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0110-174 (BLCK)U) � �. W' M t` d u7 ' W P_ o Z 0' 0 LUW� F- a to Z co 111N ON Q °) CL Q T Q O LL X W — mUU O a 0) 't Z_ 6 5 n C) Q J 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 11� Date!`' �� 4Signature of Contractor 1�1� 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. Q I�have and will maintain workers' compensation insurance, as required by S,ectio"n 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: Carver S'VATR ;h'tiND Policy No. 0400402,27i (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 /,p ptl become subject to the workers' compensation�provl.ons of Se Ion f the Labor Code, I shall forthwith comply with t d 16visions. Date: �) -, �- Applicant ✓� y"' G " "Wat•niwq:"F60'GYe to secure Wo kers"Compens�on 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 authorizeerepresentatjve�a�this City to enter upon the above-mentioned property/forfinspectio ;pdrr es. s % Signature (Ow ner/Agent1/;,, /_, " Dater�j" lF .e ........,. yam... BUILDING PERMIT PERMIT# 01. 0-1745 DATE VALUATION �7�1 LOT TRACT u$255MM JOB SITE APN ADDRESS < rl() A' TY1f1d..eedi lwi� OWNER CONTRACTOR / DESIGNER / EN (NEER All, AUMeAN ROI& LBUIL:R'il RS WC , AU:RRR'fto�'+C.+�N HOW BUIa: ERS sati. C 7699 IWKWAAVM�JE 76;" 5 J+Cf RZA,AVEME,, PALM ,LiOW7 CA 92211 RNLt`aa DESY1RT CA 9221 ; (76q)200-0277 CBL4- . 6373 USE OF PERMIT 100 Ise (470l4i' 0v WA1.Pt, • S' 0AEfi,3:3'L+' 4,, V Rit'WND10 + CITY S'fleNI:AA D 6 �1. WALL 1.09M LF f'MfiS`1'RUC' ION R, Er 101-000.,418•-000 $54.00 D Q D + OCT 18 2001 CITY OF LA QUINTA FINANCE DEPT. SUB-TC71AL CC)MORUM101T +P3-ANECK $U,0 IMS _-PATID RMS, MO. 'WrAL.W_WM'Fn6 DUE NOW RECEIPT DATA 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 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 1,40 .2'Z - Q/ S7 Electric Bond Footings Main Drain Bond Beam l� • al'aP O/ 5� 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 Encapsulation Gas Piping Gas Test 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 Final Utility Notice (Perm) 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, in order to determine the applicability of compatibility issues or need to require the filing of Master Design Guidelines by the applicant. It shall be transmitted to the Building and Safety Department as your correction list. Please attach additional explanations as necessary. S n�,-� F.K ' y Zo APPLICANT All American Home Builders SITE ADDRESS 77-510 Calle Madrid APN 774 _ 211 _ 012 g NO.: CASE NO.: 2001-454 LEGAL: LOT 13 BLOCK 285 UNIT S.C.@V.L.Q. CHECKED BY: Wally Nesbit DATE: 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 Compatibility Review �✓ �� Case logged and number assigned ✓ Verify legal and APN information LZ Consistent with MDG on file (as.applicable ✓ MDG filing required (5 filings since 9/3/98) S u.✓nas - 106- 6Consistency Consistencywith street/surrounding area: RECVD FOR PROCESSING 4(12, qo l Colors (DATE) ASSIGNED TO Materials (INITIALS) Architecture ? otcs2ms��C,- Other Requirements: Approved OX 20 O Planning Commission ._..,;..,... O City Council Community Dev. DePL Initials , .�......... vcwvv ■.w — wr�w� Exhibit ;..r,,.,..,.,..,. ) Mith Conditiont.m.,,... "..w...m RECVD FOR PROCESSING (DATE) ASSIGNED TO (INITIALS) 25-6/ 774-21 T. C. A. 020=0/5 J � � S26 soo ° /6 g 9 /6 1:71 / Q24y• 9 9 /,, = /00, N 23 (2) (& 2 ° 2230 @3 2s.Z _ Q /O Q /5 alae N 2/ ® 4 2 Q v v° 2050 © 5 Q a u N / 6 /9 ®0,418 ®// /4 // 2 o iea - H W 23 20 a m = ism ®2 a 22 3O e 22 ©. N POR. N. //2 SEG /3T6 5 R.6E. ' JN/S MAP /S FOR • - ASSESSMENT PURP.I�SES ONL Y � J � J � J ` J•� � A Sr ¢N sAQ-56'e t CH/LL.. I :ce � SEC icy � zco /io OP /6 7 OG V. .V! 24®h /6 g 9 /6 1:71 / Q24y• 9 9 / 9 IIO n /0 /> // mO 2s.Z _ Q /O Q /5 alae 5a So ©/ /O /5 ® ® /0 m /O O ®/O m 032 ®// /4 // 2 o iea - H W 23 ©// b v 2 O2 ®2 ® // 22 3O 3 22 ©. 22© ® 3 3 3O Q 3 '. io /2 O > /3 @4'@12 o iea a ® 4 3 R R /3 - 4- ® /2 N 4 e 2/ ® /© 4 2/ 4O 2/ 4O N 4 O O 4 N P 2050 1:6 5 200 ©5 2050 /©3 5 O /75 M :4e I o/1.- I li• w r /9 © 06 06 /9© 6 N 6© ©6 4i 2/2 a m '� O � ' N /7 01@8 2/3 N /7 ® a /9 7 17@ ® 8 i /6 2 /6 9 @ /6 g 9 /6 @.9 C 9 9 / 9 3 e• /0 /> // ¢ Q _ Q /O Q /5 alae W Q /5 ®, ©/ /O /5 ® ® /0 m /O O ®/O m ®// /4 // H W A /4 // ©// b /4 Oj //® /4 // ® // /l ®@ ]. )• i. •.: - 12 . O © /2 /3 O '. io /2 se S. /3 @4'@12 h /3 O 6 /3 ® /2 n ® /2 N 7 �' 7V•4 7V•v i 7v.4 o ewe 4 .O M 24 . :4e 1 74 li• w 1 I ° CAL. 4. irl sag eue i MAOR/D y � . r � 24 SANTA CARMEL/TA AT VALE LA 0 UN/T NO. 26 A[B 20/50 ZS w r r r r r a 27 AS B /9/82 LL i a l° PM 88-086 LLA 88-046 DATA LLA 88-047 ASSESSO)rS MAP BK. 774 PG 2/ RIVERS/OE COUNTY, CAUF. sit JULY /967 ,I =METROSCAN PROPERTY PROFILE= Riverside (CA) OWNERSHIP INFORMATION Parcel Number 774 ) 11 n 1? S : T : R Ref Parcel # : 000 000 000 Pos Interest: Owner Name : All American Home Builders Inc CoOwner Site Address : *No Site Address* Mail Address : 76995 Florida Ave Palm Desert Ca 92211 Telephone : Owner : Tenant: % Improved PROPERTY DESCRIPTION Map Grid Census : Tract : Block: Land Use : Y04 Vacant,Other Legal : LOT 13 BLK 285 MB 020/050 SANTA CARMELITA VALE LA QUINTA UNIT 26 Sub/Plat : Santa Carmelita Vale La Quinta Unit 26 Book :20 Page: 50 PROPERTY CHARACTERISTICS Bedrooms SALES AND LOAN INFORMATION Transferred : 06/13/2001 Loan Amount Document # :263632 Lender Sale Price Loan Type Deed Type : Grant Deed Interest Rate % Owned :100 Vesting Type Bath3Qtr ASSESSMENT AND TAX INFORMATION Land : $25,000 Exempt Type Structure ExemptAmount Other Tax Rate Area : 20-015 Total : $25,000 00-01 Taxes : $244.70 % Improved PROPERTY DESCRIPTION Map Grid Census : Tract : Block: Land Use : Y04 Vacant,Other Legal : LOT 13 BLK 285 MB 020/050 SANTA CARMELITA VALE LA QUINTA UNIT 26 Sub/Plat : Santa Carmelita Vale La Quinta Unit 26 Book :20 Page: 50 PROPERTY CHARACTERISTICS Bedrooms Stories YearBuilt AgPreserve BathFull Units Misclmprv. : No Bath3Qtr Bldg SgFt Street : Paved ADDITIONAL BathHalf Gar SgFt Waterfrnt Fireplce : No Gar Type Elect Svc : Developed RmAddtns : No Cntrl Ht : No LotAcres :.12 Gas Svc : None RmAddSF CntrL41C : No Lot SgFt : 5,227 WaterSrce : Developed AddGarType : Pool : No Roof Type SewerType : None OthrPkng 'Information compiled from various sources. Real Estate Solutions makes no representatio; - or warranties as to the accuracy or completeness ofinformation contained in this report. M