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9903-125 (SFD)U) 0_W oZ.r, O W C L EV< F. .j 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 791"TU F1 8131f00 "r Date /� y 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). ( ). 1, as owner'of the. property, am exclusively contracting with licensed contractors to/ construct the project (Sec. 7044, Business & Professionals Code). ( );.l,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 3706 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. `'; Yom. 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 — z-2 - Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation G 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 PPROVALS 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 ZC Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole x— 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: 56-4 , 34PO P.O. BOX 1504 APPLICATIO ONLY Building (� 78-495 CALLE TAMPICO/ Address i'e Ol M `11,C 4 2— LA QUINTA, CALIFORNIA 92253 1`10 � LiC,V Mailing Address ` - � i r Cti V Y (�-yj 2G'i CityZip Tel. � d' 1111it4 %--16'd _,500+7c; Contractor — tl.�lgn� _ 58LL _ Address 03.��AMICwA CityZip Tel.. �cNdJa v� �-� .s scop State Lic. City & Classif.Lic. fl Ti GGA Arch., Engr., 2A j i2a 544q Designer Address I Tel. CityI Zip I State DECLARATION N Chapter 9 (commencing with Section ;ode, and my license is i I �11 f 7pa OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5.Business and Professions Code: Any city or county which requires a permit to construct, after, 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 thathe 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). 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 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 with a contractor(s) licensed pursuant to the Contractor's License Law.) 17 I am exempt under Sec. B. & P.C. for this reason Date Owner 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. ❑ 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 employany 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 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. 1 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 BUILDING: TY�P+IE'CONST. t ��j OCC. GRP. 7 A.P. Number 1-I L,1j.1`t `r " oy � 14 - 244 'oo(0 Legal Description �L iV_ 2,pn �! `Lax /01 B 28C( 1 Project Description "j S UNI 2 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 Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ . Demolition ❑ i Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure tow TOTAL REMARKS q Vol 1 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 i ita Pa r�tners :r1, PO fox 34: ` r: a-IQuinta,'1 7A April 1.5, 1999 La Quinta'Suilding-Department, We wish to.inform you that the application should have indicated that Willivam R. Roge6`will be the gehieral contractor of record for the construction of the property to b:located at 54360 Avenida` Ranireze ` William Thomas ,Buffin/Principal Des'ert Sands Unified"Scifiolb! District 0�d 47, *01PA00. Notice: Lfi.'qvintai C.V92253 Document Cannot Be Duplicated .7.607771-8515 CERTIFICATE OF COMPLIANCE Date 4/16/99 APN # 774-244-006 No. 18583 Jurisdiction La Quinta Owner NameLa Quinta?alrtners Permit # No. 54-360, Street. Avenida Ramirez.' Log# City La Qpintazip '192253*1 Study Area Tract # BLK289 Lot #.' .19 Squ . are Footage -.1,445 Type of Development Single Family Residence;:'' No. of Units Comments At the present, time, the Desert. Sands Unified -School 'District does not collect fees on garages/carports; Covered patios/walkwaysidential additibris, .unddr 500 square f�etdetached etached accissory structures or replacement mobilehomes. It has been determined the 'above-named owner is-ek,&Tiot from paying school -fees at this time due to the following reason: ..EXEMPTION NOT APPLICABLE This ceftifi6s*that school facility fees imposed Pursuant to Government Code 53080 in the amount of 1.93 X 1,445 or $ 2,7881.185 t the* property listed above and that bii1da, g, permit's and/or Certificates of Occupancy -for this squ4re footage -in . this proposed project.'mgp6w ae issued Fees Paid By CCNalley Indpendent Bank/Michelle Eichstedt Tel­ �hone Sb8, 8470 Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Juanita Green Payment'Recdived $2,788.85 Check No. 183314 Signature NOTICE will ol[A's jjmbly Bill 3081 (CHAP 5'49�.STATS. '1996) this will . serve to notify you that the 90 -day approval period in which you may p . rotest the fees or other payment identified above begin to run fra the ate on which,ffie,b6ilding or installation permit for this;;prbj6 iq�,muedoe on which they are paid to the Dikrict(s) or'to'another public entity authorized to them on the Dist . (i behaif, whichEiverj'derlier. Collector: Attach A copy -of county or city plan check application form to district copy for All waivers. Embossed Originai7'.8uilding,'Dept.YApplicant Copy - Applicant/Receipt Copy - Accounting I Dated J"Uary a6, 1999 state of California County, of- ) Y.G. On before thea pe>reotiu•i•ly . epnonr. ea perlrnatally Anown ;to Ma:.(or proved:. to die: oil, . the brei® og' oratin'tactory evf,denc:e) tia hn the parson(e) whoa name (a) "in/erp eu6dribed to the within In' sCio*snt and a6knoalediiiid to me .thigh' h®/she/they ®iieout'ed= this .nnmo,`iit hLs/her/.t:h®>Y;: auCttozzl.ael': popaaityi(! e�)j, and that by hid/hair/Clash' ii.j6n ore (t)` on. th©.. .r l inetWment the p'arpon{a), or,thh.entity upon behale of .Nhioh the pereoir(u)., acted, ' xevut:nd the inletsument, WITS8919 my hand and'. Wibial neal. Ugnaturai " F HAIL ZAX OTATB UMO. T01 wxL1.1AM 'JCUI "O."11 0BiN ;rruat,e rr.r�t9�rl;u'r 0 :(This';Area ifor official noterial areal) i AM 26,1999 1211317M cUf-.V- a'-E,(IA.,1 a 1100.607 P. iii PXUORDTNQ RX.Mi Reww', nxc CHICAGO TITLH Crcc' k,th11Nr 99.8024KCi A:700.9910 ' e�a11...R»oOpDE�u 110'` ;TLi..xB, h�Xu rNfy,, , 41NL>188F `0T181EhyvrN».faltoW(I LIBLOOr; S1AIL: `Y' ',8T4TMidG1 'TO:�K WILLIAM TMOMA9 oupylN ---...— ' SPAAR .Apoy 0 T11_{Ligg ;sun s ArM. 74-244 OOS-S Ot;-li -_ 774-244c, 1ZA,N' ' DEIf, 1) The uneersi vied. grantor (e)- deUltlre (u)`,, DoaumentoX C nnaler,,tax iA 9,uu x XJI]C Compo a .on; full: vnlue-.uf ",j)X0 In ty cnnvev"Ar nr t .. , Comyu eii on- full value:`letio _lvgnq not ee�cutiihrllares >totnnining at, time o! Gale. Vnirla rpolcated °urea, (' ) City+ uC —. -- --_ , aria FOR A VAbVJU LH 'CONBID13111h1(ION, receipt•. of whiuh in 1Lnrnhy,nuknuwledged, MICHOMS 8I, ISTRUT, hN uNMAR1iIBU womnN hereby. (IRAN (8) to 192LLIAM TH 0UP8 N, AN 1114r+htut.ryt) MAN_ the realLTy in tho• Cloy of LA .OI1. NTA, cutnet y, of'. (11ye •nide, Rtnte of California, describe . LOTS 19P :BLOC 209, 11Hrr No'. , RAN'1'h Q1111MIn,ITA Nr VAt'R IA QUINTA, A9 8BR MAG. 11 HOOK' 20, PA(18.. 5U, OV-.:�MAI!S, . IIHCORDq. -OP 1t M41101 11'IMIINTY CAALYIP0181 `1# Dated J"Uary a6, 1999 state of California County, of- ) Y.G. On before thea pe>reotiu•i•ly . epnonr. ea perlrnatally Anown ;to Ma:.(or proved:. to die: oil, . the brei® og' oratin'tactory evf,denc:e) tia hn the parson(e) whoa name (a) "in/erp eu6dribed to the within In' sCio*snt and a6knoalediiiid to me .thigh' h®/she/they ®iieout'ed= this .nnmo,`iit hLs/her/.t:h®>Y;: auCttozzl.ael': popaaityi(! e�)j, and that by hid/hair/Clash' ii.j6n ore (t)` on. th©.. .r l inetWment the p'arpon{a), or,thh.entity upon behale of .Nhioh the pereoir(u)., acted, ' xevut:nd the inletsument, WITS8919 my hand and'. Wibial neal. Ugnaturai " F HAIL ZAX OTATB UMO. T01 wxL1.1AM 'JCUI "O."11 0BiN ;rruat,e rr.r�t9�rl;u'r 0 :(This';Area ifor official noterial areal) i Op r Aff 6NG I RC District r/ann-ftw orm Gp ' Y I') This form is'to._"beused by'CDD.staff�:for reyiew of single famllydwellings in the RC (Cove Residential) District, in order. .to determine ,the applicability of ;compatibility issues or need to eequire .the filing -•of Master Ddsign,.G ide"Lines: by the applicant.. It shall be'transmitted to Building &`Safety as your correction:.list. Please:attach additional explanations as necessary. APPLICANT: CA= CONSTRUCTION F t_ 3 PROJECT -: Avenida .Ramirez ADDRESS: , Ile APW -4-24,4=005 `�'� �� ` 77¢ iq LEGAL: LOT. OM, QCK 289` UNIT ,. S.C. @ V.L.Q. C K' D BY : GRF7G! TROUSDELL BIN NO:. See:_Bldg -st affCASE NO. 99-48 CHECK -DATE- inform-the DATE:Inform the assigned Building ,:plan checker, upon your assignment: to this case. The CDD Executive Secretary-maintains..a logbookto track applications ,and assign case numbers. REQUIRED ITEMh `. .: ;Y ..N COM MENTMOR,RECTION Case 'logged and number ,assigned Verify legal and APN information', Consistent with MDG on file(as applicable) , MDG filing required`.(:5+'"filings since 9/3/98) Consistency -with street/surrounding-area \OQ Colors a\.`y Materials. 0 Architecture OTHER REQUIREMENTS14 `GQs ' The zoning; code, architectur,a'lsand landscaping .manuals,`and)/d assigned inspector should ju r be -consulted where uncertainties arise The compileted `ch"ec.kiist, shall, be maintained in the Building &..Safety :a`ddress ffCertificate. bf Occupancy • C��t� of �La Qu��nta=• . � �� • w Ing and afety Departmen This Certificate-issuod pursuant to, -.the requirements =of-Section;.109 of the'Uniform Bui/ding -Code; -.certifying that, at the , iime : of issuance; :this, structure was in compliance. •with the various or, - .< <. of the City regu%sting building `construction. of use. For -the fol/o:wing: BUILDING ADDRESS: 54-360. AVENIDA-RAMERIZ Use Classification: SFD Bldg: -Permit- No.: 990.3-125 Occupancy Group;:. R:3 Type of :Construction:. - VN Land :Use` Zone: 'RC. " Owner of Building: LA-QUINTA PARTNERS> Address: 51=370 AVENI'DA BERMUDAS City: LAzQUINTA, CA 92253 By: STEVE TRA XEL Date: 12-6-99 Building Official POST IN A CONSPICUOUS PLACE 4/5/99