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0209-020 (SFD) (2)LICENSED CONTRACTOR DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Fes—. Chapter 9 (commencing with Section 7000) of Division 3 of the Business and N W Professionals Code,, and my License is in full force and effect. - O =) ch License # Lic. Class Exp: Date 'w Z /Date Signature of Contractor r- �w"/ �0 " (>J 0 <• J UCID OWNER -BUILDER DECLARATION Wd I hereby affirm under penalty of perjury that I am exempt from the Contractor's U) License Law for the following reason: Z ( ) 1, 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). co () I am exempt under Section B&P.C. for this reason LO C\I Date Sianature 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. YQ I have and will maintain workers' compensation insurance, as required by .�ection 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, STATE FUND Policy No. }fSlg t+SS-J2 (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 ,Coded I' shall fo , hwith comply withMse provisiond Date Applicant ; j;� ,, � , g, Warning: Failure to secure Workers' Comp.sation 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. •,41. 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) Date/ d� BUILDING PERMIT` PERMITk � - f - 0!�Y0?.��2t3 • �; DATE.l f VALUATIONLOT TRACT �V JOB 0 ADDRESS '� ' � 1D ,'%3t 'Itt� 3.4� i APN 774-433-01.2 OWNER CONTRACTOR / DESIGNER / ENGINEER A r0,RTt.0A 0. 77rsRMS Ca`.?�&4r, r9UM-1014 #1 -900 AN,Q311JR, 52, 030' 01-900 AVM7.aE 52,030 .IMNO CA 9220.1 tJ P10 CA 92201 ('60)772a-n4e ("Put 1! 51, s; r. USE OF PERMIT - 1641 S, K SnI.. PCR: e9'1T DO&S 1•f(>T li+1t",1.t D1,P ail,O0,: 'tir't,R1.1.JFrS'k0,U 0,R isRIV7'W:AYAPPROAC-H TRACT t"ONSTICUCTION SF :PORC HAIATIO 73,00 SF x' S.["[Id,SAIM) CO'Sly OF COMYTORIMCIN FEWDi3V!#'FFMY�;9;Kdb.RY COMITRUCIrION 111% FILAN CHEM FEE i EXIT:DltzPOICI 11' 101.000.4391318 425 f�&!�',Ct`t"ICAJ,.111ZE 101= 1-421-000 �� tvl,Jsc�TRICAL �� X, 1101-1000-420-000 $:11 col:i3tNit;ll+tfr71 S� 101-000.419-000 STR.0140 R�tC7'I10,N FRI,` • R&M 101-000m241 000 "I! t:93�1�1'�3140 ;tar. 101-000-423-000 $ 8 Ly�V' ZOPER I PA.0i r, KIR $2,110 PRECISE P111`�H 101 -0100-w-?W -34.5 $10 3100 I7.52 0199 9.dt0 6.Ot1 li.Crp, ,f.f20 I " 4J, P2WKn1._VX1.ES'D11.V. NOW $3071-62, SEP 2 illi!i CITYOF LAQIUINTA FINANCE DEPT. EIPT DATE-/..-. RDAFl/,/ I FjRY�_ I�-d3, _ INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION T DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs — Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck / Exhaust Fans F.A.U. O.K. to Wrap Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath - at - Drywall - Int. Lath Final Final POOLS -SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Waste Lines �0�—�� Gas Test Electric Final Heater Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection _a 5_O/� Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final y 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 G� Final Utility Notice (Perm) .. _ r , �j ,. yn:7`xr.T. �'9 � - s�Jr'Dey�r ._:_ .. ,-1 . y. ry,,., . •C,�� � �;�yrT. .: w P.O. Building BOX 1504 APPLICATION ONLY S -��`� 1v j�� 78-495 CALLETAMPICO Address / i �' - N `�� LA QUINTA, CALIFORNIA 92253 Mailing iu �' Address ` / 9 c. Z CityI Zip I State I 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 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 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 ($500). C., 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.) H 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.) i 7 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I 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 it 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. 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 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 a0plicant Date Mailing Address City, State, Zip BUILDING: TYPE'CONST. (5� ryR -DCC. GRP. A.P. Number Legal Description /5 Project Description l I T v772-2-77 � Contractor _ Address City y,,,,,,�'2 Zip , Tel. 77 2 -2-q�Y State Lic.� 8 Classif. City Lic. # Arch., Engr.,� r Designer V����" 45,4,Z6;,1 Address Tel. CityI Zip I State I 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 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 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 ($500). C., 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.) H 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.) i 7 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I 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 it 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. 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 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 a0plicant Date Mailing Address City, State, Zip BUILDING: TYPE'CONST. (5� ryR -DCC. GRP. A.P. Number Legal Description /5 Project Description l I T TOTAL 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 from Property Line FINAL DATE IN-3PECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIV610N Sq. Ft. L . Size %/ No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT Plan Chk. Dep. AMOUNT v _n Plan Chk. Bal. ! Const. Mech. Electrical -` Plumbing ®/ S.M.I. ,, G' Grading Driveway Enc. Ai,_ Infrastructure F \p�1 C� •©I / TOTAL 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 from Property Line FINAL DATE IN-3PECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIV610N CERTIFICATE OF COMPLIANCE �Ftsc Desert Sands Unified School District o�cS�o 47950 Dune Palms Road q BERMUDA DUNES r Date 9/24/02 La QUm7 ta CA 92253 Cn RANCHO MIRAGE d N INDIAN WELLSLM DESERT ti No. 23647 (760) 771-8515 ? F LA QUINTA " INDIO y7� O Owner Alex Torres ,t APN # 774-135-012 Address 81-900 Avenue 52 #30 Jurisdiction La Quinta _ City Indio Zip 92201 Permit # Tract # Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F., Lot # No. Street S.F. Unit 1 13 53740 Avenida Navarro 1641 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 _ Unit 9 Unit 5 Unit 10 Comments CC#01.654 for the amount of 3,517.40 is over by $5.66. , 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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that 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 Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14 X 1,641 S.F. or $3,511.74 have been paid 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 CC/CB&T - Alex Torres Check No. 01654 Name on the check Telephone 760/772-2848 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Monica Guillen y $3,51,7.40 $sss _ Payment Recd OvevUnder R Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whiciever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy- Applicant/Receipt Copy -Accounting r RECORDING REQUESTED BY AND WREN RECORDED MAIL TO: JACOB A.,TORRES 81900 'AVE. 52 SPACE 30 INDIO, CA 92201 [ Space Above This Line for Recorder's Use Only A.P.N.: 774-135-012 TRA ft: Order No.: 531159-7 Escrow No.: 2-35710 GRANT DEED THE UNDERSIGNED GRANTOR(s) DECLARE(s) THAT DOCUMENTARY TRANSFER TAX IS: COUNTY $33.00 [ ) computed on full value of property conveyed, or [ . ] computed on full value less value of liens or encumbrances remaining at time of sale, [ ] unincorporated area; [ X ) City of _LA OUINTA , and FORA VALUABLE CONSIDERATION, Receipt of which is- hereby�aclmowledged, - MERTON L. SCHWARTZ and JACQUELINE SCHWARTZ, Husband and Wife as Joint Tenants hereby GRANT(S) to JACOB A. TORRES, A MARRIED MAN AS HIS SOLE AND SEPARATE PROPERTY the following described property in the City of LA QUINTA, County of Riverside State of California; 0 Lot 13, BLOCK 240, UNIT #23 of SANTA CARMELITA AT VALE LA QUINTA, in the City of LA QUINTA, County of Riverside, as per map recorded in Book 20, Page(s) 25, in the Office of the County Recorder of said County. I , ERTON L. SCHWARTZ J UEL E SCHWARTZ Document Date: February 28, 2002 STATE OF CALIFORNIA )SS COUNTY OF Los Angel ac ) 'On March 14, 2002 before me, 6uN(h L.p/7-j �f personally appeared MERTON L. SCHWARTZ and -JACQUELINE SCHW Z personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) Ware subscribed to the within instrument and acknowledged to me that ho ire/they executed the same in hWhier/their authorized capacity(ies) and that by hi6ihar/their signature(s) on the instrument the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature This area' forofftc al notarial seal. BUNNY FRIEDMAN Commission # 12434/R Notary Pubitc - Califorrm UX Angeles County My Cor m. Bsp W Dec2a, 2M3 Mail Tax Statements to: SAME AS ABOVE or Address Noted Below CE"ED TO 8E A TRUE AND CORRECT COPY OF Certific' teof 'Occupancy a City.,,of La'Quinta.• v Buildinand Safety'De'partment.g This Certificate issued pursuant to the requiiements of Section 109 of the Uniform. Building Code, certifying that, at the time- of issuance, this structure was in comp/lance with the' various ordinances of theCity regulating building construction or use: For the following.-, BUILDING ADDRESS: 53z. AVENIDA NAVARRO Use Classification: SFD Bldg. Permit No.: 0209-020 Occupancy Group: R3 Type of, Construction:. VN . Land Use Zone: RC Owner of Building: A TORRES Address: 81-900 AVE 52 #30 City: INDIO CA 92201 By: KIRK KIRKLAND Date: 2-11-03 Building Official POST IN A CONSPICUOUS PLACE