (' Ar % 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 OX to Wrap F.A.U. _ Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. -7, - , Fans & Controls Party Wall Insulation=< ;,Condensate Lines Party Wall Firewall Exterior Lath r" Drywall - Int. Lath Final Finalu;s.. _ - BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond 7/7 Footings Main Drain Bond Beam Approval to Cover Equipment Location Under rou / --Underground Plbg. Tes Q Final - _ Ga PLUMBING APPROVALS' Gas Test ^[o rAS -- Elec ric inal 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 oe Encapsulation 3 Gas Piping Gas Test Appliances Final Z 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 r Final Utility Notice (Perm) COMMENTS: /f S WATER FALL 4'WX3'H X 3DEPTH ANTIQUE.GOLD BOULDERS!, 1'6" R6'-9 " `R41 '-9 'r \ WALL { \ NOTE: COURTYARD POOL IV P/A OO 3 - EXISTING BLOCK WALL- 9 2'-8 " GARAGE 8' S „ '-8" SLEEVES FOR HAMMOCK 7,_i0tr R2'-0" S NCE FREEFORM THIS RADIUS WATERFALL CROSSECTION (no scale) upbasin Antique gold boulders lower basinRZ-12,11 31-011 "'' >.V T pool water 4'-0" de Ri CONTRACTOR cannot assume remonsibifity rnr GENERAL SPECIFICATIONS damage to curbs. sidewalks. driveways cement dabs sewers lawns res fenres. re wining wal SIZE $ X 11 Sprinklers. tef=hone lines or shrubs When weds is made through a neighboes property it is understood AREA 65 PERIMETER 31 that you. theowner. hay hat n i bor's remission and amme full responsibilrtv DEPTH 3X4 DATE signature TILE CHOICE Mum SQ.1 7 xnx G. z EXISTING PLANTS NOT TO BE REMOVED I ,v NOTE COURTYARD POOL 2600 MOTOR HP 1 MOTOR HP HP FILTER STA RITE 300 SQ FT FILTER TE 102 GPM tma r amimm m emwm = m ramal 1 m GASLINE BY ••••••••••ff:••••""""" POOL LIGHT40O W CLOCKT104R ELECTRICAL BY. DOD EL 100 AUTO CLEANER ruCkA =MCD ................. LDECK TYPE SALT FINISH NATURAL STEP .............. Ff. SPA SPECS. RAISED REMOTE LIGHT SWITCH LY.. i 1 54-260 /AVENIDA MARTINEZ SLA QUINTA su6jLc 1 1 U IavS I,ti;LL_ -TION AS PER TRACT L4I AND ALL APPLICAB`E CODES POO s 2 BY PALM DESERT TEMECULA 73-011 COUNTRY 28910 RANCHO CLUB DR. STE F-4 CALIFORNIA RD. 10, PALM DESERT CA. STE 206 92260 TEMECULA CA. NOTE: 92590. LANDSCAPE AND FURNITURE (760)346 -4032(909)676 -SWIM ARE SHOWN FOR ILLUSTRATION ONLY AND ARE NOT INCLUDED IA_574127 — 6 I REVISED LITE VIP WATTS 10-1-98 RI LEVEL TS 22" 24" ?7" WALL u DESIGNER DAMWALL DAMWALL TOP " RICHARD/EV SPILLWAY WIDE DATE I N ED 9-9-98ACCESS HAND ' WG BUM , ' ,`; '"' `' ` ' 's ' , (vT 14 11 : PAT CLEAVER i r s z, -,- ., g s 3 F• r Adds: REMOTE LIGHT SWITCH LY.. i 1 54-260 /AVENIDA MARTINEZ SLA QUINTA su6jLc 1 1 U IavS I,ti;LL_ -TION AS PER TRACT L4I AND ALL APPLICAB`E CODES POO s 2 BY PALM DESERT TEMECULA 73-011 COUNTRY 28910 RANCHO CLUB DR. STE F-4 CALIFORNIA RD. 10, PALM DESERT CA. STE 206 92260 TEMECULA CA. NOTE: 92590. LANDSCAPE AND FURNITURE (760)346 -4032(909)676 -SWIM ARE SHOWN FOR ILLUSTRATION ONLY AND ARE NOT INCLUDED IA_574127 — 6 I Building 54-260 Martinez Address Owner _. dajestia Homer; Mailing Address P. 0. Box 76 City =aa Quinta ZIp 92253 Contractor Larry Danotto Address 3280 Sanas Springs Far City Zip Tel.: ID IQ 92261 322-3569 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 773-0786 State Lic. City & Classif. 627265 $ Lic. # 2154 Arch., Engr., Designer Address Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION (7I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 000) of Division 3 of the Business and Professions Code, and my license is in full force and ehffact. SIGNATURE `" DATE OWNEWBUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Busmass and Professions Code: Any city or county which requires a permit to construct, atter, improve, demolish, or repair any structure. prior to its issuance also requires the applicant for such permit to file a signed statement that hes licensed pursuant to the provisions of the Contractors License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or tut. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a ciffl penalty or not more than five hundred dollars ($500). O 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, Bu isness and Professions Code:. The Contractor's License Law does not appy to arc owner or 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 safe. ft, however, the buiding or improvement is sold within one year of completion. the owner4ku7der will have the burden of proving that he did not build or improve for the purpose or sale.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. a_ & 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, ora certified copy thereof_ (Sec. 3800, Labor Code.) Policy No. Company Copy is filed with the city. ❑ Certified copy is hereby furnished. , CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed ff the pard is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg work for which this permit is issued, 1 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: ff, after makig this Certificate or Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you rn st forthwith comply with such provisions or this pemnd shag be deemed revoked. r CONSTRUCTION LENDING AGENCY Ihereby 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 -of this city to enter the above-- mentioned property for inspection purposes. Signature of applicant -Date- Mailing ateMailing Address City, State, Zip No. 10812 BUILDING: TYPE CONST. OCC: GRP. A.P. Number 774-254-001 Legal Description trot 18 Block 301 Project Description SH 120' of 5' garden wall 50' of 4' ret wall Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 3514.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. b's - U U Mech. Electrical Plumbing S.M.I. .40 Grading Driveway Enc. Infrastructure lor 49, TOTAL L b .11au REMARKS Y ZONE: BY: Minimum Setback Distances: Front Setback from Center Line ti 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: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SQ. FT. ® CAR P. Q. FT. WALL SQ. FT. ® Sq FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ® c BATH TUB • SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR @ V4c HOUSE SEWER REMARKS: GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCKSTORAGE FOUND. REINF GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. ^ BOND BEAM 7 / a� WATER SYSTEM GRADING cu. yd. $ -plus-x$_=$ LUMBER GR. FINAL INSP. FRAMING C/ 2 � aL1 FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING ?lg� C,/ MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION, CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL 4 P.O. BOX 1504 Building 54-'260 Marti ez78-105CALLEESTADO Address LA QUINTA, CALIFORNIA 92253 Owner majestic Homes Mailing Address P. 0. Boy: 75 City Zip Tel. La Quinta 92253 773--0786 Contractor Larry Donoho Address 3280 Sends Springs Or City Zip Tel.' P.S. 92262 322-3569 State Lic. City & Classif. 627265 Lic. # 2154 Arch., Engr., Designer Address Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. l ♦ SIGNATURE DATE 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 subjects the applicant to a civil penalty of not more than five hundred dollars (5500). ❑ 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, 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.) O I, asowner 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 contractor(s) licensed pursuant to the Contractor's License Law.) 0 1 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 it 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 (8100) 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 I hereby 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 It 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 -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. 10440 BUILDING: TYPE CONST. OCC. GRP. A.P. Number 774-254-001 Legal Description Lot 18 Blk 301 Project Description SFD 11 Sq. Ft. 1700 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ NOTE: SUPPLMENTA=-, PERMIT; CHANGE OF CONTRACTOR ONLY I Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL U 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: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CARP. SQ. FT. WALL SO. FT. ® SQ, FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR , HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/. c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER REMARKS: GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. —" FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 4 W P.O. BOX 1504 Building 78-105 CALLE ESTADO Address -d LA QUINTA, CALIFORNIA 92253 Owner Mailing Address P. 0. Bogs: 76 City Zip Tel. La Qui.nta 52253 773--0786 Contractor r 1 Same Address City Zip Tela f State'Lic. City & Classif. ry Lic. # Arch., Engr., Designer T. Roach Address Tel. 46558 Arapahoe 360-1114 City Zip State Indian Wells 1 52210 Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my lice s is in,full force and effect. r ! Jti..✓'..,,."=.`__. ,„ ..,_ , ,_- SIGNATURE DATE OWNE9-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, after, 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 subjects the applicant to a civil penalty of not more than Ove hundred dollars ($500). ❑ 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, 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 contractor(s) licensed pursuant to the Contractor's License Law.) O 1 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 % - f 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 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 Ihereby 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 it 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 -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant -Date- Mailing ateMailing Address City, State, Zip 'No 10411 JILDING: TYPE CONST. OCC. GRP. P. Number gal Description 774-254-001 Lot 18 ka 4.01 oject Description SFD ZONE: BY: Minimum Setback Distances: Sq. Ft. No. Size 1700 Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit includes garden wall; permit not to include retaining wall or pool Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Estimated Valuation 100,572.50 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 543.63 Const. 643.00 Mech. 62.00 Electrical 132.50 Plumbing .141.00 S.M.I. 10.10 Grading 20.00 Driveway Enc. 20.00 Infrastructure 2165.46 Precise Plan 25.00 rt -g ' r Pnh J. TOTAL 3787.69 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: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES F1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. WALL SQ. FT. ® SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation ROUGH PLUMB. FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) LAUNDRY TRAY AIR HANDLING UNIT CFM HEATING (FINAL) KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ® c BATH TUB BOND BEAM SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/. c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR ® V4C HOUSE SEWER FRAMING pn ' L FINAL INSP. GAS PIPING PERMIT FEE PERMIT FEE:d PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR, SETBACK ! a Z Z GROUND PLUMBING/ DERGROUND A.C. UNIT COLL. AREA SLAB GRADE &V&2- l Z ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCKSTORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPIEQUIP. REINF. STEEL d ! 2 GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ —plus—x$—=$ LUMBER GR. FINAL INSP. FRAMING pn ' L FINAL INSP. ROOFING (/ 3 Q [[[ 'j P)i h ,n y / pp -c-eAM, `l1;-,1q;LL(7 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LA RING 3 Z q Z• 10? t40 —' MESH INSULATIONISOUND , FINISH GRADING FINAL INSPECTION l CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (61 9) 347-8631 La uinta Permit # Log # Date 12119/91 No. 111069 Owner Name Type of Permit Majestic Homes No. 77825 street Calle Madrid city La Quinta zip 92253' Study Area 110 APN # Tract # Lot. # E= Square Footage 11700 Type of Development Single Family Residence No. of units 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: This certifies that school facility fees imposed pursuant to Government Code 533080 in the amount of 1.58 X 1700 lor$2,686.00 have been paid to D.S.0 S.D. for the properly listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By Majestic Homes Tel_ephone,.50$-6014 Name on the check ' ` ` By James E. Lively Assistant Superintendent, Business Services Fee collected /exempted by Vickie J. Durrett Signature r . Payment Receiv 3 r Al " , = V' check No. 97363 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/lteceipt Copy - Accounting RECORDING REQUESTED BY Recording Requested By CHICAGO TITLE COMPANY IND WHEN RE EO MAIL THIS DEED AND. UNLESS OTHER. visa SHOWN EIOW. MAIL TAX STATEMENTS TO: NAY[ LAWRANCE DEVORE, TRUSTEE (DDR[[[ P.O. BOX 76 CITY • STAT[ LA QUINTA, CA. 92253 STA z,t• L J 'itle Order. No. Escrow No. COPY of DoCLImejit,13e d on D ....2. 19,"s No...` .. has not been comparod vli-ih orl ital. WILLIAM LE. County Recorder RIVERSIDE COUNTY, CALIFORNIA SPACE ABOVE THIS LINE FOR RECORDER'S USE Quitclaim Deed The undersigned declares that the documentary transfer tax is a ............... ............................................ and is ❑ computed on the full value of the interest or property conveyed, or is ❑ computed on the full valueless the value of liens or encumbrances remaining thereon at the time of sale. The land, tenements or realty is located in ❑ unincorporated area [ city of ..... La Quinta ................................................... FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, ALICE TIPTON, A SINGLE WOMAN do es . hereby remise, release and forever quitclaim to LAWRANCE DEVORE, TRUSTEE OF THE SUNNY BRITE LIVING TRUST DATED 12/11/91 the following described real property in theCitY Of L3 Quinta county of Riverside state of California. LOT 18 BLOCK 301 UNIT 27 SANTA CARMELITA AT VALE LA QUINTA AS PER MAP RECOR.DED.IN BOOK 19 PAGE 82 OF MAPS IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY Dated December 11- 1991 STATE OF CALIFORNIA } SS. COUNTY OF RTVFRSTDF. 11 on this the 11th day ofDec e0er 1991 , before me, the undersigned, a Notary Public in and for said County and State, personally appeared - ALICE TTPTON , personally known to me or proved to me on the basis of satisfactory evidence to be the person whose name IS subscribed to the within instrument and acknowledged th@t SHE executed the same. SiVire Alice Tipton FOR NOTARY SEAL OR STAMP - OFF92AL 56ij CINDY UJUM MOYAIh' Pu&c — CAUFOIRU FRINCIPAI OFFICE N NVIANDE coum Cohtt!t!sr !tx >t APfa 12, 11 MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE Name Street Address City & State S ` . 9 w {IJVWL ?_..• -; ,.:.}s-r ;.. 1 R^ sr - r.: .,. : ;•:>- S : 4P'7'G Jl4 + tis .•m'"{ ,, y" appyj, ; ,may-n,'N ' O yyd [•kR, tiG l _ _ . i' t i '1`C ' `" ;5 J 4 COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL Received From:, _11-11-5X6 Address: Account No. n Service Address Meter(s) ! Lot(s) > ' Servlce(s) ❑ Backflow(s) ❑ House Lateral(s) ❑ Detector Check(s) ❑ Meter Surcharge Sanitation Capacity Charge s ❑ W.S.B.F.C. ❑ Temporary Construction Meter rn 'r--Ph.rnn ❑ Uncollected Account - Name ❑ Inspection Fee -Tract - Fee - ❑ Plan Check Fees Water 1 Sewer - Tract - ❑ Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit ❑ Other Remarks: TOTAL ❑Copy to: Cash Water Service Check . / Money Cashier Order CVWD 438(11189)