11724 (SFD)4
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 52-255 Catrranza LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address
CityZip Tel.
1
Contractor
Address
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm 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.
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,Susiness 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 thealleged 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 ($500).
O 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 'hat 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
or proving that he did not.build or improve for the purpose of sale.)
❑ I, 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
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.)
❑ 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
❑ 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.)
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.
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 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 it 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 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
No. 11724
BUILDING: TYPE CONST. OCC. GRP.;
A.P. Number 773--255-013
Legal Description
Project Description SFD
Sq. Ft. 1650 No. No. Dw.
Size Stories Units
New:& Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit does not include any block walls
or pool.
Estimated Valuation $100,168.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. 250.00 ` - .
294.76
Const.
639.50
Mech.
62. DO
Electrical
131.05
Plumbing
147.00
S.M.I.
10.20
Grading
20.00
Driveway Enc.
Infrastructure
2,146.70
rrecise .Mian .25. UU
tirts in Public
25.00
TOTAL 3, /25.21
.3, UIT.21
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: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. ®
ROCK STORAGE
DRAINAGE PIPING
WALL SQ. FT.
METER LOOP
DRINKING FOUNTAIN.
SO FT ®
OTHER APPJEQUIP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
TEMP. POLE
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
SERVICE
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FRAMING 4f
72
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE,TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. .& c
BATH TUB
FIRE ZONE ROOFING
SQ. FT. ,@ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE ," PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING NDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER2
3 GH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus -x$_=$
LUMBER GR.
FINAL INSP. 3
FRAMING 4f
72
FINAL INSP. u.Fs
ROOFING (p/
✓
�ro /ty�
► f� V
GyT �? Cop
( l J %
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
I?HINGS(�� q�
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION-
NSPECTIONCERT.
CERT.OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS.
GARDEN WALL FINAL
IIIIIIIIIJ
ARROW PRINTING. INDIO. CA 3500 II/DO 371213 -CJ
4 I '7�)//JVD/r`//•/
4
P.O. BOX 1504 N o . 11724
Building 78-105 CALLE ESTADO
Address 52-255 Carranza LA OUINTA, CALIFORNIA 92253
Owner
iaz
Mailing
Address
City Zip Tel.
Contractor
Address
City
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address TTel.
City IZip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm 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.
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, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that hes licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the ausiness 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 ($500).
❑ 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 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
orimprovement 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.)
O 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractors License Law
does not apply to an owner of property who builds or Improves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Lew.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date owner
WORKERS' COMPENSATION DECLARATION
1 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
❑ 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 (5100) valuation
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.
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
1 hereby 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 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
btalling Address
11LDING: TYPE CONST. OCC. GRP.
P. Number 773-255-013
Description
.t Description SFD
Sq. Ft. 1650 No. No. Dw.
Size Stories Units
New)0 Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit does not include any block walls
or pool.
Estimated Valuation $100,168.00
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. ?94 76
Const. 639.50_
Mech. 62.00
Electrical
Plumbing 147.00
S.M.I. _
Grading 20-00
Driveway Enc.
Infrastructure 2,146.70
Prp-r-isp- P71 -an 25.00
TOTAL 3,726.21 3,476-91
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: Date Permit
Validated by:
Validation:
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 3/3/93 1 Type of Permit La Quinta
No. 112057�r:�_�r�;, Permit #
Log
Owner Name Mi uel A.''
No. 52-255 Street Avendia Carranza
City La Quinta Zip 92253 Study Area 112
APN # 773-255-013 Tract # I I Lot # 0 Square Footage 11650
Type of Development I Single Family Residence I No. of units 0
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 1.58 x 1650 or $ 2,607.00 have been paid to D.S.U.S.D. 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 Miguel A. Diaz/Cashier's Check Telephone 564-2139
Name on the check
By James F. Lively
Assistant Superintendent, Business Services
- - v
Fee collected /exempted by Vickie J. Durrett -
Paymei=t-Recei;�.ed ?
Signature f Cly C i�L'LQ Check No. 053297
Collector. Attach a copy of county or city plan check application form to di`srict copy for all -waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy 4 -Accounting
COACHELLA VALLEY WATER DISTRICT �1
CASH RECEIPT DETAIL6 ? 5
Received From - Date:: _ - -
Account No. 62pt(s) Tract�Q
Service Address - G.A. Code
Meter(s) — � $ el
Service(s) `
. QQ
❑ Backflow(s)
❑ House Laterals)
❑ DetectorCheck(s)
❑ Meter Surcharge
�4Sanitation Capacity Charge d S7
'
❑ W.S.B.F.C,
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account- Name
❑ Inspection Fee - Tract -
Fee -
❑ Plan Check Fees Water / Sewer -
Tract -
❑ Bond Payment - A.D. - Bond
Assmt.
❑ Customer Deposit
❑ Other
TOTAL $
Remarks:
' ❑Copy to:
C /
Cash
Water Service
Check
O S3� r '
Cashier '
Money
Order
D-438(11/89)
------------ -
:4
J
�.0
P.O. Box 1504
78-495 CALLE. TAMPICO (760) .777-70'00
LA,QUINTA, CALIFORNIA 92253 (TDD) (760) 777-1227
December 16, 1999
Miguel and Irma Diaz
52255 Avenida Carranza
La Quinta, CA 92253
SUBJECT: PARCEL MERGER 99-365; APN's 774-094-011 & -012
The, Community Development Department has reviewed the above referenced application, and
provides this letter to advise you of its approval. Enclosed is an approved copy and original draft
grant deed form (to be notarized/recorded), along with approved Exhibits A, B and Site Plan.
These items must be filed for recordation by Riverside County, along with a copy of your existing
deed to the property. A copy of the revised., recorded grant deed must be submitted to the
Community. Development Department. along with any future permit application(s).
Please be aware that, as the property owner, it is your responsibility to record these documents.
The City cannot file them for recordation on your behalf as we do not have any ownership interest
in the property. The Riverside County Recorder's office can be reached at 909-486-7000.
Enclosed is a letter to the County Recorder verifying approval of the merger by the City, and
requesting its recordation.
There are utility agencies which may have easements affected by this approval. The City has
approved this merger based on zoning compliance and correctness of the property descriptions.
Any potential conflicts with recorded utility easements should be investigated prior to any
construction. By execution of this approval, the applicant agrees to indemnify, defend, and hold
harmless the City of La Quinta from any legal claim or litigation arising out of the City's approval
of this parcel merger.
If you have any questions, please contact me at 760-777-7069.
Very truly yours,
JERRY HERMAN
COMMUNITY DEVELOPMENT DIRECTOR
Wallace Nesbit
Associate Planner
WN/wn
encl.
C. Greg Butler, Building & Safety Department J
File; Parcel Merger 99-36.5
CAWrkgrp\Letters\mgr99365.wpd ��
r.
J
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
December 16, 1999
County Recorder
County of Riverside
P. 0. Box 751
Riverside, CA 92502-0751
r
(7 60) 777-7000
(TDD) (760) 777-1227
SUBJECT: RECORDING OF PARCEL MERGER 99-365
To Whom It Concerns:
The City of La Quinta has approved the above referenced Parcel Merger. Please allow its
recording as presented by the applicant.
Should you have any questions, please call me at (760) 777-7069.
Very truly yours,
JERRY.HERMAN
COMMUNITY DEVELOPMENT DEPARTMENT
Wallace Nesbit
Associate Planner
WN/wn
c: File; Parcel Merger 99-365
EXHIBIT A
CERTIFICATE
OF PARCEL MERGER NO.,! --.%S,.
Owners
Existing Parcels
Assessor Parcel Numbers
/ge" 4
OfA
Irma L D' /11&VfL
o1 -4a
_
Legal Description of Merged Parcel
.Lots 13 and 14, Block 214,.Sana Carmelita at Vale
La Quinta, Unit No. 20, as shown by Map on file in
book 19, page 38
of maps, records of Riverside
County, California...
APPROVED -BY COMMUNITY DEVELOPMENTDEPT
BY ) ..,:.. DATE
EXHIBIT
CASE NO,, _%,% - 3 (.s.
I L I
EXHIBIT B
CERTIFICATE OF- PARCEL MEAGER NO," -X
m
0 14
In
ISO
w 13
V
TRA 020
U -11A
12
m
%.�VLIMA
APPROVED 8Y COMMUNITY DEVELOPMENT DEPT
BY ��?� DATE 1 2 ib q�
EXHIBIT
CASE NO. coq talc 99 S
Record Owner DUI HI(sva A./-*& rq L This Certificate of Parcel Merger No. is
Address SZ 2SS4vPt'O" �4it/twazit hereby approved
Map Prepared BY �4M� ar G✓Act.ac.€ N�sa�r .
Address Title
Date
Area/District --7 9
-SITE PIAS --
CERTIFICATE. OF PAACELMEAGEA NO,, -.-
APPROVED BY COMMUNITY DEVELOPMENT 'DEPT
BY � —DATE IZ114299
EXHIBIT _rerE
CASE NO. ftt 992
IVO SiCAL r—
Record Owner
SAMC
A
Address
Map Prepared 8y. Mr. Miguel Diaz
Addren 527255.avenida carranza
La Quinta, 92253
scWe
AssesmWeparcel ft 774-094-o11and.:-!OT2
Vacant land
P.O. Box 1504
78-495 CALLE TAMPICO
LA:.QUINTA, CALIFORNIA 92253
January 12, 2000
M
Miguel and Irma Diaz
52255 Avenida Carranza
La Quinta, CA 922
SUBJECT: WITHDRAWAL OF PARCEL MERGER 99-365
APN's 774-094-011 and -012
(7 60) 777-7000
(TDD) (760) 777-1227
Please be aware that, due to the refund of fees associated with the above application,
the approval granted by letter dated December 16, 1999 is now void and of no
further effect. This merger may not be recorded or in any way acted upon, pending
submittal of any new application for the subject properties. A letter to Riverside
County has also been sent to this effect (copy enclosed).
If you have any questions regarding this matter, please contact me at 760-777-7069.
Very truly yours,
JERRY HERMAN
COMMUNITY DEVELOPMENT DIRECTOR
Wallace Nesbit
Associate Planner
W N/wn
encl.
c: Greg Butler, Building & Safety Department
File; Parcel Merger 99-365
C:\Wrkgrp\Letters\mgr99365void.wpd
P.O. Box 1504
78-49.5 "CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
January 12, 2000
County Recorder
County of Riverside
P. 0. Box 751
Riverside, CA 92502-0751
� � f
SUBJECT: WITHDRAWAL OF PARCEL MERGER 99-365
. APN's 774-094-011. and -012
To Whom It Concerns:
(760) 777-7000
(TDD) (760) 777-1227
Please be aware that, due to the refund of fees associated with the above application,
the approval granted by letter dated December 16, 1999 is now void and of no
further effect. This merger may not be recorded or in any way acted upon, pending .
submittal of any new application for. the subject properties.
Should you have any questions, please call mei at (760) 777-7069.
Very truly. yours,
JERRY HERMAN
COMMUNITY DEVELOPMENT DEPARTMENT
Wallace Nesbit
Associate Planner
W N/wn
c: Greg _Butter, Building & Safety Department
File; Parcel Merger 99-365
M