Loading...
9710-022 (SFD)LICENSED CONTRACTOR DECLARATION I f�ereby 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 610086 F3 W. 1/99 vDate 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 a 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. (.) 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 Policy No. XIII '1" FU115 X46.97 UNFF'00072 4 (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: 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 nulland 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 purposes. Signature (Owner/Agent) Date 4 PERMIT # CONTROL # BUILDING PERMIT 9710422 DATE 41- ^VALUATION $93,981.60 LOT . 11� 14TRACT v/yes rJOB SITE ADDRESS 53-730 AVENIDA JUAREZ APN OWNER CONTRACTOR / DESIGNER / ENGINEER MARVIN JOFWS0N PLATiNiJM DEVE LOP MWT INC CATHEMAL CTI' ' _ CA 92234 (7f€ 0)8"7'56 C. 8L# 32% USE OF PERMIT P®.4D , 517D - P—EU6T DOES NOT -INC-ILMEBILO3CK. WAt..z.s'0R `'POO .DEC 10. 1997 TRA,CTCONSTRUCT:IOA4' SF C:AfU ;1YCARP'0RT A3. SF 6 FT. WOOD'rwENCE 200.00 LF ESTIMATE -PERMIT FEE SI.iHIv[ARV C."ONSTRUC711,I0N FW. 1:01.0011.41.8-000 PLAN CHEXXFEE 101.000-439-318 $..51.!5,'27 IVISCH'ANICA1. FET, 101-000-421-000 $53.50 ELEC'"IR.iCAL FEE10.1-00(} 420-000 $.126.32 PLUIV031Nr C'! B . X0.1 -00t}-419-009 $133.50 STROKO N-10TION FE - REW ,1.01000-241-000 $9.40 GRADING FIM $20,00: CNF'}2.ra,5t'!`ft1 C TV0 Fa 225-000.443-342 sz,om m - PRLC.i'SE PLAN $25.00 FEE DROSIT -$250.00 SUB -TOTAL CONSTRUC°t'ION AND PLAN CHECK $3,554.87 LESS :PIM -PAID EEs -$25%oo TOTAL PERMIT FE V% DUE NONV S3o304.87 RECEIPT DATE BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck k# JJ Exhaust Fans O.K. to Wrap F.A.U. Framing lV16 Compressor r Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall insulation Condensate Lines Party Wall Firewall Exterior Lath 1402 a� Drywall - Int. Lath if Z Final Final POOLS - SPAS BLOCKWALL APPROVAL9 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 Heater Final _14 Water Piping 4 Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral A 0 Pool Cover Sewer Connection 70 Encapsulation G as Test ApOtaff5es Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit 14 Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power final tility Notice (Perm) .yj�,�„� ya.�, .--T•,•,,•,.w.,�yw..,,,-!•, t•-„._-.,,,,�.4 ...� .-r.,,--„�i3� '�'°�' ��'K"�'�xF�'F'''y�`),�y�.y� r� -70 i4 P.O. BOX 1504 APPLICATION ONLY Building ; i' 78-495 CALLE TAMPICO Address r , LA QUINTA, CALIFORNIA 92253 Owner BUILDING: TYPE"CONST. OCC. GRP. Mailing -n (" i'” Address l� k (Y1r'� `: e 1 -'.1 I —7 '1 /� t i �l J A.P. Number «rte-*T��-iC—� I I `-i City ._ illfIp t 2— Tel. -7 ., j' \ , �� Legal Description t`1 �t �y nl nl`n��l,'-CI'2 Contractor � r'""\ � Project Description •� �'" � - ��, ``�� `C1 Address t U I j t t I �( IrK 1t CA 2> � ,� - City 1 Zip Tom. State Lid. N,,,City & Classif. t o t MPA A 0 _ Lic. # Sq. Ft. No. No. Dw. Arch., Engr., tj Size �Q Stories ` Units Designer New 0--' Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address / Tel. . 2-51-09Z coy.S—��7 CriIty, / Zip State Lic. # .1. LICENSEO-CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division Tcif the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby 'affirm that I 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, atter, 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 (8500). I-1 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, 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 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'11, 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 or property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) i 1 1 am exempt under Sec. B. & P.C. foi`ttiis reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 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 n 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 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. MOM 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 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. t mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip PERMIT AMOUNT Plan Chk. Dep. (� Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS 1 ZONE: BY - Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line ® Side Street Setback from Center Line AIM Side Setback from Property Line FINAL DAZ9L. �� a INSPECTOR Issby, Date Permit Validated a' Val' WHITE = FINANCE YELLOW = APPLICANT 1D PINK = BUILDING DIVISION I Desert Sands Unified School District Notice: 82-879 Highway 111 Indio, CA 92201 Document Cannot Be Duplicated 619-775-3500 CERTIFICATE OF COMPLIANCE Date 12/9/97 No. 16382 Owner Name Marvin Johnson N0.53730 City La Quinta Tract # APN # 774-111-011 Jurisdiction La Quinta Street Avenida Juarez zip 92253 Lot # Square Footage Type of Development Single Family Residence Comments Permit # Log # Study Area 1496 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 1,496 or $ 2,752.64 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 oc/Palm Springs Savings Bank/Platium Development Teleptione ('321-7288 Name on the check. By Dr. Doris Wilson Superintendent Fee collected /exempted by Pauline Pearson Signature �� A ' rR N. 146 `r Payment Received $25752.6"' - Check No. 483406054-' 40TICE: 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 tbove 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 tilled 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 LOCATION MAP N.T.S. 46600„ 2 EXHIBIT "B" 0 u W J Q U In P.O.B. Axl) - N89'59'00"W -10 100.00' (:)j / A.P.N. # 774-111-012 0l C1 -� N89'59'00"W T 79.99' o . M N89 -59'00"W CALLE -12 �— 5' P.U.E. ARROBA CURVE 0 0 14 oI 3 o A.P.N. # 774-111-011 0 o� rn 90.02 0 Mo M �� N89'57'00"W 100.00' o 0 '(n 30 � a� LOT LINE TO BE REMOVED m N 13 01' 0 (:)j / A.P.N. # 774-111-012 0l C1 -� N89'59'00"W T 79.99' o . M N89 -59'00"W CALLE -12 �— 5' P.U.E. ARROBA CURVE I RADIUS I LENGTH I TANGENT I DELTA C7 20.00 31.43 20.01 90.02 0 PARCEL MERGER 97-329 CITY OF LA QUINTA I -DEPARTMENT OF PUBLIC WORKS ENGINEERING DIVISION ,--©T--�-- �NE---AaJJ ST I-Efd T LEGAL DESCRIPTION: LOTS 13 & 14, IN BLOCK 192 OF SANTA CARMELITA CITY ENGINEER AT VALE LA QUINTA UNIT NO. 19, IN THE COUNTY DESIGN BY SCALE OF RIVERSIDE, STATE OF CALIFORNIA, AS PER MAPS RECORDED IN BOOK 19, PAGES 33.AND 34 OF MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY. CHECKED BY SHEET NO. CLEMENT CALVILLO, R.C.E. 27743 DATE R.C.E. FILE NO. Recording Requested By: And When Recorded Mail To: Marvin'Johnson �:fildred Johnson z 4Gs0�z EXHIBIT A CERTIFICATE OF PARCEL MERGER N0.9 - Existing Parcels Record Owners Assessor Parcel Numbers Marvin & Mildred R. Johnson 774-111-011 774-11.1-012 Legal Description of Merged Parcel Lots 13 & 14 of Block 192 of Santa Carmelita at Vale La Quinta unit #19 as per map recorded in book 19, pages 33 and 34 of Maps, Records of Riverside County, California. Parcel Merger No. 97-329 f f� s f . 466022 PARCEL MERGER 97-329 EXHIBIT "B" Lots 13 and 14 in' Block 192 of Santa Carmelita at Vale La Quinta, Unit 19, as shown by map on file in Book 19, pages 33 and 34 of Maps, Riverside County, California, more particularly described. as follows: Beginning at the Northwest corner of Lot 14 of said map; Thence N 89° 59'00" W, 100.00 feet along the North line of Lot 14 of said map, Thence S.0° 03'00" E, 100.00 feet along the East line of Lot 14 and 13 of said map, Thence N 890 59'00" W, 79.99 feet along the South line of Lot 13 of said map; to a point on a tangent curve concave . Northeasterly. having a radius of 20.00 feet; thence Northwesterly 31.43 feet along said curve through a central angle of 900 02' 00", to a tangent point; Thence N.0° 03'00" W, 79.99 feet along the West line of Lot 13 and 14 of said map, to the Point Of Beginning. Contains 9,914 square feet, more or less. Subject to all easements, rights, right-of-way and covenants of record. I ; 1� CipKent N: Calvillo R.C.E. No. 27743 Exp. 3-31-98 RN *\ Exp. 3,91-99 l* Of /O—Y 97 Date 0 r 1� 78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 – (760) 777-7000 FAX (760) 777-7101 TDD (760) 777-1227 December 18, 1997 County Recorder County of Riverside Post Office Box 751 Riverside, Calif. 92502 SUBJECT: Recording of Parcel Merger 97-329 .Dear Sirs: The City of La Quinta has approved the above noted Parcel Merger. Please allow its .recor ing as presented bV Mr Marvin Johnson irlatinum Development). Should you have any questions, please call me at (760) 77,7-7064.. Very truly yours, JERRY HERMAN COMMUNITY DEVELOPMENT DIRECTOR STAN B. SAWA Principal Planner sbs ltr co rec pm 97-329 MAILING ADDRESS - P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253