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9801-075 (SFD)t ' I 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 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: (�) 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 his reason Date 474 Signature of Owner"J�'...-�""" -' . 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. i'itllCR, I +I;1URAINCG I W, 43".) 00 96 (This section need not be completed if the permit valuation is for $100.00 or less) ( ) ` 1 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 thoseproyylsions. Date: Applicant /.44! ,__ _..._.-...--•---- Warni g: Fat ure 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 forlp pection purposes. 2 ,,Signature (Owner/Agent) Date 2 BUILDING PERMIT PERMIT#�aP�Vi1I '.CONTRO` # DATE VALUATION ,S77a'l O.20 LOT .7 . TRACT''.-* .16! ,1t ADDRESS .;I ­.k6 y L°0.4` I✓N0A X4tW.IRE7 APN 77J -W-019 OWNER CONTRACTOR / DESIGNER / ENGINEER OSCAR ':1i1tAd:,;'SCIO M,1.1;.'!�11`l;sL '`10�'`11.I? ,' 131,I1LDET t. \N.T111. V1,!'f;; 36950 .it Nig i't�.i %4S R a ;iei iv.iC:aiv t36a; .t.':�a'i'c y"; BiiRIVIU A DUNES C, ik 92201 I.NDW) CA. 92"201. USE OF PERMIT `i' i'i R 3F;0- i'F3, b 9.1T IDt IFN NO) 1'N0..lrT*:.iii.t_X.K -WPP LLS 0K f'C KA'J, Pi. N CHECK POR`1'1C?N OF H_D:S tt133i1CFD :►.5`i:, Fc"s1e OF' , SIAA4E P1, AN TY''PE. � N 2 3 19�� TRACT irONS RIA F ►GN 1,2i0.'k) 3 -FJ PORCWPAIV.) W-12.0 SF GARAGE/CARIPO Y S::ti.0i) 1,f"� �:;� I -NI TA at ,o�} . 7 T�f R moi, �y t7- pp P./���! e^g ? ay��� oOSy�dN.�ft8fi.'�i tl {. D ��OST ( CONI.3.q RVC7 ''910 / -! a�! ( ?7,3 9.20 a g, yy gnty p yng c;'tiNt'."I1 U(71'10N R1_ 101-000-418-000 $�•3c). i F'I,A,-N0-tl"`'K.. FF.F 1014'410-439-119 $1I4 tie iblfst 1-1ANIC'AI;,f :F 1014.0-4221-000 EUEC. Mi AjL, V i:r_' I U 1-0001-420-000 P11 UIN4Bf W.11 F aF 101-0KI-4 f 9-00 ► S.121 1. 50 . �;•rl�c')niC3 Ai(1`.1'Tt�i^d I�1�#�. - R.OST}l 101-(1fi{)-'M'� 1-�1(3(1Q?.^4. C)IZADINC:.F'r 1$111-0(10--.423-0(.X1 $dtl.tdif ' INP 'f,'A.8'11i . 1'ORL FEE' faRf- 188. PLAN t0.1-0(10 d�3t�i d5 `8:iy.0+:t NNDVI..A,N C1.1 EC's` LESS 01.E-1A.1D :FEES $0,011, TOTAL I''EtdIM1 T VVEN DUE NOW RECEIPT DATE BY ( DATE FINALED INSPECTOR 1 .1 INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPRQVALS MECHANICAL APPROVALS Set Backs �` Underground Ducts Forms & Footings Ducts Slab Grade. Return Air Steel Combustion Air Roof Deck if Exhaust Fans O.K. to Wrap 0H F.A.U. Framing Compressor Insulation // Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath /Q DryWall - Int. Lath �3 Final Final C6 BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines F Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral 0 Pool Cover Sewer Connection 7V Encapsulation Gas Piping Gas Test — 1 Appliances Final Final Utility Notice (Gas) i 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) COMMENTS: d P.O. BOX 1504 APPLICATION ONLY Building/ r 78-495 CALLE TAMPICO Address.�74',s'ly: ,-l9.'I/ �di�.a i`%E';Z_1.&A0UINTA, CALIFORNIA 92253 vi" AICIO Ax'hf/ /ezo, Mailing / Address 3(o :Igo .1/CI Yf'�yx' .�•! JGI, City Zip Tel Contractor Address State Lic.I City & Classif. Lic. q Arch., Engr., Designer Address Tel. City I ZipI State I Lic. ff 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 Contractors License Law for the following 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 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. 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). 1J 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 I 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 wilh a contractor(s) licensed pursuant to the Contractor's License Law.) 1-1 I am exempt under Sec. B. & P.C. for this reason _ jet �;� �':}•'•:�. Date Owner' -VS ,,f•�'- i WORKERS' COMPENSATION DECLARATION Ihereby 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 r] 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 (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 should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith complywith 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 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 to but [ding 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 BUILDING: TYPE"CONST. OCC. GRP. A.P. Number -7-73- 09,2-019 Legal Description '&" I f):r 7 r31-9 �o% Ila IT G.o' Project Description Sq. Ft. Size New ❑ No. Storii No. Dw. 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 Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK =,BUILDING DIVISION vf_'q. Desert Sands -Unified School District a 82 879 Highway 1'11 Notice: , -. . Document Cannot Be -Duplicated Indio,CA 92201. ,619-775=3500 CERTIFICATE OF"CO'MP. IANCE Date 1/22/98 APIC# 773-082-019 No. 16533'' Jurisdiction La Quinta Owner NameCoachella Valley 'Housing Coalition Permit # No. 51-365Street Ave Ramirez :. Log # City La Quinta "Zip 92253 ., Study Area Tract # Lot # Square -Footage 1210 ' Type of Development Single Fairiiily Residence No. of Units 1 Comments At the ,present time, the Desert. Sands Unified School District does not -collect fees ,oh':,garages/carports, covered patios/walkways, residenrial''ad'ditionsunder 500 square feet;; detached accessory structures orreplacement mobilehomes. It has, been determined the above-named owner is 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 53.080 in the amount of 1.84 X 1,21011-_ or. $ 2,226 40 the property listed above and that building permits and/or Certificates of Occupancy. for, this square. 'footage:in- this proposed -project may, now be issued' Fees Paid By Cashier's Chedk/Bank of America Telephone, Name'on the"check By Dr. Doris Wilson.,.* - ,5 �l Superintendent - Fee collected /exempted by Ellen Fatino Payment Received. $x;226 40 Check No. 2006714095 Signature 2� . JOTICE: Pursuant of Assembly Bill 3081 (CHAP, 549,_STATS. 1996) this will 'serve to notify you that the 90 -day approval period in wliichyou may protest the fees or other payment identified ibove will begin to run from the date on which the, budding or installation permit for this project is sssued or on which'.theyare paid to the Dislrict(s)'or to another public entity authorized to xiIlect them on the Dislricl('s)(s') behalf, whichwAir is earlier: Collector: Attach a copy of county'.or city.: plan check application -form to district copy.for allwaivers. Embossed Original -Building Dept./Applicant Copy = Applicahi t/Receipt . 'Copy - Accounting 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 diens. , 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 7 BLOCK 67 OF UNIT 6 OF SANTA CARIVIELITA AT VALLE LA QUINTA, AS SHOWN BY MAP RECORDED IN BOOK 18, PAGE 67 OF MAPS, RIVERSIDECOUNTY RECORDS. I - 16 X7 Date Oscar?Feriiando Martinez Date Rosa Hilda Martinez RECORDING REQUESTED BY CHICAGO TITLE COMPANY --_7 n' ND WHEN RECORDED MAIL TO IOSCAR FERNANDO MARTINEZ & ROSA7 HILDA MARTINEZ 36-950 DUNE PALMS ROAD BERMUDA DUNES, CALIFORNIA 92201 L COpY I__. J Escrow No. 7741226 - F32 Order No 7741226 SPACE ABOVE THIS. UNE FOR RECORDER'S USE — CTC #7204055-K10 GRANT DEED Assessor's -82Parcel No: 773 P rcel THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAXIS $24-2.01 unincorporated area 0 City of LA QUINTA XQ 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 sale, and FOR A VALUABLE CONSIDERATION:; receipt of which is hereby acknowledged, THE COACHELLA-VALLEY HOUSING COALITION, A CALIFORNIA NON-PROFIT•PUBLIC BENEFIT CORPORATION hereby GRANT(S) to OSCAR FERNANDO MARTINEZ and ROSA HILDA MARTINEZ, HUSBAND AND WIFE, AS JOINT TENANTS the following described real property in the City. of LA QUINTA Countyof RIVERSIDE ;,State of California: LOT 7 BLOCK 67 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 10, 1997 THE COACHELLA VALLEY HOUSING COALITION ACAL ORN ANON -PROFIT PUBLIC BENEFIT STATE OF CALIFORNIA CORP TI COUNTYOF RIVERSIDE } SS. On - DECEMBER /. , 1997 before me,, BY: PHYLLIS M. MUNSEY JO MEALEY, 'EXECUTIVE DIRECTOR 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 •, 11611116111 Mass I'l l lilies nnu 1 x1111111 evidence) to be the person(s) whose name(s) is/aresubscribed. to the ;� PHYtLISM. MUNSEY f�' • within instrument and acknowledged to methat he/she/they executed the a Comm..#1067900 Notary PtabliC-C8lrfomla',� same in his/her/their authorized capacity(ie§), and that by his/her/their ,d Riverside County} signature(s) on the instrument the person(s);.or the entity upon behalf of which M Commission ares y`rAuRust N the persons) acted, executed the instrument. LT' 6, 1999 .1u/eluuruuouulu flails 1111,n1u: WIT S my hand and official seal. )27- ff/,A Signatureof Notary Date My Commiwiofl.Expires FOR NOTARY SEAL. OR STAMP MAIL AX 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 GD1 -05/30/67bk Xrt�` 'a 20,1 11 has been installed chart 1-ccollilliclida- ard using —Z;0)ags -V:Iltic of o .si 4 I R A U E % "N' F -4% .xN4 ;£'., I; ,�r:'�-•sr" 4 ': w' c p`� %Si` t spa •(.,. ,.� .1;; ':,�:qf i41 ip =4Yd1 A. / 1!rii6 r` 1jii y 7{]av (qa��p. ! ryyy3e ' 1 �` �� ^ Y F 'jy ilk, f IV y ; GHJ a' x Y ice; F 11�.rJ 1 ! .o'gr 8: h ac r� .,'yW,"SH 4 T."•`-- e`t,.. t. r.5•, a J C;c�coon Sl.tbili'recl [ntiul.cci011 4 30 Ib. bag ....;i-. I ml m, ,uruoJ.rcu„rd ?e GREENSTONEW'd ♦ LOUISIANA-PACIFIC COMPANY NO"1-1i: 'Ihis curerage Than unnl.cn>ates fur .settling and is for estimating purpnscs unlc. Stated R-v:duc is provided by installing the requi.cd numhcr Id hag. Ixr I(AxI .sq. If. nt a minimum insIdled thickness. Installminn of the millirtd numtxr of bags nmc \'it'IIl mune lh:m the .gxrcilicd minimum Ihickncss:old wim I. ,vcight per .cq. II. Actual raver:I)9- ,rill III- inTli ...nerd by jut r..... i. nls :uLl applirali,m Ierhniqurs.:unI .' may vary as nmch :Ls IIY:.• mithu I siµnil'iraullr :ditaing the stated R-v:duc. bailorc of the installer Io pruvidc:n Il•:INI the required numhcr .d hags per IOuO sq. If. and :n Iced life minimum lhickncss mar result in a Irnver installed It-r;duc. t:nny.aeliun itIay occur IT ing installations above It ;m', ".q.60n): nu.n• than file staled numhcr .d hags,lu "blain the . .i minimum inswilcd'Ihicknc.s.s. , GreenStone and Cocoon aretrademarks of GreenStone, a Louisiana-Pacific company.'© 1997 ATOMIZED PNEUMATIC APPLICATION COVERAGE CHART Maine at 19.4 Nei Govelape No Adjustment for busses 56.7 75°F Mean Minimum Gross Coverage. Based on Maximum Nei 30.6 Minimum Weight Temperallne Thickness 2'" 6' Trusses on 16' Centers Coverage Per Septan Fool Installed. the Weight Per To Obtain an 1. ruhluin •? Minimum Ban:: So"arn font of hags ne,ini.c.1 Insulalinn ShmAd N61 Br, Smarr. Feel Ilegmin:d Pr hlslalle.A Snu.uc Feet I'm 1.000 1lrsislance (B) ol: Less t Ilan: Pel Bag 1.000 Srinare l eat In::nlation Pm Bay Snnmr. Dent (inch's) ::lim Ill Not Be, 1 rs I hall: (Ill:;) 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 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.. 1 Printed in USA. RV 30M 8/97. Sidewalls (pressure filled -density 2.0 PPCF) . 8-97-TT/G-A R-13 (2 x 4) 3:5 51.4 19.4 .583 56.7 17.6 R-20 (2 x 6) 5.5 702.7 30.6 .917 36.1 27.7 • ;:fir ,;;J(:: y' s V.' c 1:lt�sk i'S x i Yrt+Ftdt�l;a�y�A i ae "ell t .._ &t t' rnti� 19�t�`%iy' @S} .•. :',''�.'.•.::.:�. � � � � a.>