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0012-227 (PLBG)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 6845 3 AB ,A43B � af�7.o?} D ra a lr,j� / U Signature of Contractor?-' OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 1 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 offere&for sale (Sec. 7044, Business & Professionals Code). i ( ) 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 Policy No. STATE FUN?Y • 0d•0•QOl9z4 (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 subj di' to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply W, ith�those provisions. J� .,Date-. ' � l - 4'`; t �pplicani %( Warning: Failure to secure Workers' Co/r,nsation 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, indemnity & 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 adfhorize represeritatives of t its City to enter upon the above-mentioned property for inspection purposes./ Signature (Owner/Age" t)"► f� f;1� f•��° Date Z.) x .� BUILDING PERMIT PERMIT# DATE VALUATION _ LOT.` TRACT' JOB SITE APN ; ADDRESS &V6W AVEMDA l.ARP4111CZA. OWNER CONTRACTOR/DESIGNER/ENGINEER RITA, FLO /ML AK:i".'! URS, Ai.1--16:00 ASI.. RA DEAkBOMO'. ENOINEk k'2�. 0 & CQ}:nn 5.3 -6W AVTIR .3A CARILWLA 6IR-1 5 MROS COMT LA QUJN A. ICA 92253 CAITM, RAL CTfT CA 92234 . (760)327-2200. CAL41 35177 K USE OF PERMIT ' SI7Pvc ASAAWDOX 3D?'WYR CONNECT. I.OW-IMUy7Pi{QRX T 2000,21, VALUATION 1,800.00 1.9 X9'Wd `=D t:OST OF f XrNSTI;UiG'"TION PLUM RN 0 FTS: -- 3.C:'�Is.R 101.000.41 SN000 MR-1•'F°MA.L C0T,1: tt UCTI-014 AND PLAN CJ -:=K $30.00 LMS P.I`tE•�PAID M3 $0.00 TOTALMMITFEMSDUK, NOW $30.00, RECEIPT DATEBY 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 F.A.U. Framing 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 POOLS - SPAS BLOCKWALL APPROVALS 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 O.K. for Finish Plaster Sewer Lateral _ Pool Cover Sewer Connection 3 _? /p ( �7a Encapsulation Gas Piping G Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) l !� 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) August 24, P.O. Box 1504 78-495 CALLE TAMPICO CIS P^'!!�I (760) 777-7000 LA QUINTA, CALIFORNIA 92253 'TA (TDD) (76 0) 777-1227 1999 AUG 2 5 REC,0 . Mr. Mario Alvarez BUILDING %L, SgFEiY 53600 Avenida Carranza La Quinta, CA 92253 SUBJECT: PARCEL MERGER 99-360; APN's 774-121-006 & -007 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 of your draft grant deed (to be notarized/recorded), along with approved Exhibits A and B; these items must be filed for recordation by Riverside County, along with a copy of your existing deeds 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 File; Parcel Merger 99-360 CAW rkgrp\Letters\mgr99360.wpd �� P.O. Box 1504 78-495 CALLE TAMPICO (7 60) 777-7000 LA QuINTA, CALIFORNIA 92253 (TDD) (760) 777-1227 August 24, 1999 County Recorder County of Riverside P. 0. Box 751 Riverside, CA 92502-0751 SUBJECT: RECORDING OF PARCEL MERGER 99-360 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 W N/wn c: File; Parcel Merger 99-360 EXHIBIT A CERTIFICATE OF PARCEL MERGER N0. 360. Record Owners Existing Parcels Assessor Parcel Numbers Mario Alvarez 774-121-006-6 Mario Alvarez 774-121-007-7 Legal Description of Merged Parcel Lots 18 and 19, Block 232, Unit No. 22, of Santa Carmelita at Vale La Quinta, in the City of La Quinta, County of Riverside, State of California, as per map recorded in Book 20, Page 24 of Maps, in the Office of the County Recorder of said County. APPROVED BY COMMUNITY DEVELOPMENT DEPT BY e ✓ALAIE&`r- DATE 8 a __2__. EXHIBIT 'a CASE NO. 4�12cic.M1404-? 99- 3 ( 0 APPROVED BY COMMUNITY DEVELOPMENT D ty 'A-. )vA9&,r DATE n(—ZyZ2q- EXHIBIT 9 4, Ek��W -,9 'CASE NO. EXHIBIT B 99 - CERTIFICATE OF PARCEL MERGER NO, 0 7711-1 oo(. 775'-I1/ -oo2 Zor 19 o so POO CE 5 m DEPARTMENT USE ONLY Record Owner ip 4t ~z( t This Certificate of Parcel Merger No.. 99-30 is -3-6 hereby approved Address. A Vk"j),0.,q ZA Map Prepared By By Address SA S Title )AIT A� --k Area/District Date -- 5 / SITE PLAN CERTIFICATE OF PARCEL MERGER NO. APPROVED BY COMMUNITY DEVELOPMENT DEPT BY w,✓61ar'-- DATE f zY 99 EXHIBIT Slilt �6u CASE NO. i°M".j 77'1-12l-oo(.' 775'-12/-yo2 �o J a u d I J � J PEI I� 0 I �}VeN;-b 14 C'R2R awza RECORD OWNER ADDRESS: 53600 AVENIDA CARRANZA,LA. QUINTA, CA. 92253 MP PREPARED BY MARIO ALVAREZ (OWNER) HOUSE = 1246 SAME -ADDRESS GARAGE = 504 SCALE COVERED PATIO = 234 ASSESSOR"S PARCEL NO. 774-121-006 & 007