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SFD (0308-199)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#TfLic.. Cllyass ,i f� Exp. Date 81129:20 >y 1 y�f �Da'W l Signature of Contractor ��/ - .�� w- —\•\ 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, 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 d�u:1�I7.iIN ; f:7F' Policy No ve (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 PiliforriiAi and agree that if I should become subject to the workers' compensatiori provisions of�Section 3700 oNthe Labor Code, I shall forthwith comply with those provisionsAN ate: Al, I4 - r_3 Applicant 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. 1 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 tabove-mentioned property for inspection. purpose's. ,.,z Signature (Owner/Agent) �� ` Date l 1-1 ' k BUILDING• PERMIT PERMIT# DATE VALUATION $1.1:p _734,_ LOT ' TRACT 22 JOB SITE ADDRESS 51-542AVRIM. A.NAVARRO APN`.'iraa3 OWNER CONTRACTOR / DESIGNER / EN (NEER DaCl'CLASBMI 1L 2�Ca 1%3IRi�8J�•LTs13'LIiL3'3 t;3f ' LIE;` 35.5.58 St MMMM. n.AVE 35-558 MTAMTa.T , 1) AV& NAU%41)�.°�.LMT CA 92,211 PALM D ERT CA. 92211 (760)3155041-01 M110 PFINDIM USE OF PERMIT 3 1971 SY. SPE). P&3.Ati'.IT t?OW.' VNOT INCLUDE SLOC K W AiLI j PODUSPP•: OR DRIVEWAY APPROACH. 75% REDUCED .PGA11 CHECK FEE FOR. IMUI,1IPIL,$ PIANS OV SAME TYPE TRACT CONSTRUCTION 1001.0091F FCfp,C HIP ,no Yl£1.,fl0 8? GA.TtAt1MARPORT BS9.04i • 3'•}.Y:L.i•GYe@h.7::i%.1) W/WJ&MO.L• W`lIb1S,ARd6J'w,7,.LO di�,lch➢o1d41` ' PER=, ME 9101/ii LAKY CONISTR JC'1` O FEE 101,000-418-000 PLAN CHECK r9r,�Ski.��kd3i?-d3�43iI?, �I�i.l C f FEE U1gPOBIXT 101-000-439-318 4250,00 NEC:RXISi.ICAL 'LECTRiCA.L. FEE -101 1,000-420-000 $12337 PLUMBING FEE$14.100 STR�OAiO ¢/TCiMH FEE RUM 101-000-241-000 Stf..d► . 01 d3Rt�F}INC 101 x,00 X223 rl t a .�fo :, .IDEVELOPER •IBbl'ACT TSE ” .PRWI SE K AN 101-000,+14'1-345 � 100.00 ' v ST-TOTAT. MUM WC 1014 ,f�i 'D MF.'R41' C*M= . gyp,&)0.05 '4'OTAL p°'XRWf IMSDUE NOW. DEC 19- 2003 �3� f 4t1e41 a rc. CITY OF LA QUINTA FINANCE DEPT, V RECEIPT DATE G'7' F" BY D FINA 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 Vf Combustion Air Roof Deck _ Exhaust Fans O.K. to Wrap Framing F.A.U. 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 BLOCKWALL APPROVALS 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 — Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans OX for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test _ ,p/G' elf 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 Utility Notice (Perm) — COMMENTS:' 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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that 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 Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14 X 1,871 S.F. or $4,003.94 have been paid for 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/La Jolla Bank - Joseph Birdsell Check No. 853232 Name on the check Telephone 760/360.2301 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Sharon M Gllvre% Payment Recd $0.00 $4,003.94 Over/Under Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will a 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 issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. - NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting CERTIFICATE OF COMPLIANCE Desert Sands Unified School District ��i�sc �q�.. 47950 Dune Palms Road BERMUDA DUNES r Date 12/19/03 La Quinta, CA 92253 RANCHO MIRAGE d 25297 / ) 760 771-8515 � IN LM DESERLS T CONo. d`, PALM DESERT - V LA QUINTA�' INDIO Q ® y Owner Douglas Birdsell APN # 773-145-003 Address 35-558 Summerland Ave Jurisdiction La Quinta City Palm Desert Zip 92211 Permit # 0308-199 Tract # Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 22 51542 Avenida Navarro 1871 Unit 6 y Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that 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 Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14 X 1,871 S.F. or $4,003.94 have been paid for 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/La Jolla Bank - Joseph Birdsell Check No. 853232 Name on the check Telephone 760/360.2301 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Sharon M Gllvre% Payment Recd $0.00 $4,003.94 Over/Under Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will a 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 issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. - NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting OCT -20-2003 MON 07:35 AM STEWART ESCROW LQ FAX NO. 7607715854 P. 02 RECORDING REQUESTED By. STEWART TITLE OF CALIFORNIA, INC. WHEN RECORDED MAIL TO: BID, LLC:JOSEPH M. BIRDSELL 35-558 SumMRLAND AVENUE PALM DESERT, CA 92211 ORDER N0. 514232220 ESCROW NO. 580074035 SPACE ABOVE THIS LINE F012 RECORDER'S USE GRANT DEED The undersigned grantor(s)declare(s): A.P.N.: 773-145-003 , Documentary transfer tax is S City tax S . ( ) computed on full value of property conveyed, or ( ) computed on full value less value of liens or encumbrances remaining at time of sale. ( ) Unincorporated area: ( ) City of , and FOR VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, ALICE ESQUER, OR HER SUCCESSORS, AS TRUSTEE OF THE ALICE ESQUER LIVING TRUST, U/A DATED 11/18/02 hereby GRANTS to JOSEPH M. BIRDSELL,, -AN UNMARRIED MAN 'the following described real property in the County of RIVERSIDE , State of California ,LOT 22, BLOCK 110, MAP BOOK 018/079, SANTA CARKELITA VALE, LA QUINTA UNIT 12, AS PER THE OFFICIAL RECORDS IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY. DATE: June 02, 2003 STATE OF CALIFORNIA }ss. ALICE ESQUE , TRUSTEE COUNTY OF Q%C_ } On 6 -o? -U 3 , before ;41 QV, personally appeared / Personally ,known to me (or proved to me on the basis of satisfk- . tory evidence) to be the pemn(s), whose name(s)(As re sub- O"icu►L SEAL scribed to the within instrument and acknowledged to the that _ K_ AMENGER COMM *1368387 C) hr(s3bthey executed the same in his/her/their authorized S Notary Public • Califomia S capacity(ies), and that by his/%'dieif signature(s) on the instru- RIVERSIDE COUNTY ment the personAUGUST5,s) or the entity upon behalf of which the per- My Comr ST 5,2 0rpirea 2006 sons) acted, executed the instrument. WITNESS my h tcial seal. Signature (This area for official nolarial seal) MAIL- TAX ST MENTS AS DIRECTED ABOVE F LA OUINTA Fy o a B & SAFETY DEPARTMENT 777-7012 SPECTION REQUEST LINE. 777-7153 Owne 0. AS BIRDSELL Contra cto OSEPH BIRDSELL BUILDERS Permit Number 0309-199- POST-ON 309-199POST ON JOB IN CONSPICUOUS PLACE r INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 51-542 AVE. NAVARRO 1871 S.F. SFD PERMIT DOES NOT.INCLUDE BLOCK WALL, POOL/SPA OR DRIVEWAY APPROACH TYPE OF INSPECTION DATE INSP. TEMPORARYPOWER- -FJ SETBACKS U/G PLUMBING U/G ELECTRICAL/ GROUNDING C" FOOTINGS / STEEL CONCRETE SLAB + DO NOT POUR CONCRETE UNTIL ABOVE SIGNED ROOF NAIL'/'PRE-ROOF_ d OKAY TO WRAP { FRAMING COMBINATION ROUGH.ELECTRIC ROUGH PLUMBING ROUGH MECHANICAL" INSULATION -Q Cf COVER NO WORK UNTIL ABOVE SIGNED ± INTERIOR GYP. BD. DRYWALL !' EXTERIOR LATH ' GAS TEST._.:. SEPTIC ABANDONMENT SEWER CONNECTION" f SEPTIC / GREASE INTERCEPTOR i MASONRY INSPECTIONS FOOTINGS / STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE /"SETBACKS U/G PLUMBING I U/G-GAS U/G ELECTRICAL PRE -PLASTER ALARMS / BARRIERS).. FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER . p ELECTRICAL' _ PLUMBING -MECHANICAL PUBLIC WORKS DEPARTMENT COMMUNITY DEVELOPMENT DEPT. FINAL / JOB COMPLETED ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING �•� _ - �..-. _sem..... -- .�.- .. _ _ _ -- -- - - - •� Certificate of Occupancy.0 OF'L19w Building & Safety Department This Certificate is issued pursuant to the- requirements of Section 109 of the California Building s Code, certifying• that, at • the time of issuance, this structure was in compliance with the provisions of the Building Code_ and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 51-542 AVENIDA NAVARRO Use classification: SFD Building Permit No.: 0308-199 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC Owner of Building: DOUGLAS BIRDSELL _ Address: 35-558 SUMMERLAND AVE. City, ST, ZIP: PALM DESERT CA 92211 `By: KIRK KIRKLAND _Date: 7-9-2004 Building Official - POST IN A CONSPICUOUS PLACE