9907-544 (SFD)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
533670 B
Date Signature of Contractor
OWNER -BUILDER DECLARATION
06/301M
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 Fam exempt under Section B&P.C. for this reason
,Date v 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
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.
Gv.LDt;-N L�� OILL ialvli�l. r ° ra�t'� 1.04
(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
subject'to the workers' compensation provisions of Section 3700 of the Labor
CodeI shall forthwith comply with those prov-isions.
,Date:Applicant—
Warning:
pplicant 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.
,Sgnature (Owner/Agent) Date
PERMIT #
BUILDING PERMIT
911197.1
DATE 4wniv.99VALUATION S165,464.(ij) LOT 113 TRACT Urt
JOB SITE ADDRESS �%i••645Q�E`V�� 1�NAA&ANJ.a�
APN 70-077"M
OWNER
CONTRACTOR / DESIGNER / ENGINEER
TA,cTA,NE A,i..t�,.>'°ONO
FnT lt�v ti�..6.�ri.: V IDa!pol"aAi-rf
44-7775 trt )S N4AN0S
LA 0, ONTA CIA 92253
MI'M Tk!,c(y Wr CA 92760
(760lII 5411 N �6)
USE OF PERMIT
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RECEIPT
DATE
BY' -
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
Q - 2 - Q C(5T
Exhaust Fans
O.K. to Wrap
- S T
F.A.U.
Framing
5 7
Compressor
Insulation
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
eo
POOLS - SPAS
BLOCKWALL
P ROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines�'j
3� ��[(
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
9=7_ _
Encapsulation
Gas Piping
Gas Test
o19
Appliances
Final
COMMENTS:
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 -/,� 99- C
Final
Utility Notice (Perm)
kc
i
Notice:
Document Cannot Be Duplicated
Date 7/29/99
No. 19121
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Owner NameZane Alacano
No. 78-645 Street Calle Naranja
City La Quinta
Tract #
Lot #
Type of Development Single Family Residence.
Comments
Jurisdiction
APN #
La Quinta
Permit #
Log #
Zip 92253 Study Area
Square Footage 2,596
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
1.93 X 2,596 or $ 5,010.28 the property listed above Tana;that building f,
permits and/or Certificates of Occupancy for this square footage in this proposed proje�i ay�nowbe issued
7: w.
^► ..�
Fees Paid By cc/1st Bank/Daniel Alacano Telephone _,360-&632 =�
Name on the check
-
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Juanita Green
Signature
Payment Received $5,010.28
Check No. 51433
NOTICE: Pursuant of AMembly 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
I
JUL.27.1999 5:37PM COMMONWEALTH
RECORDING RRQUESTED SYt I �}
FIDELITY NATIONAL TITLE COMPANY
99.8862KC 16214 -PP + j
M= RECORDED MAIL TSXS DR= AND,
UNLESS OTEMRWISM SSO9aN BELOW,
MAIL TAX STATM WT9 TO.- /
ZANE ALACANO oo
and JERI ALACANO
SPACB ABpyE
GRANT DEED
NO. 722 P.1/1
C�Cp CC�r. G
TRIS LZNX 8'OR RECORDER"S USE
APRT; 769-077001
The undersigned grantor(s) declare(s):
Documentary transfer tax is
(XXX) Computed on full value of property conveyed, or
( ) Computed on full value less liens and encumbrances remaining at time of sale.
( ) Unincorporated area; ( ) City of and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
A & M CONSTRUCTION, A CALIFORNIA PARTNERSHip
hereby GRANT(S) to
ZANE A14ACANO and ,7ERI ALACANO, husband and wife as joint tenants
the real property in the City of LA QUINTA, County of Riverside, State of California,
described as:
Lot 113, of DESERT CLUB, Tract , Unit No. 5, as per map recorded in Book 2�, Page(s)
51-53 inclusive of maps, in the office of the County Recorder of said County.
Dated
State of California
County of
On
before me,
personally appeared
personally known to me (or proved to me on
the basis of satisfactory evidence) to be
the person(a) whose name(s) is/are subscribed
to the within instrument and acknowledged to
me that he/she/they executed the same in
hie/her/their authorized capacity(ies), and
that by his/hear/their signature(s) on the
instrument the person(s), or the entity upon
behalf of which the person(a) acted, executed
the instrument.
WITNESS my hand and official seal,
A & M CONSTRUCTION
A CALIFORNIA PARTNfiRSHIP
BY
MANUEL ABARCA, GENERAL, pARTNXR
BY
RICK MORRIS, GENERAL PARTNER
Signature (This area for official notarial seal)
XXX& TAX STATXMM0 TOt
-ale
a i V
YOUNG ENGINEERING SERVICES
47-159 Youngs Lane, Indio, Ca. 92201 (760) 342-9214 fax (760) 342-6164
August 23, 1999
Tom Hartung
Building Official
City of La Quinta
Re: Truss Review Zane Alacano Residence - 78-645 Calle Narania, La Quinta
Dear Tom,
We have reviewed the truss submittal package prepared by Spates Fabricators for the above project and
found it to be in substantial conformance with the approved plans.
If you have any questions or concerns please call.
Sincerely,
Jeffery B. Young S.E.