12771 (SFD)1
Building
Address 54--955 Avenida J
Owner ,~-Roger L. Kri.ngen
Mailing
Address
city�
�
�domad Construction
Address
•54--974 Ave. Madera
City Zip Tela
La Qui.nta, C41, 92253 564-0602
State Lic. , City w
& Classif. B 628.581 Lic. # 3074
Arch., Engr.,
Designer Terry Roach
Address Tel.
77419 Ba+wgrass Circle 360-1114
City Zip State
Palm Desert,ICA 92264 Lic, a
LICENSED CONTRACTOR'S DECLARATION
I hereby affithat I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Divirm sion 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 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, 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 thealleged 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).
❑ 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
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, 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. & P.C. for this reason
Ti'119�
P.O. BOX 1504
78-105 CALLE ESTADO
uarez LA QUINTA, CALIFORNIA 92253
. 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
❑ 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 thg 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: It, 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 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 this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant -Date-
Mailing
ateMailing Address
City, State, Zip
No. 12771
11LDING: TYPE CONST. OCC. GRP."
P. Number 774-265-023
gal Description Lot 11 Block 275
Project Description
SPB
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback fro ro ine
FINAL DATE
Issued by: - Dat`1 Ae�Pyermit
Validated by: I t t'"t
Validation: Y` !'
.r
Sq. Ft. 1664
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Estimated Valuation
$100,723.00
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
Z. 5
Const.
b 4 3.O U
Mech.
bl. Ou
Electrical
2 31.60
Plumbing
14:1.00
S.M.I.
0.0
Grading
2U. 00
Driveway Enc.
.00
Infrastructure
2,141.83
Precise JI>a
U
Arts in I?uA
..c Places
25 . GU
TOTAL
Z...)
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback fro ro ine
FINAL DATE
Issued by: - Dat`1 Ae�Pyermit
Validated by: I t t'"t
Validation: Y` !'
.r
CONSTRUCTION ESTIMATE
NO: • ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
L)_NITS
COLL. AREA
SLAB-dRAOE ` U
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SQ. FT. @
HEATING (FINAL)
OTHER APPJEQUIP.
WALL SD. FT.
GAS (FINAL)
DRINKING FOUNTAIN
SQ. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
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 _ -
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR. SUSPENDEDLAUNDRY
FINAL INSP.
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.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
LATHING
SQ.FT.GAR ® 3/ac
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 PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING3--n
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB-dRAOE ` U
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE 3 —LIl-q(Y o
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
=$
LUMBER GR.
FINAL INSP. ��%�pj
FRAMING ,q 2 q4p
FINAL INSP.
ROOFING ��� y
W 1 r�sQ
( ( ^ri7 C�
th(eCA-/ . `Fe!'V--
5-1 3_1 `" Lp
A- w
REMARKS:
_241��—
N
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND ♦
FINISH GRADING
FINAL INSPECTION 3
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 619-775-3500
Date 3/9/94 1 Type of Permit I La Quinta
No. 112709 Permit #
Owner Name Roger L. Kringen Log
No. 54-955 Street Avenida Juarez
City La Quinta Zip 92253 Study Area 110
APN # Tract # I J Lot # 0 Square Footage 11664
Type of Development I Single Family Residence I 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 1664 or $ 2,745.60 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 Roger L. Kringen Telephones
Name on the check-a'�•-a
By Dolores A. Ballesteros
•.,,, � ,�,: , , ;rte �.;
Superintendent r �; IR
Fee collected /exempted by Elizabeth K. Roper
Signature/
Check No. 1266
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 THIS DEED AND. UNLESS OTH
WISE SHOWN BELOW. MAIL TAX STATEMENTS TO:
NAYC Roger L. Kringen
Mpn s Earlene M. Kringen
CITY e
O L
oTitle Order No. I9Z78Z1l9q222Z 22j Escrow No. 12846
GRANT DEED
The undersigned declares that the documentary transfer tax is 8.....61.60 and is
lyn 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 thereon at the time of sale. The land,
tenements or realty is located in
❑ unincorporated area ® city of ..... La ... Qua.nta......................................................................... and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Margaret H. Jones Trustee of the. Margaret: H. Jones Trust, dated February 6, 1987
hereby GRANT (S) to
Roger L. Kringen and Earlene M. Kringen, husband and wife as community property
the following described real property in the City of La Quinta
county of Riverside , state of California:
`77y -- o a 3- 60 7 -
LOTS
LOTS 11 and 12 OF BLOCK 275 UNIT NO. 25 OF THE SANTA CARMELITA AT VALE
LA QUINTA, AS PER MAP RECORDED IN BOOK 19, PAGE 51 OF MAPS, RECORDS
IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY -
Dated December 11, 1991
• -rustee
STATE OF C4or
l
COUNTY OFZf � 1 SS.
On this the day of � 19_/ before me the undersigned, a
Notary Public iCounty and ate, personally appeared
M t H J
arQare ones, trustee
personally known
to me i to be the
person whose name is subscribed to the within instrument
.and acknowledned that she executed the same.
Signature of Notary
FOR NOTARY SEAL OR STAMP
'�i��,���rorosra��+m+ererrNi
PHYLLIS M. GENOVESE
OFRCIAL SEAL
NOTARY PUBLIC -CALIFORNIA
LOS ANGELES COUNTY
My Commission Expires June 19, 1992
MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE.
Name Street Address City 8 State
CAL-1/CT (Rev 2-88)
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SPACE ABOVE THIS LINE FOR
RECORDER'S USE
GRANT DEED
The undersigned declares that the documentary transfer tax is 8.....61.60 and is
lyn 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 thereon at the time of sale. The land,
tenements or realty is located in
❑ unincorporated area ® city of ..... La ... Qua.nta......................................................................... and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Margaret H. Jones Trustee of the. Margaret: H. Jones Trust, dated February 6, 1987
hereby GRANT (S) to
Roger L. Kringen and Earlene M. Kringen, husband and wife as community property
the following described real property in the City of La Quinta
county of Riverside , state of California:
`77y -- o a 3- 60 7 -
LOTS
LOTS 11 and 12 OF BLOCK 275 UNIT NO. 25 OF THE SANTA CARMELITA AT VALE
LA QUINTA, AS PER MAP RECORDED IN BOOK 19, PAGE 51 OF MAPS, RECORDS
IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY -
Dated December 11, 1991
• -rustee
STATE OF C4or
l
COUNTY OFZf � 1 SS.
On this the day of � 19_/ before me the undersigned, a
Notary Public iCounty and ate, personally appeared
M t H J
arQare ones, trustee
personally known
to me i to be the
person whose name is subscribed to the within instrument
.and acknowledned that she executed the same.
Signature of Notary
FOR NOTARY SEAL OR STAMP
'�i��,���rorosra��+m+ererrNi
PHYLLIS M. GENOVESE
OFRCIAL SEAL
NOTARY PUBLIC -CALIFORNIA
LOS ANGELES COUNTY
My Commission Expires June 19, 1992
MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE.
Name Street Address City 8 State
CAL-1/CT (Rev 2-88)
W!
WN
�t 1 11�Illtltct
ltt�i�titl fett�ttt111t
This Certificate issued pursuant to the requirements of Section 306 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 54-955 Avenida Juarez
Use Classification Single Family Dwelling Bldg. Permit No. 12771
Group R3 Type Construction V Fre Zone Use Zone RR
Owner of Building Roger L. Kringen Address 75-641 Camino De Paco
City Indian Wells; CA 92210 By; Daniel. P. Crawford Jr.
Dote: February 2, 1995
Building Officl POST IN A CONSPICUOUS PLACE