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9612-156 (SFD)LICENSED CONTRACTOR DECLARATION It 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 Pi'e,.essionais Code, and my License is in full force and effect. License # Lic. Class Exp. Date _513670 vflate/- 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: 1, as owner of the property, or my employees, with wage's as their sole compensation, Will.do the work, and'the structure isnot intended orofferedfor sale (Sec. 7044, Business & Professionals Code). ( ), 1, as owner of the. property, am exclusively contracting licensed d contractors to construct •the project (Sec. 7044, Business & Professionals Code). O I ar*6xempt under Section B&P.C. fo,r this reason Date Signature of Owner WORKER'S COMPENSATION ,DECLARATION hereby affirm under. penalty of perjury one of the following decWrations: !.have and Will maintain a certificate of consent to self -insure for workers' compensation, las' provided for by Section 3700 of the Labor Code, for the performance of the work4or which this permit is issued. �e I Nive 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. 0 f ) L =4 RA :.t MW32?374-tl,h (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 subjecttothe workers' compensation provisions of Section 3700 of the Labor _Pode, I shall. forthwith comply with those provisions. V'Date: 1 --LA g Applicant— Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal'penalties and civil.fines up-to'$1.00,000,.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 ab6ve-mentioned property for inspection purposes. /ignature (Owner/Agent)-J%=:a= Date PERM T# CONTROL# SUILDING PERMIT 96,12456 4 5 916 DATE'. .VALUATION LOT TRACT JOB SITE APN ADDRESS, SO C"'U'Li, PALOMA OWNER CONTRACTOR DESIGNER ENGINEER SUNROSE CORPORATION VALM DESPRT CA 92260 PAUVI DESENOt' C.A. 92260 (619)772-1.492 CSI N 1137 USE OF PERMIT U-0-PER1Ul Y D(ASNOT 114CLUDE- 1XIDILIK: WALLS Oklloii. 7 3 Sr. P rJRC a UT I A r 0 J60XIO sr. ESTIMATED K AN (I AECK O�F S74,1115 pLAN 043(K 1'.431,04,11111' Ftps' IW -009-4411-000 $98q50 [10CAL FEES. 10.1-00.0-420-000 $184.42 01J.11NIRM0 9rolf"S 10f.0011-11119-000 101.401) 2.11 .000 $16,141 is f2.6li:1f1V! 1(11A 6-48-000 *20.06 2225-4)(M-443-342 13,697,24 10 1 410-44J -.1-45 �4ART INP'L 4ACITAC S k ' " 5 70 10( )0-5_-000 $ 172, 77 11 1t =!( A 11,(_ "ON "TRUC71 11 'E�7'9 6 N AND 111-Aiq CH S6.0 0? Jq I , _ . C1W, OF LA QUINTA T,ESS PRE-RAJD Hms S'250,M JAN 10 1957-KYUM, PFRMIT F910% 01A."i NOW $5,752.49 FINANGEDEPT. ........... .. ......... ................. .. .... DATE FINALED - OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel I Combustion Air Roof Deck Exhaust Fans OX to Wrap '�, F.A.U. Framing *1 Z Compressor Insulation j 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 APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam ...Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I 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 V( Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole �f 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: r P.O: BOX 1504 APPLICATION ONLY - Buildingi 78-105 CALLE ESTADO Address ® CA"t; ALBA LA QUINTA, CALIFORNIA 92253 Owner l Mailing ® Address ��— �y�C'0 _ /;;o CR Zip Tel. Contractor City Zip Tel.. Ylm /� fZ '1>09 ® 77- State Lic. City & Classif. 23 533 '7b 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 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that 1 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, 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). IJ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, andthe 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.) 1'1 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.) ] 1 am exempt under Sec. B. 8'P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of. consenttoself-insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company O Copy is filed with the city. O 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.,, -,- 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 it 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. -OCC. GRP. A.P. Number %6 %— 06'y 061— 7 Legal Description / ✓ _.L Project Description Sq. Ft. `No. No. Dw. Size .2 7.32— Stories' % Units New 9?-' Add ❑ Alter ❑ Repair ❑ Demolition ❑ 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 Y: Rear Setback from Rear Prop. Line r Side Street Setback from Center Line ii PAID Property Line FINAL DATE PAI ` INSPECTOR Issued by -C C Date Permit IJEValidated by: 1JJ� Vani ff' t I ik, Y BUILDING DIVISION CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEPS + 1ST FL. SO. FT. @ $ UNITS SLAB GRADE 2ND FL. SO. FT. @ BONDING YARD SPKLR SYSTEM POR. SO. FT. (u MOBILEHOME SVC. BAR SINK GAR. SO. FT. @ POWER OUTLET ROOF DRAINS CAR P. S0. FT. @ GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. @ OTHER APPJEOUIP. DRINKING FOUNTAIN SO. FT. @ TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 11A c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR @ 3/ac HOUSE SEWER LATHING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE = ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL, AREA SLAB GRADE ROUGH PLUMB, BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK 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. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 51 Notice: Document Cannot Be Duplicated Date 1/10/97 No. 15171 Desert Sands Unified School District 82-879 Highway 111 Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE Owner Name Sunrose Corporation Jurisdiction No. 50620 Street Calle Paloma City La Quinta zip 92253 Tract # Lot # Type of Development Single Family Residence By Comments APN # 769-064-001 La Quinta Permit # Log # Study Area 125 Square Footage 2732 No. of Units 1 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 2,732 or $ 5,026.88 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 cc/First Bank/Sunrose Corporation Telephone 772-14.92 4 Name on the check Dr Carol McGrew Administrator in Charge Fee collected /exempted by Pauline Pearson Signature 1 J 01,56A PQ Al AA .611_ Payment Received $5,026.88 Check No. 36737 10TICE: 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 protest the fees or other payment identified bove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to .Ilett them on the Dislricl('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 --;° RECORDING REQUESTED BY AND WHEN RECORDED MAIL TO F 7 TRACY M. TUVELL MICHAEL TUVELL 72850 SOMERA ROAD PALM DESERT, CA 92260 (PAID Doc. Transfer Tex FRANK K. JOHNSON Rist. Co. Recorder 430148 RECEIVED FOR RECORD AT 2:00 O'CLOCK NOV - 81996 R@M0d n OMc W Re=d6 d Rndrside Caunry. CatAarwa I Recorder Fees i Escrow N0. 6760085 -P18 Order No. /~ 6760085 - SPACE ABOVE THIS UNE FOR RECORDERS USE Z _ AW 769-064-0.0.1 -GRANT DEED THE UNDERSIGNED GRANTOR(S) DECLARES) DOCUMENTARYTRANSFERTAXIS $49.50 ❑ unincorporated area City of . ® computed on the, full value of the interest or property conveyed, or is ❑ computed on the full value less the value of liens or encumbrances remaining at time of sale, and FOR A VALUABLE' CONSIDERATION, receipt of which is hereby acknowledged, ANGELA RUSSO, SURVIVING. TRUSTEE OF THE' RUSSO -FAMILY- TRUST" U/I5/T DATED 2/4/81 hereby GRAW(S) to 4`1 MICHAEL TUVELL AND TRACY M. TUVELL, HUSBAND AND WIFE, AS COMMUNITY PROPERTY V r ^} the following described real property in the l " County of R ✓CQ9 i d <.-, State of California: LOT 70, DESERT CLUB TRACT, UNIT NO. 5, AS SHOWN BY MAP ON FILE IN BOOK 21 PAGES 61 AND 62 OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA. Dated October 14, 19.96 - �—�"CJ 0/ STATE OF C IFORN A ANGELA RUSSO COUNTY OF. �i ���� ) SS, On before me, a Notary Public In and for said: " unty:and"State, personally appeared � (or proved to me on the basis of satisfactory GEMW R N= eviden.:e) to be the person(*),whose name(e) is/aaa subscribed to the COmmbdon11M96M within Instrument and acknowledged tome that he•/she/t* executed the @1MVyCqm0L�&4ol=Sep2&.1M same in lai+�%her/tiwk authorized capacity*), and that by*hle/her/tlwksignature{e) on the Instrument the person(e), or the entity upon behalf of which the person (e) acted, executed the Instrument. WITNESS my handandofficial seal. /C Signature of.N99fyFOR NOTARY SEAL OR STAMP MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE:. IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE Name Street'Address City, State & Zip GD1-10/13/88bk COACHELLA VALLEY WATER DISTRICT _ CASH,RECEIPT DETAIL NQ 5953 Received From: n I U C' (__Q C G. 0,1 (� Date, Address: fS�J J �SuMPrc.;. Account No.(D Vy to (� U `{ • U `� Lot(s) Tract f Service Address G.A. Code 1111 kD_ ❑ Service(s) ❑ Backflow(s) ❑ House Lateral(s) (IIV ❑ DetectorCheck(s) i ❑ Meter Surcharge Sanitation Capacity Charge r .� e7 S ' V t E ❑ W.S.B.F.C. j ❑ Temporary Construction Meter ❑ Turn on Charge 1 ❑ Uncollected Account -Name . } ❑ Inspection Fee - Tract - i Fee - i ❑ Plan Check Fees Water I Sewer - Tract ❑ Bond Payment - A.D. - Bond Assmt. l❑ Customer Deposit ❑ Other f !(E _ I TOTAL $ / / 75U V Remarks: I . Cash Water Service Check- 'r J r Money i Cashier Order _gl11189l TA`N„-17-97 FR1 1.3 �' u ' , r° f R `0 1 p ` CAL gl ST ENGINEERIN� 32-81 lurura vista, Cathedral City, ca. 92:34 (619) 32R-3150 =(Tl4)248-5139' January 17, 1997 __. ---- .y. Mr Mark Harold, Building Department City f La Quint.a 78-495 Calle Tampico ?- ' La Quinta, Ca. 92253. r Certification of Finished Floor Elevation esert Cub Re: Tract Juvell Residence} Dear Mr. Harold, have made a field review the above noted project We are writing to inform you that we ,of floor of the residence is 12” above the - . site and have determined that the.finished elevation curb as shown on the approved site plan. -r' top of Please contact our office if you have any questions regarding this matter. Sincerely, Cali West Engineering Kurt M, Saxon, P.E. Y'/ �. rte/ — •-��. , � i , .. _ J II .. i.. `... A—_. _ _ . .. ..a .-MIY 6�CM::iiR Jlb• v' . � 4 ., i. , .. Y� ... f ff fifi •.. Y ._ •.fin ...