9705-050 (SFD)LICENSED CONTRACTOR DECLARATION
1 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
257274 B tW-V97
r
Date . ' Signature of Contractor '�✓rt -
OWNER -BUILDER DECLARATION
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
Xerformance of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Sect, 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:
Carrier Policy No.
CAL COMP W 97 1130493
(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
Code, I shall forthwith comply with those provisions.
Date: ' Applicant -/ ___1
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
& 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 authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) ` '' Date
BUILDING PERMIT PERMIT# CONTROL#
970.15-0.44)5351
DATE 6fI2J97 VALUATION S9t,bl2.U(1 LOT `0 TRACT 1111 V10d
JOB SITE
ADDRESS �L-940 AVEN11)A RIJII1 )1
APN 77.3-1162-005
OWNER
CONTRACTOR / DESIGNER / ENGINEER
NEA1,'i'.1TAKE'l: t:*:'1I1tPRISES
NFATI TI,T. BAKER E1 m7l,t1'1: r..s
1875 BUSINESS CENTER lAdVE:
18751. SINI SS CENTER 1: KIW,,
SAN FA KNA#t. ANC) CA 02409
SAN BERNARDINO CA 9.2408
( 31X) 9-i241 01311# 4706
USE OF PERMIT
Y1A,,,& I I" tlO&S Wil' IN0.0UL :4..00K WALLS OR 110UL
'114AO' CONSTRUC TION 1.502,00 SF
ll,* =1t0f/PA'r1C, 78.(N) S1Z
GARAt'llYCARK-71111' 40)01 8F
,J
RMAIAt E D COS t' OF CONS'iTRUC: f1011
91.6 t 2.00
#•h'RIVI!'1' :F Af..R Yljt11)lY1:A R
101-000-418-000 �I:�:+.�tl.
- .4
P),AN0I-T,r7 174T 101 -IM -439.3!9
F1 s' 1:7Fii'ClSI
&W- FiANICA1,1r11s 101-000-421-000
19XC. r)RICAL FEE 141 -(100 -420 -{)(?I)
PlItMBINQ 04. 101.00() -4.14 -OM 3121.50
ST(.FW; NIUrt"M FEE -1ZSs:11D 101 -apo -241.-a00 Ssi.If;
ORLMiNG i -rd: 141 -VW -423 124.00
o CID
1N FRA.S—MtJt"'FVRFFt+". 225-000-44V-142 $2.04793
PREK1Sf.PL.I N 1014100-44!-345 �2g.(3(►
IYL AN C1i`i:M11M 101-000-4-w-3 8 4373.iV
7
SUB-It'n'A . C ONSIRLICTION AND PLAN l`:`f1R*K._
53,1194 11 �
LESS PRE -PAID FEES .
.. -Sf)28 00 ,
WrAT, t E'RMiT FEVS DOW NOW
.S2. JI
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
ic
v
3
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footin
Ducts
10
Return Air
Combustion Air
Root Deck
Exhaust Fans
rap
F.A.U.
Framing
Compressor
Insulation 1q,
Vents
Fireplace P.L.
Grills
Firfr lace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wali Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVA S
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground PI . Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines % 6o2
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
Ga
as Test
-Apptignces
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)
Building
Address
Owner
• �� �'io� d50
4
P.O. BOX 1504 APPLICATION ONLY
78-105 CALLE ESTADO
10 ? LA QUINTA, CALIFORNIA 92253
Neal T. Baker Enterorises
Mailing
Address 1875 Business Center Dr.
CityZip Tel.
SganBernardino 92408 1909-884-7241
Contractor
Neal T. Bkker
Address
1875 Business Center Dr.
CityZip Tel.
San Bernardino 52408 9U9-884-7241
State Lic. City
& Classif. California B Lic' #x3257274
Arch., Engr.,
Designer Steven P. Murray
Address Tel.
370 W. Sixth St. #21U 909-884-7660
CityZip State
San Bernardino 52408 Lic. #C-11170
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 Busine's/s•and Professions Code, and my license is in full forced
effect. / .__.– �� �i7 � /.AJC - ,-2,—§n /
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby ffirm that I am exempt from the Contractor's License Law for the following
reason: (Sed 7031.5,Business 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 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 to a civil penalty of not more than five hundred dollars ($500).
17 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 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 1 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.)
i 7 I 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 Com en atio Insurance; ora certified opppy ther@�o_f Sec. 3800, Labor Code.)
Policy No. W9 J U Company l.ci1 t,UPYt1
I7 Copy is filed with the city. O 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
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 Nnne _. _..
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.
1 agree to comply with all city and county ordinances and state laws -relating to building
construction, and hereby authorize representatives -of t iS city to enter the above-
mentioned property for inspection purposes.
;lit 4-28-�i7
Signature of applicant • ,—_ .. - Date=
Mailing Address iu a�, �s ±± •.yT r�
City, State, Zip
BUILDING DIVISION
BUILDING: TYPE CONSTResidentaO�GC. GRP.
A.P. Number 7731620055
Legal Description LUT 20 ( SEE ATTACHED)
Description
Sq. Ft. 15U2 No. Single No. Dw. Single
Size Stories
Stories Units
Newff Add O Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep. W
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
R
FINAL DATE INSPECTOR
Issued by: Date
Validated by:
Validation:
C)lTY ®F ! A 020°11N'TA
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FE &'
1ST FL. SO. FT. @ $
2ND FL, SO. FT. @
POR. SO. FT. @
GAR. SO, FT,
CAR P. I SO. FT. 0
WALL SO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SO. FT. @ c
BATH TUB
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11A c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
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
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Notice:
Document Cannot Be Duplicated
Date 5/21/97
No. 15557
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Jurisdiction
Owner Name Neal T. Baker Enterprises
No. 51840 Street Avenida Rubio
City La Quinta zip 92253
Tract #
Type of Development
Comments
Lot #
APN # 773-162-005
La Quinta
Permit #
Log #
Study Area , 113
Square Footage 1502
Single Family Residence
No. of Units 1
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 thaf school facility fees imposed pursuant to Government Code 53080 in the amount of
1.84 X 1,502 or $ 2,763.68 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/Business Bank of California/Neal T. Baker J TelephQne,,909-884-7241
Enterprises Name on the check; v
By Dr. Carol McGrew �-
Administrator in Charge
'e'*%\
Fee collected /exempted by Pauline Pearson Payment Received $2;763.68
Check No. 73290
Signature
Q, A -4 A A 9% 1 AA )a--Vk-
10TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
bove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
ollect them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant . Copy - Applicant/Receipt Copy - Accounting
11-
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55 AND 56 OF MAPS,
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WHEN AFCORDEO MAIL TO
REA& T. BARER ENTERPRISES, INC
1875 BU81noso Center Dr
San 0ornardino, Calif 92408
ESCROW MUMMA: 1765-K
OROUR IMUM ' BEA:
MAIL TAX S'TATFIVIEN(S TO
11871E T. BUM EWSR?RISZS" INC
1875 Business Center Dr
San Bernardino, Calif . 92400
cQ Jiml1 9 Av
W
SPACE ABOVE THIS LINE Fr)A RECORDER'S USE
DOCUMENTAAY TRAMBFIER TAX 9 1 IRS% is,
X Coninn,o on invi nnjocwaiwin — ..a., oo wout., coAt"im OW
COftip.,1.11 — tht COASrlvr41 n.W%4 b6fts a. o"W"It"Ac4s
GRANT DEED
FCR A VALUAWE CONSID[kA7)ON. -ei.uspfol notobi, ac%j.*wi@jr)"
JOHN REGINA&D X"JIFY
?web%- ORANT(So to
NZAL TM.. BAKER ENTERPRISES, INC.. A California Corporation
In,. -Al 1.,Op.,Iy - lh'c- r47 .0
La Quinta
C"'Y et Riverside
AS PER LEGAL DESCRIPTION ATTACHED HERETO AND MADE PART HERZOr-'
11"l-, July 12, 1989
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PARCEL I:
Late 4 and 5 of Block 29 of Santa Carmelita at Vale La Quints. Unit 2 as shown by
Map on file in Book 18. Pages 55 and 56 of Maps. tacorde of Riverside County
PARCEL II:
Lct 10 of Block 30 of Santa Carmelite at Dale La Qsinta. Unit 2 as shown by map
on -file in Book 18. Pages 55 and 56 of. Maps, Records of Riverside County
PARCEL 111:
Lots 3. 15. 17, 19.•20 and 21 of Block 31 of Santa Carmelita at Vale La Quints.
Unit 2 as shown by Map 'on file in Book 18. Paged 55 and 56 of Maps. Records of
Riverside County
PARCEL IV:
Lots 20 and 24 of Block 32 of Santa Carmelita at .Vale La Quints., Unit 2 as shown by
Map on file in Book 18. Pages 55 and 56 of Maps. Records of Riverside County
PARCEL V:
Lots 7, 8. 9 and 10 of Block 33 of Santa Carmalita ac Vale La Quints. Unit2 as shown
by Map on file in Book 18. Pages 55 .and 5A of Maps, Records of Riverside County
PARCEL V1:
Lots 3, 4. 20, 21 and 22 of Block 34 of Santa Carmelita at Vale La Quints, Unit 2
as shown by Map on file in Book 18, Pages 55 and 56 of Maps, Records of Riverside
Caunty