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05170, 06770, 0111-012 (SFD)P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 52-540 Rubio LA QUINTA, CALIFORNIA 92253 Owner Mailing Address Iso 1 Le. Ymnte City I Zip Tel. Contractor ct ..., ., .. -a /a Loa Address _ V Tela State Lic. - I City & Classif. 512643 Lic. # Arch., Engr., Designer Address Tel. City( Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9'(8ommencing with Sectio 7000) of Division Sof the Business and Professions; Code, and 'my,license is in full force and i ffect. Iii tit / .- r - GNATURE - Da OWNER -BUILDER DECLARATION I 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 Penttit 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 he is licensed pursuant to the provisions of the Contractors 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 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 (8500). ❑ 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.) 0 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project (Sac. 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 No. 05170 A BUILDING: TYPE CONST: OCC: GRP. A.P. Number 773-281-003 Legal Description Project Description ✓9 r - �Sq. Ft. 1345 No. No. Dw. Size ' Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 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 it the permit is for one hundred dollars ($100) valuation of less.) 1 certify that in the performance of thip 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 Cali omia_ Date ' Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become sWect 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.) Lenders Name Lenders 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. 1 certity 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 stimated Valuation $74,05 74,05 PERMIT Plan Chk. Dep. Plan Chk. Bal. 4knO Const. Mech. Electrical INSPECTOR Plumbing 12/28%88 S.M.I. Date Permit Grading Driveway Enc. Validation: Infrastructure TOTAL $20 REMARKS AMOUNT i1 An It `.1' rf ? ? n nn 9191 nn fi? _AR w - :'.Can•; 4 care .i.R ^7"7"'14 ♦ "!_'XCi-..tfl? 4 ff 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 12/28%88 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SO. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING. MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO. FT. ® FINAL INSP. WALL SD. FT. WATER SYSTEM DRINKING FOUNTAIN. GRADING cu. yd. $ plus x$ =$ URINAL SO. FT. FINAL INSP. FRAMING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE,TEMIPERM 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 ® 1% c SEWAGE DISPOSAL SO.FT.GAR @ V4c HOUSE SEWER FINAL INSPECTION 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 APPJEOUIP. 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 02 REMARKS: VENTILATION FIRE ZONE ROOFING: FIRE FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINiT1ALS ' GARDEN WALL FINAL 7d Desert Sands Unified School District �� CERTIFICATION OF PAYMENT �o-rie T OF tct �� fir SCHOOL FACILITY FEES A yip TO: City of La Quina� Ito 10)D TE: — Department of Com nity a el pm 78-105 Cal a Esta o La Quinta, A 9 253 This is to c t'f( that developer of which is located at within this Distric , has paid school facility fees impo ed pursuant to the thorrity genera ed b Government C e Section 53080 in the AS nt of covering a total of ware feet of (10 residential or ( ) industrial/commercial development and that building permits for this footage in this development may now be issued by your jurisdiction. OL I D� for DESERT SANDS 0 - 8"/, ot UNIFIED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37 \Y,9 1 a% 'Of (IC E OF, E. LEON .SPAUGY .AGI?ICUL'I:URAL COtiIh-IISSIONER CO�twS;iO`ER JAMES 0 WALLACE AN U ASS SiANT COMMISSIONER WEIGH I,S &;MEASURES . CLEMENT BEwEhISTE ` SEALER 49-613 Ilwy '86, Suite A-12 Coacliella,.:CA' 9.2236 619'-142-829,1 DATE / 2 ' 2 — CASE NO DEVELOPER'S NAME- ADDRESS:, AME:ADDRESS:. z TELEPLIONE: s L44& Dear Developer: G After reviewing your landscaping, plans,'all,plant material listed is not in violation of. quarantine 1-aws goverrn ng the Coachella Valley. If substitution's do occur and they differ; frc:n plant material"listed, .this. office must be notified itnnediately. Thank you for protecting and preserving the Coachella _Vahey's:7pest-free environment. Building Address 52-540 Rubio Owner G. J. Htwph3► Mailing Address 0.H 1124 City Zip Palm Dssm 92260 Contractor 4 P.O. BOX 1504 78-105 CALLE ESTADO LA.QUINTA, CALIFORNIA 92253 No. 06770 BUILDING: TYPE CONST. OCC: GRP. A.P. Number 773-283-003 Tel. Legal Description Project Description + SF0 Address City Zip Tel. State Lic. City & Classif. 2327235 Lic. # , . . Sq. Ft. 1629 No. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City JZip 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 OWNEWBUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Busoness and Professions Code: Any city or county which requires a permit to construct, ager, 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 Contractors 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 the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penally of not more than rive hundred dollars (5500). ❑ 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, Buisness and Professions Code: The Contractors 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• suchrnprovements are not intended or offered for sale. If, however, the building or improvement is sold wi0un one year of completion, the owner -budder will have the burden of proving that he did not build or inprove 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 Workers 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 compteted 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: f1, after making this Certfficate of Exemption you should become subject to the workers' Compensation provisions of the Labor Code, you must forthwith comply with such Provisions or thfa 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 Lenders Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 100 days. I certity 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 Estimated Valuation $90,070 PERMIT AMOUNT Plan Chk. Dep. $250.00 Plan Chk. Bal. 259.97 Const. 539.00 Mech. 33.5 Electrical 115.50 Plumbing 5.37 S.M.I. 20.00 Grading 20.00 Driveway Enc. 1.988.32 Infrastructure TOTAL $3.470.43 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 12/27i89Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SO. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING. MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. SQ. FT. ® FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN. WALL Sp. FT. LUMBER GR. FINAL INSP. URINAL SQ. FT. ROOFING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES VENTILATION WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FIREPLACE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® I% c SEWAGE DISPOSAL SQ.FT.GAR ® V4c HOUSE SEWER CERT. OCC. 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 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. 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 G .::MUGHYv.CONSTRUCTION' STATE CONSTRU -'10N_LICENSE 8327235 December 19, 1989. Mr. Tom Levy _ General Manager Coachella Valley -Water': -Dept': P.O. Box. 1058 Coachella, CA•92236 Re:.. Location of'.water line�on Avenida ,Rubi o .between Ensenada and Nogales .in `La Quirita Dear Mr. Levy: On .December 19. 1989, I. spoke Eby telephone �t�o Mr;: Valencia regarding location of above mentioned water�line. His maps showed it,'tos be locatedto,%the _west ofsOcenter bine on Rubio. For County HealthDepartmenfapp"roach�k of`'sewage set back requirements; `I��willi need;.a letter from: -your organization stating lroc 116 -fir,!?.` P? Your help in this.'atter is greatly ;appreciated: x S' c r 1 h 4 Y G. MURPHY' cc: Riverside County, 1hy. Dept ile Ii. ..P.-..19-:- BOX 1124 PLM DESERT, CA 92261 Bui=l_ d�nDept� k o `..+L'E �x i �. }ZS.�'l7";- tv f, f 4�'• a�'�4v.`b;�f"� r (619) 340.0423' FAX (619);568 4429 1 Fitch Engineers Inc. May 13, 1989 Mr. Chris Barca 2441 Le Vante La Costa, Ca. 92009 M AY 17 1989 CITY OF LPA QUINTA PLANNING & DEVELOPMENT DEPT. SUBJECT: Report of In -Place Tests- S2 540 Avenida Rubio La Quinta, Ca. Gentlemen: .In accordance with your request, this report has been prepared to present the results of the in-place tests performed on the fill material at the subject site by Fitch Engineers, Inc. These tests were performed-on.5/13/89. AVAILABLE PLANS To assist in determining the, locations and elevations of our field density tests and to'define t -he general extent of the site grading for this phase of work, we were provided with a grading plan by Fitch Engineers, Inc. FIELD TESTING Field density tests were performed by a representative of Fitch Engineers Inc. upon completion of site grading. The density tests were taken according to A.S.T.M. Test 1556-74 and the location and results of those tests are shown on the attached plates. The locations and.elevations of the in-situ tests were determined in accordance with'their importanceand the accuracy and proximity of the survey control provided by Fitch Engineers Inc. representatives. Unless otherwise noted, their locations and elevations were determined by pacing and hand level methods and should be considered accurate only to the degree implied by the CIVIL ENGINEERING — PLANNING — SURVEYING — DESIGN P.O.' BOX 4551 PALM DESERT, CA 92261 (6'19)145.7667 r -2- method used. LABORATORY TESTS. A=: maximum dry densi-ty, determina'`tion was performed; on a representa- tive sample . of 'the soils. 'used i.n . the `'compacted f"i,lls, according to A.S.T.M' Test`1557-78, Method'A. This met -h'4' specifies that a four (4) inch diameter cylirnd:rical mold of'1/30 cubic foot volume be used and that ' the soil: tes't'ed be .placed i -n five (5) equal layers with each layer, c•om,pacted%by :twenty -f :ve (2-'5`) blows. of a 10 pound hammer with a 1.8 inch"drop. The results of thes:e•.tests as pre- sented on .Pl,a to N.o ' 1 'were used in con j-unc.,tio-n wi th - the f ield density tests..to determine; the''pe.rcent o'f relative compaction of the compacted fill'. This report covrs only the work performed .on May 13, 1989. Our opinions epresented herein are based on ourobservations and the' relative .compa'ction tests resu-l',ts.. Due; to possible variations fily < in the unifo itof. compacte:•f d ills, we only' warrant that our work was performed. in acco-rdance with the currently accepted standards of practice and in such a manner as to have-'reis table certainty that the mass grading complies :_w:ith the. job:requArements. No other warranty,."express or'-Jmp:lied'is;,.given'or `int:ended. If you should have -, a"n"y questions• after xevi'ewirig. this report, please do'not hes' ,tate t'o coritac`t: this office. This opportunity to be., of. ;professional service is sincerely appreciated. Respectfully .submi.t<ted, PITCH ENGINEERS' :•I-NC�. WM. H. FITCH R.C.E. 12571 JOB NAME 52 540 AvenidaRubio, La-'Quint'a Ca. J0[3 NO. _ ..� ,.'. ' TEST NO. DATE LOCATION ELEVATION 0.11 DEPTH dF LEST. 'MOISTURE •/. DRY DEW Ibs'/cu.1L SOIL TYPE REL.. COM •/. I' 1 5/13%89 See Sketch =1' 5:3 109.6 117.7 93.1 I. 2' �� " -0•.5' 4.2 115.7 117.7 98.3 �. 3 �� ". 116.4 F.G. 3.1 117.7 98.9 I. I OIL TY P 7. lbs. l= 1112'.47. cu. t. @ -Mo sture i i,r. 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 ' 7369-20 B 03/3112( Date 9 i�� Signature of Contractor i' � 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 performance of the work for which this permit is issued. (%,) 1 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' compensatiori insurance carrier & policy no. are: Carrier STkf ? FUND Policy No. 1 CMOS -MI, (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 pro,vsions of Section 3700 of the Labor Code, I sh II fo hwith comply with jSrovisions. Date: 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 & 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 .omply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned propVyol'l pection purposes.Signature (Owner/Agent) Date I PERMIT # 131.1.6LDING PERMIT,' DATE VALUATION 9:321,499 0 LOT 26 TRACT B .I6 JOB SITE ADDRESS/�-� I�i1!i.I�iA� APN OWNER CONTRACTOR/DESIGNER/EN (NEER :+�rr�� MMUILOr COM -E O .Y K(D13 P. 0.DOX 114) 1.3??:MMA. ��3�'+:MUC. AS U, rciWTA CA 922S3 LA QUINTA CA 9225 MIR '6255 USE OF PERMIT SALMU FAWL i TMUM 6 V0 a f,A:'t't' As. A U 1' 1.TA 50- 3 d:NCLULmr. B DCK WALIA POOMPA Oft 0- WWAY APPROACH TRACT CONSTRUCTION 1,3".9I; 3F Po'acwqP7110 44.00 >ssy 7K00 SF ESUMAIIIED coff Ole :' ONYM )t.'"� OV 117.499.3T PERwr FEW, anr y c1014 "TRUCTI'ON FEE 14x1.000.41 8-000 SX02.10 1PLA111 CRECK FEE 101.000.439-318 $583.69 VEM DRINDSIT 101-000-439-318 42$400 It!IECHANff:A1. IEE 1011 -000 -421 -OW $66.50 ILLECTIPWA, FRE 1014=420 -OM $129,01 Pi.F13u1SINO 1t`RE 101-000 1 9_1010 f $130.00 (#` ROI' 1 It,2t:3`4'[O 'P>rE • f LSID 101.0004241-000 S111,715 011ADING PEZ 101 -000 -473 -ON) PROD C:E"VE110PER1. IMPACT i'�.tX S1,9".00 PF WIISta PLAN 101-000-441-345 $IOfj.40 = TYI T T.`idE�C+"C,A1 ANY) PI -AN CMM. $3,650.48 001 , �1 •;�, � NOV 1 5 2,00,1- �$ ct,c�; XMITUMITJ fsl3UE.SOW F19 NICE OEPI RECEIPT DATE BY DAT INALE INSPECTOR 2-4 It —1 INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings _ �� /� � Underground Ducts Ducts f [ Slab Grade Steel Z -� pJ %a_ / Return Air Combustion Air f [ Roof Deck Exhaust Fans I O.K. to Wrap Framing Insulation Fireplace P.L. —Zd 2 j F.A.U. Compressor Vents Grills i [ [ [ Fireplace T.O. Fans & Controls [ Party Wall Insulation Condensate Lines Party Wall Firewall t- [ Exterior Lath Drywall - Int. Lath >12- Final " ` y � BLOCKWALL APPROVALS Final [ POOLS - SPAS Steel [ Set Backs Electric Bond I Footings Bond Beam �Z f�/ Main Drain Approval to Cover [ Equipment Location { Underground Electric [ Underground Pibg. Test [ 'Final Gas Piping { PLUMBING APPROVALS _ _ Waste Lines Z/�� U/ %f, Water Piping / ) Gas Test [ Electric Final Heater Final Plumbing Final [ [ [ Plumbing Top Out Equipment Enclosure f Shower Pans O.K. for Finish Plaster [ Sewer Lateral Sewer Connection �1j��3 � e /G G{ Pool Cover 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) j y Building Address Owner Mailing Address City IZip Contractor Address city Izip 10/1-7 e.r� c&t4t 4 Quikm 1 P.O. BOX 1504 �� 2�� APPLICATION ONLY 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 01 (1 — 7i State Lic. —. , , City & Classjf- 1 Lic. # 0 Arch„ Engr., Designer Address Tel. CityI Zip I State I Lic. # ' LICENSED CONTRACTOR'S DECLARATION I Nrehy affirm thal I am licensed under provisions of Chapter 9 (commencing with Section of Division 3 of th¢ effect, Pusini ess and Professions Cody, and my license Is In full force and effec6 SIGNATURE ❑ATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Iollowing reason: (Sec 7031 5,13usiness and Professions Code: Any city or county which requires a permit to construct, alter, lmpiovu, demolish, or repair any structure, prior to Its issuance also requires the applicant for such parmd 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 the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit rpWecrs 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 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 nor 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.) 1 I, as Owner of The property, am exclusively conlrac-ing with licensed contractors to con- struct the project. fS6e: 7044, Business and Professions Code.- The Cordrecror's License Law does nor giy to an owner of PIW*rty. who 110ds or improw06 thereon, and who conlmcfs for such prgreers with if cdn1r3c1or(Sy Yaeawd pursuant to. the Contractor's License Law.) I l 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 Compensation Insurance, or a cerilfled ropy Il�ersof.,1�ec. 3800, Labor Code.) Pnlicy No. Company .fd 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: It, after making Ihls Cerffficafo of Exemption you should become subject to the Workers' Compannafian provisions of the Labor Code, you must forthwith comply with such provisions or Ibis pemrlf.stW? be deemed revoked. CONSTRUCTION LENDING AGENCY f 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 slate that the above information Is correct. I.Agree to comply with all city and county ordinances and stale laws relating to building construction, and hereby authorize reprewnWIVes -of this city to enter the above• mentioned properly for inspection purposes. Signature of a0plicant _ _Date Mailing Address—. Cty, State, Zip_ BUILDING: TYPE -CONST.` OCC. GRP. P. Number Legal Description Project Descriptio WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Sq. Ft. Size No. No. Dw. Stories Units New'W Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. -- Grading i t, Driveway Enc. t _ ,' Infrastructure IT I OUCT 16 2nuw CIjY OFLA u.•c• 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 FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION 01'/12/61 14:30 FAX 17608,049062 ---"'- RECORDING RE6bESTED'.BY: AND WHEN kE(:ORDED MAILTHIS•DEED AND, UNLESS OTHERWISE SHOWN�BELOW, MAIL TAX STATEMENTS TO: William Thomas< Buffin- Power Brokers D.O. Box 134 La Quinta, ,CA 92253 COMMONWEALTH TITLE (0002 S Z_ 57,110 I}Lle 2vaiv SPACE ABOVE THIS LINE FOR RECORDER'S USE The undersigned grantors) deGGrant „Deed A.P:N. 773-283-003 are(s): -- Documentary transfer tax is`$ ( x)j.computed.on full value'of-property conveyed; or ( 'X computed'on full valueless value of liens and encumbrarices.remaining at time of.sale. ( )Unincorporated area: ( ) City of , and F6R A VALUABLE CONSIDERATION, 'receipt of which is hereby acknowledged, GERALD'MURPHY hereby GRANT(S) to WILLIAM THOMAS BDFFIN, an unmarried man the real property in the City.of La Quinta. County of Riverside= State of California, described as Lot 21 of Block 16.4 Unit`No.. ,.Santa Carmelita at Vale La Quinta, as per map recorded in Book Pages mf Maps, Records of Riverside County, California Dated September: 21 2001 Sighature of Grantor state of California ) . County' of - 'GERALD MURPHY On before me. personally appeared. - -- GERALD'MURPHY personally known tome (or proved.to me on the 5asis`of satisfactory — — — — evidence) to be the. person(s) whpse-names) is/arersubschbed to the within instrument -and acknowledged to me that he/she%they executed M . the same • in his/her/their authorized capacity(ies), 'and that 'by his/her/their signature(s) on the instrument the: person(s); ,or the entity upon behalf of which the person(s) acted, executed the insft'ument. WITNESS my hand and official &eel, Signature MAIL TAX STATEMENTS TO„—saa-�a ataeve Form 3195-4 (6-94) . , THIS FORM FURNISHED BY COMMONWEALTH LAND TITLE COMPANY Desert San&,Unif ed School D sfrict• 47 950'. Dune .Palms`Road. . Notice: La:. , uinta,• CA. 92253 Q� Document Cannot Be Duplicated 760-771'=8515 CERTIFICATE :OF COMPLIANCE Date 11/14/01 APN # 773-283-003" No. 22682 Jurisdiction La Quints Owner NameBuffin/KelloggPermit #:0111-012 No. 52-540 Street Avenida Rubio Log # City. La Quinta Zip ;92253 Study Area Tract.# BLK1,64 Lot # 21 Square'Footage 1899 Type of Development Single Family Residence ' No. of Units 1 Comments At the present time the Desert Sands Unified:"Sch6ol Distract 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:exe'mpt from paymg,school fees at'this time due to the following reason: EXEMPTION NOT APPLICABLE x•: This certifies that school facility fees imposed pursuant to Government C6de;53080. in the amount of 2.05 X 1,899 or $• 3,892.95 the. property'listed above -and'tliat building permits and/or Certificates ofOccupancyfor'this,square footage in this proposed project inay now be issued Fees Paid By CC/Union Balk of California Marc K611 Telephone Name�on'llie check' By Dr. Doris Wilson. Superintendent Fee collected /exempted by Juanita Green Payment Received S3,892.96 Check Nb. 7426219 ,n. Signature NOTICE: Pursuant ofAss bly Bill 3081; (CHAP 549,.STATS.1996) this will serve'to notify you,that the�90-day approval period in which you may protesfthe fees or other payment identified above will begin to run $o a date on which the build collect permit for this project is sssued or on which they'are. paid to the District(s)-or to another public'entity authorized to collect them on the Distri )(s') behalf, whichever is`earlier. e 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 � fi RC DISTRICT PLANNING'REVIEW FORM This form is to be used. by, CDD` staff for review of 'sing.le.,family dwellings in the RC (Cove Residential)' District-per`S,ection 9:50:0.90 -:of the Zoning Code. Its purpose is to determine: 1) that the proposed house design does`not duplicate4he same architectural style of any house within 20-0"feef of -the applicant; and/or 2') -if thereF is -a need; for; the applicant to i e or Master Design 'Guidelines If the applicant does needao file a;Masters Design. Guideline, please transmitted this'' information•: to the Building; and Safety Department -as part of your correction list. Please attach 'add.itional'-explanations as necessary., APPLICANT BUFF IN/ -KELLOGG:: SITE ADDRESS .527-540 'Avenida Rubio APN 773 - 283 - 003 CASE NO.:: 2001-574 LEGAL: LOT 21 BLOCK 164 UNIT S.C.@V.L.Q. CHECK AND APPROVED BY`: Michele °Rambo DATE: 01 Inform the assignedBuilding plan .checker,,upon your assignment to this.case. The CDD Executive Secretary maintains adog book to track applications and assign case numbers. REQUIRED ITEM . Y N COMMENTICORRECTION Verify legal,.and APN.information Consistent with MDG on file (as. applicable' A� I r, MDG filing required (5 filings since 98 9/3/ 1 .l ,1I Tel . Architectural variety within 200 feet of the surrounding area: Colors Materials Architectural design features M SENO. Other Requirements: Certificate of Occupancy City of La Quinta Building and Safety Department ?° N This Certificate issued pursuant to the. requirements of Section 109 .of the .Uniform Building. Code, certifying (that, at the,- me`of issuance, this structure-Wasin' compliance with the various ordinances of the City-'regu/ating bai/ding construction or. use. For; the following: BUILDING. ADDRESS: 52-540 A.VENIDA RUBIQ Use Classification: SINGLE FAMILY'DWELLING Bldg. Permit -No.: 0.111-012 Occupancy Group: 1173 Type of Construction:' VN Land Use Zone: RC Owner of Building: BUFFIN/KELLOGG Address: P.O.--BOX 1141 City: LA QUINTA, .CA., 9225.3 By: RICHARD KIRKLAND Date: 04/29/02. Building Official POST IN A CONSPICUOUS PLACE