Loading...
0004-073 (SFD)f LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of ,ihaptef 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 I % £38535 :13 / ,,,� moi' . ,,� Jpate Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that'l am exempt from the Contractor's License Law for the following reason: ( ) 1, as owner of the property, or my,iemployees with wages as their sole compensation, will do the work, and thq�lstructure is not intended or offered for sale (Sec. 7044, slness & Professionals Code). ( ) I, as o gr of the property, am exclusively contracting with licensed contractors nstruct the project (Sec. 7044, Business & Professionals Code). bf ( ) I am exeml y under Section , B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby a" under penalty of perjury one of the following declarations: (. )? I have and will maintain a certificate of consent to self -insure for workers' compensatir�n, 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 STATE FUND Policy No. 22999-0009671 (This section need not be completed if the permit valuation is for $100.00 or less). ( ) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Spcjlon 3700 of the Labor Code, I,shall forthwith comply wii:K those provisibns., f•'.+�' ,$Date: 'L"VLJ2 Applicant-- Warning: pplicant Warning: Failure to secure Workers' Compensation coverage.is unla dl and shall subject an employer to criminal penalties and civil fines upto $ 00,000, in addition to the cost of compensation, damages as provided for i, ection 3706 of the Labor Code, interest and attorney's fees. // IMPORTANT Application is hereby/rade to the Director ofrBuilding 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, indemnity & 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-fo�inspectio }purposes. Sig ture (Owner/Agent) / Date BUILDING PERMIT PERMIT# DATE VALUATION $10.9,2W.40 .p tf, �/� LOT 0:04-07`3 TRACT f ` $1109 .40 89 1 'JOB SITE y APN ADDRESS 78 -CM SACd1'i'M01a�Fa'.. � 040-312-039 OWNER CONTRACTOR / DESIGNER / EN INEER LENARLD LAM L EMEL V:EN'I`LTM. P,O. BOX 450 78-080 Cefic: Estedo Ste 204 LA QUIN A. CA, 92253 LA QUI 4 TA. CA 92233'-'--- (760)5644866 MR 859 USE OF PERMIT N WHOLE ItAr €LY T9WMI ING SFD - PltRltnl dCLUDF_3 123LF 6' AND PERMIT DOW140T INC:I.UDE POOL, 4' RI..00K SMALL, TA& CONSTRUCTION 1,15100 SF FO�CH/PATIO 52.00 SF a3:A 4OVCARPORT 512.00 SF 6 FT, WALL 123.00 LF 6 FT. WALL '14.00 LF EgnmAI.TE',D cosi Off' ComTi?,iJC°:1 on MMT FU SU114MARY CONSTRUCTION FBI: 101.000-418-000 $674.60 PLAN CHECK FIS; 101-000-439-318 $562.95 MECIMICAL, FEE 101.000.421-000 160.00 /LLECTRICAX,IME. 101-000-420-000 $In06 Pl,uhi rwo FRE. 101.000.419.000 $127,25 STRONG MOTION FEE - RES1D 101-000-24 1-000 $10.92 ORADINCf EEE I01.000-423-000 $26.00 DEVFLOPL'R IMPACT FRE 11,907.00 . PRECISE PIAN 101-000.441.34.5 5100.00 FEE DEPOSIT 101-000-439-318 •$2.,50.00 SUG TOTAL. C0NfnRTJCT10H AND PLAN C1WCK $3,591.58 LE9y 1'REK-PAIDi`�'Ls ",9 1 4250,00 Taf Al, S':�-'�MI' ISS DUE .NOW I S3,447; RECEIPT DA E/tai /,. I BY 9 DATE FINALED INSPECTOR :y. INSPECTION RECORD ` OPERATION DATE INSPECTOR OPERATION DATE TINSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set BacksUnderground Ducts Forms &Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck v0 KT.— Exhaust Fans O.K. to Wrap _ V efi s F.A.U. Framing — p0 6V Compressor Insulation00 S7 Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath _ 7 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 t6l CIO 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 9E] 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) UV Qum P.O. BOX 1504 APPLICA 0 ILY Buildin78-495 CALLE TAMPICO Addressg SA -6 LA QUINTA, CALIFORNIA 92253 Owner `11_ 'IVA BUILDING: TYPE'CONST.—OCC. GRP `77 Mailing Address k A.P. Number City Zip CL" Tel. ; Legal Description -. Contractor Project Description Addiess City Zip Tel., State Lic City 71Lic. # Sq. Ft. N & Classif. 0. No. Dw. Size Stories Units Arch., Engr., Designer New 13 Add 0 Alter 0 Repair 0 Demolition 0 Address, Tel. �City Zip State f Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am license/under provisions of Chapter 9 (commencing with Section 7000) of Dl,=of the Businvt and Professions Code, and my license iXn Will force and effect. nc� I Co -7 �, `S, I •-c . � SIGNATURE DATE OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's Licejise Law for he following reason: (Sec. 7031 . 5.Business and Professions Code: Any civbr county which requires a permit to construct, after, improve, demolish, or repair any struttura, prior to,its issuance also requires the applicant for such permit to file a signed statement that he Is licensed pursuant to PERMIT AMOUNT ,,,a provisions of the Contractor's License Law, Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code. or 1pitehe is exempt therefrom, and the basis for thealleged exemption. Any violation of Secton 7031.5 by any applicant for a permit Plan Chk. Dep. subjects the applicant to a civil penalty of not more th h five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 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, Mech. provided that such improvements are not intended or offered for sale. It, however, the building orimprovement is sold within one year of completion, the owner -builder will have the burden Electrical of proving that he did not build or improve for the purpose of sale.) II I' as owner of the property, am exclusively contracting with licensed contractors to con. Plumbing 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 S.M.I. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading 1-1 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date —Owner Infrastructure 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 FWopy is filed with the city. 0 Certified copy is hereby furnished. TOTAL -------------------- CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed it the permit is for one hundred dollars ($100) valuation or less.) Icertify that in the performance of thp 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. r% III Dale Owner L NOTICE TO APPLICANT., It, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: Front Setback from Center Line —Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line 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.) Side Setback from Property Line Lender's Name Lender's Address L DATE INSPECTOR This is a building permit when properly filled out, signed and validated, and is subject to FINAL expiration it work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. Issued by: —Date Permit I agreeto comply with all city and county ordinances and state laws relating to building con Stru clion, and hereby authorize representatives -of this city to enter the above• mentioned property for inspection purposes. Validated by: Signature of a0plicant —Date— Mailing Address Validation: City, State, Zip WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION hh 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 5/4/00 APN # 640-312-039 No. 20395 Jurisdiction La Quinta Owner NameLenard Lam Permit # No. 78-620 Street Saguaro Drive Log # City La Quinta zip 92253 Study Area Tract # Lot # Square Footage 1752- Type 752Type 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 schoolfees 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 1,752 or $ 3,591.60 the property listed above and that building permits and/or Certificates of Occupancy for thissquarefootage in this proposed project may now be issued Fees Paid By CC/1st Bank - Patty Magana Name on the check By Dr. Doris Wilson Superintendent Fee collected/exempted by Ellen Patino Slgnature Telephone.," t Payment. Received Check No. 54331 $3,59;1.60 NOTICE: Pursuant otAssembly Bili 3081 (CHAP 649, STATS. 1998) 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 data on which the building or Installation permit for this project is sssued of on which they are paid to the Districts) or to another public entity authorized to collect them on the Distdct('s)(s') behalf, whichever Is earlier. Collector: Attach a copy of county or city plan check applicetlon form to district.copy for.all waivers. Embossed Original- Building DeptJApplicant Copy - Applicant/Receipt Copy - Accounting htna RECOIiD1t�IC7�R VESTED BY: A 4-E.:: in; `kJ' AND WHEN RECORDED, MAIL TO: Leonard Lam 111 Chelsea Circle Palm Desert, CA 92260 1-4b-317-039. ASSESSOR'S PARCEL NO.:.,e+i4 - 3i 2 - o3g, u -04-)- TITLE ORDER NO.: 87010418• ESCROW NO.: 18537-0'01 y ID 1 *fiN. Co. recorder ®1'7960 RECEIVED FOR RECORD AT 8.00AM JAN 15 1999 THIS SPACE FOR RECORDER'S USE ONLY pet�der (,� From The undersigned Grantor(s) declare(s) that the DOCUMENT TRANSFER TAX IS: $ 19.80 County $ City xx computed on the full.value of the interest of property conveyed, or — computed on the full value less the value of liens or encumbrances remaining thereon at the time of sale. — OR transfer is EXEMPT from tax for the following reason: FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Joseph Staretski, Trustee of The Hyman Hymson.Family Trust dated November 9, 1984 hereby GRANT(S) to Leonard Lam, a single man all that real property situated in the City of La 4uinta County of Riverside State of California, described as: Lots 88 and 89 of Desert Club Manor Tract No. '1 as per map recorded in Book 22, at page 53 of Maps, Records of Riverside County, State of California. APN # 646-312-038-9 & 646-312-039-0 Dated December 09, 1998 } The STATE OF CALIFRNIA Jos COUNTY OF } ss. On /o� .�/-� , before me Notary Public, 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 person(s), or the entity upon behalfof which the person(s) acted, executed the instrument. WITNESS ' h d official seal. r Signature MAII TAX STATEMENTS i0: iiymson Family Trust retski:; Trustee CLAIRE E. MINOR Commission # 1179260 Z Z Notary Public -California Z " Los Angeles County My Comm. Expires Apr 1120D2 (rhis area for official notary seal) ASSESSOR'S PARCEL NUMBER COUNTY OF RIVERSIDE HEALTH SERVICES AGENCY dol ( _ 7) 2 • _ DEPARTMENT OF ENVIRONMENTAL HEALTH PERMIT APPLICATION FOR A SUBSURFACE SEWAGE DISPOSAL SYSTEM r 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. t, Contractor, Conttac/Person t� bt= � ► e5kjrC40t �j / � Address �" ,y / city State Zip ()' 1 OlIt 4s 0 f •/� � V / �l.%7%�.�� �J4". • C%i2 � ._.J Telephone Telephone 564 • 1W,-4 a Owner L�f?ice. �, ► AddressCity State Zip i,�. ` dx � f4 ��,a✓- Vii+ �Z-7 c Telephone . Z Job Property Address ,� %8.62v '514, Uig j--c� . City q) v/.-- Trp P0 WLot Size Water Agency/well Use of Permit, P/P, SUP, PUP, etc. Legal Description gip., �() I JG �r/1�L lel► l{� C-7� Dwelling, MH Site etc. Signature of Applicant T> W-4` Date CHECK BOX -IF REQUIRE�" � a/ f G D If any box is checked, this application shall be considered rejected until the information is provided and the fee paid. Resdbmittals later than 90 ❑ Detailed Contour Plot Plans Required (1 to 5 foot interval) day'after date noted below may require repayment of fees. ❑ Staff Specialist Lot Inspection Required m Q Holding Tank Agreements Completed Thomas Bros. Page Grid Z Z ❑ Certification of Existing°S.D. System Required l'— ❑ Date Lot Inspection Completed: Initials WQCB Clearance Required LU❑ (Attach for DOH -SAN -007, Santa Ana Region Only) Remarks: ❑ 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. G C/42 / Soils Percolation Boring Report by �» Lic/Project # Date Soils Map Page Soil Type Approved By � eO ' Date No of Systems Type of System(s) U Holding Tank ❑ Replacement No. Dwelling Units Bedrooms, Fixture Units (1) Septic Tank Soil Rate r) S }' L�©O Grease�Sand Grease Ihtcp/Lint Trap 1 ,New ❑Addition r� ' VV �. Existing 3&Aroorl X 1COO Gal. Na Gala Sq. Ft. Total Linear Sidewall Allowance Leach Bed sq. ft. of Bottom Area Ft. Bottom Area --------�, �. ft. rock/ sq. ft. running ft. Inlet Tested .Depth ❑ NA Install Line(s) ft: I\g ft. wide with min. inches rock below dr\ainlines or � \ 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: O Total Depth Allowable 1- NN/A� Applicable Overburden Factor ❑ 1 i /T/ 1 v r TD �� Depth Ll cj / 5' `Q6' Well Review Approved: Date: Well Drilling Permit # SIGNATURE Grading Plan Approved: Date: SIGNATURE Sewer Verification Approved: Date: Plan Check Only Approved: Date: REMARKS: �5r..,.3" t 5i•C. LaL.:rcl Ia i�(_..tC'J !•aPn f.r, , .,� �rt� �� L? -•t.. . /�'ri i"E\ tiA � t r^� f�c���+� •�v lahC•�.�11 � ! i. i°IOn �� 1 �'.Q ,1 Y:• niw ' 1 This application Is /DENIED for the category checked in SECTION B FOR OFFICE USE ONLY above, regarding the•desigil of a subsurface disposal system as indicated on the acompanied plot plan, using the requirements set forth in SECTION C above. A build- I 1 S7 ing permit is necessary for the installation of the above -designed system. No con. Revenue code Fee $ 1 structlon Is permitted In the required reserved 100% expansion area. Septic I , e(r1 Tank must be 100' minimum from any wells. Check # (2) Leach lines must be 100' minimum from any wells, including expansion area.' Date EInitial (3)r5 we er lines must be 50' minimum from any wells. r epage pits must be 150' minimum from any wells, including expansion area. z Signature ofNklealth Official Date DEH -SAN -122 (Rev 9/98) UISirioulion: WHI I t—Uftice rile; Tti-LUW—Applicant; FINK—bldg. Uept.; UULUtNHUL—vIanS/Hecoras Maa rr . 22 •q�2►0000 8:09PM ABEL KR I EGER WI LMETH REI: 1,�'U:t►���i3�if!itipl� r:�f :• CHiCAuU TITLEZOMPANY AND WHEN RECORDED; MAIL TO; • i Leonard Lam iii Chelsea Circle- . Palm Desert, CA 92260 pao. TrandetTt�: p14,06. Recorder No • 9265 IP • I ui `36 "aECEw Ao e:oo RE -CORD • 'SAN 151999 MEW8 uge ONLY ASSESSORIi.PARCt3 NO.: �k� oar. . s�i.-_ Grarttor(e) declares) that the:D000MENT TRANSFER 'TR 071 t) -o4z- TAX IS TITLE' ORDER NO.; 87.0104,18; 4, ,Toy a� •�� � •� ` � �� � --..a" ... , •. OF tN _ PUBLIC WORKS CLEARANCE LETTER .FOR CUSTOM HOME LOTS r w . 7. F Dear'Bullder .. - _.. ,. ^r 'y i c..,." ,• ; y ...:� . .-.i , • �j.•�,.,.. Y ?'t.i.:f s y;.w� '1SPas` ,. Prior to issuance of a building permit, you will be required to obtain clearance from the Public Works Department for one,: or more, of the following. k �' _ j . �`�'.t J{ Y' S 1Y.lai••a _ --F ,kk� .2. j' 1.. Verification that rough grading Is complete, and the. pad elevation certifications ; `:� 's prepared by a, licensed surveyor, .or engineer, are on file In the Public Works � 4 �: Department. fi t t rrr M51 _ • - _ .. � , . t-- sr r -YF. ,cy. . - 'y "'Sr A„•y a. -- %+ "„�� x. ' .•x�? 2: Verification that infrastructure improvements and other, required tract improvements` rya y .`- } -. • wP y miry. 1.: 4.•F 3 are complete, or sufficiently advanced to warrant building permit Issuance;, '3. Prepare an engineered grading plan that provides for -on lot storm water retention, ,,­, �Y and have it checked and approved by the Public Works Department fry Tract 26524 (Estancias) x.. • Tract 26769 (Mountain View Estates)' . _ 4 •.,..L 'f IP 4C SP+ � I,t�r'.j^•A qbl� 4`�1 4. Prepare an engineered grading plan that provides• for building pad, grading mf"° accordance with the existing soils report and tract gradings plan, and have '� checked and approved by the Public Works Department. T,A*t' • Tract 28034 (South Valley Estates)k. ;,axx FOR WTERNAL USE BY PUBUC WORKS DEPARTMENT LOT: It P B IC woAKS AUT; RIZATION DATE F:IPWDB7nDOCSIFORMSIPW CLEARANCE LETTER.ss C MENTS: r n'rE�-• ri ry ee t' 11�j' �' 4:- P.6..,Bbx'1504 aw 78-4'95. CALLS TAMPICo (760) 777-7000 LA QUINTA, CALIFORN,IA'92253 (TDD) (7 610) 77,7-1227 September 18, 2000 To: Whom it may. concern , �RE-;-7-8-6 2.0—SAGUARO'DRI VE �-- . Re: Assessment.District.2000-1, Phase Vh Improvements -Areas A, B, C & D The Property Owner: LEONARD LANs APN 614 -.312 ='0 3 9 / 6 4 6 - 312-038 isaocated within the..City's, current sewer: -assessment district ,'TheCity anticipates 'construction of sewer facilities within the referenced project limits-beguming eiii *Mid, to late' October 2000. and expected to be completed in date May 200:,L If you have dny,questions.regarding the project please don't hesitate to ' contact me immediately at 777-7045. Sincerely, UOinA Freeland Senior Engineer c: Tom Berg; B&A Project File-98'-19X-B,C&D. ; T:\PWDERVR6JEC13198Prjc1s19819PhVNettas\GmicSwrMmo.wpd �� This Certificate issued; pursuant :to the requirements of Section 109 of the Uniform. Bui/ding.Code, certifying that, at. the time of issuance, this structure: was in comp/lance with the various ordinances of "the: Cityregu/atj boi/ding:construction or use. For the_ fo/%wing: : ,BO ILDIN.G ADDRESS: 78-620 SAGUARO DR.. Use CI`assification: SF:D Bldg. Permit No.: 000467'3 Occupancy Group R 3, :Type of Construction: VN Land Use Zone: RL:o Owner of Building: LENARD. LAM Address: P.O_BOX 450 City: LA QUINTA, CA 92253 By: STEVE TRAXEL l ` Date: 11-17-00 Building Official POST INA CONSPICUOUS PLACE