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0010-275 (SFD)F N � W W r W 0o�. - O H cO ~a~ U) -Z LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divis' n 3 of the Business and Professionals Code, and my License is in full force d effect:. License # Lic. Class f Exp. Date 1 1 / 7461198 C10PJ Date Signature of Contractor— OWNER-BUILDER 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 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 carver & policy no. are: Camel 'VI1.J..r'NOVA 1NIi, 00 Policy No. (This section need not be-oompleted 'If the permit valuation is for $100.00 or less). ( ) I certify that in the performance of the for which this, permit is issued, I shall not employ any person in any ma r rk so as to become subject to'the workers' compensation laws of Califom' and agree that if I should become subject to the workers' compensation isions of Section 3.700 of the Labor ,06de, 1 shj forjjtw h comply with th Date: r v 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 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 .s . & 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 1 have. read this app ' ation and state that the above'infonnation is correct. I agreeto comply with I ity, and State laws relating to the building c�truction, and hereby aut o�►o ze representatives of this City to enter upon ,tile above-mentioned props r inspection purposes. Signature(Owner/AgentZ ) "°'i""'” a Date �� BUILDING PERMIT PERMITO DATE VALUATION LOT 001,0-275 TRACT JOB SITE: APN ADDRESS 7 75- 170449 OWNER CONTRACTOR /DESIGNER / ENGINEER .M Cw- gr21L11iN 56.12"1 LSryy7CRY191-1,1z !t-OrlkZ`?ILE C/JL LA. QUIT A Cyd, 92253 Lik ('XI.W`.E:A CA 9225:1 (760)564-4831 CDL0 626 . USE OF PERMIT �IAICxl.;P:1?rP�,11+ArlI.1� ?��Iti1Lt7 [ 11�� SYD . WITH OUR`,i11' t' OUSE - P R1MIT f]t3M NCYf INCLUDE Ei3.k= WAL d 100tJS4'.«S OR APPROACH DRIVPWAY CUnOM COMTRUC:Z 1ON -„048.00 SF PORC H11PA' 10 501100 SF (lAR.AORdCA.RPORT (SF) 14,249.20 . X9TD4A1'KD C07f OF cQlv9TRTJC110X CONSTRUCTION FE T?, 101-OWA I S -NO $11W6100 PLAN CHECK I;1?.T_ 101-00&4-49-319 $i,41M.16 MECRAMICA1, FRE. 101-000-421.000 $111 oo EJXCTRICALI, F82110krCIf ^�I3J-0100 $ 56. � 4�iJ1I.AA[4ita(.11"1CIZ 101.6CM- 419-000 9TROND MOTION "U,- 1t.Y.11D 1,01-000-2,11-000 $41.82 ORAD040 FOP 101-000-42,51-000 00.42:1-000 $10.00 13i:''iri. L-Op➢:k, I&1PAC71 Flit $1,90.00 APT INvaPUBLIC! PLKCFC,' • I7Efsr11'tr01-,1la��fV0 -2-y5(5� -��j 0 ��.y q,,sq 1C Fr t: aJC+¢'+JJ1 t o 101-0 '1.7-43V—�.Y 1 p u 1i1J{,�:.i1V CO �.111i.U(WNON AND P_l.AIN C111`JCK 61 9.0-A ®�^�,1,1AL �4d�91 LESS PRP -P IWS 41,000.00 a - ftl'Al PP -V ff.rF . 8 YVE n m� RECEIPT DATEBY S, 1 2 DATE FINALED INSPECTOR INSFECTIOO rJ RECOPD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings /fi D Ducts Slab Grade D Return Air Steel Combustion Air Roof Deck Q Exhaust Fans O.K. to Wrap Z F.A.U. FraminglL (/ Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS e 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 0 / Q / Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sew onn 6 Encapsulation Gas il(las Test �f/ O Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fbdures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: s5 -s?s' N 5 U.f LA 444 "1 PO. BOX 1504 APPLICATION ONLY 78-495;CALLE TAMPICO DUINTA, CALIFORNIA 92253 Mailing Address City n ` r,�l %J2_2_63 ] &tCla sate tif. 1 1� j g b I LicYM Arch., Engr., Designer sr6/ � P.. /\J r li: 1 Q Address^- 4 City-yN�}�1Dl J/�, ZipO( �State f Llc..p I LICENSED CONTRACTOR'S DECLARATION I herebyy affirm that I am licensed•under'provielons of Chapter (commencing with ffect. , Section 71100) of Division 3,of the Business and Professions Code, and my llcense Win ful6foroe and e SIGNATUAr PATE OWNEWBUILDER DECLARATION I ,hereby affirm that I am exempt from the Contractor's License Law for the following reason; (Sec. 709.7.5,Busmesa and Professions Code: Any cry or county which requfres a pemrlt. to construct, alter, impious;, demoilah,. or ,repak any structure„ prior to,,ft Issuance also requlieS the appllcanr /or such; permN to file a signed statement that he lsI)oensed pursuant to the provisbns o! the Con6actors Cloacae Law, Chapter 9 (Commencing with Section 7000) o/ Division 3 of the Businesa 'end 'P - skins Coda, or that he to .exempt therefrom, and the basis A¢r the alleged a'xemptkxr. Acy v/o/atbc of Seoflon 7.03.1-.5 Dy 'any applicant for a permit aiibjecis the.appilcant: to a'alvll penahy of nStmore than Ave hundred'do4 (5500), i'. I, as owner of the property, or my employees with wages as theirsole compensation, milli do the work, and the structure is not intended or offered for sale. (Sec. 7044, &dsness and Professions Coder The Contractor's. License. Law does not apply to pan owner of property who builds or improves thereon .and who does such work himself or through his own employees, provided that .such tinnprovements are not. Intended or offered for sale. If; however, the. building or improvement is sold.within one year of completion; the ownerbul/der willhave the burden of proving that he did not build or Improve, for the purpose of sale.) 111, as owner of the property, am exclusively contracting with licensed contractors4o�coo- oluct the project:, (Sec: 7044, Bustness' and Professions Cede:.,The Contractor's License Law does not apply' to an ,owner of property who builds or Improves thereon,. and who contracts for such prd)ects,with'a contracror(s)'licensed pursuant to thwContractork License Law.) i7 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 Cornpehsation Insurance, or a certified copy'tfiereoi..(Sec. 3800 Labor Code.)' Policy No._ Company n Copyls filed with the city. O Certified copy Whereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ;(This, section need .not be completed if the permit Is for one hundred dollars (SI100)' vaiustion or less.) I certify that`in the performance of the work. for whichahis permit Is Issued, 1 shall not employ any pperson in any manner so as to become subject to the Workers',Compensation L.aws.oUCahfo_ Alia. Date _ Owner NOTICE TO APPLICANT; Il, alter making this Certificate of Exromption you should become, subject to the Workers' Compensation provisions of - the Labor Code, you must forthwith comply with such, provisions or this.permhshall be;deemed revoked. CONSTRUCTION LENDING,AQENCY Ihereby affirm that there, is, a construction, lending agency, for the performance of 'the work for whiCfi,�this permit isissuad.,,(Sac. 3007,.CIW/Coda.) Z - Lender's Name Lender's Address This is a building'Ormittwhen properly filled out, -signed and;velidated, and Is subject to 'expiration if,work thereunder Is suspended for 18o'days. I certify fhat I have read this application and state that the above information is.coneeL I agree to comply with all city and, county ordinances and state laws relating to building consfrucboo, and hereby authorize representatives !of this .city to enter the above• mentioned property foi, inspection purposes. Signaturepf applicant Date Mailing Address City, State, Zip LDING: TYPECONST. OCC. GRP. . Number_ -r 5 _1� 0 6 Description Project Description 5r-�P,s( Sq. iz Ft. 5 Size (/ New Add O No. Dw. Units Alter Repair ❑ Demolition O Estimated Valuation gam} Jam, ,fir, (0) PERMIT r AMOUNT l• Plan Chk. Dep. Plan .Ch'k. Bal. Const. 00 0 ' Mech. Electrical Plumbing FINAL DATE 'Issued by: S.M.I. Validated by: Grading Validation: Driveway Enc. Infrastructure TOTAL REMARKS. ZONE: BY' Minimum Setback Distances: Front Setback -from Center,Line Rear Setback from Rear Prop. Line EQ Side Street Setback from Center Line ' Side Setback, from Property Line e FINAL DATE 'Issued by: INSPECTOR Date Validated by: _ F.:r- 2 �0 Validation: w rlrti .0'TY U WHITE= FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Coachella Valley Un` id School District P.O. Box 847, Tht..mal, CA 92274 (760) 399-5137, Ext. 235 Project Name: Owner's Name: _J Project Address:_ Project Descnpdon: APN: 11 Type of Developm6 This Box For District Use Oni DEVELOPER FEES PAID ARFa: AMOUNT: RCPT A*. CK A! CASH t ITWS: DATx: CERTIFICATE OF COMPLIANCE (California Education Code 17620) Date: January. 2, 2001, Phone No: 775 170 res Lot)#'s: Commercial Industrial. Total Square Feet of Building Area: SnAit Certification of Applicant/Owners: The person signingr certifies that the, above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized to sign on behalf of the owner/developer. Dated: Signature• _ ,r.•..sari•r..*t:.*w,r•.•..�►..r..s.:r••sw•••.r.•..••••.r=r.w•.•..w«.,r..rr..** SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WALL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code Project 1.7620 65995 Approval Number of Sq^ SOAR Amount per Sq.Ft. S 14-76 Amount Collected $ 16 . 456 _ AR Building. Permit Application Completed:,Yes/No Agreement Existing Not Subject to Fee Prior to 1/1/87 Requirement Note: Certificate issued,by; Marcela 'Valdez Signame: Facilities Cleric NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES Section 66020 of the Government Code mated by Aseembly 6W 30610 effective January 1,.1997. requires that dds'Dhttriet provide (I)ijulefim notice to the project appellud, at the time of payment of school tees, mitigation payment or other esaedena ("Fero" , of the 90-day.perlod to protest the imposition of these Feu and (2) the -amount of the fees. Thorsore, in accordance with section 66026 of the Government code and other applicable law, this Notice shaft serve to advise you that theMkiny protest period in regard to tach Foes ar the vdldty therc4 commence wNh the payment of the fees or performance:of any other requirements as described in section 66020 of the Geverament code. Additloodly, the amount of the tau imposed ht so herein set forth.-hether payableat this'tbneor is whole or io part prior *lssoada.of a Certitiab of Oaapma. Asia the latter, the 90 days start on the dab bereoL This Certificate of Compliance is valid for thirty (30) days from the dab of issoanea .Sitoosion will be granted only for good cause, as determines) by the School District, and up to three (3) such extensions may be granted. At such time n this Co tlfieate expires, if a building permit bas not been issued for tbaproject that is the subject of this Certificate, the owner wW'be reimbursed all fees that were paid to obtain this Cordilede of Compfisma Rev. 09/27/99 ,outer West. Concepts 35/2TU 23:21 160771.1706OCS FAX NO. : WAOQ1675 Dec. '26 2000 11:40AM P2 ENTERPRISMINt PAGE 01 WIN gird Aorklun LT&Mo'g It"i Paul 1 A'I a' 55=63 MaZzy Rizzo DCI: YtiShEler Wt Za bUbgrA, CA .92253, JOHNSON A288 N0,1 769-620-014-2 The u, MWMW Grarlw(s) decbOW the DOCUMEW TPJW*IM , TMEOFOMMO.; I 102 -So cou"W S City AL ammuted on ths Ul ftm of ft kftrut Of pMPWty 00MwivC or EBCRQW NQ. GRANT DEED -CA =,Z'ptTw."m.0, of fuofwft faAWN maw. FOR A IVALUABLE MMMFtAT*N, nit d WhkM Is hWW advaMW04 .70nach= A. Mpg* it. JPsul and Sharon Lee Mul, huetsaad and w1fe as joint tenants to IrMIM0 properly skuRw in rd cl CY of La guinta COLMd jUverolde ah" of CsHomk dewdMd a; Lot 19 or Tract 25397 as per amp reacruca AD J19cm 4110, page# 29 ;to 25 Ancluolvelar M"pq Oawd A-M-0NSW Ill 2995 f M STATE, OF WFORNIA, 4 -AM tba I JOW COUNTY OF OrL-- 47,y bWbm me Nd" Public, personally appooW pemoWly known to me (p oved ft bods -d i ! s( .fes ba we- pawn(s) Whose nemwA tW=1v the within InW� and ed 91they =1 tbLsWWMM 10 ME Authafto upackywl, an thiLt /kh*l*ndurvM on the in"ke"'M ft loorw(sy, *IrNeartty L**n WW of WhIch the posors(*acted, exedited the bn&umv& WITNESS mW hand afflaW mal. MAIL TAx 9TATemwe To; SAM A5 IRI!ACCMM Ji 38059.9; CTI RECEIVED FOR FIFLORD Ay 8.-00 OrLOOK OCT - 31996 i 1i IA A288 N0,1 769-620-014-2 The u, MWMW Grarlw(s) decbOW the DOCUMEW TPJW*IM , TMEOFOMMO.; I 102 -So cou"W S City AL ammuted on ths Ul ftm of ft kftrut Of pMPWty 00MwivC or EBCRQW NQ. GRANT DEED -CA =,Z'ptTw."m.0, of fuofwft faAWN maw. FOR A IVALUABLE MMMFtAT*N, nit d WhkM Is hWW advaMW04 .70nach= A. Mpg* it. JPsul and Sharon Lee Mul, huetsaad and w1fe as joint tenants to IrMIM0 properly skuRw in rd cl CY of La guinta COLMd jUverolde ah" of CsHomk dewdMd a; Lot 19 or Tract 25397 as per amp reacruca AD J19cm 4110, page# 29 ;to 25 Ancluolvelar M"pq Oawd A-M-0NSW Ill 2995 f M STATE, OF WFORNIA, 4 -AM tba I JOW COUNTY OF OrL-- 47,y bWbm me Nd" Public, personally appooW pemoWly known to me (p oved ft bods -d i ! s( .fes ba we- pawn(s) Whose nemwA tW=1v the within InW� and ed 91they =1 tbLsWWMM 10 ME Authafto upackywl, an thiLt /kh*l*ndurvM on the in"ke"'M ft loorw(sy, *IrNeartty L**n WW of WhIch the posors(*acted, exedited the bn&umv& WITNESS mW hand afflaW mal. MAIL TAx 9TATemwe To; SAM A5 IRI!ACCMM Ji Certificate of Occupancy City of La Quinta Building and Safety Department 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: 55-585 CHERRY HILLS Use Classification: SINGLE FAMILY DWELLING Occupancy Group.: R-3 Type of Construction: VN Bldg. Permit No. 0010-275 Land Use Zone: RL Owner of Building: J PAUL Address: 55-525 CHERRY HILLS City: LA QUINTA, CA., 92253 By: GARY HARTMAN Building Officia Date: 11/21/01 POST IN A CONSPICUOUS PLACE Larry E. Johnson, Civil Engineer 45175 Panorama Dr., Suite A-1 Telephone (760) 340-5597 Palm Desert, CA 92260 Fax (760) 340-5597 February 8, 2001 City of La Quints Dept. of Building & Safety 78495 Calle Tampico La Quinta, CA 92253 RE: Pad Grade Certification — Lot 19, Tract 25397 — 55585 Cherry. Hills Gentlemen, A field survey conducted under my supervision on this date indicates that the existing pad elevation for subject lot averages 95.3. Since the design elevation is 95.0, the existing pad grade is higher by more than the one tenth of a foot normally deemed acceptable. The top of forms are elevation 95.8 as opposed to the design elevation of 95.5. We shot the grades on each side of this lot and determined that they are both still higher than the subject lot. The house to the north has a finished floor of 96.18 and the one to the south has a finished floor of 96.50. Based on this survey, it is my professional opinion that this lot will have positive drainage and blend in well with its neighbors. Being 0.3 feet higher than design will not cause a problem. Sincerely, �4zP� s ¢ O y -� No. 20191 Z EXPIRES N 9-30-01 P �FOF C AQ*(3 _O . iol ..r *r -Feb 02 01 12:40p p.5 *Sladden Engineering 6782 Stanton Ave., Suite E,, Buena Park, CA 90621 (562) 864-4121 (714) 523.0952 Fax (714) 623=1369 39-725 Garand Ln., Suite G. Palm Desert, CA 92211 (760) 772-3893 Fax (760) 772-3895 FIELD MEMO ,err Project Name. SS('* f l Site Address Job Phone Date 1-2-4-00 Job No. 52:— 07-9 Client: Work. Done TLS T C e%PT"A-t o r4:- o iJ T -t ' ;V\ Test Summary / Footings Inspected Test No. Location Elev. Dry Density Moist % % Relative Compaction Ref. Max pcf Moist % Comments Field Tech. Super. or Agent 24 hour`notice requested to schedule Field Technician. Thank you for the opportunity to be of service. Feb 02 01 12;39p p,4 Slodden Engineering 6782 Stanton Ave., Suite E, Buena Park, CA 90621 (562) 864-4121 (714) 523-0952 Fax (714) 523-1369 39-725 Garand Ln., Suite G, Palm Desert, CA 92211 (760) 772-3893 Fax (760) 772-3895 Date /Z4-40 Job No. FIELD MEMO Project Name ��^� av Client; Site Address �Q Job Phone ` Work Done TrE T t p#A�oA 004 OQCA- `% Test Summary / Footings Inspected Test No. location EIS Dry Density Moist % % Relative Compaction Ref. Max pccf Moist % 1 ` t s i Comments l L Super. or Agent 24 hour notice requested to schedule Field Technician. Thank you for the opportunity to be of service. `-� Veb 02 01 12,:39p p•3 Sudden Engineering 6782 Stanton Ave., Suite E, Buena Park, CA 90621 (562) 864-4-121 (714) 523-0952 Fax (714) 523-1369 39-725 Garand Ln., Suite G, Palm Desert, CA 92211 (760) 772-3893 Fax (760)712-3895 FIELD MEMO Project Name 5`� 85 �'�� �► Site Address) Job Phone Work Done Test Summary / Footings Inspected Date //;O -Oh Job No. 22- OZ.BS Client: Test Location �I� Density Moist % % Relative Compaction Ret. Max. pct Moist % 3• - - -; i 8 oc� .a � 1Jz . 1 c Comments 0 - Field Field Tech. Super. or Agent 24 hour notice requested to schedule Field Technician: Thank you for the opportunity to be of service. r_ In 02 01. :12:39p p.2 M *51addeningineering. 6782 Stanton Ave., Suite E, Buena Park, CA 90621 (662),864-4121 (714) 523-0952 Fax (714) 523-1369 397725 Garand Ln., Suite.G; Palm Desert, CA 92211 (760) 772-3893 Fax (760) 772-3895 FIELD MEMO �e:�ti •, Project Name Site Address Job Phone Work Done r rtfs� Co��cxJ d u '� i�1SG � Test Summary/ Footings Inspected Date Job No. �22-pL�j Client: Test No. Location Elev., pry Density Moist /o %a Relative Compaction Ref. Max pcf Moist % Z• : - - - ,�- - - !-0 ilk t«.C, <Z � tZ r 21) I Comments Field. Tech. Super. or Agent 24 hour, notice requested to schedule Field Technician. Thank you for the opportunity to be of service. il'�eb 02, bl 12:39p P. R Sladden Engineering 6782 Stanton': Ave:, Suite E, Buena Park, CA 90621 (562) 864-4121 (714) 523-0952 Fax (714) 523-1369 39-725 Garand Ln., Suite G, Palm Desert, CA 922i 1 (760) 712=3893 Fax (760) 772-3895 Date. 1 2 o Job;N05Z''" 02-K, FIELD MEMO Project Name 55 �'� Client: Site Address Job Phone Work Done OQ Test Summary /.Footings inspected Test No, Location Elev. Dry Density Moist k % Relative compaction Ref. Max pcf Moist % Comments P" Field Tech. Super. or Agent 24 hour notice requested to schedule Fleid.Technician. Thank you for the opportunity to be of service.