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0004-012 (SFD)LICENSED CONTRACTOR DECLARATION I ',iereby 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 533570 B ate �� ` �- Signature of Contactor 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). ; O lam exempt under Section - B&P.C:., fort Is reason ., Date lo -,'L/-• ](:Signature of Owner �,i 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 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 WI DEN EAOIX Policy No. N�ATG 322374-04 (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 Va ject to the workers' compensation provisions of Section 3700 of the Labor e, I shall forthwith comply with those provision's. e: :A 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. /r Signature (Owner/Agent) ` �'� �'-r _� Date_�G V BUILDING PERMIT PERMIT# DATE VALUATION LOT 0004-012 TRACT $107,x3:).:0 16 13LX 29 JOB SITE APN ADDRESS ,s• A90 AMMA MORALES S 77 3-11.52 •04*. OWNER CONTRACTOR/DESIGNER/ENGINEER M TU WK 81W -03E CORPOTRA17014 72850 SO_TV M.11D 39725 GARAND. LANG; SUITE C PAT,M DMRT GA 92260 PLM DESERT CA 92211 (760)W-7186, CBVf, . 1137. USE OF PERMIT SWOLE FAWY DWE LUNO SPD • PERMIT DOS NOT INCLUDE HLOCK WALLS OR POOL TRACT CONSTRUCTION I, 73%00 9F :g&R AOF,/CAP.PORT 444.00 SF 3 FTI WOOD FL'NCE 200.00 LF ES7INA.TED COS' OF C0IY9!RUC1I0N 10.7,4.16M PERhIffF": fs'tM11URY CONSTRUCTION FEE 101.000-418-000 $667.50 P AN d3ECK FEW 101-000-439-318 $556.68 M.KCHANICA1, FI?E 101-000-421-000 $60,00 ELECTRICAL FEE 101-000-4120-000 $140.93 PLUMBING FEE 101.000-•419.000 $116.73 ti � STRONG MOTION FEF -- RESID 101-000"-241-000 $10,74 GRADING FEF 101-000-423.000 $20,00 D_�TRI,OPER IMPACT FEE $1,907,00 .1 ~• PRIXISR PI.A 4 101-000.441.345 $100100 _ ' N'EF DEPOSIT 101-000.439-318 •$250.00 .r � C^7 ...i SM-rMAT. C''O)gS7MTJG-.f02d AND PLAN C1*:CTC O` �3,S79.G0 LESS PRF -PAW FSS -$250,00 TOTAY 1'1 M'1'3!". S MUR NOW ,329,150 RECEIPT DATEBY f} �( DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap - Crz7 F.A.U. Framing � Compressor Insulation i Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath U Final IS% BLOCKWALL APPROVALS Final POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Water Piping / / �! �6 s� Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection =s— DO S' T. Encapsulation Gas Piping Gas Test' r Appliances Final Final Utility Notice (Gas) 5 ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final OVJ Utility Notice (Perm) ., COMMENTS: p4 , o� vTAbf 0 4 " *BOX 1504 APPLICATION ONLY Building SI _ a 78-495 CALLE TAMPICO Address d U tic'$ LA QUINTA, CALIFORNIA 92253 Owner /'1 i!n K 7-tt/Mailing VLDL U. Address City �n�y Zlp f/V Tel V/// Cctt actor S uti Address Lip I eL N%O State Lic. City & Classif.� D Lic. # f 3 Arch., Engr., Designer Address Tel. City (Zip r (State 7 3 370 Lic. # 1 LICENSED CONTRACTOR'S DECLAR ON 01 I hereby affirm that I am licensed under provisions of er 9 (commencing with Section 7000) of_., 3 of a Bus'ness and Pr essions C my license LLs� n full force and effect. r'��/a—OG 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 (8500). 17 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.) 111, 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 doesnot apply to an owner of property no builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Il 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 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 1-1 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 ($1001 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 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 stale 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 BUILDING: TYPE'CONST. OCC. GRP. / A.P. Number --7 -73 — 15-2. - doq /&, lie e,4,?7 Description Project Description Sq.f iFt. f t No. J No. Dw. Size ( ((((((JJJJJJ // Stories J Units New Add O Alter ❑ Repair ❑ Demolition O itimated Valuation PERMIT �(AMOUNT Plan Chk. Dep. /f 3W -_Zu Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS y r . ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Li lie 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 Desert Sands. Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated • 760.771-8515 Date 6/14/00 No. 20550 Owner NameMike Tuvell CERTIFICATE OF COMPLIANCE APN # 773-152-009 Jurisdiction • La Ouinta Permit # 0004-012 No. 51-890 Street Avenida Morales Log # city La Quinta Zip 92253 Study Area Tract # BLK29 Lot # 16 Square Footage 1787 Type of Development Single Family Residence No. of Units 1 Comments paid by CC#54732 for $3,627.61 + Cash $35.74 = $3,663.35 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 1,787 or $ 3,663.35 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 See Comments/1st Bank/Mark Tuvell Telephone' 760-345-7186 Name on the check By Dr. Doris Wilson M jib Superintendent Fee collected /exemp by Mary Ann L. Boda Payment Received r`43,663.35 - Check 43,663.35 - Check No. See Comments Signature NOTICE: Pursuant of Assembly Bill 3081 (CHAP 849, STATS. 1998) this will serve to notify you that the t)0 -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 !wilding or installation permit for this project is assued or on which they are paid to the Districts) or to another public entity authorized to collect them on the Distrlcq'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 DeptJAppiicant . Copy - Applicant/Receipt Copy - Accounting RECORDING REQUESTED BY: AND WHEN RECORDED, MAIL TO: Mark F. Tuvell 72850 Somera Rd. Palm Desert, CA 92260 3 THIS SPACE FOR RECORDER'S USE ONLY ASSESSOR'S PARCEL" NO.: 773-152-009 The undersigned Grantor(s) declare that the DOCUMENT TRANSFER TAX IS. TITLE ORDER NO.: 501479-13 $ 25.30 County $ City xx computed on the full value of the interest of property conveyed, or ESCROW NO.: 5847 -DS _computed on the full value less the value of liens or encumbrances remaining thereon at the time of sale. GRANTDEED OR transfer is EXEMPT from tax for the following reason: FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Roberta J. McCoy, a single woman hereby GRANT(S) to Mark F. Tuvell, a_married man as his sole and'separate property all that real property situated in the City of La Quinta County of Riverside, State of California, described as: Lot 16 Blk 29 MB 018/055 Santa Carmelita Vale La Quinta Unit 2 as recorded in Book 18, Page 55 of Maps in the Office of the County Recorder of said County Dated March 13, 2000 STATE OF CALIFORNIA, COUNTY OF ON before me Roberta J. McCoy Notary Public, personally appeared 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 signatures) on the instrument the person(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: Mark F. Tuvell - 72850 Somera Rd., Palm Desert, CA 92260 (This area for official notary seal) AC 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 SUNROSE CORPORATION ' SITE ADDRESS - 51-890 Avenida Morales APN 773 - `152 -'009 BIN NO.: CASE NO.: 2000-211 LEGAL: LOT 16 BLOCK 29 UNIT S.C.@V.L.Q. CHECKED BY: Fred - Baker DATE: 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 V MDG filing required (5 filings since 9/3/98) Consistency with street/surrounding area: Colors Materials 'Architecture V Other Requirements: 11 1 *Certificate of Occupanc'* 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 fol%wing; BUILDING ADDRESS: 51-890 AVENIDA MORALES Use Classification: SFD Bldg. Permit No.: 0004-012 Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC Owner -of Building: MARK TUVELL Building Official Address: 72-850 SOMERA RD. City: PALM DESERT, CA 92260 By: STEVE TRAXEL Date: 09-28-00 POST IN A CONSPICUOUS PLACE