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0009-051 (SFD)LICENSED CONTRACTOR DECLARATION t 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. Class Exp. Date 595754 131 C9 OCV'10/2( dD to `� �- ZCO 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). ( ) 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) 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: Carrier STATE RIND Policy No. 229-00 UNIT 0011090 (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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: �wZ4v--'�Qffi'3 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 pure ses. t / ,,Signature (Owner/Agent) / ��_� Date BUILDING PERMIT PERMIT# DATE VALUATION LOT 000-051. TRACT ()9.+2f+/2(C S93,M3M 96 `U 1 JOB SITE APN ADDRESSR wV�.a 646-3112 046 OWNER CONTRACTOR / DESIGNER / ENGINEER AUCIUMN.E & ji VA PAZ PAZ CONKCRUCTl01\i CO 2e-995ppAppV1�++ZppNMA Its MDOZA e2.9 ) As�'4I MiDA M,IEMDt�p.'�.J�1r,'q �5 A (� .f ¢ LA QVbTrA r.,"A .72253 T5 ped LA Q6suv. A CA 92223 (160)5CA-302:3 CBLO 5537 USE OF PERMIT SINGLE E 1+A ELY 1JWFt,LWG SPD -PLAN HA -1 PERI rr [?OF-% NOT IMCLUOR SLOCKWA tVP(K)L. /DRf1TEWA Y APPIPOACH TRACT CONSTRUCTION 11501.00 8F PORCHIPATIO 58.00 Sig GARt3,GOCARPORT (SP) 4,074.30 5 FT. WOOD PENCE 200.00 LP ESTDAAM COST OF CON,SA3 UC nON 93XOM x0 CONSTRUCTION FEE 101-000.418-000 $612,50 PIAN CHf'; K IrSE 101-000-439-318 $513.45 MECHANICAL FEE 101-000-421-000 $60.00 � rr 1B1,Y,CGTRICAL PC, 9 101-000-420-000 $131.30 PLUM 3ING FE1r 101-000-419-000 STRONG MOTION FEE = RESID 101-000-241-000 $9.31 C1I3ADINO FR 101.000-423-000 $20.00 DEVELOPER IMPACT FZZ $1,907.00 3 �- PRECISE PLAN 101.00e0-441.345 $100.00 "M DEPOSIT 101-000-439-318 �a SUB -TOTAL CON1T1Rti7C"1'I:ON AND PLAN Ca"iF;= $3,4&x.31 LESS PRF. -PAID n. x, a 4250.00 TOTAL 3'.1 RM—C . S 'DUE NOW 1 � S3.7-14.31 RECEIPT DATE 9 BY ^q t + D I 1 INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings _ _ _ t _ Ducts Slab Grade fl`- Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K: to Wrap F.A.U. Framing 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 3_x"1c'L— 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 I I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Water Piping - to - Heater Final 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 Final COMMENTS: 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) AMIM, MM P.O. BOX 1504 APPLICATION ONLY Building 78-495 CALLE TAMPICO a Address o LA QUINTA, CALIFORNIA 92253 (��/ Owner BUILDING: TYP/E'CONST. OCC. GRP. Mailing b4i0 .•• ?�'1 L Address _� U f„� y. .A A.P. Number l74 k _ City Zip Tel. /. h . - — I A . c' . ., -. Legal DescriptiontLSf5 RT C_ .0!S City State Lic. & Classif. Lic. # 55 Arch., Engr., Designer 4 OeFs� Address Tel. City`!, ('1_.f."M IZIp ILic. t# LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am,fieepsed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of thaZ6sirless and Prfessions Code, and my license is in full force and effect. /J _/ - .- t n OWNER -BUILDER DECLARATION I hereby affirm that I fim 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, alter, 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 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). l- 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, Bussness 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 1 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.) i i? 1 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 1`7 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 employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. _ Date Owner NOTICE TO APPLICANT: 9, 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 shell be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby 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. I certify that I have read this application and slate 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 sof this city to enter the above- mentioned property for inspection purposes. Signature of Mailing Add City, State, ectDescription 2r&t-%,.L+4 lr' "49 Sq. Ft. No," No. Dw Size '1301 -Stories Units I New V Add ❑ Alter ❑ Repair ❑ Demolition ❑ A -'S Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS 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 t FINAL DATE' INSPECTOR (� Issued by: Date rmA a .I' 1 Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 9/26/00 APIC# 646-312-046 No. 21021 Jurisdiction La Quinta Owner NameAugustine & Eva Paz Permit # 0009-051 No. 78-550 Street Saguaro Log # City La Quinta," zip 92253 Study Area Tract # Lot # Square Footage 1501 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 2.05 X 1;501' or $ 3,077.05 the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed projectmaynow be issued Fees Paid By CC / Valley Independent Bank / Augustine Paz �, ,Telephone 3023Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Annette Barlow Payment Received - $3,077.05 r Check No. 227392. Signature v U1-------------- �+ VOTICE: Pursuant at Assembly Bill 3081 (CHAP,549,, STATS. 1996) this will serve to notify you that the 90aay 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 or installation permit for this project is issued or on which' they are paid to the District(s) or to another public entity authorized to :ollect them on the Distdct('s)(s') behalf, whichever is earlier. . 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 eti AUG. 3.2000 10*21AM COMMONWEALTH ■ ■ = ORDING REQUESTED BY: ■% ORANGE COAST TITLE COMPACOMPANY ` R-188255-1 i10225KC WHEN RECORDED MAIL THIS DEED AND, UNLpSS OTHERWIs9 SHOWN aELOW, '.MAIL: -TAX STATMMENTS TO. AGUSTIN PAZ and EVA PAZ 52995 AVENIDA MENDOZA LA QUINTA, CALIFORNIA 92253 NO. 162 P.1/1 QVAOV L17 M►S� �nvTn If GR�iNT DEED -' 1` - Uae 78 -r.—So The undersigned grantor(s) declares) :�(� Documentary transfer tax is $27.50 (XXX) Computed on full value of property conveyed, or, ( ) Computed on full value less liens and encumbrances remaining at ime of sale, ( ) Unincorporated area: ( )'City of and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,. - JOSE LUIS GARCIA and ESTELA G. GARCIA, husband and wife as joint tenants . hereby GRANTS) to AGUSTIN PAZ and EVA PAZ, husband and wife as joint tenants the real property in the City of LA QUINTA, County of Riverside, State of California, described as; of 96, Unit No. 1„ Trac Desert Club Manor, as per map recorded in Book 22, Pages) 53 i us , e office of the County Recorder of said County, bated July 28, 2000 State of California County of } S.S. On - before me, personally appeared personally known to me (or proved to me on. the basis of satisfactory evidence) to be the Person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the pereon(s), or the entity upon behalf of which the person -W acted, executed the instrument. WITNESS my hand and official seal. Signature MAIL TAX .STATEMENTS TO, -NOSE LUIS GARCIA ESTELA G. GARCIA -(This area for official notarial seal) i CEL NUMBER ASSESSOR'S PARCEL COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY Gy6 _.� , _ a y! DEPARTMENT OF ENVIRONMENTAL HEALTH PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM APPLICANT. Submit this form with four copies of a SCALED plot plan (1-20 SCALE) drawn to County specifications as indicated on the attached check list. A non-refundable filing fee is required when the application is submitted. Check must be made payable to the County of Riverside. Approval of this applica- tion shall remain valid for a period not to exceed one year from date of payment. LMS # Agent, Contractor, Contact Person Address City State Zip Telephone ..,. r P o.. L-jr)ca'L�. Civ, u r� L� Owner Address City State Zip Telephone ¢ b.(�%,-)s-t. X �� t S�,-�� & PA. r- ZO Job Property Address City Zip WLot Size Water Agency/Well Use of Permit, P/P, SUP, PUP etc. Legal Description Cn 50-K G U LoTQG UU�T v� i � 0 0 . (,u , j> , Dwelling H Site Prep., etc. Signature of Applicant Date Zoo CHECK BOX IF REQUIRED If any box is checked, this application shall be considered rejected until ❑ Detailed Contour Plot Plans Required (1 to 5 foot interval) the information is provided and the fee paid. Resubmittals later than 90 days after date noted below may require repayment of fees. ❑ Staff Specialist Lot Inspection Required ca ❑ Holding Tank Agreements Completed Thomas Bros. Page Grid Z � ❑Certification of Existing S.D. System Required I'- ❑ Date Lot Inspection Completed: Initials U ❑ WOCB Clearance Required W (Attach for DOH -SAN -007, Santa Ana Region Only) Remarks: U) ❑ Soils Percolation Report Required ❑ Maintenance Booklet Provided ❑ Special Feasibility Boring Report Required ❑ Final Inspection by Department of Environmental Health is required. ❑ Rereview Required Initials Date Please call 24 hours PRIOR to inspection. C/42 / Soils Percolation Boring Report by I Uc/Project # Date Soils Map Page Soil Type Approved By Date No of Systems e of System(s) N we%Qg Units (1) Septic Tank Soil Rate Grease/Sand Holding Tank ❑ Replacement New ❑ Addition JExisting edrooms Axture Units Grease Intcp/Lint Trap O AJC 3 �"t" X 1000 Gal. !Z 1� Gal. Sq. Ft. Total Linear Sidewall Allowance Leach Bed sq. ft. of Bottom Area Ft. Bottom Area ft. rock/ -sq. ft. running ft. Install Line(s) ft. long i'it. wide with Inlet Tested Depth ❑ NA min. inches rock,below drainlines or r U Proposed Bottom Tested Depth Z Leach lines/bed special design for slope: (3) Pit Diameter No. Pits Pit Below Inlet (BI) Seepage Pit Maximum Other: Q Total Depth Allowable Applicable Depth U U.1 N/A -- Overburden Factor ❑ 5' [ 6 N� TO Well Review Approved: Date: Well Drilling Permit # SIGNATURE Grading Plan Approved:SIA Date: Sewer Verification Approved: Date: Plan Check Only Approved: Date: REMARKS: n, yJoel� P�w.J,s -146 frw0A r,i +c�.-�.�� .�1 1.,.^e e'1 This application Is APPROVED/DENIED for the category checked in SECTION B FOR OFFICE USE ONLY above, regarding)he design of a subsurface disposal system as indicated on the acompanied plot plan, using the requirements set forth in SECTION C above. A build- d ing permit is necessary for the installation of the above -designed system. No con- struction Is permitted In the required reserved 100% expansion area., Revenue code J Fee $ r (1) Septic Tank must be 100' minimum from any wells. �% /,, L Check #^ `�' S— q— h QQ/ be (2)_Leach,lines must be 100' minimum from any wells, including expansion area. Date O-« Initial (3) Sewer lines must be 50' minimum from any wells.,_. --- . - - �' Z- --- _. , 0 (4) Seepage pits must be 150' minimum from any wells, including expansion area. ` F- 0 UJ Signature of Health Official �-- 2Y- 00 t Date DEH -SAN -122 (Rev 9/98) Distribution: WHITE—Office File; YELLOW—Applicant; PINK—Bldg. Dept.; GOLDENROL—Plans/Records • M A IV1010E118 0Y UNAUTHORIZED USE WARNING S ,I, 'THESE DESIGNS ARE THE PROPERTY bF E LENCH DESIGN GROUP. REPRODUCTION R IN ANY FORM WITHOUT. WRITTEN CONSENT IS EXPRESSLY PROHIBITED. UNAUTHORIZED B USE EXTENDS TO ORIGINAL AND MODIFIED A DERIVATIVE PLANS AND IS APPLICABLE•TO ! , INTENTIONAL AND UNINTENTIONAL 1 ' INFRINGEMENTS. D 0 N 0 -T U S x • E D PROPERTY LINE NEW +/=4' HIGH RETAINING LL A. 50.00' O CD o NEW 6' HIGH WOOD FENCE" z ' o - _ H ..- b W o a. Q o. • z: COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY X v U. J _, ONCRETE •PAD I w _ Q DEPARTMENT OF EWIRONMENTAL HEALTH. X _ ,,� mom' �. •4 p _» z Food Sewage Disposal OZ _j 200 AMP r f J z Trailar Park coo Gal. Septic Tank (g ELECT. PANEL r? pt S Ft. of teach line • CY Motel, Apt., Hotel q• z O Z c/ Dwelling- 3 �k "` oTic No, G Dia yo BI 43 TD AVY MD S epage Pit Z • • J C •, , W tj Cammerciat BuildingConnection to Sewer t a.,.o./ 6� iJ Q W Swimming Pool Connect to Existing S.S.D.S. H z w . w• CL CL _ • �No on-site regenerating water softening devices may be discharged into the individual sewage disposal I cc z ► • C7 ystem herewith approved without clearance from the Water Quality Control Board. a _ ` ` , Q U -- �,c��ater supply serving this installation must be from an approved source _ ., I• r o W _ ' II sewage disposal installation must conform with requirements of current Uniform Plumbing Code. H .+ J 2 -0 • • • ` �' _ N N �ny cutting, grading or filling in excess of two(2) feet will nullify sewage disposal approval H iv , = Approval has been obtained from the Regional Water Quality Control Board for installation of the sewage xj .. + disposal system. . This is to certify that the Riverside County Environmental Health Services approves the subsurface sewage V • ' w • W Z disposal plot plan to obtain building permit for installation construction. 5'-0• 40'-0 SE r SETBA .K w K ':t�'LA N • . • v .. _ 'THE BREEZE= AQOBE-98 z I iFtF.- •_o•` AlaovE GufFsl� z : j DEPARTMENT 4F PiICLIC HEALT w ' IS VALID FOR OM � (� PAC ELEV.: O�—B" AB4.VE CURB Q . z :MEAS3U�REC C4D CENTER : 3 ' O �� APPROVAL YEAR � i O F THE• boy ' O r ERIC DATE AL �' r r LL z m W •- -_ z LL LLIW _W :. J 0 Via- 4"s�� drat' fi � i uSt ba 50 iL LL 6' HIGH OWN: o from any yaIIs, indWing. expansion ar s. 5�.1.. +.4,- * r BOCK W LL ` - Lit lives t�:a�st be 100 ft. opt nimum and O J p I !�- I z SNP., so pits m6e-t be 150 ft. n, inimum from any WfAls 06 0000 Zy 1•0 r�" w W XP GARAE DOOR W I . . 6'HIGH BROWN • BOCK WALL A 04(o-3Vz-0Q.� • • • •' ��78-550 SAGUARO DRIVE ADDRESS. .�' - ----LOT 96UNIT N0.1, TRACT DESERT CLUB MANOR,, —4 HIGH BROWN LEGAL. W ' . • ¢ �; BLOCK WALL . m BOOK 22 PAGE(S) 53 p ��, t- RBPANE TANK t (3) QUEEN PALMS. ; r b w ai '• : , 15 GAL OR EQUAL .� to c., CO.. ;{ �• �'' • (MIN. 1 1/2" DIA,TRUNK SIZE) ` - w ' -4. LANTINGS TO SCREEN TANK PROPERTY LINE O , • .•.0 Inn 41 ELI j .. o i�fr�sM MGi1N ( V1M1 f7 10� J Uj /(`C7 crr++ s S1T� PLAN - SCAL1 /8": SCALE:1/8"=1'-0" P 9 PLANS PREPARED BY: ' LENDEL VENTURES, INC. , de. . LENCH II ' PRESIDENT • DgAWN REI CHECKED SL GATE SCALE Jos No. SHEET OF SHEETS 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 in compliance. with, the various ordinances of the City regulating building construction or use. For. the following: BUILDING ADDRESS.: 78-550 SAGUARO Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0009-051. .Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL Owner of Building: PAZ CONSTRUCTION CO. Address: City: —r&4wl Building Official M Date: POST IN A CONSPICUOUS PLACE 52-995 AVENIDA MENDOZA LA QUINTA, CA 92253 GREG FOX MARCH 14;2001