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0308-329 (SFD),4 _ to W O =) M I W o Z CD O.o _J CID WW H f1 U) Z Cl) L0 N Oa) UQ d — �� r�0 Q J LL J mUU O c rn F qt Z_ co =) �O Q J LICENSED CONTRACTOR DECLARATION I hereby 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 Date 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). 9 ( ),,I am exempt under SectionB&P.C. ,of his reason, Date /Q r) 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. (This section need not be completed if the permit valuation is for $100.00 or less). /('vi I certify that in the performance of the work for which this permit is issued, Irk 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-Povisions.-- Date: 0-&0 Applicant— Warning: pplicant Warning: Failure to secure Wor ers�Compensation coverage i;unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize,•reprresentatives�oofhis City to enter upon the above-mentioned property for inspection pufrpose . Signature (Owner/Agent) ��`��% r Date f� - _03 BUILDING PERMIT PERMIT# . . DATE VALUATION LOT TRACT �, . a -$%,194.30 1 W,'R.285 /( (,, JOB SITE APN Yh gyp g �sgy�t y Phn' ADDRESS 17,$2,9 4R►IaRaw K Lii 6a l.c V1' 774-111-001 OWNER CONTRACTOR / DESIGNER / EN (NEER RICIO PROPERME-9 OWNTHMUMUER r°r-s7a ��?Ncsz; �sH PALM DF..SEZCr CA 92211 () 4 USE OF PERMIT MWIGIZF 1546 S. V. SF D PERMIT b3OPS NOT INCLUDE BLOCK WALL, POC+L&P A OR DRItIfC'JdeiY APPRO .% L I TRACT CONSTRUCTION 1,546,00 SF OCT 08 1003 V 1'ORG'111P1?.T1i3 153.00 SF Ctf RA.WC.A,RPORT $21,40 3 ar r OF LA DUINTA F NANCE DEPT. KSTU ..TED L'C'1W O..F Ci1NFIM9')MC1R 96,194-30 CCINSTRUCTIO14 F'hG 101.000.418w000 $626,00 PLAN CHECK FFM 101-000-139-318 $52€1.10 ME DEPOSIT ILOI -00©- 39.313 4250M MECHANICAL FLOE, 1.01-00"21-000 $59.00 N:E,F'CTRICAL FEL 101.000.420-000 31110 PL1.Jl BINOFLpE° 101.100'1-ri19-000 $119,00 STRIONO MOTI(NN FEE - R.FMID 101.000.241.000 19.62 0"XINO ME 101-000-1523-000 11113.00 DEVELOPER IMPACT FEE, 32,405.00 PR7 ISE PLAN 101,-000-44 1.-34.5 $IOU.1iU BUB -T071AL C014W. RUt"f ON AND PUR CM-ECK $3,965.75 M9S PIE-PAIDF!"sES -$250,00 TOT.Ai, 7i.':a&W YFHS DVI N4' W $3173 5.75 RECEIPT DATE BY D E FINALEED 0 INSPECTOR f.t,�J ` INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs —72 Underground Ducts Forms & Footings Ducts Slab Grade utj Return Air Steel Combustion Air Roof Deck . cot,( 57 Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation — —Q 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 G BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground. Electric Underground Pibg. Test . . Final Gas Piping PLUMBING APPROVALS 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 a2 zw 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 - -U Final Utility Notice (Perm) COMMENTS: ©300 - 3)9 Building '� �.. 1✓ Address Owner y. %�1 CO Zrap id i LL Mailing • Address `7 570 S0ri9 City_ Zip _ ress ty jZip W • 4 P.O. BOX 1504 APPLICATION ONLY Cori U048-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 A/d Sk P State Lic. City & Classif. I Lic. # Designer Address CityI Zip I State Lic. # ,)Vo -yv 995 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 Contractors License law for the following reason: (Sec. 7031.5,8usiness 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 Ill. 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 (S500). l: 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 iiroving that he did not build or improve for the purpose of sale.) Tlil, as owner of the property, am exclusively contracting with licensed contractors to con- stfr"uct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does notapply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Co��:n 'License Law.) 11 1 am exempt under Sec. B. & P.C. fo Date .1163 Owner Ulm 1� WO ERS' COMPENSATION DECLARATION 1 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 if the permit is for one hundred dollars ($100) valuation or less.) A I certify that in the perforM e wort/tor which this permit Is issued, I shall not employ agy person in any matoto b mb t to the Workers' Compensation Laws o ah rri Date Owner NOTI T APPLICANT: If, r making is CerflftOe of Exemption you should become subject to the Workers' Cot vensali?n provisions of the Labor Code, you must forthwith comply with such provisions or Jilts 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 pe mit is issued. (Sec. 3097, Ciyjl Coha.��� Lender's Name dG 4 Lender's Address —r_ .. This is a building permit pop rly ft ed ou,signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read thisapplication d state that the above information is correct. I agree to comply with all city and count rdinances and state laws relating to building construction, and he4y aur orize rep nt rivesf this city to enter the above- mentioned property to i specs purpose . Q ;^�-<f Signature of applicant Dat v '- 03 Mailing Address •-� City, State, Zip BUILDING: TYPE'CONST. OCC. GRP. A.P. Number -r-744,g)) ' —T ' cot uss i �(,1 W,� Legal Description 5 fD Project Description Sq. Ft. Size 154(a No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing IIn1 _ --" 1111 S. M.I. l l u fl 1111 Grading 1' 0 7 V 1 Driveway Enc. I I I Infrastructure L .--- 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 INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Tract # BLK 285 Study Area Type Single Family Residence No. of Units 1 Lot # No. Street Unit 1 1 77525 Calle Chillon Unit 2 Unit 3 Unit 4 Unit 5 S.F. Lot # No. 1546 Unit 6 Unit 7 Unit 8 Unit 9 Unit 10 Comments Certs #25058 through 25060 used for CC#116332 in the amount of $11,594.52. Street S.F. 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 1,546 S.F. or $3,308.44 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/South Bay Bank - Roper Morris Check No. 116332 Name on the check Telephone By Dr. Doris Wilson Superintendent Fee collected /exempted by aron McGilvrey Signature C Funding Residential Payment Recd 1$0.00 $3,308.44 Over/Under 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, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting NM RC DISTRICT - PLANNING REVIEW FORM This form is to be used by CDD staff for review of single family dwellings in the RC (Cove Residential) District per Section 9.50.090 of the Zoning Code. Its purpose is to determine: 1) that the proposed housing design does not duplicate the same architectural style of any house within 200 feet of the applicant, and/or 2) if there is a need for the applicant to file for Master Design Guidelines. If the applicant does need to file a Master Design Guideline, please transmit this information to the Building and Safety Department as part of your correction list. Please attach additional explanations as necessary. 0 APPLICANT: i CS SITE ADDRESS: I — `j l,d ( ie PJ APN r 74 - :� /I - 061 CASE NO.: & T7 LEGAL: LOT ( BLOCK � UNIT S.C.@V.L.Q. . CHECK AND APPROVED BY: DATE: Inform the assigned Building plan checker upon your assignment to this case. The CDD Executive Secretary maintains a log book to track applications and assign case numbers. REQUIRED ITEM Y N COMMENT/CORRECTION Verify legal and APN information Consistent with MDG.on file (as applicable) MDG filing required (5 filings since 9/3/98) Date Reso Architectural variety within 200 feet of the surrounding area: Architectural design features Manning Firy. Council Nifo Corn,;-nunit Dev. Dept, Case No. —Fill Exhibit _._..� ® With Conditions Other Requirements: dUUJ 1 4: nU rK r l Kb I HMtK 1 LHN 1 1 1 Lt b bbb btln4 I U 'deUU44bb OCT e7 2003 15:37 FR r 1 tb l WICK i uev 1 , 064 ZM. , . _ , _ _ • - - . . R ECMING R)EQUESM by First Awn Me Company AND WHEN RECORDED MAIL TO: ROW Mortis 77570 Springfield lane, OM Palm Desert, CA 97211 • � , C Y of Document ded on as No. a has not been compared with original. GARY L. ORSO V.U9 ci GRANT DEED I� h A.P.N.: 774^211-001 and 774- T.RA No. Q p !,r Fle No.: RPD -1094511 (51) � 2i1-OOi Mw ulaersti4eed a MN(I) I)Wu ; DOCUMDMY TPMSF a TAX s59.4a, MY Y'M FM rAx:o oo; �• �n+puoea on the cormder�tma ar hA1 Dupre of tom. OR mmpuoe0 an the canslderatton or tLr vinic less value o! gena anular anaun�rloes rdnalNlq at thne o! s+fe, t winwozaeed arer, I I Cly or tai Quleta. and FOR A VALUA9LE CONSIDERATION, receipt of whIM Is hereby admowiedged, Many G. Bailey and Shirley Baiielr, husband and ndfe as joint Danants hereby GRAM to Rico Properties, LLC the following desalbed property in the of L3 Qulnt;a, County of RiVWslde, State of Calibrnia; Dated: _ 07-12212023 . e • sway seaey Mall Tare S1a&mrits Tb. $AMB AS ABM rw� TOTAL PRGE.03 ** ** TOTAL PAGE.07 ** eremr�000e�c� �se��eede V.U9 ci GRANT DEED I� h A.P.N.: 774^211-001 and 774- T.RA No. Q p !,r Fle No.: RPD -1094511 (51) � 2i1-OOi Mw ulaersti4eed a MN(I) I)Wu ; DOCUMDMY TPMSF a TAX s59.4a, MY Y'M FM rAx:o oo; �• �n+puoea on the cormder�tma ar hA1 Dupre of tom. OR mmpuoe0 an the canslderatton or tLr vinic less value o! gena anular anaun�rloes rdnalNlq at thne o! s+fe, t winwozaeed arer, I I Cly or tai Quleta. and FOR A VALUA9LE CONSIDERATION, receipt of whIM Is hereby admowiedged, Many G. Bailey and Shirley Baiielr, husband and ndfe as joint Danants hereby GRAM to Rico Properties, LLC the following desalbed property in the of L3 Qulnt;a, County of RiVWslde, State of Calibrnia; Dated: _ 07-12212023 . e • sway seaey Mall Tare S1a&mrits Tb. $AMB AS ABM rw� TOTAL PRGE.03 ** ** TOTAL PAGE.07 ** ter,O:ccuparc.-+% fi.a t: 77 auil-dibgDe°pii en Ot.-to the. requipo"j-pi This C-., Hifkate 1q,'�js$M-',jd-.&rsua, nbi§-of Se6fioa-`409,-'oFthe California Building .v.: Codi; ce&6/At h 144 ianci, thhs stru, with the L rice 1 ordinances-'�01-t QC n -d 1he various.t g VVIS/oft , so 1YI14 06,4 pf, f th I -y to Wing buildin or g. 6g trodtio.n arid/ordm. 77 . DING ADqRE$S--525 -CALLE CHILLON BUIL Use classification: SINGLE FAMILY DWELLING ByildjnqP rYnit No.:.0308-329 Occupancy Group: R3 Type of Construction: V -N 4, Land Use Zone: RC - 77 Owner of Btii-lding* RICO PROPERTIES Address: -'-"570.SPRINGTIME. LANE City, ST, ZIP. PALM DESERT, CA 92211 $y. STEVERAXEL Owner Date: June -15; 2004 Building Official I/ POST IN A CONSPICUOUS PLACE JUN -07-2004 07:27 AM P. 02 CERTIFICATE OF FIELD VERIFICATION AND DIIAGNOSTIC TESTING :' CF -4R d� Project Title h lJ / h Date ,y Pro)qgt Address Builder Name Plan Number Sample Group Number r Ifyin $Slgn®ture T_ Dat® ample House Number Firm: �l d--���yLNeI�S / /�- // HERSProvider: � L.4-xsrt0L StrestAddress: 7�'6�6� �i1�� CJ�'[� City/State/Zlp: Copies to: Builder, HERS Provider HERS TEit ANCE STATEMENT The house was; ' Y21wTested ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form cam lY with the diagnostic tested compliance requirements as checked on this form. � Distribution system Is fully ducted (i.e., does not use building cavities as plenums or platform returns In Ileu of ducts) Where cloth backed, rubber adhesive duct tape is Installed, mastic and drawbands are used In combination with cltith backed'rubber adhesive duct tape to seal leaks at duct connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Dlagnoitle Leakage Testing Results (Maximum 60/4 Duct Leakage) Measured Duct Pressurizatlon Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM If fan flow is calculated as 400cfmlton x number of tons enter , calculated value here If fan flow is measured enter measured value here /� / Leakage Percentage (100 x Test Leakage/Fan Flow) = T b + Check Box for Pass or Feil (Pass=6% or less) ❑ ass Fail iTHERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent �es ❑ No Thermostatic Expansion Valve (or Commission approved equivalent) is installed and Access is provided for inspection Yes is a pass . ® MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT 1. 0 Yes 0 No ACCA Manual D Design requirements have been met (rater has verified that actual Installation matches values In CF -1R and design on plan. 2, 0 Yes ❑ No TXV is Installed or Fan flow has been verified. If no TXV, verified fan flow matches design from CF -11R. Measured Fan Flow = Yes for both 1 and 2 is a Pass Li ass Fall O0 Pass Fall