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9801-082 (SFD)�'. 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 Da 6 Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of'perjury that I am exempt from the Contractor's License Law for the following reason: (X) 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't6e property, am exclusively contracting with licensed contractors'to construct the project (Sec. 7044, Business & Professionals Code). �() I am exempt under Section , B&P.C. fo�tktis reason ,� Date 2 �/ 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. (k) 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 carrier & policy no. are: Carrier Policy No. T141,110K 9N1,C3URPJ4Cr-'1 X2007 4370 W) !Y, (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 fortwith comply with th se�provisions. d Date: 2 / 4 4Applicant AKZ= �— 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'ngAection purposes. Signature (Owner/Agent) Date 6 PERMIT # CONTROL #. BUILDING PERMIT DATE VALUATION 1,.�Ce'g.x4E LOT. k TRACT ro 7.�'i f 2Gf� aGJOB SITE ADDRESS 111-30.5 Eti%`�.P�li,i)�41&+dE�f�.19.6L,Z APN 77XCf�2'.41.5 at 'ri OWNER CONTRACTOR/DESIGNER/ENGINEER 6:'t) �Rlt,l i.;f.? j 1. fear Sl" (,(rl{.,`1 .•� i A"' l•. .J I..I 'Y lJa..) 1i.\✓'I\. 0WAFH / 7!'LI 11 [_1% Iy �L'j"!`d.d •�PR-1 i H. • ,.J II.a LI..� \ i \l 1. pf_03ox ) v�:y . 43 70 i MONROE OE 53 IE (.'A 9a 236 INDIC) C.A 9"401 USE OF PERMIT &F C)•• 90-646C i)C)is l Ni.:,'i WALLS OR lk)0 — pi_kN �, J CHEK i '�.1�.`r1C)NI Of?• .1�j.i& 4E10L ICEi:) 75% POK Nf0,11:'Ii'1 !.S°atiAlvt:f ; OF 3ANIE Pf.. A:N 1' Y IJR. 1 ..•F A 'LJ 'f ' 1`k.AL""3'C�✓i., lfit7C't'f(AN 1,2.f,0.00 1. K)RC,WPKYKJk 102.00 Sir' cin n rs�Alt t pig; +° nxg) if. J AN, 2 • ' 3 1998 , a Y pq,, ¢��7�Y 1a t�p,ae9 ** aa tg��cos, p��^y 6, �^fp^`) �q�• 8-� _E, s 4 f lW9 it..•Y a JA! co. s,r r�jjl 7l,u Vja @ 44, fic il. �cTi � �y t 71310.," 0 KR A41 T �+`I4', SU MA Ftp 00N3'rRi, C7I0N F E 101 -0c* -418'-000 c PLAN (:` - EC`fi R31? 101-PW4,k9-!.V3 4 X114.0t. :. dist, f 1AP`fI AL .! f_;1:. 1 C►1-0()(? "1? r t)i7U V().50 FIX.::TR[ AL 1i Lir: 101-000-420400 S116.37 PL IJMl fN0 FI;X, 101-000,11 121. x 53'WON ;' W)TH-JN' F-0- � RESID 101. -*1-741-000 G1't.AL)1,'N i .F Lf' 101-0,00-123-.000 ;�ts.Gii A 1Ivh14A;;f:eti.fi"Ct.li2i:?FEE 225--0t3()-443.342 �1,'7iti.�t3 f RE0313 PLAN 1E) l -00(P141-.34`s Is ITV'r()arA1 (`.f -IN. 1"C'A,jC YK)N ;ANF) 1:f(. n N ! I 117('k_ LESS PRE. -PAID FEES 1;*,0AJ10 TUFAL P E £rtF,', [T F Sl; S D1)E NOW rt ' , J RECEIPT DATE BY DATE FINALED INSPECTOR { INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms 8 Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck _ Exhaust Fans O.K. to WrapQ _ F.A.U. Framing ��� L id ��. Compressor Insulation !%�2jAL�� Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall -Int. Lath Twvg414 Final Final _I64 POOLS - SPAS BLOCKWALL APPROVALS 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 G���� Heater Final Water Piping _ Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral QQ` Pool Cover Sewer Connection JC Encapsulation Gas Piping _ —2:5 IT 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 f Final U i* Notice (Perm) I:,11r 1 *nye-.i:'�ji�: ti P.O. BOX 1504 Buildin �78-495 CALLE TAMPICO Address /U)e QUINTA, CALIFORNIA 92253 Mailing Address Zip l jTeL City Zip Tel.. State Lic. & Classif. City Lic. # Arch., Engr., Designer Address Tel. APPLICATION ONLY R BUILDING- TYPE'CONST. T OCC. GRP. A.P. Number -77 s nq ` nj s Legal Description ir^'"'�13� $LIC 1,-7 1 WIT Project Description CityI Zip I State I 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 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5.Susiness and Professions Code: Any city or county which requires a - permit to construct, atter, 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 that. he is' exempt therefrom, and the basis for the alleged exemption. Ariy 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). I.: 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 I I am exempt under Sec. B. 8 P.C. for this reason Date -owner l+/..n.Pri.e'i-•--/%ii •[s .• t4,GC 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 n 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 ($100) valuation or less.) I certify that in the performance of thg 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- Lender's ame 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. I agree to comply with all city and county ordinances and state laws relating tobuilding 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 Sq. Ft. ��j� No. f No. Dw. Size aa�r Stories / Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ PERMIT AMOUNT Plan Chk. Dep. 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 FINAL DATE INSPECTOR Issued by: IDate Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION ATTORNEY - IN - FACT AGREEMENT I/We hereby appoint COACHELLA VALLEY HOUSING COALITION, and/or any of its authorized agents as my/our attorney-in-fact for the purpose of executing any notices of completion, waiver, of liens and/or executing contracts with subcontractors, and/or release of liens and/or handling building permits relating to that certain real property described below. All that certain -land located and being in the County of Riverside, State of California, described as follows: , LOT 3 BLOCK 67 OF UNIT 6 OF SANTA CARMELITA AT VALLE LA QUINTA, AS SHOWN BY MAP RECORDED IN BOOK 18, PAGE 67 OF MAPS, RIVERSIDE COUNTY RECORDS. Date Date cisco Lemus Horta . ► / 1 . 4 a -- MarthdGuardado Horta Desert Sands Viiffled Scho'01 Distrid": Notice827879'Highway ,,-1n : ridiq,*CA'4h0l. Document Cannot Be Duplicated G19-775 3500 . ERTIFICA EOFCOMPLIANCE Date 1/22/98 =i Ar.0 # 773-082-015 No. 16540 Jurisdiction Ld"Quiunta H' 'Permit #. Owner Name, Oachelld Valley, Housing Coalition 41. No. 51-305 'Street', Ave.Ramire"i Log #. Cit y La Quinta Zip 9225.3 'Study Area Tract #: Lot # Square Foo'tage 121',0 Type of Development Single Farilily, Residence No. of Units Comments At the pres&nt. time, the Desert' Sands Unified School District does- not collect.' fees': on garaiges/carports, covered patios/walkways, residential additions urider'500 squarelfeet') detached accessory structures or replkem6nt mobilehomes. It has been determined the above':`h'amed'oW`ner is ek6ffipffrorn paying school fees, at this time due to the following reason: :EXEMPTION NOT APPLICABLE This certifies that school facility.feAjmpios6d pursuant to, Gbve'rnment Code, W80 in the amount of 7 .1.84 X 1,210 -oV$,`2,226.40 fhe pr 1bbv qpqrty liste�d, ean&that,,building P and/or Certificates of Odbilpancy for this s ware footage in this., t manow be issued proposedprojqc -Y Fees Paid By Cashier's Check/Bank of America Telephone NanWon the check' By Dr. Doris Wilson Superintendent Fee collected /exenpted by Ellen Paltino PaymentReceived2. 44 Check No:,: 2006714095 Signature NOTICE: Pursuant of Assembly Bill M61 (CHAP 59l'9 STATS; 1996) this will serve to notify,jou that iheik �y appi6val period in'Wh 6 you Y, me protest the fees or other payment identified above will begin to run from the dateon which the building or installation permit for this' project is sissiul-66'or on which they are paid to the.(),istricl(s) or to,another public entity authorized to collect them on the District('s)(�) behalf,, Whichever is i;alrliair. Attach a copy of county or city plan. check,applichtion, ormto,district copy,,,for.all-.-,Waivers. Embossed Original- Building Dept./Applic'int Copy - Applicant/Receipt Coipy'-AAccounting RECORDING REQUESTED BY .CHICAGO TITLE COMPANY ,,-—AND WHEN RECORDED MAIL TO (--FRANCISCO LEMUS HORTA.& MARTHA? HORTA GUARDADO P.O. BOX 1529 COACHELLA, CALIFORNIA 92236 QOp� L Escrow No. 7741224 - F32 Order No. 7741224 - SPACE ABOVE THIS UNE FOR RECORDER'S USE CTC #7204057-K10 Assessor's Parcel No: 773-082-015-7 THE UNDERSIGNED GRANTOR(S),DECIARE(S) DOCUMENTARY TRANSFER TAXIS $24.20 ED unincorporated area Q City of LA QUINTA X❑ computed on the full value of the interest or property conveyed, or is ❑ computed on the full value less the value of liens -or encumbrances remaining at'time of said, and FOR A VALUABLE CONSIDERATION, receipt of which is herebacknowled ed, THE COACHELLA VALLEY HOUSING'COALI-TION.,• A CALIFORNIA NON=PROF T PUBLIC BENEFIT CORPORATION hereby GRANT(S) to FRANCISCO LEMUS HORTA and MARTHA HORTA GUARDADOj HUSBAND AND WIFE, AS JOINT TENANTS the following described real property in the City of LA ,QUINTA County of RIVERSIDE ,'State of California: LOT 3 BLOCK 67 OF,UNIT 6 OF SANTA CARMELI,TA AT VALE LA QUINTA AS SHOWN BY MAP RECORDED IN BOOK 18, PAGE 67 OF MAPS, RIVERSIDE COUNTY RECORDS. Dated December 11, 1997 A STATEOF CALIFORNIA CORE COUNTYOF RIVERSIDE ) On DECEMBER )-a, 1997 before.m'e, BY: PHYLLIS M. MUNSEY. a Notary Public in and for said County and State, personally appeared JOHN F. MEALEY personally known to me (or proved to "me on the basis of satisfactory evidence) to be the person(s) whose names) is/are subscribed'to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), -and, that by' ,his/her/th'eir signature(s) on the instrument the peeson(s), or the entity upon behalfi.of which the person(s) acted, executed the instrument. VALLEY HOUSING COALITION •ON-?RQFIT.PUBLIC BENEFIT ON �iiu���nu�utn111unn111n18nnnff 1: PHYWS M. MUNSEY Comm.#1067900 Z R+ 'Notary Public-Caldomia 9 Riverside County z My Commission Expires, August 6, 19 WITNES hand andowfficialseal. ����ir����rr�itsuun� Iloilo III 9 r )77- §bnature of Notary l VDate My Commission Expires FOR NOTARY SEAL OR STAMP MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING UNE: 'IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE SAME AS ABOVE Name Street Address City, State & Zip GDt-05/30/87bk R1 e Al it flow — 111C X u ,'! IN C.10 t 1) , f "•. i t 4.� �1 ,tl ,j. • e Al it flow — 111C X u ,'! IN t 1) , f "•. i t 4.� �1 ,tl ,j. • f 1 , i + I' � i t J •T 7 . S .;6._•,,. ^.:'2._. Lin _..L.: vl � .l. aw t$ R,GREENSTONEN , and is for �+� eyj� .'Oitv�.•.'k.p-vided by inmalling [lie it i1w, .,I bag, IT �Sx r t.tV� t A Qh- "Y,t+}�ivjt �i. mid applicmi."t w.1 1000."1. It. and ;n least thc 'ninininni thickness ay 44. 9� C. i• upE ��a Vs ire+ �djf iE °Y Cocoon i mar EirtienStorie tin at dP .#is vK Pyr re an tie Indu�frias, Inc.* Ail rights reserved. Prin!ed ir�ILJSA. RV 30M 8/97. �rt •�t�-k ���j���'4 �r",T,y�...a ��,, a �. �R '�^t� e ani k�� ! �;,��! Cocoon Stilbflf%Cd 111SLILt 011 30 lb. bag ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART n Vahm, al 19.4 Net Coverage No Adjuslmenl I.,fi,,ws 56.7 75'F Mean Minimum 5.5. Cross Coverage Based on Maximum Net .917 Minimum Wright TemPeratwe I hickness 2' x 6' husses a,, 16' Centel:: coverage. Per Square Feel -Installed -. The Weight Per To Obtain an hrsulation Minimum Gags Square fool of Bails But, ed Insualmn ShmdA Not Oc $quare Feel net, !it Per Installed Snume FOCI Prr I,ggO IlrsisLulre (n) nl; Lens s lhzn: 1'er Batt 1.0011 Aqumn I rrl In::nl q'nn Prr ll.ig Srin.m:lrrl (nchr.::) _ ;tlouddaNnI l bn: Ilhs l R-50 13.5 20.5 48.8 1.464 21.3 _ 46.9 R-42 11.4 24.4 41.0 1.230 25.6 39.1 R-40 10.8 25.6 .39.0 1.171 26.9 .37.2 R-38 10.3 27.0 37.1 1.113 28.4 35.2. R-32 8.6 32.0 31.2 .937 34.0 29.4 R-30 8.1 34.2 29.3 .878 36.5 27.4 `13-24 6.5 42.7 23.4 .703 46.4 21.6 R-22 5.9 46,6'F 21.:5 .644 .51.6 19.6 R-19; 5.1, 53.9 18:5 .556 59.5. 16.8 R-13• 3.5 78.8. '- 12.7 -.381 87.0 11.5 R-11° 3:0 931 10.7, 322 102.8 9.7' Sidewalls lo'ressure lilleciglensity 2.0'PPCF1 R-13 (2 x 4) 3.551.4 19.4 .583 56.7 17.6 R-20 (2 x 6) 5.5. 32.7. 30.6 .917 36.1 I,X.r. Tit if•�iLSlr s:Yi rT,'�T''�!, 4 fC M1 -r, ri pili 1 1cT�.Fa i,(r�t.F iTvat ttYF,�j!.'