14188 (SFD)Building 52-255 Ave. Juarez.
Address
Owner,. #q`1:11', -.m E Derain
Mailing
Address
City Zip
1( Legal Description
Project Description SFS
Zip ITel.
State Lia B 695405 (City 3330
& Classif. Lic. #
-Arch.; Engr:, _...
Designer
Address Tel.
City Zip 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,l iml 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 rile a signed statement that he is licensed pursuant'to
the provisions of the Contractor's License Law, Chapter 9 (ccmmencing 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.(3500).
0 I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure isnot 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.)
O 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.) — — -
0 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
a I hereby affirm that I have a certificate of consent :.o self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company `
❑ 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) v n
or less.)
- I certifythat in the performance of the work for which this permit is issued, I sha 1 not
=any person in any manner so as to become subject to the workers' Compen ion
Laws of California.
Date Owner
NOTICE TO APPLICANT., If, after making this `Certificate of Exemption, you should Q�
subject to the Workers' Compensation provisions of the Labor Code,: you must_ fo I li—
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 if 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 INS city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Sq. Ft. 2025 No.
Size -z. Stories,,
New ❑ Add ,p Alter ❑
No. Dw.
-Units
Repair'p Demolition ❑
it 8'B courtyard wall
Y.ditio' nal wall and/o£
obtained • separa ely.
- s ,
i -
Estimated Valuation $123,9133.00
1 to -be f
PERMIT
AMOUNT
Plan Chk. Dep. "' 250.00
Di lances:
Plan Chk. ,Bal. "
351.34
Const.
7-3.50
Mech.
55.50
Electrical
142.61
Plumbing
0
138.00
.S.M.I.
11.38
Grading
20.00
Driveway Enc.
.00
Infrastructure
G.o X25 . 08
Precise Plan
2-11 . u u
Arts in Pubi c Places
1W0!avJ.a.0 -
ZONE:
BY:
Di lances:
p
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
'L�t Z
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING`FEES ,.
1ST FL. SO. FT. ® $
UNITS
O GH P U B. O w BONDING HEATING (ROUGH)
STORAGE TANK
FORMS s
2ND FL. SQ. FT. p
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
DRAINAGE PIPING
WALL SO. Ff.
DRINKING FOUNTAIN,
SO. FT. ®
WATER SYSTEM
GRADING
FINAL INSP. �%A cu. yd.
FINAL INSP. $ plus
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FRAMING /2 �/�
WATER PIPING
NOTE: Not to be used as property tax valuation
REMARKS:
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
I
IKITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE I PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING to 4,jqJNDERGROUND A.C. UNIT
COLL. AREA
SLAB GRADE;
O GH P U B. O w BONDING HEATING (ROUGH)
STORAGE TANK
FORMS s
SE ER "7t ROUGH WIRING DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE 0 y!
GROUT
i
WATER HEATER SERVICE FINAL INSP.
BOND BEAM `
WATER SYSTEM
GRADING
FINAL INSP. �%A cu. yd.
FINAL INSP. $ plus
-
x$ =$
LUMBER GR.
FRAMING /2 �/�
LJ 6 6
44 -ROOFING 1-7,16
�J bJ A`v1'y r`fsr'
D lT�o�vP
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND /
AO
�
FINISH
FINAL INSPECTION `�
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
r.
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
Date 9/13/94 Type of Permit I La Quinta
No. 113061 Permit #
Owner Name Wm. E Doran Log
No. 52-255 Street Avenida Juarez
City La Quinta Zip 92253 Study Area 113
APN # I Tract # Lot # 0 Square Footage 12026
Type of Development I Single Family Residence No. of units 0
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 1.65 x 2 026 or $ 3,342.90 have been paid to D.S.U.S.D. for
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 William Doran
Name on the check
By Dolores A. Ballesteros
Superintendent
Fee collected //exempted by Tomi Doebereiner
Signature l 1 a,{ ��Rtu Q
Telephone
� � t
Payment Received
Check No. 1298
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.
First American Title Insurance Company
Order No.
Escrow No.
Loan No.
WHEN RECORDED MAIL TO:
Mr. & Mr William Mrs. W ilia Doran, Trustees
MAIL TAX STATEMENTS TO:
Saule-as'-above'_.-
a
3CA�
0 Y
Uj U
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cc J
05. 0
C)
0
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op
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DOCUMENTARY TRANSFER TAX $.t .......:.....: ..........t....................
.Computed on the consideration or value-of.properry-oconveyed; OR
...... Computed on the consideration or value less liens or encumbrances
_ iemaining aftime of sale"` - - - - "
Signature of Declarant or Agent determining tax—Firm Name
GRANT DEED
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
JAMES W. HINES, JR. -and LOIS L.HINES, TRUSTEES UDT SEPTEMBER 14, 1987
M
hereby GRANT(S)to WILLIAM E. DORAN and VERNA H. DORAN, TRUSTEES OF THE DORAN FAMILY
TRUST dated 09/10/81
the real property in the City of La Quinta
County of Riverside State of California, described as
Lots 4 and 5 of Block 7� of Santa Carmelita at Vale La Quinta , Unit No. 1 as shown
on a map thereof recorded in Book 18, Page 46 of Maps, in tfie Office of the
County Recorder of said County.
Dated October 22, 1993 O&MM„�f��
STATE OF CALIFO n }ss.
CO Y OF }
On
personally appeared
me,
9 -
-
Ja s W.. Hines, Trustee
Lois L. Hines, Trustee
personally known to me (or proved to me on the basis of satisfactory OFFICDFELLBAUM
evidence) to be the person(s) whose name(s) is/are subscribed to the within CAROL -n NOTAAYPUinstrument and ack nowledged to me that4w/sWthey executed the same ; PRINCIPAin iiedw/their authorized capacity(ies), and that by 4is/laer/their signa- ORANGture(s) on the instrument the person(s) or the entity upon behalf of which My Commission Expires
the person(s) acted, executed the instrument.
WITNESS my and and official seal Q
Signature �. � (This area for official notarial seal)
MATT, TAX STATEMENTS AS DIRECTED AROVR -
1002(1/91)
COACHELLA VALLEY WATER DISTRICT +
j CASH RECEIPT DETAIL N° 48312
Received Fr m �\\,,` 1 Q. VY -N 1= • + Q Y Q rN Dater (S ICIL,
Address: �
Account No. Lot( 1 K' 7 Tract C
Service Address Q.A. Code
7 •.It
O Meters)It
$
1e"8ervlce(s) BSZ�
❑ Backtlow(s)
❑ House Lateral(s)
E7 Detector Check (a)
❑ MMeterSurcharge
❑ Sanitation Capacity Charge 145S41.1 / t7-
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account -Name
I ❑ Inspection Fee -Tract -
Fee -
❑ Plan Check Fees Water I Sewer -
Tract -
❑ Bond Payment - A.D. Bond
Assmt.
❑ Customer Deposit
i
❑ Other
1 J TOTAL
Remarks: G it I I N1'141 , ✓1 R - tl T-� ' p�„�
r
❑Copy to:
Cash Water Service
Check / « C 3
Money
Order. Cashier
CVWD 3801/89)
i Z.,�
-k
Earth Systems Consultants
Southern California
October 7, 1994
Building Department
City of La Quinta
78-495 Calle Tampico
La Quinta, California 92253
Project: 52225 Avenida Juarez
La Quinta, California
Buena Engineers Division
79-811 B Country Club Drive
Bermuda Dunes, CA 92201
(619) 345-1588
(619) 328-9131
FAX (619) 345-7315
This letter was prepared to formally notify City officials that our firm has been
retained by Mr. Bill Doran to perform inspection services during the grouting
operations on the above referenced single family residence. The inspection services
will be performed by a certified ICBO inspector in accordance with the project
specifications.
If there 'are any questions concerning this report, please contact the undersigned.
Respectfully submitted,
Earth Systems Consultants
Brett L. Anderson, P. E.
Copies: 1 - City of La Quinta; Building Department
1- - Bill Doran