0401-007 (SFD)}` , s -=a,r , , r ,.., .'..�.. •.,ra.
wr. x �. .. a,+,,`t _•� �. • J.� 1•. t Aa :,i;' =`+. . id'k 3! ...'♦ � �•.f �. «. k` -A. w"-� rt '. y,t � i.. , _ i; � +�� i�.,`. ':� o".! , x"` •ry^ r.+^.. A k' ,i+ i Y^ : F'h ;
# �t °i t ' ?.l t �!,.•; y, d33 >�t� ty<i'au T: .r'c9` [�. �fa6 _h
LICEN$ED ;CONTRACTQR`DECLARATION=
I,I-,ereby,affirm- under penalty of perjury.that I am licensed under, provisions of
F_ Chapter 9 (co mmencing_'with "Section 7000) of'DiVision'3 of the,Busine.ss°and
attiN,w'' Professionals Code, and my License is in f force -and effect
O>� ch License # Lic. Class Exp. Date
LO
6132901 'El 12/3 1 7
W.
`o Zr_ / /Date �.,� ' Signature of Contractor, y �l " `L Y�`' r
J O—
r"r- V C) 'OWNER -BUILDER DECLARATION
FW ; 6-1
WI hereby affirm under penalty of perjury that I am exempt from the Contractor's
OIL U)License Law for the following reason:
,4 Z ( ) 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).
1, as' owner of the property, am exclusively contracting with licensed
<-
contractors .to construct the project (Sec. 7044, Business &Professionals
..Code): ..
C') O I am exempt under Section B&P.C. for this reason
w Date Signature of Owner
U.:Q. WORKER'S COMPENSATION DECLARATION
" (L
of W I hereby affirm under penalty of perjury one of the following declarations:
.`Lo llImmm; 0 O 1 have and will maintain a certificate of consent to self -insure for workers'
X W LL, compensation, as provided for by Section 3700 of the Labor Code, for the
0 J Q performance of the work for.which this permit is issued.
�m Q O ( ) I have and will maintain workers' compensation insurance, as required by
i 0, U Q Section 37001 of the Labor Code, for the performance of the work for which this
`d I permit is issued. My workers' compensation insurance carrier & policy no. are:
J Z
ma, Carver ITA T E F''1 ND Policy No. 22!x- DIMM-200
k -co /ya -
Q - (This. section need not be completed if the permit valuation is for $100.00 or less).
J () 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'shalltforthwith cornply with those provisions.
Date ... Zi,: Applicant :' A --L .. 'L__..
,) Ll, t
0= 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
'787.& 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 inspection purposes;
! r
t • Signature (Owner/Agent() / (, Date `' • i. `i
U D NG.,.,:PERMIT-#'
B iL I MIT:.
PER
DATE VALUATION- - LOT TRACT "'"•% °
`
s
V
JOB SITE _
APN y "
�,.)+1°' � ►4:
ADDRESS ;:744..40 i3 «,. 1".�..ri , �i
. 474 t? 1i+) l•
OWNER
CONTRACTOR / DESIGNER'/ENGINEER -' . '� X?" '�•`ia
1101M.i 3+RIANC:'1?,
DAV11*) L. AUa,U'�^T{h,'A'CyiT�:J7 , a
Y?0.•i�l.X 134
'4! 780 tWJ`�I.l+1J.i 'AGE71
I_& QUWA CA 92253
.;1'
i1-ERNIl_113f317'C.rE+f16Z CIA It , p; .f.Oli
(760 -1-08-72R i lyyr.
USE OF PERMIT
IR231 S.F. SyYD F+ /.Rbf,3T I)OFIZ 140T JNC1XDZ BLAOCKW Ai,.i,,.k'!C OUSPA.
c.7R.DRIVF,ld.A, AI'I'3€t)ACK
{ ,
��1✓��f��t
d. r.t ,
TRACT COW33TRUCITY14 1192. 9F
C�t�i�tlf3L1{�4fbPORT 491.00; air
rya v
•
ID C09.7.1 mr C:
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
Qc
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
(f w jZ
Compressor
Insulation
—
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 `'
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
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
Q
Appliances
Final
Final
Utility Notice (Gas) G
ELECTRICAL APPROVALS
Temp. Power Pole37-27
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power Q y
Final
Utility Notice (Perm)
COMMENTS:
CERT,IFICATE.OF COMPLIANCE �,
Desert Sands�Unified School District 4�' �o
:479li0Dune Palms :Road z
..„ . Q BERMUDA DUNES r
Date 2/4'/04 La Quanta;"CA 92253.'
RANCHO MIRAGE (7
INDIAN WELLS
No. 25472 (760)77.1 85.16 ; �% PLAQUINT� y
QINDIO
Owner Power Finance APN`# 774-212-007
Address P O Box 134 Jurisdiction La Quinta
City La Quinta Zip .92253 Permit#: ;. 0401-007
Tract # Stud' 'A'a.
Type Single Family Residence. No. of Units 1
x,
Lot # -;No. Street _ -,S.F. Lot # No: Street S.F.
Unit 1 541407AvemdaYRamice 1823 :Un f'6 ;
Unit 2 Unlit 7
Unit 3 Unit 8•
Unit 4 Unit9
Unit 5 Unit 10
Comments
At the. present time, the Desert Sands Unified:School-District does not collect•fees on_°garages/carports; covered.patiostwalkways, residential additions under
1. 500 square feet, detached accessory structures .(spaces,.that do not contain fa6iIities':for Irving; sleeping,. cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fe`e's 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`CodpA5995,ft Seq.
in the amount of $2.14X.1,823 S.F. ,or .$3,901.22 have been paid for'the property listed above and that
building permits and/or, Certificates of. Occupancy for tliis�square footage in. this. proposed project may now be issued.
Fees Paid By CCNalley Independent:;Bank:.n Alissa Aiton Check No. 305307
Name'on the check Telephone ,760/485-3039
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sharon MCGilvre' 0700.
Payment Recd $
$3;901.22 over/Under
Signature C
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90-day.approval period in which you may protest the fees or
other payment identified above will begin to:run from the date,.on which the, building of installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or id another public entity.authoriied to collect them on the District('s)behalf, whichever is earlier.
NOTICE" -this Document NOT VALID if Duplicated
Embossed Original- Building Departme'nVApplicant Copy= Applicant/ Receipt Copy - Accounting
7603400394 STEWART TITLE PD
RECORDING REQUESTED BY:
STEWART TITLE OF CALIFORNIA, INC.
WHEN RECORDED MAIL TO.
POWER FINANCE
wll3 D /��
w1
v 4ave4 7
ORDER NO. 501226051
ESCROW NO. 530069251
r
160 P01/05 NOV 26 '03 09:00
DOC M 2003-4139648
'JC
08.417/sea ea:eBA Foe:30.89
Poos f or Z Doo T Tom Pold
V r Rsoorded In ofr,eJ.l k words
Cwmty of RJv*r*Id1
Gory L. ors*
Mssusor, Cirtonly CJork ti R***rder r71
I IN I If
M B 1 U PAG! "M IDA PGOR me FOR
A A L COW LONG REI d1A Rchs EXAM
GRANT DEED5
The undersigned grantor(s) daelare(s): A.P.N.: 774-212-o017-8
Documentary transfer tax is $ 58.85 City tax S TRH 020 -0/19 1
( 1/j computed on full value of property conveyed, or VC
( ) computed an full value less value of liens or encumbrances remaining at time of sale.
( ) Unincorporated area: ( x ) City of , and
FOR VALUABLE CONSIDERATION, receiprof w ich ishereby acknowledged,
PETER RAWLHY , TRUSTEE OF THE RAWLEY FAMILY TRUST DATED
7th DAY OCTOBER, -9993
hereby GRANTS to POWER FINANCE & ASSOCIATES, INC A CALIFORNIA
CORPORATION
the following described real property in the
County 0 Riveraide State of California
(&�T 1�8 BZ♦ CR tQ 8�6 OF SANTA CAM. LITA AT VALE LA QUINTA, UNIT
Na. 26, AS PER MAP RECORDED .IN'BOOK 20, PAGE 50 OF mAp3, IN TVZ
OFFICE OF THE COUNTY RECORDER OF SAID COUNTY.
SEB; ATTACHED EXHIBIT .crAn
DATE: April $,aoo3
STATE OF CALIFORNIA
COUNTY OF LD��JeS } �
V
On, -T, bcl'ore me u�j['n�
personally appeared
personally known to me (or proved to me on the basis f satistac-
tury evidence) to be the person(s), whose oame(si /fub-
scri to the witbin instrument and acknowledged t that
�Cjlloes),
executed the sante in i r authorized
caand that by his/her/their si tg att�s on the instru-
meat the person(s) or the entity upon behalf of which the per-
sons) acted, executed the instrument.
WITNESS my hand and official seal.
SignatureA)f1A 141 A
TSR RAWLIIY
Trustee
4 EN_ M
10C 210 .
Llotsrtti wn 11* 4w
"My FWft - Cat bmia
� Ivtptibe Cas try
► Oec ti m
(This area for official notarial seri)
ABOVE
)escripdon: Riverside, CA Document -Year. DOWD 2003.439648 Page: 1 of 2
Wer- espy Comment:
AUG -11-2004 07:24 AM
Plan Number
Sampla Group Number
P.01
CF -4R
ing Signature D e Sarnpte Mouse Number
HER8 Pr®vider,
Street address: 7 o l City/StatelZip! ZO 1i2 6 Cle V
Copies to: Builder, HERS Provider
HER WEg CQjdP6IANC"TA-rFbjKNT
The house was: Tested ❑ Approved at part of trample testing, but was not tested
As the HERS rater providing diagnostic testing and field:veriflcation, I certify that the houses Identified on this form
co ly with the diagnostic tested compliance-requirafhents as checked on this fcrm.
Distribution system is fully'ducted (I.e., does not use building cavities as plenums or platform returns in lieu
r ducts)
where cloth backed, rubber adhesive duct tape Is Installed, mastic and drawbands are used in combination
with cloth backed, rubber adhesive duct tape to seal leaks at duct connections.
2I MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION. COMPLIANCE CREDIT
Duct Diagnostic Leakage Tenting Results (Maximum Ela Duct Leakage)
Me®sured
Duct Pressurization Test Results (CFM ® 25 Pa) values
Test Leakage Flow In CFM
If fan flow is calculated as 400cfmfton x number of tons enter
calculated value here
If fan flow Is measured enter measured value here
Leakage Percentage (10D.x Test Leakage/Fan Flow) r.
Check Box for Pets of Fell (Passe or less)
THERMOSTATIC EXPANSION VALVE (TXV) or Commission
Pass Fail
Eiw�tent
iff Yes ❑ No Thermostatic Expansion Valve (or Commission approved
equivalent) is installed and Access Is provided for Inspection
Yes is a pass
❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT
t . 0 Yes Q No RCCA Manual D Design requirements have been met
(rater has verified that actual Installation matches values in
CF -1 R and design on pip.
2. 0 Yes ❑ No TXV is Installed or Fan flow has been verified. If no TXV,
verified fan flow matches design from CF -1R.
Measured Fan Flow=
Yes for both 1 and 2 Is a Pass
Z Feil
ltll)q
❑ Q
Pass Fail
-� ,-
Cerrificato of Occupancy
G� OF9 Building & Safety Department
This Certificate`is issued pursuant to the requirements of Section, 109. of the, California Building
Code, certifying that, at I the time of - issuance, this structure was ; in compliance, with the. -
provisions of the Building Code and the various ordinances ,of the City regulating building; .
construction and/or use.
BUILDING ADDRESS: 54-140 "ENIDA RAMIREZ
Use classification: SFD Building, Permit No.: 0401-007,,
Occupancy Group: R3 Type of Construction:'VN Land Use Zone: RC
Owner of Building: POWER FINANCE Address: P.O. BOX 134
City, ST,21P: LA QUINTA CA 92253
By: KIRK KIRKLAND
'
Date: 8-13-04
Building Official
POST IN A CONSPICUOUS.PLACE