10034 (SFD)4 oil
P.O. BOX 1504 oN�0. 10 o 3 4
7&105 CALLE ESTADO N
Address 54-800 Rubio LA QUINTA, CALIFORNIA 92253
Owner l/
Doug & Cindy Hassett BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 61-875 Ave 48 #115
A.P. Number
CityZip Tel.
Indo 192201 1 Legal Description
Contractor Project Description SFD
East Valley Construct -don
Address
P. 4. Box 1281
City Zip Tel.:
Yea Quinta 92253 554-4844
State Lic. City
& Classif. B 295565 Lic. # 1961 Sq. Ft. No. No. Dw.
Arch., Engr., Size 1759 Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel. Permit includes patio and block galls.
City Zip State Permit will not include pool
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
effect. r
SIGNATURE - DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I -am exempt from the Contractor's License Law for the following' 108, 605.00
+reason: (Sec.. 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 AMOUNT
requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT
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 Plan Chk. Dep. 250.00
subjects fhe 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 Plan Chk. Bal. 314. 30
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 671.4) t3
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, MBCh. 50
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 Electrical -�+�
of 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- Plumbing 1 .
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
00
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. 10 . 90
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading 20. 00
O I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc. 20.00
Date owner Infrastructure 2255.65
Arts in Public 25. GO
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.)
(POE�Cyct
_ Company
�is iIad with the city:O Certified copy is hereby furnished.
�, -fly/li t l t3i�c_ TOTAL 3904.97 3554697
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation i (: 1{/1 (€'� �'} } (t r`$'}t}'Lt,� 9 4 - r t•.�� n •/ , i. �r
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 ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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.) Side Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
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. Issued by: Date Permit
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. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEE,
1ST FL. SO. FT. ® $
2ND FL SQ. FT. ®
POR. SO. FT. ®
GAR. SQ, FT, ®
CARR SQ. FT.
WALL SO. FT. ®
SQ, 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
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
STORAGE TANK
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FOUND. REINF.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
HEATING (FINAL)
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GAS (FINAL)
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
PERM
FAMPERES
LAVATORY
HEATING SYSTEM FORCED GRAVITY
ERV ENT
SHOWER '
BOILER. B.T.U.
SO. FT. ® c
BATH TUB
LUMBER GR.
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 V. c
SEWAGE DISPOSAL
/�
z
SQ.FT.GAR ® V4c
HOUSE SEWER
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK I
WOUND PLUMBING (
11 UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
'04
SEWER OR-SERR
UGH WIRING.
AT
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL 2 9/
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
/�_cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMINGL�
FINAL INSP. !A C/v
ROOFING l - / 9 L
/
i _ 1��
ll �11I t
/�
z
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND 412-40
FINISH GRADING
n
FINAL INSPECTION-
r
NSPECTION•CERT.
CERT.OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 111/25/911 Type of Permit I La Quinta
No. 11015 Permit #
Log #
Owner Name Doug & Cindy Hassett
No. 54-800 street Rubio
city La Quinta zip 92253 Study Area 110
APN # Tract # Lot # Square Footage 11759
Type of Development 16ingle -Family Residence No. of units
Comments
At the present time, the Desert Sands Unified School District does not collect fees on
garages/carports, covered patios/walkways, residential additions und3r 500 square feet,
detached accessory structures or replacement mobilehomes. It has 1-een determined
the above-named owner is exempt from paying school fees at this time due to the
following reason:
This certifies that school facility fees imposed pursuant to Governmmt Code 53080
in the amount of 1.58 X 11.759 or $ 2,77922 have been paid to D.S.0 S.D. for
the property listed above and that building permits and/or Certificate of Occupancy for
this square footage in this proposed project may now be issued
Fees Paid By East Valley Construction Telephone
Name on the check
By James E. LivelyIle
Assistant Superintendent, Business Services r ..
R,4 rA-1
Fee collected /exempted by Vickie J. Durrett ;
Payment Receive 1 f�
Signature ' Check No. 081
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
RECORDING REQUESTED BY
MAIL TAX STATEMENTS
F
NAME
ADDRESS
CITY &
S I A -r E L
n I. u 5,7 6
Escrow No.
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SPACE ABOVE THIS LINE FOR RECORDER'S USE
)7.50
j"hkitnimentary transfer tax
full v,,Illle of prol-f:1-ty convoyed, or
0 Computed ()It full value le." a n 4 e Li
of
Signature of declarant or agent determining tax - fil-Ill Ilaille
0 Unincorporated area City
Tille Order NO.
LGIS; rant Deed
THIS FORM Fl�lnjql&HED BY qTFWART 'TITLE COMPANY OF RIVERSIDE COLIN
-Iry
L -i
.1 ckm-WIedged,
1�'()H A VAI.,L)AI31,J I C,0NSIDHRA'IA0N, receipt of which i.,; hereh), o
A S'NGLL MAN
hl. rtl)v GkANT(S) If)
I111tltiir[\ti I!. AN
HA`;-S[-::I.'T ANU c W.I. I -T AS
the fullo"vilig described real property ill the
(;aunt) ofStale of California:
A E U'l-l'A Al.' VALE LA Q[j!_YNTA
276 ()1-;' -,�'AWJ.'A CA10 .
2 1. 1�j 'I� 9
N PAGRS 5( N.ND 5.1
T
s i-i0WN1 BY MAII
V 1;� f z CAL] A
tM A Y S, F: I.- A)1;: coujqN., I! . .1 -F(.
WITNESSED: AICT
ROBERT E. BAYERV
DATED mat -ch L5_. 1 9 1-)
STATE OF CAL.17qZN-1A
COLHILy ()I'
VClorc Inc.
joiLling therein, July, k.... Notary l'uhlic ill and kir the s;kill Stilt,
CIIIIIIIIINS111nal and swm-ll. pt.sonallyal'Inaml
c7p�, -0 R G E S 11
t,,=MESSED GRANT DEEED FROM SHELTON To HASSETT
1`0R N 0'1'/\ k Y S 1: i\ L Olt ST,;\ rl 11
RIVERSIDE
0—APRIL ----------
.1v,il 1,�l -;:fill (omit" ;111(1 S!:Itc,
RbBERif 'E. BAYER
pc rso mi I I v : 1 v I),lccd ------
kno,vil (o file. tu h - pon-sk)II.whose mune is subscril)(A lu Ille-within
i,
instrument. ;a ;j tvjjjjvSS thereto, Allk beillL. by 111C duly scorn, .dc-
poscd'anti Said:
(;silics if
Ilk
RCE
ISID'
silinc pk�rmun Licscr r.)b 22. IC94
personally known lu ----
:111d vjwsc nam", is sllbscrikvd to 11w w-ilhill annceca insil-11111 1
Ylcl,lc 111:
_._BET=Y ......
-----
i_-49 1:1 Ty I'll I ll i,:, in 11 if, I I'ov .aid t if 1 :iiia
to
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qq
NAME
1\.N0
ADDRES
17ITY 6,
STA -1 I -
MAIL TAX STATEMENTS
F
NAME
ADDRESS
CITY &
S I A -r E L
n I. u 5,7 6
Escrow No.
cl
cc
LU a: CD
cc , v -K Z—
rx C; n
_j C)
4)
ILL.C7 N
0
Ci-
<
cr.
SPACE ABOVE THIS LINE FOR RECORDER'S USE
)7.50
j"hkitnimentary transfer tax
full v,,Illle of prol-f:1-ty convoyed, or
0 Computed ()It full value le." a n 4 e Li
of
Signature of declarant or agent determining tax - fil-Ill Ilaille
0 Unincorporated area City
Tille Order NO.
LGIS; rant Deed
THIS FORM Fl�lnjql&HED BY qTFWART 'TITLE COMPANY OF RIVERSIDE COLIN
-Iry
L -i
.1 ckm-WIedged,
1�'()H A VAI.,L)AI31,J I C,0NSIDHRA'IA0N, receipt of which i.,; hereh), o
A S'NGLL MAN
hl. rtl)v GkANT(S) If)
I111tltiir[\ti I!. AN
HA`;-S[-::I.'T ANU c W.I. I -T AS
the fullo"vilig described real property ill the
(;aunt) ofStale of California:
A E U'l-l'A Al.' VALE LA Q[j!_YNTA
276 ()1-;' -,�'AWJ.'A CA10 .
2 1. 1�j 'I� 9
N PAGRS 5( N.ND 5.1
T
s i-i0WN1 BY MAII
V 1;� f z CAL] A
tM A Y S, F: I.- A)1;: coujqN., I! . .1 -F(.
WITNESSED: AICT
ROBERT E. BAYERV
DATED mat -ch L5_. 1 9 1-)
STATE OF CAL.17qZN-1A
COLHILy ()I'
VClorc Inc.
joiLling therein, July, k.... Notary l'uhlic ill and kir the s;kill Stilt,
CIIIIIIIIINS111nal and swm-ll. pt.sonallyal'Inaml
c7p�, -0 R G E S 11
t,,=MESSED GRANT DEEED FROM SHELTON To HASSETT
1`0R N 0'1'/\ k Y S 1: i\ L Olt ST,;\ rl 11
RIVERSIDE
0—APRIL ----------
.1v,il 1,�l -;:fill (omit" ;111(1 S!:Itc,
RbBERif 'E. BAYER
pc rso mi I I v : 1 v I),lccd ------
kno,vil (o file. tu h - pon-sk)II.whose mune is subscril)(A lu Ille-within
i,
instrument. ;a ;j tvjjjjvSS thereto, Allk beillL. by 111C duly scorn, .dc-
poscd'anti Said:
(;silics if
Ilk
RCE
ISID'
silinc pk�rmun Licscr r.)b 22. IC94
personally known lu ----
:111d vjwsc nam", is sllbscrikvd to 11w w-ilhill annceca insil-11111 1
Ylcl,lc 111:
_._BET=Y ......
-----
i_-49 1:1 Ty I'll I ll i,:, in 11 if, I I'ov .aid t if 1 :iiia
\
COACHELLA VALLEY WATER DISTRICT
4 ,
CASH RECEIPT DETAIL
Received From:
1:.Address: =L` C • L �i'�(,
J off.. L /-
- Date:
Account No. �F . 1 �
� ()
Z. �.
Service Address
�Z
Lot(s) Z.
-7_
Tract- �. ryZ 1
terO
»•
G:A. Code
G Back(low(s)
QCj
?
- .>
❑ House Lateral(s)
L DetectorCheck(s)
G Meter Surcharge
_
11, anitation Capacity'ChargeL.._
C� W.S.B.F,C.
Temporary Construction Meter
+
!� Turn on Charge
,
• ' C Uncollected Account - Name
+
Inspection Fee - Tract -
Fee
Q Plan Check FeesWaterI Sewer -
`
Tract
Q Bond Payment - A.D. - ' Bond
Assmt.
❑ Customerbeposit
L' Other
',
MTOTA
Remarks: _..
i
L -'
IL
,
S
LCopy to:
y
Cash
Check { >'
Money
Water Service
Order
Cashier -
r
CVWD-438 (11189)
1.
.
8• Masonry
�9. Plumbing
LO.' Lathing
11 D
rywall
12• Plastering`
j 13. HVAC. �� 1 i1
L • Electrical
1v/
L5. Roofing
16. -Sheet Metal
��• Floors -All Types
ti. 18• Glass - Glazing,
19• Insulation/Weatherstrip
20• Sewage Disposal
21• Painting/Decorating
22. Tile
23.., Cabinets -Installations
24 . Ornamental Metal
25. Fences/Blockwalls
.26• Landscaping
2.7.. Others
28.
DO HOT REMOVB THIS. CARD
Before Final Building Inspection Will Be Made
This Form Must Be Completed and,Filed With Title 24 Calcs and 'Plans
o
P.O. box IN4
7W 105 CALLE ESTADO
LA OUINTA. CALIFORNIA 9ZW '
Contractor
Owner
Address,��-
c.J"ddres
Ov
La '
Quinta City License
No.: Expires: 123i- Bldq, permit No.:. ci 0 3
This form shall be,
posted on the job with the building Inspection Card and it
shall be the duty of the General Contractor or if Owner -builder Permit, the owner
to see that all sub -contractors sign this card, giving his City of La Quinta
Business License Number, Contractors License Number and a current certificate
Of Workman's Compensation Insurance Certificate when he starts the fob. Failure
to comply may cause building Inspectors to stop work, or complaints to be filed
against such contractors or owners. ,
CITY CONT.
SUB -CONTRACTORS {
NAME LIC. NO. EXPIRES.LIC. NO. EXPIRE
1-
Graded Excavate
2•
Pipelines
3••
Cement -Foundations
4.
Cement Walks i Drives
5•
Asphalt Paving
6.
Framing
7-
Steel Structural
8• Masonry
�9. Plumbing
LO.' Lathing
11 D
rywall
12• Plastering`
j 13. HVAC. �� 1 i1
L • Electrical
1v/
L5. Roofing
16. -Sheet Metal
��• Floors -All Types
ti. 18• Glass - Glazing,
19• Insulation/Weatherstrip
20• Sewage Disposal
21• Painting/Decorating
22. Tile
23.., Cabinets -Installations
24 . Ornamental Metal
25. Fences/Blockwalls
.26• Landscaping
2.7.. Others
28.
DO HOT REMOVB THIS. CARD
Before Final Building Inspection Will Be Made
This Form Must Be Completed and,Filed With Title 24 Calcs and 'Plans
CALVIN C. KAMINSKAS i� s DAN RILEY
'' a Sealer. Welghls & Meosures
Asslsionl Commissioner °
V
(714) 275-3000 ' o � - (714) 275-3030 ,..
414 q
OFFICE OF
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE, Commissioner
83-612 Avenue 45. Suite 7
Indio, CA 92201
(619) 342-8291 ;
DATE / - .2- CASE NO. j� C 6✓ 5 ! l - z 6 -,91,-,4(.
.
DEVELOPER'S NAME:. 14 .T !7L
ADDRESS :
TELEPI IONE': (
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If-subs=itutions
do occur and they differ from plant material listed, this office must be notified
immediately. °
g the Coachella Valley's pest -free environment.
Thank you for protecting and preservin
W •
Agricultural Commissionei4ls Office
cc: Indio and Riverside
4080 LEMON STREET, ROOM .19, RIVERSIDE, CALIFORNIA 92501 — FAX (714) 275-3012
Cs
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ittltn �tnPt t1!5tun
This. Certificate issued pursuant to the requirements of Section 306 of the Uniform Building�
Code. certifying that at the time of issuancethis structure was in compliance with the various.
ordinances of the City regulating building construction or use. For the following:
BUILDING ADDRESS 54-800 Avenida Rubio
Use Classification SFD Bldg. Permit -No. 10-034
Group R3 -Type Construction VN Fire Zone Use Zone SR
Owner of Building Doug &.Cindy Hassett. Address 81875 Ave 48 #115
City Indio, CA—92201 Lonnie Day
By:
Date; 3/30/92
Bui 7Z& 4!
ding Official —Z POST IN A CONSPICUOUS . PLACIE'
11