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9801-081 (SFD)c 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 Da4e? 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: (N) 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. 704,4, Business & Professionals Code). ( ) I, as owner;:of'fhe 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 /bate 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. ( ) 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. TRUCK FN.S1JKAf`•R.7.L; I rS�s tT 41711 0) 94 (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:0- Applicant � CP— --- Warnin 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 3,106 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 t/he above-mentioned property for inspection purposes. Signature (Owner/Agent) w- [DateI°j PERM'T;,� «�'CONTROLk BUILDINGPERMIT' DATE VALUATION LOT } TRACT i • zD, k i , 'r, a a ADDRESS.OB §I-fE :��d'��ldtilii.9 A �tr5�i�@-�E APN %%� ��.3.4tlI� 7. OWNER CONTRACTOR / DESIGNER / ENGINEER vAi1' UT:' , R.011,i0.11:10 t.i ALP1Ci.:X t.Jb:r,1`:..E." ! "ILPLA.311: ei. Zir�i. i.i C. Vpf.1.,r.... . -VI-12.0 PALO VE•R.Di> ii.33 =i57ui NIONROE Cr N D10 C::,A W.20 I IND1.0 f;Tc.11'i _r!-31.57 USE OF PERMIT SIM r , 41 /, a IAC l7- pEft4i111IJOEy iVCj'F fW7,tX* LAA 0 '*,. WAiJ,S' Oft CA.:vt 'PL.AN --/ ( H8(.','K I- owrioN of ems 6:woUCEC.) 3% OR ISSUItNCE OF •1�4'Y�E. Sr�lvQ's I�c,.Arr JAN 2 3 1998' ; TRACT � �,N;: F'rf:h'"t'{iiiv 1,^ 10.00 .131 b'r:)B24vf€�f'r�`f1L� iU7l�i► 13X y C -1t q� 7� f �NTIN 0?A11Au.I1(:'ARK) R T 526,00 3 y� ESIUiI.ATED Calf Ort�.N) PERMIT FEE eitMli'AR'S' C'0N,'ri'RUC7"I0N FEE 1014M -41184M $ti4t1.5f) � pt: A N (11,P1K. 1 -TLE 8 1.04.Qi "0.1;/;Flrlte7{::r1{ FEE lei fislf� w?i 000 i!rltl,sdf "` kLEt_`T1�(C'AF. FEE IOi•�1i3ii 32U Ut3Ci $1116. 37 '. R'L&I8%I1; G [ FK $121..50 1n[fiN9)TI()V 17F._R)07311) 101 -000Y.141 -M) -,7�.?s t _IVITNO 03 it�R•'lIV1%"`i+"..-}`�I y1.7 4�'T�iiV -t�.j •11 1"9P fWTF. UC'f (JRW F11- 221 i-000-443-342 it 'V PRE01S..E. PLA.Af 101-f1(i0-mit-315 525ociir S1_1B-'T'0TAI i:`O'Rd P'R.tis:,"i ION AND PLAN i;:i$i?i_N; LESSTRE-RAID FEI.-S $10.00 ' Y RECEIPT I DATE BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR . BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap _ p j F.A.U. Framing Compressor Insulation Vents Fireplace .L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath / 8 Drywall - Int. Lath p Final Final 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 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 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 - L Final I? Utility Notice (Perm) _ w-wv�-•�*i. �. ., V.vZ.. ::. ^yP�•t�w y; ,.. ,. cY hC' ..� �,,f�'•,i►''+f,'+��,-w"�'!5�'",,r:d�►�'t�+r'�';�Yr'��2'I'C�'�xweh'sv-"r i +c`> ,+ Building. V X, a 3: 0 1.���V, Address / l"'i , Owner7 c�'U fI(��o Mailing - % 0 j1 D iJPI� Address t� ` city— Zip 0 yid 0 Contractor ,,: Z'13 Address 0 P.O. BOX 1504 APPLICATION ONLY 78-495 CALLE TAMPICO P(°2_LA QUINTA, CALIFORNIA 92253 ?—A A BUILDING: TYPE'CONST. / OCC. GRP. ! ' 5 A.P. Number —715 - 083-6o4 TeI. ' Legal Description A--_ L,2721 SLV— W. r, IZip ITel.. State Lic: I City • & Classif. Lic. ff Arch., Engr., Designer Address Tel. City Zip State Lic. N 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. SIGNATURE - DATE • OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5.8usiness 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 thealleged 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). I.: 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 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 .Of 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 l 1, 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 contractors) licensed pursuant to the Contractor's License Law.) _ . i 7 I am exempt under Sec. B. & P.C. for this reason a Date Owner •tMtJrr. a V. 4 lG r 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. 9800, Labor Code.) Policy No. Company Fl 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 U the permit is for one hundred dollars (E100) 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 shouldbecome 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 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 a0plicant Date Mailing Address City, State, Zip Project Description Sq. Ft. No. No. Dw. Size Stories % Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 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: Date—Perm it Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT • PINK= BUILDING DIVISION n ATTORNEY - IN -FACT AGREEMENT. I/We hereby appoint:,COACHELLA 'VALLEY HOUSING COALITION, and/or any.of.its authorized agents as my/our attorney -iii -fact for the purpose of executing any notices. of completion, waiver; _ of liens an executing contracts with- subcontractors, and/or. release of liens and/or handling building permits relating -to that certaiin'real property described below. All that certain land located and being in the County of Riverside, State of California, described as follows: LOT 21 BLOCK 67 OF UNIT 60F.SANTA CARMELITA AT VALLE LA QUINTA, AS SHOWN ,BY MAP RECORDED IN BOOK 18; PAGE 67 OF MAPS, RIVERSIDE COUNTY RECORDS. - /2— ` / �_- F% Date Samuel Rodolfo. Garcia )?-- Date Date Victoria Garcia Desert Sands Unified School District Notice: ,827 79,Highway,-,111 Document Cannot Be: Duplicated Indio, CA 92201 " 619-775=3500 CERTIFICATE OF COMPLIANCE Date 1/22/98 APN # 773-083-004 No. 16539 Jurisdiction' La, .Quinta Owner NameCoacliella Valley Housing Coalition Permit # q. No. 51-31,0 .§t reet ``' Ave. Ramirez.. Log # City :La Quinta` ' Zip '92253• Study Area • Tract'#.Lot# Square Footage ' 1210 .Type ofDevelopment Single.Family Residence' No. of Units 1 Comments At the present time, the Desert Sands Unified School District does'not. collect fees on-,garages/carports, covered patios/wa"ays, residential additions under 500 square feet; detached accessory structures or replacement mobilehomes. It has been determined the above=named ownor';s exempt"from paying" school fees at ,this. time due to the following reason: . EXEMPTION NOT'APPLICABLE This certifies that school facility fees imposed pursuant,to. Government Code 53080 in the amount of 1.84 X 1,210 or.$ 2,226.40 y:= the -property listed above and.that building permits and/or Certificates of Occupancy for thi's square: footage in this proposed project may now be issued Fees Paid By Cashier's Check/Bank of America Telephone t Name -on the check By Dr. Doris Wilson ` Superintendent Fee collected /exempted by Ellen''Patino Payment.;Received r$-2,226.40:' Check No: 200671,4095 Signature IOTICE: Pursuant of Assembly Bill 3681 (CHAP '549, STATS. 1996) this will serve fo notify you; that the 90-day-approvel period in which you may;protesl the fees or other payment identified bole will begin to Fun from the'dale ori which the building or installation, permit for this projectis'sssueddr onlwhich they are paid'to the Distrjct(s)`or to another public entity authorized to ollect them on the District('s)(s') behalf. -"ichever is earlier. ' Collector: Attach a copy 6f county or city plan check application form to districtcopy for all'waivers. Embossed Original- Building'Depi./Applicant Copy- Applicant/ i ceipt Copy - Accounting a. RECORDING REQUESTED BY C�H?CAGO TITLE, COMPANY ---AND WHEAT ERCCORDED MAIL TO (SAMUEL RODOLFO GARCIA & VICTORIA- GARCIA 44-720 PALO VERDE #33 INDIO, CALIFORNIA 92201 'COP� L Escrow No. 7741222 - F32 Order No. 7741222_- CTC 741222-CTC #7204227-K1O SPACE ABOVE THIS UNE FOR RECORDERS USE -.DEED Assessor's Parcel No: 773 -171 - THE UNDERSIGNED GRANTOR(S) DECLARES) DOCUMENTARY TRANSFER TAXIS.$24-..20 17 unincorporated area •City of LA QUINTA Q computed on the:full value of the interest or property conveyed, or is Q . computed on'the full value less'the value of lieiis'or encumbrances remaining at time of sale, and FOR A VALUABLE- CONSIDERATION, receipt _of which:is hereby acknowledged, THE COACHELLA VALLEY'HOUSING COALITION ,- -'A CALIFORNTA'NON=-PROFIT PUBLIC BENEFIT CORPORATION hereby GRANTS) to SAMUEL RODOLFO GARCIA and VICTORIA GARCIA, HUSBAND AND WIFE; AS -JOINT TENANTS the followmg.described real property in the City of 'LA QUINTA ; Countyof RIVERSIDE ;;State:; of, California: LOT 21 BLOCK 66 OF UNIT 6 OF SANTA CARMELITA AT VALE LA QUINTA AS SHOWN BY MAP RECORDED IN BOOK 18, PAGE 67 .OF MAPS, -RIVERSIDE COUNTY RECORDS. Dated December 11, 1997THE CO}1CHE�LA VALLEY HOUSING COALITION A O I NON-PROFIT PUBLIC BENEFIT STATE OF CALIFORNIA CORE COUNTYOF RIVERSIDE } SS... On _ DECEMBER /a , 1997 before me,,"' 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 persons) whose-name(s) 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/h"ir signature(s) on the instrument the person (s),or-the entity upon behalf of which the persons) acted, executed the instrument. IVE ,:,"i#��ui�u�tu�u�nn��n�rr�rn�nuv- PHYLLIS M. MUNSEY a Coriim #106791?p Z 'Notary Public -California > WeisiCounty Vmmiselon lf'-111811111111. Auaust6 IGO WITNESS my hand and doofjficialseal. rur�uur rrur16rrn4rirn: Signature Of NO Date MyCommission Expires FOR NOTARY SEAL OR STAMP MAIL T STATEMENTS TO PARTY SHOWN ON FOLLOWING UNE IF NO ; PARTY. SO. SHOWN, MAIL AS DIRECTED ABOVE SAME AS ABOVE Name Street Address City, State & Zp r=k 61iflAni 44� I yi.?,+.., � :.y1.. x�F COc0x011 Stabilir_ccl 111tiul<<liOn 41 30 Ib. bag dlruurfrrclrn'cd til` GREENSTONE V. " A LOUISIANA-PACIFIC COMPANY NVTF.: 'This coven,µ• ehmt rinnpcn.:ocs Gn scnlini: :uxI is for ealimating purposes only. Sl: led It -value is proride[I by insudling the inquired in ober Id hags per 10(x) sq. fi. al a mininnml inslallcd dlicknc.., Insl:dlaliun of the required moiler rd bales nl:qvicld mom Ihan IIIc .alx a'il'Iad mininnnn Ihi, We. arra) nnnununl wcil;hl per sq. II. Aem:d av lra•r:.gv grill br int hlrnrcJ by ioh ronJilinnv :mal appliralirm wclmigol.. and may vary .r. murk .Is In w'ilhrnll siuniliramt, afreclin); the slated It -value. Ilailure rd Iha• in..t.dlcr to pn n'ide aI 1u;I.al the required number rd hal;.. per 1000 sq. fl. and al lead the nininuun Ihick.I mac result in a lower insl:dled R -value. t:. noparlinn uLrr ro'g'ue during; inatalLUinn.. alnn'c R-io, requiring; nn no Ihan the .laled number .II h❑g;.. u. nblain Ihr mini nnn i in.sudled Ihickocss. GreenStone and Cocoon are trademarks of GreenStone, a Louisiana-Pacific company. © 1997 ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART R-Valne at 19.4 Net Coverage NO Adbrslmgnl Ior Tmssrs 56.7 76°F MeanMinimum R-20 (2 x 6) 5.5 Gras Covr.ra(n gaseA on Maximum Net .917 Minimum Wriohl Temperature Thickness 2 x 6• lnlmses on 16' Cenlws Coverage Per Square Foul Installed The wemhl PC -I 10 Ohlam an InsulationMinimum Raps Sgnme Fnnl of limps RCgt ed Insulation ShOnIA Not RC Sm.am Feet Remun�A Pm In,I"11"I ;rlilare Feel Pel 1.0no Ilrs¢Iancr.IR) of. I ess Than: 1,,, Raft 1,000 Squa., fort Insldahnn Ile, Rall Square Ire) (inches) Shunld Nin 11.• 1 C55 Ihall llhs 1 R-50 13.5 20.5 48.8 1.4(14 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 R-24 6.5 42.7 23.4 .703 46.4 21.6 R-22 5.9 46.6 21.5 .644 51.0 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 93.1 10.7 .322 102.8 9.7 GreenStone Industries, Inc. All rights reserved. Printed in USA. FIV 30M 0/97. Sidewalls (pressure filled -density 2.0 PPCF) 0-97-Tr/G-A 1 R-13 (2 x 4) 3.5 51.4 19.4 .583 56.7 17.6 R-20 (2 x 6) 5.5 32.7 30.6 .917 36.1 27.7