Loading...
11006 (SFD)4 4 a KAM P.O. BOX 1504 Building 54.565 Ave. Rubio LA CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Judi. Jones E Paul. McCain Mailing Address P. 0. Box 1773 City Zip Tel. Indic 92202 Contractor Nerjbert G. Adams Address . 57020 Monroe City Zip Tel.: Thermal 92274 399--5528 State Lic. City & Classif. B 213280 Lic. # , 553 Arch., Engr., I Designer Address Tel. City I Zip I State Lic. # 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 Business and Professions Code, and my license is in full force and tett. 43$LGNATIIRE DATE OWNER -BUILDER DECLARATION 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 Permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or 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 rive 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 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 or proving that he did not build or improve 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 Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy o. Company f CCopy is filed with the city. ❑ Certified copy is hereby furnished. f CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit Is for one hundred dollars ($100) 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 or Exemption you should become subject to the Workers' Compensation provisions or 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 Lender's 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. I certify 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 d No. 11006 11LDING: TYPE CONST. OCC: GRP. P. Number Legal Description_ Project Description Sq. Ft. No. Size 1380 Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Permit does nom include block walls Or pool 5timatedValuation 83,355.40 Minimum Setback PERMIT AMOUNT PIan"Chk. Dep. ' 250.00 Plan Chk. Bal. 235.22 Const. FINAL DATE 567.50 Mech. Date Permit 55.50 Electrical 121.28 Plumbing 141.00 S.M.I. 8.40 Grading 20.00 Driveway Enc. 20.00 Infrastructure 1822.28 TOTAL ►�z4%:1' w l ri1t7. r�grJ�:�1xv 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: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. ® POR. SO. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. ® 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 FOUND. REINF. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED METER LOOP LAUNDRY TRAY AIR HANDLING UNIT CFM REINF. STEEL 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. SQ. FT. RESID ® 11/. c SEWAGE DISPOSAL 21 , h SQ.FT.GAR ® Wic HOUSE SEWER REMARKS: 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 j PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING RGROUND A.C. UNIT COLL. AREA ••AA SLAB GRADE ry' ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER qa V-9Uc Uhw- l> OUGH 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.— Z? (Y FRAMING g�`lq� [� FINAL INSP. _ ? ROOFING g L0 21 , h - REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL WG MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION ` CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESHNITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619) 347-8631 Date 7/9/92 1 Type of Permit I La Quinta No. 111557, Permit # Log # Owner Name Judi Jones - Paul McCain No. 54665 street Avenida Rubio city La Quinta zip 92253 study Area 110 APN # 774-271-020 , Tract # J Lot # Square Footage 11380 Type of Development Single Family Residence No. of units 0 f. Comments 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=t following reason:fi EXEMPTION NOT APPLICABLE ri r 4r This certifies that school facility fees imposed pursuant to Government Code 533080 ' in the amount of 11.58 1 X 11.380 or$ 2,180.40 have been paid to D.S.0 S.D. for the property listed above and that building permits and/or Certificates: of Occupoincy for this square footage in this proposed project may now be issued.` Fees Paid By Pomona First Federal Telephone 399-5528 Name on the check ]By James E. Lively � � Assistant Superintendent, Business Services q �7. Fee collected b d /exem te p y Shelley D. Bennett �t Payment Received r Signature ' A Check No 80744356 �}':` Collector: Attach a copy of county or city plan check application form to districtcopy fbi%ali waiters. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy -Accounting RECORDING REQUESTED BY it j py y��,r}'•�y ,� ..f.. 't'C i.` ("'r �t AND WHEN RECORDED MAIL TO NAME Paul W. McCain, & Judith K. Jones ADDRESS 3700 Buchanan. Space #6 CITY& Riverside, CA 92503 STATE L MAIL TAX STATEMENTS NAME ADDRESS same as above CITY 6 STATE Escrow No. SW2002 I. Title Order No. R-1 12043-15 " L•1 SPACE ABOVE THIS LINE FOR RECORDER'S USE Documentary transfer tax $ 26-40 ® Computed on full value of property conveyed, or ❑ Computed on full value less li ?ns & encumbrances y�remaining thereon at time of "sale. i�/lLi�st�L�-ntr-+ac Calif. Castles, Inc. Signature of declarant or agent determining tax • firm name ❑ Unincorporated area City of Grant ®eed THIS FORM FURNISHED BY STEWART TITLE COMPANY OF SAN BERNARDINO-COUNTY FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged; BEVERLY JACKSON, an unmarried woman, who acquired title as BEVERLY'SHUBIN hereby GRANT(S) to PAUL W. McCAIN, . an unmarried man and JUDITH K'. JONES, an unmarried woman as joint tenants the following described real property in the County of Riverside State of California: Lot 8 in Block 270, Santa Carmelita at Vale La Quinta, Unit 25, Ls per Map recorded in Book 19, Pages 50 & 51 of Maps; Records of Riverside,,County. AP#774-271-020 DATED March 26th 1992 STATE OF CALIFORNIA, . County of Orange On March 26, 1992 before me, the undersigned, a Notary Public in and for the said State, residing therein, duly commissioned and sworn, personally appeared Beverly Jackson Beverly ve y cks on O --- -- to be Inc persons: ( X 1 INDIVIDUAL. whose name is subscribed to this instrument, and acknowledged that he (she or they) executed it V Y ' behalf of the corporation therein named and acknowk edged to me that such corporation executed the within- ithininstrument t� c M j��{^��Jf O CT)0 N ( ) PARTNERSHIP that executed the within ( WW V LL. WITNESS thy hand and official seal OBF=DIALD-��CALJFORNJA Cr �`�n�t.�j-� Signature 1 ' l•� KATMERYN LU co ORWIECName V/ (Typed or Printed) - My Comm-Exptre4V GOP a3 a W t SPACE ABOVE THIS LINE FOR RECORDER'S USE Documentary transfer tax $ 26-40 ® Computed on full value of property conveyed, or ❑ Computed on full value less li ?ns & encumbrances y�remaining thereon at time of "sale. i�/lLi�st�L�-ntr-+ac Calif. Castles, Inc. Signature of declarant or agent determining tax • firm name ❑ Unincorporated area City of Grant ®eed THIS FORM FURNISHED BY STEWART TITLE COMPANY OF SAN BERNARDINO-COUNTY FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged; BEVERLY JACKSON, an unmarried woman, who acquired title as BEVERLY'SHUBIN hereby GRANT(S) to PAUL W. McCAIN, . an unmarried man and JUDITH K'. JONES, an unmarried woman as joint tenants the following described real property in the County of Riverside State of California: Lot 8 in Block 270, Santa Carmelita at Vale La Quinta, Unit 25, Ls per Map recorded in Book 19, Pages 50 & 51 of Maps; Records of Riverside,,County. AP#774-271-020 DATED March 26th 1992 STATE OF CALIFORNIA, . County of Orange On March 26, 1992 before me, the undersigned, a Notary Public in and for the said State, residing therein, duly commissioned and sworn, personally appeared Beverly Jackson Beverly ve y cks on FORM 72.13 MAIL TAX STATEMENTS AS DIRECTED ABOVE personally known to (or proved to me on the. basis of satisfactory evidence) --- -- to be Inc persons: ( X 1 INDIVIDUAL. whose name is subscribed to this instrument, and acknowledged that he (she or they) executed it ( ) CORPORATION who executed the within instrument as president and secretary, on behalf of the corporation therein named and acknowk edged to me that such corporation executed the within- ithininstrument instrumentpursuant to its anicles and by-laws and a resolution of its Board of Directors ( ) PARTNERSHIP that executed the within instrument on behalf of the partnership, 'and acknowl- it. edged to me that the partnership executed FOR NOTARY S EaL OR STAMP WITNESS thy hand and official seal OBF=DIALD-��CALJFORNJA �`�n�t.�j-� Signature 1 ' l•� KATMERYN NOTARY FuBLIC Katheryn Scott ORWIECName (Typed or Printed) - My Comm-Exptre4V GOP FORM 72.13 MAIL TAX STATEMENTS AS DIRECTED ABOVE COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL Received FrorrL-. Address: �57 7�oo7 Account No. Service Address Mete r(s) �Service(s) 0 Backtlow(s) 0 House Lateral(s) .0 Detector Check(s) EI Meter Surcharge XSanitation Capacity Charge 0 W.S.B.F.C. 0 Temporary Construction Meter 0 Turn on Charge 0 Uncollected Account - Name 0 Inspection Fee - Tract - Fee - 0 Plan Check Fees Water I Sewer - Tract - 0 Bond Payment - A.D. --Bond 0 Customer Deposit 0 Other Remarks: G.A. Gide I Uol s e—)O ASen d— 41 4 T Va. r C t 14auilita . �utl�ru ��� s���e�1 �tnt�tuu . - . . - This Certificate issued, pursuant to the ipquIrements of Section 306 of the Uniform Building! Code certifying that at the time of issuance this structure was in comp!iance with the various ordinancesof the City regulating, building construction` or use. For the following; BUILDING ADDRESS 54-665 Avenida Rubio Use Classification Single Family Dwelling 'Bldg. Permit No. 11nQ6 .Group R3 -Type Construction VN Fire Zone Use Zone RR Owner.of Building Judi Jones & Paul McCain Address P.O. Box 1773 - City Indio, CA: 92202 Lonnie Day` By: Date; July 12, 1993 Building 0 ff icc Is l - POST IN i CONtIRICUOUS PLACIE