Loading...
SFD (0207-157)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 736920 S 03/3112t el D'a'te l 7 /4 Signature of Contractor( OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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, 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 I Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty ofo perjury one of, the following declarations: . ( ) I have and will maintain a certificate of consent to self -insure for workers' I ompensation, as provided for b'y Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. V) 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 STATE FUND Policy No. }91-da02 (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 " Codeid.shallforthwith comply witdl•rthose provisions. .-.Date: I /%3 Applicant ,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 andSafety for a permit subject to the conditions and restrictions set forth, on • his application. e 1. Each person upon whose behalf this application is made & each persgn ats whose request and for whose benefit work is petformed 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 thelbuilding construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for in'spection.purposes. °' ,_Signature (Owner/Agent) Date YO � �R;I I } O BUILDING PERMIT PERMITk DATE VALUATION LOT 1849 TRACT MIX in, 3 JOB SITE ADDRESS 4 �i7:su S il. ��� i APN 7"r3-275-0221 OWNER CONTRACTOR/DESIGNER/EN (NEER Ct"fNIRK OORAR`!I' HOWE, 1JIrJ. x30)'14.' ;1 i 51370 A.V•.WY1DA.�"r.MdU d :.A(21TA A -' 2 33 i.AQUMMIA. CIA 92250' i (760)168-141014 LO 61255 USE OF PERMIT I' / I PERW1:�OESVC1VN1 C1Xi JR.8iWt)t"X bitALLS1 1,006L i 011 DRIVEWAY APPROACH' •r TRACT C 01011 ROCTION 110:63.001V poplc1tOP!010 + 395.00 SF 0AR AM(!A�-,'PbN`)' 34,016 8F COM'R•l.TC1110N FE9. 101-000-413a000 $671 (1-0 BLAH CHECK PRE 101-000.429-319 $530.35 FPE UEP01.131T 1 X11 8000 43M I S 4250.00 111M:iNNICAL F99 101-000.421-t7ftd) 139,00 M1NTWCAL.1 EE' 10111000420-000 $121.34 PLIJ dik+M0 YEV. 101-000.419w000 $110.75 r t ) ONO 14 O k IM' WR7. • R1 SID .101.000.241.000 3111.80 MADRID VIM DEVFW?1FA IMPACT FEE �2,Aiis.Ofl PP.EC1SZPLAN $100.00 T4,(Msm 0 IMIS PRE-PAWFUS -821 X00 l�yyft,.,�;C' yy�� ../yy.�,.t� 11 Yn4yy��pp����pAttZrrpp ^^����++yy�� DUE • r0 T W �",ICiAS1.6l18'.R:..4s`.�ek7 Je'7.l'ENOWY t � ��9y S3,795.559. S3, 95.559. ei �� � � ?001 .CCFy OF LAQUINTA� RNANCEDEFr RECEIPT DATE g .F : .% By DATE FINALED INSPEC J INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR.. BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms 8 Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans 0. K. to Wrap F.A.U. Framing — Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath L -�� Drywall - Int. Lath Final Final 2-7 v3 ��_ 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 I I Gas Piping PLUMBING APPROVALS Waste Lines Z�F 2 Gas Test Electric Final Neater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral_ Pool Cover Sewer Connection /� _ !�� Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole61 Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Z Cy Final Utility Notice (Perm) COMMENTS: oat - \0 Building -2 — 3Sa Address Owner i O is oz 4 eA uu�cv P.O. BOX 1504 APPLICATION ONLY 78-495 CALLE TAMPICO J14rr'D LA QUINTA, CALIFORNIA 92253 :�OsP / lSvr -r.. Mailing �or Address 1 City & Zip_ �2 S� Tel. l� I � R-3Zy Contractor_ / 0 ss ty lZip Li c. State c. _ j ] City 8 ate Lf. t' 1 � /") Arch., Engr., ��✓ Designer Address Tel. City (Zip (State uc. # LICENSED CONTRACTOR'S DECLARATION I herebyffi arm 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. SIGNATUREDATE OWNER -BUILDER DECLARATION I hereby affirm that 1 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 permitto construct, alter, improve, demolish, or repair any structure, prior to its Issuance also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to the provisions of 16e Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or thathe 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 10 a civil penally of not more than five hundred dollars ($500). t.: I, as onet 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 Prolessions Code: The Contractor's License Lew 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 i I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the proiact. (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 conlractorls) licensed pursuant to the Contractor's License Law.) I'I I am exempt under Sec._ B. d P.C. for this reason Dale Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to sell -Insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company t'I Copy is filed with the city. l:7 Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need riot be completed if the permit is for -one hundred dollars ($100) valuation Or. less.) Icertify Thai 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 Caliornia. 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 permlhis Issued. (Sec. 3097, Civil Code.) Lender's Name lender's Address. _ This is abuilding permit when properly filled out, signed and.validaled, and is subject to expiration if work thereunder is suspended for 180 days. I certify ,hal I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and slate 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, Slate, Zip BUILDING: TYPE'CONST. OCC. GRP. -2- A.P. Number 7 -3 — 2-7 ✓ 'D—I:L egal Description roject Description 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: bate Permit Validated by:_ Validation: .WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION _ _ 1, --, , Sq. Ft. Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition CI - U� ehytz 3 R�rTL� v Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 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 INSPECTOR Issued by: bate Permit Validated by:_ Validation: .WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION _ _ 1, --, , Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 18-19 52350 Avenida Navarro 1663 Unit 6 Unit 2 Unit 7 - Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 - Comments Check #7924495 covers Cert. #23477 and #23478 r 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 1,663 S.F. or $3,558.82 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 -Union Bank of California -Mark Kellogg Check No. 7924495 Name on the check Telephone 760-832-4641 Funding Residential By Dr. Doris Wilson Superintendent " Fee collected /exempted by Yolanda Garcia $6,770.96, $3212.14 Payment Recd ° Over/Under Signature NOTICE: Pursuant to Government Code'Section 66020(d)(1), 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 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 Doe uf orient NOT VALID if Duplicated Embossed Original, Building Departryient/Applicant Copy - Applicant/Receipt Copy - Accounting CERTIFICATE OF COMPLIANCE Desert Sands Unified School District SS�,FIsc o 47950 Dune Palms Road zq�cS13 ¢ BERMUDA DUNES Date 8/13/02 La Quinta, CA 92253 , CHH MIRAGE n RIAN No. 23478 (760) 771-8515 IAN P LALS QDESERT �y Q INDIO y� 0 Owner Buffin/Kellogg APN # 773-275-022 Address P.O. Box 1141 Jurisdiction La Quinta City La Quinta Zip 92253 Permit # 0207-157 Tract # BLK103 Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 18-19 52350 Avenida Navarro 1663 Unit 6 Unit 2 Unit 7 - Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 - Comments Check #7924495 covers Cert. #23477 and #23478 r 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 1,663 S.F. or $3,558.82 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 -Union Bank of California -Mark Kellogg Check No. 7924495 Name on the check Telephone 760-832-4641 Funding Residential By Dr. Doris Wilson Superintendent " Fee collected /exempted by Yolanda Garcia $6,770.96, $3212.14 Payment Recd ° Over/Under Signature NOTICE: Pursuant to Government Code'Section 66020(d)(1), 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 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 Doe uf orient NOT VALID if Duplicated Embossed Original, Building Departryient/Applicant Copy - Applicant/Receipt Copy - Accounting RECORDING REQUESTED 8y*. ANO WHEN RecoRDED MAIL T41S DEEC AND, UNLESS PTHERWISE SHOWN BELOW, MAIL TAX STATEMENTS TO; ROBERT KE:uLOGG 75271 STARDUST DANE INDIAN WELLS, CA 92210 SPACE A30VE THIS LINE FOR ` F-COROER'S'USE Grant C)eed A.P,N. 273-275-022The undersigned grentor(i) deelare(a): DecumentaN transfer tax Is $ ( xs) computed on ,Ull valus of propeny conveyed, or ( ) computed an'UII value1883 value of liens end eneimbrances r9malning at time of 9216, and ( ) Unincorporated area: ( ) City o1 FOR A VALUABLE CONSIDERA70N, receipt of which Is hereby acknowledged• HARRIETT SILVER hereby GRANTS) to ROBERT KELLOGG a married man as his sole and separate property the real property in the City of La Quiaca County of•Je=side State of Callfomla, d8wilbed as Lot 18 & 19 oc Bloc's; 103 Unit No. w Santa" Cartnelita at Vale La Quintz., as per ,nap recordad is Book if mapa, Records of Riverside County, Collicraia May 30 2002 Signature of Grantor Date state of CalitorMe ) county or ) HARRIETT. SILVER . Cn bsrore me, _ ... personally appearad HARRIE'r'r STt.vR personally known to me (orrproved to me on the b88Ie of sehaf8dory. - evidence) to'a.lhe Pa whose nar9(9) Islare aubseribed to the within ineWmenl and aeknawleEpedio me lhal hWeite/lhay oxacuted the same In hie/hedlheir authorised capadly(tea), end that by hlg(har/their signeture(s) on thadnatrument the aenon(s), or the enllty upon behalf of wMeh.the persona) stied, executed the listrurnent. , VVITNESS ny hand anti official 4081. w , Signature MAIL TAX S%ATEMENTS TO, I • nA,� S`a�`.IC�B �3MOj W1+t)G:i, �.pllc s t r� ti L THIS. - MAP /S FOR SSESSMENT PURPOSES "ONLY-': 0 4 S ONORA } �60.02 $L•s � J� so.oz -79,48 52-21 sa.o2_ �q.ae x`'.52. -ZZ 0 52-27ci 0 0 52-253 a/O ° O 0 22 /2 / • 30 30 0 22 O 11 l 3 0 3o q /00 0o O . n i00 oZ•SCe 0o ° 5Z-Zq5 °w 020-09/ rRA Oto -07/ 5Z-23 0 0 2/ O 2 Y 2 2/ O2 /2 2 2/ O � 5Z -3o 2..�4 s2-333 p 3 5 5Z- zY o 52-337 h p © 20 Z) 20O /©3 20 3 O 5 -3z, ,oz.�z cc Z-•Zo - 5Z -Z`73 Q rRA ozo-o78 0.22Ac /9 v 4 /9 ® 4 _ej I_ 2 z•� m /9 /52-337 , 52-260 - ss ©.Z2Ac- -3 75 52-z7a /S�Z+ u5 V� /& 0 5 5 ° /8 © /5 .5 rRA'oza� e O lei: �Z' uBoz e4 5 /8 5Z -3f5 rRA 020-078 JJZ 2a0o© l6 7!62�15 VSt/-39 /8 R 0250-09/ SVQTO o0© L /7T/ 7 2-3�5 g ' 0AN M /7 o 75 5ZJyoo/6 7 ,6 Zm O7 /6 7 77 rRA 020-078 rRA °ro-o/ i TRA 5 Z- y Z 5 o Q — - - - - - 8 /5 O ® B Q /5 ® . l8 020 052 `^ /5 /8. Q 4 52-5/20 O.z3nd 5 _910 5z- 4/5 Z_Z 5z.'`1 5 p Z SZ.- 935 TRA 020-07/ /4 9 /9 9 ; �/ /4 9O 9 �( /4 O9 /9 9 Q O _ Q 1o1.z Q �- TRA 020- 078 S Zy3 TRA 020-07/ 5'Z -Y65 52-45.0 n i - 9 11 G 3 /3 ® Q /O /3 /O /3 /O l0 1o3.2 30 30 /o0 52-/g3 Q *� X4.98 g.ozQa 0 O 52-98S } 30 30 020-09/ 30 30 $' v SZ -92 y? © J. 34/2 / 77-9 goS1 pi -7f,'9 oz u m } ENSENADA o r o; ' I ASSESSOR'S MAP BK. 773 PG -27 1 RIVERSIDE' COUNTY, CALIF. ' SK ASSESSOR'S MA'P SK. 773 pe 28 RIVERS/DE COUNTY, CALIF. sx RC DISTRICT - PLANNING REVIEW FORM This form is to be used by CDD staff for review of single family dwellings in the RC (Cove Residential) District per Section 9.50.090 of the Zoning Code. Its purpose is to determine: 1) that the proposed house design does not duplicate the same architectural style of any house within 200 feet of the applicant, and/or 2) if there is a need for the applicant to file for Master Design Guidelines. If the applicant does need to file a Master Design Guideline, please transmitted this information to the Building and Safety Department as part of your correction list. Please attach additional explanations as necessary. APPLICANT Kellogg f Buffen SITE ADDRESS 52-350 Navarro APN 773 - 275 - 022 CASE NO.: 2002-686 LEGAL: LOT / 9 BLOCK l a 3 UNIT L 1 CHECK AND APPROVED BY: Wally Nesbit DATE: S.C.@V.L.Q. Inform the assigned Building plan checker upon your assignment to this case. The CDD Executive Secretary maintains a log book to track applications and assign case numbers. REQUIRED ITEM Y N COMMENT/CORRECTION Verify legal and APN information ✓ MCr� —£ 9l'Zs—fg ��2�9/ Consistent with MDG on file (as applicable MDG filing required (5 filings since 9/3/98) �/, Architectural variety within 200 feet of the surrounding area: Colors Materials Architectural. design _features ft2royed Dr Oth90 RlV0ftW90h$M1ss10fk ❑ City Council WCommur ii Dev. Dept Initials Case No. Exhibit Certificate of Occupancy �� � City of La Quinta Building and SafetyDepartment OFTM 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 U-1 52-350 AVENIDA NAVARRO Bldg. Permit No.: 02077157 Type of Construction: VNLand Use Zone: RC Owner of Building:- BUFFIN/KELLOGG Building Official Address: P.O. BOX 1141 City: LA QUINTA CA92253 By: KIRK KIRKLAND Date: 2-27-2003 POST IN A CONSPICUOUS PLACE