9801-056 (SFD)LICENSED CONTRACTOR DECLARATION
P I 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. Classy; Exp. Date
j�19680 13 /'31!99
,Date
_ !!1'} , fir'•
'Signature of Contractor. -,
f �l OWNER -BUILDER DECLARATION ~'1"
[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 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
performance of the work for which -this permit is issued.
( 1 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:
Cartier Policy No.
STAT'£ FUND 12➢- 998
(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 th&if I should become
subject to the workers' compensation provisions ofS tion 3700 of the.Labor
ode 1 s all forthwith comply with hose Arovisibris.
r Date ,t CJ, Applicant _ ��
.Warning: Failure to secure Workers' Compensation co ege is unlawful raand
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 authoriz6"'tepresentatives of this City to enter, upon
`the above-mentioned property for
riin�specti kn purposes
y( Signature (Owner/A t). t Date
/`r�1 ru 1Ljl �►YI11
BUILDING PERMIT
PERMIT# CONTROL#
DATE . VALUATION. LOT
980.1`fl-56 TRACT
'I'EL4C')'
rl ! l A $97,772.40
20 #1 lei
Si.
JOB SITE
APN
ADDRESS
70-705 SAGEBRUSH AVENUE
646-31.9-0261
OWNER
CONTRACTOR / DESIGNER / ENGINEER
AL CARRER
KPO'L:L09 CON'SMUC'TION
PO'BOX 977
'79140 OC4.1`il'LLO
LA QUINTA C.A. 92253
LA QU1N'6'A CA 9.225-1
,
rh760)360-4335; CBL # 2231 -
Z�:
uoe or rcrIMIT
0
SFD - PERMIT DOES NOT INCLUDE 13LOC-K WAL LS OR POOL,
�-
CID
ij
�y�CD�
f
TRACT CONSTTZUC" ON 1,100,00 SF
car.1
GAR. (M CARPOIR
469.00 SF'
i1
/
5 FT. WOOD PENCE
'200.00 .Lk f
�
sS'��14fArcu C09f OF CTINST fluelf10N
97 777:40 .,
PERMIT FEE S1UA'WARY
~
CONST UC'1'1ON'VEE 101-000-418-000
$�53f►_5U
�:
PLAN CHECK FEE: 101-000-4393.18
$535.40
INMCHANICAL F 101-OflO-12.1-OffO
553:"x0
ELfi 1'1UCAL'FEE 101-000-420-000
$1 3.8ts
14:003ING PEP' 102-000-419-000
$1.%.00
STRONG MU'1'ifiN FEE - RES ID 101 -OW -241-000
$9.78
GRADINO'f=ES 101 -WO -423-000
$61}.00
1NF'i+ASTRUCT11RE F FX 225-000.443~342
$2,161..0
'M. C[SE• PLAN 10:1-000-441.345
$25.00
f
FEE E 'DE> OSIT
-$250.00
r'
}
RECEIPT
SUB -r0'1 _,1L CONS"Y R.i.3C`i'ION AND PLAN Cf.-W'CK
L1 SS .PRE -PAID FEkS
TOTAL PERM17 FEES DUE NOW
DATE BY r
I DATE FINALED
INSPECTOR
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
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
a
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
7�—
Final
POOLS - SPAS
_
BLOCKWALL APPROVALS
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
Appliances
JI
f
Final
COMMENTS:
i
S
Iv'I
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.1.
Smoke Detectors
Temp. Use of Power
Final
' Utility Notice (Perm)
LICENSED CONTRACTOR DECLARATION
I heraby 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
619680 B 5/31/99
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 slruclwe Is nul inlended ur 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 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
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.
STATE FUND 1297996
(This section need not be completed d 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' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with 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
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 for inspection purposes.
Signature (Owner/Agent) Date_
PERMIT# CONTROLk
BUILDING PERMIT
'801-056 6 5 6
DATE VALUATION $97 772.40 LOT 20 TRACT
2_/J
t a TRACT #1 D
SE
JOB SITE
ADDRESS 78-705 SAGEBRUSH AVENUE
APN
646-311-020
OWNER
CONTRACTOR/DESIGNER/ENGINEER
AL CARPER
APOLLOS CONSTRUCTION
PO BOX 977
79140 OCOTILLO
LA QUINTA CA 92253
LA QUINTA CA 92253
(760)360-4335 CBL# 2231
USE OF PERMIT
SFD
SFD - PERMIT DOES NOT INCLUDE BLOCK WALLS OR POOL.
TRACT CONSTRUCTION 1,600.00 SF
GARAGEICARPORT 469.00 SF
5 FT. WOOD FENCE 200.00 LF
`
ESTIMATED COST OF CONSTRUCTION
97,772.40
PERMIT FEE SUMMARY
CONSTRUCTION FEE 101-000418-000 $630.50
PLAN CHECK FEE 101-000439-318 x535.40
MECHANICAL FEE 1014000-421-000 553.50
ELECTRICAL FEE 1014)00-420-000 5128.88
PLUMBING FEE 101-000-419-000 5156:00
STRONG MOTION FEE - RESID 101-000-241-000 $9.78
GRADING FEE 101-000-423-000 520.00
INFRASTRUCTURE FEE 225-000-443-342 52.161.63
PRECISE PLAN 1014)00-441-345 525.00
FEE DEPOSIT 4250.00
SUB -TOTAL CONSTRUCTION AND PLAN CHECK
$3,720.69
LESS PRE -PAID FEES
-$250.00
TOTAL PERMIT FEES DUE NOW
$3,470.69
L�
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
Desert Sands Unified School District
Notice: 82-879 Highway 111 r
Document Cannot Be Duplicated Indio, CA 92201 -
_ 619-775-3500
CERTIFICATE OF COMPLIANCE
Date 2/10/98 APN # 6,46-311-020
No. 16635 Jurisdiction La Quinta
Owner Name Al Carper Pernit #
No. 78705 Street Sagebrush Ave. Log #'t
City La Quinta r zip. 92253" Study Area
Tract # j Lot # 20 Square Footage 1600
Type of Development Single Family Residence No. of Units 1
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 .
1.84 X 1,600 or $ 2,944.00 '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 oc/Hemet Federal Savings/Apollos Construction Telepl►oneY`
Name on the check R• p;
By Dr. Doris Wilson T
Superintendent j';>.
Fee collected /exempted by Pauline Pearson Payment Received y $x,94,4,00
Check No. 67404659
SignatureQ11�—
IOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protist the fees or other payment identified
will begin to run from the dale on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or b another public entity authorized to
ziIlecl them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
A
Embossed Original- Building Dept./Applicant Copy - pplicant/Receipt Copy -Accounting
� �r r �4'�ii§%,'F'##x-"'� � . 4 i. �• :�i
F. Plano . T t_. 2 7 S �.: •.M 1�•M!`,r�;•,fl..+•e. �,.Z.«�.s s � ,7 a r• 7. �! s ' i (`• � P 1 `� , i
T
t s f' 'K_� ,1�► ��, •� t.� f J' d ,l...- .®,� - • • . • THIS
assessor's PAR.C_:i.. O." ii?r,-"s`:1 1;2!?-`? `i'hE undei signed. ani l ,s' y t; ,}� DOCUMENT TRANSFER!%
I i�G �'i is r C,l 2 tr'"c1 } dj
TAX IS: ath�
T;TLF ORDER 5 26,95 couril" S City
tX c; r-noured cr the SUIT ve!ue of the it"t„rest of ;Crooerty conveyed, 6r' �
ESCROW `D.' i90I :I�. •�gc0r..1puted or. the 1WI,vaIUe,Ie5s; the �"'allle or liens er encumbrances"✓�
RANT
`4?FrlalrllilC� iP's?ieC�n c�i tl: tll#1G of Se�l`e'.'
t 00 Ad� E I .,. is fi,ansfer i , EXEMPT from 1• ,,x'10, the follo,'Yit'1�,". -L'e'sson:
FOR VAi..LiA'iLL CONSIDEFi_A—HON, re .eipt of which is hereby at;knr,v;e�aYr9, - '1
Jr",rnes W. Anglin and okirine C. Arig,'! ,H-i,i,mban•d and Wife *k
_,{+ar
t° hereby GRANT (S to Allan I., Carper and 'Ba ._ty k. C' 3Ype-v al -I'd Wife_ ._t. 0j_1 -1.t T'e11a—.'ar_3.
all that real prop44 s tuat,! i in i'.a y a s � 0 ! �I €'A n �; I:.y- Xer. it Stat iCas r i,_, ' � i ter,
i r�c •."r. SP C"cul, I i t�i�, s. it_ State* c3 _ �, i,c�:�n t.i:�sl:r.tc � ,
Lot 20 of Desert Clap Manor T,, 4: r s hoxn on a map thereof n--orded in Book 22 page 53
of 1 -ops- in ti -.e Qf l� �f F
the County REcorder of F?i'1er,;idl . `(liJn'}a, C alifor,�
i•
Dated Noveml✓er 19, 199-l"
STATE OF CALIFORNia
COUNTY OF„!ijC1L t�? _ � •_ y /` �� ; 'F .
oN)V J jjZg �.LfY baforr, Me._ t P �+P.iC ��.. .w James W. Anglir,
Pub ? t,..psma o -vi lIV apDearad 10
nne G. Anglin ;{
f personally Known to nle (orprove•d tonne or the basis of satisfactory. evidence) s
to he the persons) whose names) 'fare subscribed to the within iiiSirum3i.t dnd
`•.
ack:noviledged to ma that �ib/s' they. executed the same in t =lhK/their
aut6orizev rapacity(ies), and that by 141%r/their signature(s) on the instrument PERRY WLLS
the person(si, or the antily upon behalf df which the persons) acted, executed /* "d`c' �`��`� y� {
�r Comrn. iY t01iPA�
the instrument, ! m� d Al NOTARY PU&,I% • CAOPCWA
WITNESS my hand. and offi;iel seal. m" s �a 1997 °d
F • ,> � ct,ntf�
Signature _ __•—,_ — y
MAIL TAX STATEMENTS TO: (This 'area for ,ifficiEl notary scall
Allan L. Carper 33013 R.tinabout, Plano, T,X 75023
3r 4 - • j
i,.
'Del
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
78-495 Calle Tampico/PO Box 1504
La Quinta, CA 92253
Phone: 760-777-7125
Fax: 760-777-1233
To: Greg Butler
From: .Wally Nesbit
Date: 11/2/98
,Subject: 78-705 and 78-715 Sagebrush
COMMENTS/INSTRUCTIONS/DESCRIPTION
Attached are copies of letters asking for payment of the CVFTL fees which were not
assessed at permit issuance in February 19.98. These fees were no- previously paid
as part of any prior permit on record in.the respective address files,. and the amounts.
have not been remitted. Therefore, this Department requests a hold on any final
inspection, until the fees are paid. Please inform the assigned inspector so that he can
in turn inform the builder: As a reminder, all homes proposed in this area are subject
to this fee unless record of payment. with a prior permit exists in the address files.
Should you have any further questions, please contact meat 760-777-7069.
TRANSMITTED BY: 14.os
Wallace K Nesbit
Associate. Planner 760-777-7069 OFTKE°4
78-495 CALLE TAMPICO - LA QUINTA, CALIFORNIA 92253 - (760) 777=7000
FAX (760) 777-7101
TDD (760) 777.-1227
July 22, 1998
Mr.. Al Carper
P.O.. Box 977
La Quinta, CA 92253
Dear. Mr. Carper:
Please be advised that your permit #9801-056 for the dwelling. located at 78-705
Sagebrush Avenue was issued without the Coachella Valley Fringe Toed Lizard fee.
For your project #9801-056 the -fee equals $78.00.
Please contact Wallace Nesbit of the Community Development Department at
(760) 777-7069 to make these arrangements.
Thank you in advance for your attention to this matter.
Sincerely,
Mark Harold-
Building
aroldBuilding & Safety Manager
c: Wallace Nesbit
MAILING ADDRESS - P.O. BOX 1504 LA. QUINTA, CALIFORWA 92253 �`
Certificate'of Occupancy �
City of La Quinta..
Building and Safety Department
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 incompliance with the various ordinances
of the City regulating building construction or use. For the fol%wing:
BUILDING ADDRESS: '78-705 SAGEBRUSH AVENUE
Use Classification: SFD - Bldg. Permit No.:, 9801-056
Occupancy Group: R3 Type of 'Construction: VN Land Use Zone: RC
Owner of'Building: AL CARPER Address: P.O. BOX 977
City: -LA QUINTA, CA 92253
By: STEVE TRAXEL
i Date: 7-7-99
Building Official
POST IN A'CONSPICUOUS PLACE