05-0853 (RR)J
BUILDING & SAFETY DEPARTMENT
P.O. BOX 1504 (760).777-7012
t 8-495 CALLS TAMPICO FAX .(760) 777-7011
p QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
on Number
erty Address
APN:
Application description .
Property Zoning . . . . . .
Application valuation . . . .
Owner
-------------------------
LAULIE SMITH
796,00 CORTEZ LANE
LA QUINTA CA 922.53
05-000.00853 Date 3/23/05
79600 CORTEZ LN
649-.052-008-32 -2667 -
RE -ROOF
LOW DENSITY RESIDENTIAL
6000
Contractor
------------------------
OWNER
Permit . . . . . . RE -ROOF
Additional desc .
Permit Fee . . . . 3.0..00 Plan Check Fee .00
Issue Date Valuation . . . 0
Qty Unit Charge Per Extension
BASE FEE_ 30.00
Special Notes and Comments
Re -roof, .replace existing shake roof
..tile with Eagle Lite roof tile. Refer to
structural calculations by Charles D
Garland..
Fee summary Charged Paid Credited Due
Permit Fee Total 30.00 .00 .00 30.00
Plan Check Total .0'0 .00 .00 .00
Grand.Total 30.00 .00 .00 30.00
P.O. BOX 1.504 • VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-70.11
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (960) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 19- " d 3 Date: 3 -2-5- °--)
Applicant: ON el*,—
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS "
LICENSED CONTRACTOR'S 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.
Ucense Class License No.
Date Contractor
OWNER43UILDER DECLARATION -
I hereby affirm under penalty of perjury that tam exempt from the. Contractors' State License Law for ftfollowing reason (Seo. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to filwa signed
statement that he or she is licensedpursuant to the,provistons of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Businesg
and Professions Code) or that he or she.is exempt therefrom and the,basts for the alleged exemption. _ Any violation of Section' 7031.6 by any applicant a permit subjects
the applicanIt to a civil penattyof 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,
Business and Professions Code: The Contractors' State License Law;does not apply to an owner' f property who builds or. improves thereon, and who does the work
himself or herself or through his or her own employees, provided that the 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 or she did not build or lmprove:for the purpose of sale.).
(� 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who.builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State: License Law.).
U 'I am exempt under Sec. A P.C. for this reason
nnA
3
Date a3 Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self4nsure 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 wdrkers' compensation:insurance, as required by Section 37.0.0 of the Labor Code, for the performance of the work for which this perrnitis.
issued. My workers'oompensation insurance carrier and policy number are:
Cartier Poiicy.Number
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 lawssrof 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,tho .pro "
Date ata IC& Applicant
WARNII, G: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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.
CONSTRUCTION LENDING AGENCY
I hereby.affrrrm under penalty of perjury that there i&a construction lending agency for the performance of the work.for which this permit Is issued (Sec. 3097, Civ. C.)..
Lender's Name
Lender's. Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the!Director of Building and Safety for a permit subject to the conditions and restrictions set forth or this application.
1. Each person upon whose behalf this application is made; each person at whose requestand for whose benefit work, is.perfor med under or pursuant:to any permit
issued as a result of this application, the, owner, and the applicant, each agrees to, and shall, defend; Indemnify and hold harmless the City of Le Ouinta, its
officers, agents and employees for any actor omission related to the work being performed under or following issuance of this permit
2. Any perm issued as _a result of this:application becomes null and void if work Is notcomrnenoed within 180 days,from date of issuance of such permit, or.
cessation of work for 180 days will subject perrnitto 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 county ordinances and state laws relating to building
construction, and hereby authorize representatives of this co ntyto r e ove-mentioned pmpertyfor inspection purposes.
'Date 3 a3 S Signature (Applicant or Agent):
CITY OF LA Q TR
UINTA SUB -CONTRACTOR .LIST ,
� �O
JOB ADDRESS %9&We A¢.v� PERMIT NUMBER OWNER � BUILDER
This form shall be -posted on the job with the Building Inspection Card at all Aim sin a con-APIculug-pleAge. Only persons appearing on this list or their employees are authorized to work
on this job. 'Any -changes to this list must be approved by the Building Division prior'to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance.
• 1[ 3�ttA
A Ai
ition requested below must be competed by applicant. "On File" is not an acceptable response.
..........
......... .
n.
::::..::.::::..::.:.::.::<.:.::.t......��tr.��:�r.'�....::.:.:...:..::::::..:::::::::.:::........odc �:a .....�►nsa.. ..#Rlst�r. �
Classification License. Number Exp. Date Carrier Name PolicyNumber Exp. Date Ucense: Number Exp. Date
(e.g. A, B, C-8) (xxxxxx) (xxlxx/xx) (e.g. State Fund, CalComp) (Format Varies) (xx/x- x/xx) (xxxx) (xxlxxlxx)
1-1
ArChlieCtUre, Interiors, Space anci Lana Planning
Structural Calculations
14 March 2005
The City of La Quints
Department of Building and Safety
78.495 Calle Tampico
La Quints, CA 92253
Project: Single Family Residence for:
Laulie Smith
79-600 Cortez Lane
La Quinta, CA
Regarding: Project Observation
To Whom it May Concem,
On 4 March 20051 was asked to visit the noted project site to perform structural observations with regard to reviewing
the noted owner's desire to re -roof the noted residence. The re -roofing would involve changing the existing heavy
shake roof to "Eagle -Lite° #LHE 8704 light weight concrete roof file (ICBO Report #4660) having a per roofing square
load of 720 lbs. At the time of my visit I noted a home built in the early to late sixties with exceptionally fine lumber in
very good condition.
I did feel it was prudent to check some of the spans in light of using the noted file and found that, in my professional
opinion, none of the current framing members will be over stressed and thus will constitute no threat to personal safety
or property. Please find attached my evaluation calculations.
If you have any further questions regarding this project please do not.hesitate in contacting me.
74854 Velle Way, Suite 5 ❑ Palm Desert, CA 92260 ❑ Phone: (760) 340.3628.❑ Facsimile: (760) 340-3728
COACHELLA VALLEY WATER DISTRICT"
CASH RECEIPT DETAIL 96085 S ®p !�
�q +fir 85 �
Received From- L�_ 7
1 't I JL
Address:
Account'No. '-' -
Lot(s) �A
Service Address _� ` �' :4 j '
_ L f ' E
❑ Meter(s)
❑ Service(s)
❑ Backfiow(s)-
❑ House Lateral(s)
O DetectorCheck(s)
❑ Meter Surcharge
"nitatiohCapacity Charge 5!
❑ W.S.B.F.C.
❑l Temporary Construction -Meter
❑ Turn on Charge
❑ Uncollected Account -Name
O Inspection Fee - Tract -
Fee -
❑ Pian Check Fees Water /.Sewer -
Tract -
❑ Bond Payment- AM. - Bond
Assmt
❑ Customer Deposit
❑ Other
____ Tract
S
TOTAL S
Remarks: C?
rL'
_. )'I
ey to: j
Cash _
Check C_ % -"
Money
Order
drawing of record.
7 r.'
Water Service
Cashier r
D-438.(11 /89)
These deviations from the drawings of record are beyond the control of
CVWD;, therefore, the district will not be responsible for any charges
incurred by the homeowner as a result of these inaccuracies.
July 1, 2002
03/14/2005 17:04
Bin #
Permit N
Project Address:
A. P. Number: (o4q _
Contractor:- ld
Address: F
City, ST, Zip;
Telephone.
State Lie. d ;
Arch., Env, Designer;
Address:
City, ST, Zip:
Telephone..
S ic. q: •
N e of Contact Petson:
Tedepho of Contac Person:
7607777011
,5 J - 0
TP
LA QUINTA
Cray of La Quin
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampko
La Qainta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
A&W Owner's Name: �1 �U-Lt cr.rJF�� �6 M uT4
$ -► Q Address: ! �..'i e La
City, ST, ZIP' ,fn (Z)%11,n+71 —
Telcphone:
Project Description: p(P_rn ^
r v
• Idl•�
PAGE 01/01
7.2- Lbs
Construction Type: Occupancy.
PMjeCt type (circle onc): New Add'n Alter epai Demo
S4: oZQi;3 #Stories: 1 M Units:
Estimated Valuc of Project:
DO NOT WRITE BELOW THIS LINE
0 Submittal
1R ' R -cd TRACKMG 17
PERMIT FEES
oOSets
Plan Check'tabmitted 3 / 19 I Amount
Struetural Coles.
Reviewed, ready for eorrectiow
Plan Check Deposit
Trans Cale&
Called CoalactPerson
Plan Check Balance
TMC24 Cales.
Plans picked up
Construction
Flood plain plan
Plow rtaubmitted
Mechanical
Grading plan
Review, ready for torrent sone°
Electrical
Subcostattor fist
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M:I.
H:O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
'"i Review, ready for torrectlonVissue
Developer Impact Fee
Planning Approval
Coiled Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fen
` •�/� �� /� fU�
�`�
tal Permit pees
vi
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,�, vc f ear! 1111 V
� a�s-
MAR 14,2005 04:02P
LA QUINTA CITY 76077/7011
page 1
Order No,
Escrow No.
Loan No.
WHEN RECORDED MAIL TO:
DOCUMENTARY TRANSFER TAX $............... ......... ......... SPACE ABOVE THIS LINE FOR RECORDER'S USE
..... Computed on the consideration or value of property conveyed; OR
...... Computed on the consideration or, value less liens or encumbrances
remaining at time of sale. Signature of Declarant or Agent determining tax — Firm Name
GRANT DEED
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Olga Moreno,
hereby GRANT($) to Laulie Smith, a single woman
the real property in the City of La Quinta
County of Riverside
, State of California, described as
Lot 32 of Tract.No. 2667, in the Coachella Valley Water District, as shown by Map on file.
in Book 50, Pages 64 and 65, of Map Records of Riverside County, California. Together with
that portion of Lot 16; of said Tract 2667, described as follows: Beginning at the South
West corner of said Lot 16, thence North 08° 07' 15" East 61.24 Ft. to the Northeast corner
of Lot 32 Thence South 01' 38' 36" Fast 55.16 Ft. to the North Line of Cortez Lane Thence
on a curve concave to the North. AKA: 79600 Cortez Lane La Qui.nta CA 92253
Dated
}
STATE OF CALIFORNIA }ss:
COUNTY OF Riverside }
On July 28, 2003 before me,
personally appeared Olga. Moreno '
personally known to me
evwemmpo be the persohf* whose -names) is/am subscribed to the within
instrument and acknowledged to me that he/sheA*,ey executed the same
in +9e/her/14ow authorized capacity(k*, and that by his/herM*W signa-
ture(* on the instrument the'person(s) or the entity upon behalf of which
the person(e}aeted, executed the instrument.
WITNESS my hand and official seal.
Signature.
MAIL TAX ATEMENTS TO:
Hyesuk S. Konecny, Notary Ru�llid.v_
MIIESUK t KONECW
Comffisdon t 138910j4'
NotwV P d*c - Cau►o
riverside County
Nly Comm- Fxpires De -82006
(This area for official notarial seal)
1002 (1/94)