The URL can be used to link to this page

SFD (0104-070)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 25381 1 4C D e Signature of Contractor-- � OWNER -BUILDER DECLARATION ,. ;,a 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 r •. • - 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. ;r,) 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. MU PUMP - (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 provisio S. Date: � • — d Applicant �* Warning: Failure to secure Workers\CompensatiQn overage is unlawful and shall subject an employer to criminal Penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney',:; fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth OR 1;108 application. 1. Each person upon whose behalf this application is made & each pill 1111 o whose request and for whose benefit work is performed under or pur t any permit issued as a result of this applicaton agrees to, & shall, in nif & hold harmless the City of La Quinta, its officers, agents and em I ees 2. Any permit issued as a result of this application becomes null an old i work is not commenced within 180 days from date of issuance f suc permit, or cessation of work for 180 days will subject permit to canc Ilation. I certify that I have read this application and state that the above inforrr ation is correct. I agree to comply with all City, and State laws relating to the mildilly construction, and hereby authorize representatives of this City to enter upon the above;mentioned property for inspection purposes. Signature (Owner/Agent) ��'�- ^ ` Date t — a BUILDING PERMIT PERMIT# 9 DATE f VALUATION LOT ()104..0'70 TRACT L✓ �r �' � ,i �'9r'� .1 '� JOB SITE �.� APN ADDRESS � e� * p Rryy�p Ty�� Q c,y-p, pyp•�,/�ysy A �W-'Si'.�)16'R.&.M.�3.f7JA.,AfsC+.1.�8.i07A. !W -OW) �y�y +7� C 774.223—.0%2 OWNER CONTRACTOR/DESIGNER/EN (NEER PA43: 01 `MAMIE i0 r •r. T.I.aCc ! IWID0 CONS R.T: M101T 17 ]9 0 MMONT 17 19 STEEMONT 3 CW AN'SXF, CSA 92054 S MEANS= CA 92054 ('760)%7.0069 Olml$ 1955 USE OF PERMIT hN(IIT 3�9a a iTJ'.•13MIT I70..&S NOT FNCLUDE.BLOCX WA1,IJ1W1A''PA, 0R :(1PP(1OAC.11,, r1 PJ.VZrWA .-MA5TZP�,. 81'98' TRACTCON1,471RUCTION SP PORC'E.VRilL'i'.it7 Sh S Pt Wool) 200,00 LrJ {3if�..f11r 4=3.00 91� EISITIMTt D C;C�IST OF COI,V'TMUC 1700 93,t7wm 'FRE, DEPOSIT 42$010 C014Sraat3'Ozl.ZZ PLAN `£(RCKMeaf'�1«€1Ct�•�35)'� $$ �J1�. �� iwS tl�tAl aC;° t,,li .i�. 111-000-421-000 F11WIMUCAL 101-000-420-000 P11UNI 3INO FBE 101-000-419-00,0 $1 JT 01401,01` ION FEE-AtI?IND 1. ()1 -000-24 3. s000 19131, 03R,D. NCT F9Z 101-000.423-000 $210.00 DFAFRIA)PER. WFACT YWT.? $1,907,00 P111X139 PLAN 101-000-441-34.5 � i 00.Olo A 11L3 i I. t':C3��I 'SSR 11' 3ClAX §xS d C; 7'`�:. U,464.31. :.MO PRE"11MD FM -$250.00 APR 1 3 2001 T(,V,tM,, YMMM MS DUE NOW S3,214.31 CITY OF LA QUINTA FINANCE DEPT RECEIPT DATE- %� BY DATE FINALED INSPECTOR OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings _`� J� Ducts Slab Grade fes) o(" Return Air Steel Combustion Air Roof Deck S'• aA..0 Exhaust Fans O.K. to Wrap 6=6'r d7 ( 5'7 F.A.U. FramingCompressor Insulation -/-tz 18� -T Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath _"�� O � �, Final a=(`(` BLOCKWALL APPROVALS Final POOLS - SPAS 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 Electric Final Waste Lines_ Neater Final Water Piping At I A s% Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection j •- 1-O f Encapsulation Gas Piping Gas Test CST Appliances 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 Final q��IO 5'( Utility Not (Perm) —Ea , O COMMENTS: Building /� /� Address fyo/%( Owner 5e e- P.O. BOX 1504 APPLICATIO ONLY 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 S Mailing ,[ Address City Zip Tel. t3,,tz �7n: xL >�. 2- m Contractor ;_,� , � 1 Address City (Zip ITel. State Lic. City & Classif.�� 2S �fi� Lic. # Arch., Engr., t Designer Address Tel. City( Zip ( State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70D0) of Division 3 of the Business and Professions Code, and my license is in full force and effect. 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). 1.11 I, as oner of the property, or my employees with wages as their sole compensation, will do the wowrk, 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 suchImprovements 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 I I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the proiect. (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.) 11 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 n 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.) r 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: 11, alter 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. 1 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 slate 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 .DING: TYPE'CONST. OCC. GRP. Number 7 7 V 06 Z ,I Description /� r Z �=« S 4 Ict Description •C 7AL 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 Issued by: D Qe.r.,if Validated by: Validation: MAR 2 3 2001 WHITE = FINANCE YELLOW = APPLICANT PINK CITY OF LA QUINTA FINANCE DEPT Sq�,- xSiie 456 No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT r' AMOUNT Plan,Chk. Dep. j 5-0 Plan Chk. Bal. y 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 Issued by: D Qe.r.,if Validated by: Validation: MAR 2 3 2001 WHITE = FINANCE YELLOW = APPLICANT PINK CITY OF LA QUINTA FINANCE DEPT 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 4/13/01 No. 21884 Jurisdiction Owner NamePacific Trades Construction APN # 774-223-002 La Quinta Permit # 0104-070 No, 54-020 Street Avenida Mendoza Log # city La Quinta zip 92253 Study Area Tract # Lot # Square Footage 1501 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 1,501 or $ 3,077.05 the property 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 CC/ Capital Bank Of North County - Juan Rodriguez Telephone 760 967--0069 Name on the check r; r� k► -;; _ �4- By Dr. Doris Wilson tV. Superintendent Fee collected /exempted by Arlene Garcia Payment Received $3,077.05r Check No. 081422 Signature NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) 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 !RE(; .9/01 10:25 FAX 17608049062 ORDING REQUESTED BY: WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW, - " MAIL TAX STATEMENTS TO; William Thomas Buffin Power Brokers B.O. Boa; 134 La Quinta, CA 92253 COWION1VEALTH TITLE Z002 6 A->/ 5L --x' 25 4V SPACE ABOVE THIS LINE FOR RECORDER'S USE The undersigned grantor(s) declare(s): Grant Deed A.P.N. 774-223-002/003 Documentary transfer tax is $ ( 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, Chester:Frangipami 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 County of Riverside Stale of California, described as Lot 20/21 of Block 295 .. . Unir No, Santa Carmelita at Vale La Quinta, as per map recorded in Book Pages County, California Dated February 26, 2001 State of California ) County of ) SS. On before me, Personally appeared Ches Fra Cl' parril 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 sage in his/her/their authorited capacity(ies), and that by his/hoer/their signature(s) on the Instrument the persori(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, , and mf Maps, Records of Riverside Signature of Grantor Chester Frangipami Form 3196-4 (6-94) THIS FORM FURNISHED ey COMMONWEALTH LAND TITLE rnMPAMv 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 Pacific Trades SITE ADDRESS 54-020 Avenida Mendoza APN 7 7 4 _ 2 2 3 _ 0 0 Z• BIN NO.: CASE NO.: LEGAL: LOT 21 BLOCK 295 UNIT CHECKED BY: Stan SAwa DATE: 2001-436 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 Compatibility Review Case logged and number assigned Verify legal and APN information Consistent with MDG on file (as.applicable MDG filing required (5 filings since 9/3/98) Consistency with street/surrounding area: Colors Materials Architecture v Other Requirements: OIL - C-Ovnp I U 1,96 xvdaAMA, 4Ih6t 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: Use Classification: SFD Occupancy Group: R 3 54-020 AVENIDA MENDOZA Type of Construction: VN Owner of Building: PACIFIC TRADES CONSTRUCTION Building Official Bldg. Permit No.: 0104-070 Land Use Zone: RC Address: 1719 S. TREMONT City: S. OCEANSIDE, CA 92054 By: STEVE TRAXEL Date: 09-14-01 POST IN A CONSPICUOUS PLACE