Loading...
0106-359 (SFD)LICENSED CONTRACTOR DECLARATION �Iiereby 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 V. Q, 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 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). rr ( ) 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 tl e performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Sieetion 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. ' '��`.��� ltd:+ If�3�•D� :,, � . . (This section need not be completed if the permit valuation is for $100.00 or less). () I certify -that in theperformance 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,l shall forthwith comply withj�blose provisions. Date. ­7,7 .� ". Applicant�j`�° a Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in ' addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's.fees. IMPORTANT Application is hereby, made to the Director of Building and Safety for a permit subject to the conditions , and restrictions set forth on - HSI, application. 1. Each person upon whose behalf this application is made & each person at ` Whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to,. & shall, indemnify & hold harmless -the City of La Quinta, its officers, agents and employees. ° •2. Any permit issued as a result of this application becomes null and void•If t work is not commenced within -180 days from datefof issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state�that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize/representatives of this'City to enter upon the above-mentioned property for Insp ctl n purposes i nature /Owner/Anent) BUILDING PERMIT PERMIT # DATE VALUATION LOT( wS� TRACT T177,12 JOB SITE ADDRESS APN OWNER CONTRACTOR/DESIGNER/EN INEER r ROM, T A 9 YLVIAX:M L XJG > CONIEW, ORARY HO WES 51370.�V'1��1i AIMMC3:l)AD IAQ13i;NTA C"A 92253 �7+sl7�"fr•1�'C�.2 f;,',1�1'.efir X735 USE OF PERMIT '.a • j X11)) PFIZAIT�0331 NOT 'INJCI<VI)E BLOCK -WtJ L:: POOL, Ot"'...i:RIV't:'Rrp Y - -- -4 -- A YyNOT!UhryION 40- H .0 TVABF GARAGVCARP01Vf 50.00 V 5 TAT. WOOD nINCE, 200,00 LP EC4'IZgE 73M CO.Ir' Or CVk4 + &Jf"MIMT 88,382.10 'ti°l�'�A� d"6''�\/ ��'b �1.rSV SRnG J ®� •'�Cry�'Y i, aFm4ri.�U �aFJYt6�'N �3�fp�� �p95.2�9 I��'Fg1y�� 1~'gt..Ay�) pC�T•dyECK q$(/��rl�/C{t�ti�tn�`��g1 dV'qR°r/V�'`OI/i�N,`r",,yfl2�,(.S�°i7(���ry(1 uJY µt1l�dj.(i�, $yrh7yy4✓.3.L.?&��ayxpP7��(/AYyy'y� (cL,,'t��►:sb'r' .f:+.CAI� r�iyi'T,LFrF'►7✓!'MJ4:. 101-000-42,0-Wv O .qb h+i•.Ku 131,11AJ11�3 101-000-419-000 sfia"n, Si dZ :?�4 i�Jff 9IC�i't, 3?'. fis'uT?i 01-�J�S1�-� ORMAiB 19Z 101 -000413-000 M00 MMIE OPE41 IMPACT I'MY, 'PRECIS F, �1 101.000.4 41.3 35 $100.00 V01, DEPOSIT . 101-000-439-318 4350.00 1 ?C� :J.� A ,Ir1 ?1�LAW,�wC 93,414.50 P, All FEM w 5t .t aAla' !� +fidU1fi�,3.►�€�`C► J U L 3 0 2001 1 !'_'��'°��, CITY OF LA'OUINIIA O'PT' FtFGEN�T- I DATEFI ALED a a e a. INSPECTOR .. / INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Main Drain Underground Ducts Forms & FootingsDucts Slab Grade Q A/ VL%l Return Air Steel Roof Deck O.K. to Wrap _ _ _ 2' _�� /s_ _� Sr� sr Combustion Air Exhaust Fans F.A.U. Framing Insulation ��/ f $� Compressor Vents Fireplace P.L. Gas Piping Waste Lines Grills Fireplace T.O. Electric Final Heater Final Water Piping Fans & Controls Party Wall Insulation Plumbing Top Out Equipment Enclosure Condensate Lines Party Wall Firewall O.K. for Finish Plaster 3��•1teral , Exterior Lath Drwvall - int. Lath ► r .. _ t -R ? Test Final COM �ENTS::,B,� Final ELECTRICAL APPROVALS TemD. Power Pole 1471�f- Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power FinaUtility Notice /--, ` ` v ,c____ I `� 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 Waste Lines PLUMBING APPROVALS g�7/�� �'� Gas Test Electric Final Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster 3��•1teral , Pool Cover, Test Final COM �ENTS::,B,� Final ELECTRICAL APPROVALS TemD. Power Pole 1471�f- Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power FinaUtility Notice •w,9Yecl7T'•.,•r as+.•..Naq�� n9^^!. ... .-I'rc+.. w-�. . ,s.o,. sA • ah..r -•-. y,�..ts /L -.. N r ' r". T R'.r-?.^jX.o�, LW �!'% :.�w.'... • 4 l .. 'IAddress 5, 'n �. Owner . J r i 1 � CL C3 � Mailing` . ,city Zi p' Contractor Grading Driveway Enc. Address Infrastructure State Lic.C "'� I & Classif. 15(1 Arch., Engr.; Designer Address Y I as P.0..BOX 1504 APPLICATI NI ONLY 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 . . . f (°mss BUILDING: TYPE'CONST. OCC. GRP. • A.P. Number IT 1 Legal Description � � i il!) i ! r.iii-{ j moi' it U Project Description Tel. City 1 Lica# Sq. Ft.�• `, No. No. Dw. Size Stories Units 1 New Add ❑ Alter ❑ Repair ❑ Demolition ❑ . Tel. CityZip . State Lic. # IC SED CONTRACTOR'S DECLARATION 1 hereby affirm that -4 li' need under provisions of Chapter 9 (commencing with Section 7000) of Division 3 Of t e ass and Professions Code, and my licen Is loll force and effect. 1 j - �C �' V , OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following. reason: (Sec. • 703 1.5. Business and Professions Code: Any xty or county which requires .a pertnlf to construct, .atter, improve, tlemolish, or repalrany"structure, . pdor to 'Its Issuance also wires the aPPlicanl for such.Permlt to file a sfgned statement that he !s Ikensed pursuant to provisions o/ fne' Contractor's License Law,' CAapter 8 (commencing wlth.Sectkn 7000) o/ vision 3 o! the Business and Prolesskns Code, or 1hal.Ae is. exempt therefrom, end the Dosis !or the alleged exemption. Any violalkn of Section 7031.5 'Dy 'any applicant !or a permtt subjects fAe applicant to a civil Penally o! not more than five hundred dollars (5500). I, as owner of the property, ar my employees witft wages as their sole compensation, will do the work, and the structure is not intended or aflered for sale. (Sec. 7044, eulsnass and Professions Code: The Contractor's License l:aw does not appry to an owner o! property who builds or improves Thereon and who does Such work' himself or through his own employses,- Providad that such Iinprovemenfs are not Intended or offered for sale. If, however, 09 building orimprovement 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 L;Cense Law does not apply, to an owner of property'who builds or improves. thereon, and who contracts for such projects with a contracror(s) licensed pursuant to the Contractor's License Law.) i] I 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, ora certificate of Worker's Compensation Insurance, or a cer fncopy' hereof: (Sec. 3800, Labor Code.) Policy No. Company S 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 (f iCO) valuation or less.) I certify that in the performance of thg workfor 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 Callornia. Date Owner NOTICE TO APPLICANT: If, after making thisCertificate 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 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 propefly filled out, signed and validated, and is subject 10 expiration if work thereunder is suspended for 180 days. 1 certify that I have read this application and state that the above information Is correct.' I This 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 a0plicant Date Mailing Address City, State, Zip imated PERMIT Plan Chk. Dep. Plan Chk. Bal. t! Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: 2 Minimum Set ack Di tances: ront Setbacl ' ne Hear k AdD MAr Prop. Line - Side StriAWL Side'Setback from Property Line F I NA>��T E INSPECTOR Iss y: Date Permit Validated by: Validation: -ad WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Notice: Document Cannot Be Duplicated Date 7/30/01 Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE APN # 773-242-012 No. 22330 Jurisdiction La Quinta Owner NameRobert & Sylvia Kellogg No. 52-231 street Avenida Juarez Permit # 0106-3 59 Log # City La Quinta zip 92253 Study Area Tract # B7U2 Lot # 1 Square Footage 1409 Type of Development Single Family Residence . No. of Units 1 Comments j 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 1,409 or $ 2,888.45 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/Union Bk of CA -Mark Kellogg/Contemp. Homes Telchone 760-564-1962 Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Annette Barlow Payment Received $2,888.45 v ' Check No. 7425683 Signature N0110E: 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 above will begin to run from the dais 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 collect 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. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting S 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: . Use Classification: SINGLE FAMILY DWELLING Occupancy Group: R3 Type of Construction: VN 52-231 AVENIDA JUAREZ Owner of Building: ROBERT & SYLVIA KELLOGG Building Official Bldg. Permit No.: 0106-359 Land Use Zone: RC Address: City: By: RICHARD KIRKLAND Date: FEBRUARY 27, 2002 POST IN A CONSPICUOUS PLACE 4 01/09/01 10:25 FAX 17608049062 COWIONWEALTH TITLE RECORDING REQUESTED BY: AND WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW, MAIL TAX STATEMENTS TO: Robert B. Kellogg Sylvia Kellogg SPACE A80VE THIS LINE FOR RECORDER'S USE The undersigned grantors) declare(s): Grant Deed A.P,N. 773-242-012 Documentary transfer tax is $ 9*— 2n i ( x.;r) computed on full value of property conveyed, or ( ) computed on full value less value of lions and encumbrances remaining at time of sale. ( ) Unincorporated area: ( ) City of + FORA VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged, Dale & Terry Edgington hereby GRANT(S) to Robert B. & Sylvia Kellogg the real property in the City of La Quinta • Slate of California, described as , County of Riversida Lot 1 bf Block 7 Unit No. Santa Carmelite at Vale La Quinta,,as per map recorded in Book Pages of Maps, records of Riverside County, California Daled June 14, 2001 Signature of Grantor Slate of California ) County of Ori before me, Dale & Terry Edgington � ;personally appeared- _ Dale & Terry Ed ; n .ton personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) islare subscribed to the wilhin instrument and acknowledged to me (hat he/ahe/they executed the same in his/her/thelr authorized capacity(ies) and that by --- his/her/their signature(s) on the Instrument the person(s), or the entity upon behalf of which the'person(s) acted, executed the instrument. WITNESS my hand and official Beal. Signature MAIL TAX STATEMENTS TO, same q )03 , and aC Z Z O Q O6•e�� e. o. O y�zoi 60 G9L \ 6'GL o'a f 06 04 �� 00 ( 0 r 1 • a of 2 A L � o\ e d •o,+ C o•o y c . � �. L uy a� Duero 2 oc of ,� oG. ooI OO O/ _ of• n � 42•LO \ /60-090 ? ° S'/ ®� Q - Is•901 -"' �6 00 9 @o o® 9 J 'ZI Lf'SO n £/ Of pe o 00 � S a ; o £ U 6 o s Yp X3 O e � W Z O/ o W.Ivd �I Q � w of �E o0 of of Doi o O6•e�� e. 001 ifs oo '� C`� a L8'f6Z/.s f'? F 'S 60 6'GL o'a f %C• I G'Ai .08 S 0 bo� VGVN3SN3 0 — + 777VO C o•o y c . � �. L uy a� Duero 2 oc of ,� oG. ooI OO O/ _ of• n � 42•LO \ /60-090 ? ° S'/ ®� Q /60-090 ® © 6-- ^ Q ez'4o� a —fGom _ O O b/ ©� O 6/ N A �6 9 @o o® 9 'ZI Lf'SO n £/ Of pe o �C c�•I � zbwL� Ztd 7 19' - Ike 9 0 N °n // ® // ZZ < x 06• •Zql � O/ 6/ o O/ £ Z 60-OZO Q ® b ° Q ; s� ' x 6 8/ © bZ mb Q Z •� � N Q O � /60-OZO ,VbU 4o'6^i� of �E o0 of of Doi Q C o% r oc. m VYONOS �` :+L° S 377VO o y I o vi OZ Q N hit 3 0 ry h u h ' h �w;t os "ve r 00 Q C o% r oc. m VYONOS �` :+L° S 377VO o y I o vi OZ Q N hit 3 0 ry h u h ' h �w;t RC DISTRICT PLANNING REVIEW FORM This form is to be used by CDD staff for review of single family dwellings in the RC (Cove Residential) District per Section 9.50.090 of -the Zoning Code. Its purpose is to determine: 1) that the proposed house design does not duplicate the same architectural style of any house within 200 feet of the applicant, and/or 2) if there is a need for the -'applicant to file for Master. Design Guidelines. If the applicant does need to file a Master Design Guideline, please transmitted this information to the Building and Safety Department as part of your correction list. Please attach additional explanations as necessary. APPLICANT . Buffin/Kellogg SITE ADDRESS 52-231 Avenida Juarez APN 773 _ 242 _ 012 CASE NO.: 2001-515 LEGAL: LOT 1 BLOCK 7 UNIT 2 S.C.@V.L.Q. CHECK AND APPROVED BY: Stan. Sawa DATE: I Inform the assigned Building plan checker upon your assignment to this case. The CDD Executive Secretary maintainsa log book to track applications and assign case numbers. REQUIRED ITEM Y N COMMENT/CORRECTION Verify legal and APN information V Consistent with MDG on file (as applicable MDG filing required (5 filings since 9/3/98) Architectural variety within 200 feet of the surrounding area: Colors Materials Architectural design features v V Other Requirements: Cvm"�6ID,LIAM - �J