Loading...
0211-055 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm underr,penalty of perjury that I am licensed under provisions of Chapter 9 (com4`encing 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 651498 fl, C, Date a 44Signature of Contractor'' . a , ► V OWNER -BUILDER DECLARATION 9 I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) I,. A 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). ( ) l,fas owner,of the property, amexclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). `' . ( ) I am exempt under Section , B&P.C. for this reason Date.' =` 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 performanceof the work for which this permit is issued. ey I have and will maintain workers' compensation insurance, as required by Se Pion 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 ,ITXfE f.1)N0 Policy No. 1.§42937-01 (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' compe� sation provis{ions of Section 3700 of the Labor Code; I shall forthwith comply wit those provisions.! ,Date: Applicant 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 aclaition 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 resultof 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 inspection purposes Signature (Owner/Agent),1 f Date BUILDING PERMIT PERMIT # .01 � VALUATION R �y�y �` p LOT TRACT p •�+ q' ql' 5 DATE /!,i A • f C © ,G..-- V1+(a J aR. n.L�I . . � ..aC'A $4 U-1 JOB SITE ADDRESS .�#.Zr .�Il� e ��a .Z APN 773,191'•016 OWNER CONTRACTOR/DESIGNER/EN (NEER wulu1111 REN11 c 0N111�. `CVr1eu t���,,°q+/MMA iJLNR;W-* �T ; '7�8m15�)�1t,.�'ry^.�}��;x.E''i',�?0.t, IC`0 QSJYIE-:r�2.30 yy52�i',27 .y m CA 2261 USE OF PERMIT 141 SY ` FI). YtF-RMIT DOES NOT INC:LUD'9 8}d7CK'WA. L, PWL OTr DR1"tIEWAY APPROACH TRACT CONSTRUCTION 11421.00 of P+JII2, KIPATIO 36,00 SIS 14RAIG WCARPORT 510100 GF. ESI `U' 1A.I.r.w c0sr OF CO S. uf:.`i'�Om PYRMX ;>Ir'.1��".i ti S UNWARY €.oNaTIRUCTION. FE IDI.000-416-000 9533,50 PLAN CHECK 1tnt 101-4100-439-316 FEEDEPO&T' !191.000.439.318 ••$v$9,00 f'ASCHAN60•w•°if, 1?LECTR1C°.I~r`L FEF 1011-0fp�0 4110-003 51,0.44 PirUIMBINOFEE STRONG MOTION1' �R - .REOffp 101-000-241-000 $31a1 apmbiwa Vs 141 wUQG 2 s-C.+fit1 $x510~ DEVELOPER IMPACT EPEE $2,400.48 MCIDY, P1:,Ml 101-000-441-345 p�Fy>'��.y���]�•[����:,�. '( A.1.7..K7i7'.f.9F._FAJD Fit " t,s��•��ap.y�y-�i 4�W25Q.LO�) DEC 12 2002 CITY OF LA QUINTA RECEIPT -0113Y'— _FIDATF, FINALED INSP TOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & FootingsDucts Slab Grade Return Air Steel Combustion Air Roof Deck _O3 Exhaust Fans O.K. to Wrap /l. O3 F.A.U. Framing LTA Compressor Insulation O Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath — _ Final Final %O- U _ _ 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 Heater Final Water Piping _ Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection :oZ Encapsulation Gas Piping Gas Test Appliances Final 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 Final Utility Notice (Perm) COMMENTS: N��i� S'rt..( w�t-C ►�iS l-ai.d�� C 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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that 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 Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14 X 1,421 S.F. or $3,040.94 have been paid for 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 CC/ VIB - Ish Coronel Check No. 277969 Name on the check Telephone 760/564-4604 Funding Residential By . Dr. Doris Wilson Superintendent Fee collected /exempted by Monica GUlllen $3,04.0.94 Payment Recd Over/Under Signature / /J//�/� ,. I/�/ Q�1 NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period n which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, wh chever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting CERTIFICATE OF COMPLIANCE Fsc DesertSands Unified School District 47950 Dune Palms Road �4�eso Q BERMUDA DUNES r" Date' 12/12/02 � La Quintaf CA 92253 RANCHO MIRAGE d � INDIAN WELLS �r No. 23953 (760) 771-8515 P d� ALM DESERT y LA TA IN10 DIO �^ J O Owner William Buffin APN # 773-291-016 Address 52275 Avenida Obregon Jurisdiction La Quinta City La Quinta Zip 92253 Permit # Tract # Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 3 52585 Avenida Ramirez. 1421 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that 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 Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14 X 1,421 S.F. or $3,040.94 have been paid for 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 CC/ VIB - Ish Coronel Check No. 277969 Name on the check Telephone 760/564-4604 Funding Residential By . Dr. Doris Wilson Superintendent Fee collected /exempted by Monica GUlllen $3,04.0.94 Payment Recd Over/Under Signature / /J//�/� ,. I/�/ Q�1 NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period n which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, wh chever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting NOV.22'2002 13:06 760 568 5184 ORANGE COAST CO. onkmEeMOI mammY: THE ESCROW SOURCE, INC. AND WHEN RECORDED MAIL TO: AND MAIL TAX STATEMENT TO: P.O. BOX 134 La Quinta, CA 92253 Order No. R-212869-1 Escrow No. 02 -3328 -SA Parcel No. 773-291-016 T�-A" 020 ORANGE COAST TITLEPALM.DESERT #4781 P.002/003 � k - - DOC e1 2002-4S497111 03/16/2002 09.064 Ra0:10.66 Page I of 2 Dee T Tax Paid Recorded In Offloial Rseerds County of RlverOW& Gary L. orso Asassaar, County Clark a Raeerder II I�'�IIII ll�l Ik�l`I III l�l�l Illi �� I ll�lll l�ll� �lll l GRAW DEE® THE UNDERSIGNED GRANTOR(S) DECLARE(S) THAT DOCUMENTARY TRANSFER TAXIS =44.00, : end CITY $ X computed on full value of property conveyed, or computed on full value less liens or encumbrances remaining at the time of sale. uninoorporated area: X La Quinta and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, CAYETANO PINA and MARIA A. PIMA, Husband and Wife as Joint Tenants WILLIAM hereby GRANTS to I S nuFir X, A HARILM MAN AS HIS SOLE An BP.PARATt3 )?ROP$RTY ( the following described real property In the County of RIVERSIDE, State of California: PARCEL NUMBER 773-291-016 .LOT 3 IN BLOCK 154 OF SANTA CARMELITA AT VALE LA QUINTA, UNIT NO. I, AS SHOWN ON FILE IN BOOK PAGE OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA Date July 28 002 AlJ� CA Y MARIA A. KNA STATE OF CALIFORNIA ) S.S. COUNTY OF RIVERSIDE } On t t c .'t oA­ art', , before me, the undersigned, a Notary Public in and for said County and State, personally lippeared CAYETANO PINA and MARIA A. PIMA personalty known to me (or proved to me on the basis of satisfactory evidence) to be the person(sfwhose name( lsg?!D s0scribed to the within Instrument and acknowledged to me that b"Wthey executed the same In hL%awltheir authorized capacity and that by hiel wAheir signaturfo>n the Instrument the person ,nor the entity upon behalf of which the persorV acted, executed the instrument. WITNESS my and and ficial seal. Signature le, Lc . PAMELAJ. NOTTINGER Cwimisftn 01310255 • Notary Publlq • cs! fomla R)� W21de County ' tNCarrfn BtOMesJYn277, 2006 Doacx.�ption: Aivars4do,CA Document-Xvar.DocM 2002.454971 Page: 1 of 2 OrCior: NS -11-22-2002 12-23-09 PX Ccmant: MEE lmmmmmmmmmt GRAW DEE® THE UNDERSIGNED GRANTOR(S) DECLARE(S) THAT DOCUMENTARY TRANSFER TAXIS =44.00, : end CITY $ X computed on full value of property conveyed, or computed on full value less liens or encumbrances remaining at the time of sale. uninoorporated area: X La Quinta and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, CAYETANO PINA and MARIA A. PIMA, Husband and Wife as Joint Tenants WILLIAM hereby GRANTS to I S nuFir X, A HARILM MAN AS HIS SOLE An BP.PARATt3 )?ROP$RTY ( the following described real property In the County of RIVERSIDE, State of California: PARCEL NUMBER 773-291-016 .LOT 3 IN BLOCK 154 OF SANTA CARMELITA AT VALE LA QUINTA, UNIT NO. I, AS SHOWN ON FILE IN BOOK PAGE OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA Date July 28 002 AlJ� CA Y MARIA A. KNA STATE OF CALIFORNIA ) S.S. COUNTY OF RIVERSIDE } On t t c .'t oA­ art', , before me, the undersigned, a Notary Public in and for said County and State, personally lippeared CAYETANO PINA and MARIA A. PIMA personalty known to me (or proved to me on the basis of satisfactory evidence) to be the person(sfwhose name( lsg?!D s0scribed to the within Instrument and acknowledged to me that b"Wthey executed the same In hL%awltheir authorized capacity and that by hiel wAheir signaturfo>n the Instrument the person ,nor the entity upon behalf of which the persorV acted, executed the instrument. WITNESS my and and ficial seal. Signature le, Lc . PAMELAJ. NOTTINGER Cwimisftn 01310255 • Notary Publlq • cs! fomla R)� W21de County ' tNCarrfn BtOMesJYn277, 2006 Doacx.�ption: Aivars4do,CA Document-Xvar.DocM 2002.454971 Page: 1 of 2 OrCior: NS -11-22-2002 12-23-09 PX Ccmant: NOV.22'2002 13:07 760 568 5184 ORANGE COAST TITLE PALM DESERT, #4781 P.003/003 .. Exhibit "A" Lot 3 of Block 154 of Unit No. 16 of Santa Carmelita at Vale in La Quinta. as per map recorded in book 18, page 99 of maps, in the office of the County Recorder of Riverside County, State of California. 111111111111111111111111111 H1111111111111 1111 ",M 97 1 " Dascript4on: R4var81d9,CA Doc=eat-Year.DocZD 2002.454972 Page: 2 of 2 Ordar. NS -11-22-2002 22-23-09 PM Cont: Mar 31 03 08:48a David Barber INSTALLATION CERTIFICATE 760 775 4041 p.1 Page 2 of 8) CF -6R Site Address Permit Number FENESTRATION/GLAZING: Total Quantity Product Ptoduct o(Like Exterior Shading: U•Faetor' (5 SI IGC' (5 # of Product Square Dcvicc or. Comments/Loci ion/ Manufacturer/Brand Name v rv l = Panes (017tionah, Feet Oycrliang Special eatur (GROUP LIKE PRODUCTS) , � / 2.5 vrirn/� X D ✓;� v L(� & 4. _ 5. _ 6. 7. 8. 9. 10. — 11. 12. 13. — 14. — 15. ' Manufactured fenestration products use the values from the product label. Field fabricated fenestration products use (he default values from Section 116 of the Energy Efficiency Standards. = Installed U -Factor must be less than or equal to values from CF -1R. Installed SHGC must be less thin or equal to val es from CFAR; or a shading device (exterior or overhang) is installed as specified on the CF -IR. Alte-natively,.insialle weighted average U -Factors for the total fenestration area are less than or equal to values from CF -IR. 1, the. undersigned, verify that the fenestration/glazing listed above my signature: 1) is the acrual fenesrration pro uct installed; 2) is equivalent to.or hasa lower U -Factor and.lower SHGC than that specified in the ceaffiicate of complia ce (Form.CF-IR) submitted for -compliance with the Energy.E)ficiency. Standards for residential buildings; and 3) the pro uct meets or exceeds the appropriate requirements for manufactured devices (from Part 6), where applicable. Item #s /4 Signature, Date Installing Subcontractor (Co. Name) OR (if applicable) General Contractor (Co. Narne) OR Owner OR Window Distributor Item #s Signature, Date Installing Subcontractor (Co. Name)' OR (if applicable) General Contractor (Co. Nance) OR Owner . OR Window Distributor Item #s Signature, Date (if applicable) � Installing Subcontractor (Co. Name) OR General Contractor (Co. Narr•e) OR Owner OR Window Distributor COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy January 4, 2001 Cle-dificate-ofOccupancy--�- - 'City of L Quinta Building and'Safety Department OFti°�' This Certificate issued pursuant- to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating bu#ding construction or use. For the following: BUILDING ADDRESS: 52-585 AVENIDA RAMIREZ Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0211-055 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RC Owner of Building: WILLIAM BUFFIN Address: 52-275 AVENIDA OBREGON City: LA QUINTA, CA 92253 . By: KIRK KIRKLAND Date: APRIL 10, 2003 Building Official POST IN A CONSPICUOUS PLACE I - �