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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) cc be !V Qi W W O y t1 O { W i'n J 07 t IL: ZiZ> 1 • Q �2 1L 3 IY � is 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