13427 (SFD)CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING; FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
YARD SPKLR SYSTEM
BONDING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
FORMS
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
ROCK STORAGE
FOUND. REINF.
DRAINAGE PIPING
CAR P. SQ. FT. ®
METER LOOP
WALL SQ. FT. ®
"' "
DRINKING FOUNTAIN.
SQ FT ®
GAS (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used a:: property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
=$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FRAMING
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET`
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
D%Y
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
GAR. FIREWALL
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TCTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING lip
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER'
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. 9�
FRAMING
FINAL INSP.
ROOFING
Pr � ��A
� (3�rCP
REMARKS:
VENTILATION
D%Y
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
//
MESH
INSULATION/SOUND—3D-1lt/60
FINISH GRADING
FINAL INSPECTION v� 9
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
_77— P.O. BOX 1504 No. 13427
Building 1-8-311 Calle Potrero 78-105 CALLE ESTADO
Owner Rank Czeranski
LA QUINTA, CALIFORNIA 92253
- 1
(waning
Address 67-220 Rango Road
City Zip 7321-8085
Cathedral Ci � 92234
Contractor
Same
Address
Zip I Tel.
State Lic. B c., 02905 ( City 2081
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
P00) of Divisiod'3 of the BTsiness and Professions Codej�h`d my license is in,full force a
effect.r'l
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,Business 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 rile 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).
❑ 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, 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.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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
❑ 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 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. ff .t J
/Date .,y. %:s. 1'' Owner !"'Y .� .� ,r"•.e- ^',
OTICE 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. 3 09 7, 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 applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE CONST. VN OCC: GRP.-
A.P. Number 774-291-013
Legal Description Lot I Bloch 277
Project Description SFD
R3
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line r
Side Setback from Property Line
FINAL DA
Issued by:
Validated
Validation
Sq. Ft. 1676
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Permit does
not include block
wails
or pool.
Estimated Valuation
$98,748.00
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
2ii . U5
Const.
5. U0
Mech.
55.5u
Electrical
Plumbing
IFT4. 1)U
.S.M.I.
9.87
Grading
ZO.00
Driveway Enc.
-00
Infrastructure
2,173.11
Precise Plan
25. tx
TOTAL
s • U
b • t%
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line r
Side Setback from Property Line
FINAL DA
Issued by:
Validated
Validation
AgLk f/
Ai db
(fftrt
I, " "i-, M A
of Qor,-
mg
(t of 1a WU*
- - �iitl�tn •nzt� � �'n��� �t�i�i�1n
This Certificate issued pursuant to the requirements of Section 306 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 building construction or use. For the following:
BUILDING ADDRESS, 77-311 Calle Potrero
Use Classification Single -Family Dwelling —Bldg. Permit No. 13427
Group R— 3 _Type Con'truction VN. Fire Zone Use Zone R-3
Ownei of Building
Hank Address-Czeranski 67-220 Rango Road
City Catherdral City, CA., 92234 Daniel P. Crawford Jr.
--7-Wim - -, - I Date April 26, 1996
Building Official• PMT IN A WNSPICUOUS 'LACI
I
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111,
NOTICE: Indio, CA 92201 -
Document Cannot Be Duplicated 619-775-3500
Date 5/16/94 1 Type of Permit La Quinta
No. 112831 Permit #
Log
Owner Name Hank Czeranski
No. 77311. " Street Calle Potrero
City La"Quinta zip 92253 Study Area 110
APN #, Tract # Lot # 0 Square Footage. 1676
Type of Development I Single Family Residence No. of units 0
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 or replacement 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 53080
in the .amount of 1.65 x 1676 or $ 2,765.40 have been paid to D.S.U.S.D. 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. Hank Czeranski Telephone 322-8085
.Name on the check
-By Dolores A. Ballesteros
Superintendent ;
Fee collected /exempted by Vickie J. Durrett =y
Payment Received=
Signature
',� Checit No. 2676
.Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy -Applicant/Receipt Copy -Accounting
HEN RECORDED MAIL 4O:
Hank Czeranski
67200 Rango Road
P% Cathedral City, Ca. 92234
ESCROW'NUMBER: 7374-1
ORDER NUMBER:
Q
42W U
z2 U N
Tn 10,O M �1
09.
p•- Y W co a
M W
U
WIr 4
SPACE ABOVE THIS LINE FOR RECORDER'S USE 0
!,
MAIL TAX STATEMENTS TO:
Same
DO MENTARY TRANSFER TAX $..30.25
as above
. Computed on the consideration or value of property conveyed; OR
... Computed on the consideration or value less liens or encumbrances
-�
remaining at time of sale.
tt
�7
Signature of Declarant or Agent determining tai — Firm Nems
GRANT DEED
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Michael Donenfeld and Tracey Lea Donenfeld, husband and wife
)i
)i
1`
hereby GRANTS) to
hereby
Hank Czeranski and-Johanna
Czeranski, husband.'and wife as joint tenants
the real property in the City of La Quinta
County of Riverside
, State of California, described as
Lot 1 of Block 277 of Santa Carmelita at Vale La Quinta, Unit No. 25, as per
map recorded in Book 19, pages 50 and 51 of maps, in the office of the County
Recorder of said County.
Dated March 2, 1994
STATE OF CALIFORNIA
COUNTY OF ___•__
r%.
M el Donen ld
)55.
Tracey L onenfeld
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL
N° 48096
TOTAL $
f e Remarks:
f 1
❑COPY to:
Cash
Check
Money
Order
- 1
Water Service
Cashier
CVWD- (11189) }
Received From:
i
�.; — L, t
Address:
Account No. ',
t
Lot(s)
^"t
Service Address'
j tf
P"Metef(s)
►
}
!r
1 Service(s)
r
❑ Backflow(s)
❑ House Lateral(s)
❑ DetectorCheck(s)
❑ Meter Surcharge
sanitation Capacity Charge
= �'
'
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name
'r
❑ Inspection Fee - Tract -
Fee -
❑ Plan Check Fees Water / Sewer -
Tract -
❑ Bond Payment - A.D. - Bond
Assmt.
❑ Customer Deposit
❑ Other
x;
N° 48096
TOTAL $
f e Remarks:
f 1
❑COPY to:
Cash
Check
Money
Order
- 1
Water Service
Cashier
CVWD- (11189) }
C•I TY OF LA QU=7NTA
Contractor �2�� —7, Address / 7— ���
rvY�
Owner,W411%
Job Address
yfV1""1
.. This form shall be posted on the job with the Building Inspection Card at all times in a
conspicuous place. It is the responsibility of the General Contractor or the Owner/Builder
to monitor the sub -contractors that are on this list are the same persons performing the
work. Any changes of this list must be approved by the City of La Quinta Department of
Building and Safety prior to work being performed by a changed sub -contractor. Failure to
comply will result in a stoppage of work and/or the voidance of building permit.
TRADE
SUB -CONTRACTOR NAME
CONTRACTOR'S
LICENSE NO.
WORKMAN COMP.
NO. ON FILE
CITY BUSINESS'
LICENSE NO.
GRADE/
EXCAVATE
PIPELINES
CEMENT/
FOUNDATIONS
--
CEMENT/WALKS
& DRIVES
ASPHALT
FRAMING
/J SX
` 1 er ,*rd E 61.-Z S -A
STEEL/
STRUCTURAL
MASONRY4S7
CD
PLUMBING
�efe�s / /� ,�/ti
M
LATHING
DRYWALL
14c -L
� 3134 Q k
PLASTERING
HVAC
4G; 2 y 2
%%L% S
/
ELECTRICAL
/2
L{
32. _
, 917
ROOFING
SHEET METAL
FLOORS
GLASS/
GLAZING
INSULATION
SEWAGE DISP
DECORATING
re- � 22�-
TILE
CABINETS/
INSTALLATION
/�
e C �"� eS
i-(Pr3g
Q
/70
ORNAMENTAL
METAL
FENCES/
BLOCK WALLS
LANDSCAPING
OTHERS