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0011-095 (BLCK)l• LICENSED CONTRACTOR DECLARATION yl her-,&4ffirm under penalty of perjury that I am licensed under provisions of ti ap (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 Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's Lice se Law for the following reason: ( Lit . 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 A49 t- l I ignature 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: Cartier Policy No. (This section need not be completed if the permit valuation is for $100.00 or less). (�Y'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: A1,22 t 1) )Applicant !_~r•2..7/�. "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 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 for inspection purposes. .,Signature (Owner/Agent) {. f ' 1jd-t, Date I'Viv'i-2 -)wz BUILDING PERMIT PERMIT# I DATE VALUATION LOT 002 1-M. TRACT 11 /1 7rAX t7i,247.45 JOB SITE ADDRESS APN , .M4%0 A'VE I) 4 JrW=14 OWNER CONTRACTOR / DESIGNER / ENGINEER 0X.,INTO771� LA Q1HITfA 6A, 92213 USE OF PPER]�MIIjT�' �•yy qqg)y� � y� �•+y tlr..l: Vl'.ns"lbd .l:) iJ.'.7.n7�.11i 4t K? Lir X S; &_44 f..F X 6- tf E`„ROXIN AIIiAil 1, CITY ;i'TAtA DAW) 6 Irt. WALL 44.00 L t FT. WALL 53.00 LF *T OF C0A93-WTC110N FERMU YNT SUMMARY CON.-STR.0 a' ION F2E 101-000-418-W.) � t OV 17 2000 SITv ur LA QUN SUB -TOTAL ') ►` lTXr3Ct101V 7'��1���dAkh�3��.'v 1yF� $54.00 ; t y+ TDRPS $0.00 'Kq`'f ,PERMTEXT"sDi7A+.00 W. '$.."w RECEIPT IJATi BY r�y-�y�� Dp=E F A�ED�� INSPECTOR INSPECTION RECORD OPERATION f DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation 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 _ Final PLUMBING APPROVALS Underground Plbg. Test Gas Piping 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 Encapsulation Gas Piping Gas Test Appliances Final 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) COMMENTS: tY ' P.O. BOX 1504 APPLICATION ONLY Building 78-105 CALLE ESTADO l Address 15Y- nO AyL7— LA QUINTA, CALIFORNIA 92253 I Owner i Mailing BUILDING: TYPE CONST: / /OCC. GRP. Address A.P. Number �{� �!- Z74/- Z6 G ^ COUA -4 City Zip TeL l ) Legal Description 1,0 1 17 Gif t,. .,%� L4,, t Zyt ContractorAA _ ` Project Description Address ii F Z 1 City Zip Tel. State Lic. City & Classif.'� °I«% �' Lic. # Sq. Ft. / , / No. No. Dw. Arch., Engr., - Size h+" 7 Stories % Units �✓ Designer New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State L til 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 Profesrsions Code, and my license is in full force and effect. SIGNATURE Z 9-- DATE OWNER ILDER DECLARATION Q I hereby affirm that I am exempfrom the Contractor's License Law for the following Estimated Valuation 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 AMOUNT requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT 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 Plan Chk. Dep. subjects the applicant to a civil penalty of not more than five hundred dollars ($500). FJ 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 r 00 builds or improves thereon and who does such work himself or through his own employees, Mech. Z , OV 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 Electrical of proving that he did not build or improve for the purpose of sale.) t 11, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing Lev 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. 1. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) 17 I am exempt under Sec. B. 8 P.C. for this reason Grading 20— Driveway Enc. Date Owner 7 TVrastructure /1, 23 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 �, ] _ __ "' J i/— /, 1 Q O Copy is filed with the city. ❑ Certified copy is hereby furnished. S _ ^ � A r S .. 0� TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS 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 ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line 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.) Side Setback from Property Line Lender's Name Lender's Address 4 This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE _ INSPECTOR 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. Issued by: Date Permit 1 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. Validated by: ' `Slgriature of applicant Date Mailing Address - Validation: - City, State, Zip BUILDING DIVISION CONSTRUCTION ESTIMATE GROUND PLUMBING NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. 0 $ $- f/ — UNITS BONDING HEATING (ROUGH) STORAGE TANK 2ND FL. SO. FT, ({� SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK YARD SPKLR SYSTEM r l POR. SO. FT. @ r MOBILEHOME SVC. OTHER APPJEQUIP. BAR SINK GAS (FINAL) GAR. SQ. FT. 0 Q 4?B POWER OUTLET GROUT ROOF DRAINS SERVICE CAR P. SO. FT. a BOND BEAM WATER SYSTEM DRAINAGE PIPING GRADING CU. yd. $ plus x$ WALL S0. FT. 0 O FINAL INSP. DRINKING FOUNTAIN FINAL INSP. SO. FT. 0 ROOFING URINAL REMARKS: ESTIMATED CONSTRUCTION VALUATION $ VENTILATION WATER PIPING NOTE: Not to be used as property tax valuation FIREPLACE FLOOR DRAIN MECHANICAL FEES WATER SOFTENER GAR. FIREWALL VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) — APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED / LAUNDRY TRAY AIR HANDLING UNIT CFM CERT. OCC. KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC INSPECTOR'S SIGNATURESIINITIALS WATER CLOSET Z COMPRESSOR HP GARDEN WALL FINAL POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER — BOILER B.T.U. SO. FT. 0 c BATH TUB SQ. FT. 0 c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO, FT. RESID ® 1'A c SEWAGE DISPOSAL SO.FT.GAR 0 3Ac 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 6.�.0� d.00> 70 y/ STRUCTURE PLUMBING ELECTRICAL HEATING d 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 APPJEQUIP. 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 DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated (619) 347-8631 Date 2/21/92 Type of Permit I La uinta No. 11204 Permit # Owner Name Donald Markowitz Log # No.' 54-880 street Juarez city La Quinta zip 922553 Study Area 110 APN # Tract # Lot # Square Footage 11474 Type of Development 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 1.58 X Fl—.47-4-7 or $ 2,328.92 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 Alex Torres Telephone Name on the check By James E. Lively Assistant Superintendent, Business Services Fee collected /exempted by Vickie J. Durrett Signature Payment Received Check No. 4108631391 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 11U. AND WHEN RECORDED MAIL TO Vr NAME Mr. &.Mrs. Robert A. Markowitz ADDRESS Mr, Donald Markowitz CITY& t� MAIL TAX STATEMENTS NAME Same as above ADDRESS CITY e ,..:.t— STATE V. Escrow No. 01211051 Title Order No. 300588 Fidelit L-1 7 _ U . � N � Q 0 0 S a $ v LU 3 O SPACE ABOVE THIS LINE FOR RECORDER'S USE Documentary transfer tax $ 26.95 M Computed on full value of property conveyed, or ❑ Computed on full value less liens & encumbrances remaining thereon at time of sale. Stewart Title Company of Riverside Count ❑ Unincorporated area City of _ Grant Deed TH16 FORM FURNISHED BY ST£WART TITLE COMPANY OF RIVER6IDE COUNTY FOR A -VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, IGOR VRATNEY, A SINGLE MAN hereby GRANT(S) to ROBERT A. MARKOWITZ AND JUNE MARKOWITZ, HUSBAND AND WIFE AND DONALD MARKOWITZ, A MARRIED MAN AS HIS SOLE AND SEPARATE PROPERTY, ALL AS JOINT TENANTS the following described real property in the County of Riverside State of California: 7 on file in Book 19, Pages 50 and 51 of Maps, Records of Riverside . ry erside County, California. DATED December 5, 1991 STATE OF CAI R Nj County of ' On December 11 1991 before me, the undersigned, a Notary Public in and for the said State, residing therein, duly commissioned and sworn, personally appeared , ***IGOR VRATNEY*** N'ITNF.SS t and and offici I .cal Signature .!�tA —M� mestone Name I'f vpFd nr I'rintrd) FOR NOTARY SEAL OR STAMP OFFICIAL SEAL MARY M; FREESTONE NOTARY PUBLIC • CALIFORNIA PRINCIPAL OFFICE IN RIVERSIDE COUNTY My Commission Erp. Mar. 28, 1994 MAIL TAX STATEMENTS AS DIRECTED ABOVE Personally known to me to be the person(s): (or proved to me on the basis of satisfactory evidence) I X) INDIVIDUAL whose name is subscribed to this instrument, ( 1 CORPORATION and acknowledged that he (she or they) executed it who executed the within instrument as president and --- behalf of the corporation therein cack _ named and owretary l edged to me that such corporation executed the within instrument pursuant to its articles and by-laws ( 1 PARTNERSHIP and a resolution of its Board of Directors that executed the within instrument on behalf of the partnership, and acknowl- edged to me that the partnership executed it. I N'ITNF.SS t and and offici I .cal Signature .!�tA —M� mestone Name I'f vpFd nr I'rintrd) FOR NOTARY SEAL OR STAMP OFFICIAL SEAL MARY M; FREESTONE NOTARY PUBLIC • CALIFORNIA PRINCIPAL OFFICE IN RIVERSIDE COUNTY My Commission Erp. Mar. 28, 1994 MAIL TAX STATEMENTS AS DIRECTED ABOVE i /r ,� �� .✓i+`1SJZ rel ii�,4�'n'S' /1� { �1 t' 4� { �: r • � t } +��# s^ri n>x, av��.�:U" �� rtr i''r" � k > -� • ; f �,r�l�.'s'• ity���'�..��G �,1F��'�' ��^„. ry�ll .�� } ?,{r. ,t-1.. :��.c�?h Y �,t N'�,:G i� } 3i { r �% ?..` .' � .. t n�,:�.r � .vki � -Y, �'t'r• c.� i' �: ,: ' -�fl'� vyjr it'' t/t r [+, ,+W /���Sl;r 1 k�y � i � -� • r ' :• t t J's�yr,� [. �� {� r J . � i 1 r � { s • 4 `fC� f{�'r { h$ r � %'i + c.I i 3r;3Y '}.�J �'�j . c � z rti� __,�, vj` �.V %, { r'� yf., h 'rt .� it J fiJ f'.l, 7�tY1. Y. J G � i✓ i� `' �. rC'.�4.. �y�f� 2'tk yis. �r .., .}� COACH EI1a WATER DISTRICT CASH RECrT DETAIL { Received From: Address: Account N v Lot(s) Tract Service Address G.A. Code Meter(s) - Service(s) ' t ❑ Backflow(s) i ❑ House Lateral(s) J ❑ Detector Check(s) ) ❑ Meter Surcharge ASanitationCapacity Charge �. ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account - Name ❑ Inspection Fee - Tract - a Fee - b Plan Check Fees Water I Sewer - 1 f Tract - t. ❑ Bond Payment - A.D. - Bo } t Assmt. ❑ Customer Deposit ❑ Other TOTAL Remarks: y t tr � F ❑Copy to: I �' Cash �' WaterServlce -GG Check Money } Cashier Order _ , ; CVWD-138 (11189) ` 'r �•: ef�`''.'• OFFICE OF AGRICULTURAL COMMISSIONER AND fly WEIGHTS & MEASURES CALVIN C. KAMINSKAS JAMES O. WALLACE 4080 LEMON STREET, ROOM 19 AsstslontCommisstonet Apdcultural Commtssloner RIVERSIDE, CALIFORNIA 92501 CLEMENT BENVENISTE Meelof of Weiontf &.Medsures (714) 781.2561 Seoier 49613 Highway 86, Suite B12 Coachella, Ca. 92236 (619) 342-8291 IInn DATE IJ to I q Z CASE W. C_ ' l O DEVEWPER' S NAME It A U. (,-. <� ADDRESS: �ZV -- 071 W S u—Cloww CIES Loo_ U, X�A TELEPHONE: ( 6 � c, -3S.3-7 5+Pb vz A Ci1PN- . c . Dear Developer: After reviewing your landscaping plans, all plant material listed is not in violation of 'quarantine laws governing the Coachella Valley. If substitutions do occur and they differ from plant material listed, this office must be notified immediately. Thank you for protecting and preserving the Coachella Valley's pest -free envirorm ent. cc: ssioner's and Riverside Office