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0102-069 (SFD)LICENSED CONTRACTOR DECLARATION co ` I hereby affirm under penalty of perjury that I am licensed under provisions of 1- - " Chapter 9 (commencing with Section 7000) of Division 3 of the Business and iv W Professionals Code, and my License is in full force and effect. �`� cr) License # Lic. Class Exp. Date �(�� W � s � � r— r cZ r— • Date" �� Signature of Contractor y' O� U Q OWNER -BUILDER DECLARATION W WW I hereby affirm under penalty of perjury that I am exempt from the Contractor's . License Law for the following reason: Z( ) 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 (St c. 7044; Business & Professionals Code). C O I am exempt under Section , B&P.C. for this reason LO O N, Date. Signature of Owner drn Q WORKER'S COMPENSATION DECLARATION Q� I. Fie'r"eby affirm under penalty of perjury one of the following declarations: � O (.) 1, F ave and will maintain a certificate of consent to self insure for workers' K W Y= .,,compensation, as provided for by Section 3700 of the Labor Code, for the 7 J Q performance of the work for which this permit is issued. n Q V +I have and will maintain workers' compensation insurance, as required by j Section 3700 of the Labor Code, for the performance of the work for which this L CDH permit is issued. My workers' compensation insurance carrier & policy no. are: IRT Z Carrier Policy No. (t)1,Q%!"3 RAMIR N WO 3ZDN, -(* g (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 3 provisio 'Of Section 370 f Labor Code, .I shall forthwith comply with those r�ns. .-Date: ? -- Applicant Warning: Failure to secure Workers' Compensation 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 A 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 employeeso - 2. Any permit issued asa result of this application becomes null and.,v, " If work is not commenced within 180 days from date of issuance a0cl permit, or cessation of work for 180 days will subject permit tokcancellation. 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 in ection purpos r Signature (Owner/Agent) —' --Date L•` BUILDING PERMIT PERMT# DATE VALUATION LOT Ol/J�-C1S4j TRACT JOB SITE APN ADDRESS 53-M) AVERMt:O:@`M2 '774—Ir 412',-t1413 OWNER CONTRACTOR (DESIGNER / EN INEER MARK Tt1'11 EL S1UaR0MI. C, 0i�pO3:%XC°(ON 1 t?'rr gi �� f rol•ICF.L4 An �'. I �) [ 4850 AFQWM9 ROP >zs,J.. A IJlt:4"ZERT : r CA 92111 PALM DEBUT CA =2260 C160' 5- S 1.86 C'.`1 -114t 1137 USE OF PERMIT Mlvtau" Fi<:AdIuy 1)'a1J:tu ,wo SP ; & 100 LF , 4" C 0M13ONA T 1014 WAL L i:ITY STATiDAIt0, P E R M IT DOFF NOT INCLUDE POOL OA DR.MUi AY APPROACH. YUYELL "A' Ptl,.+Jt1) 7 itACT CONSTRUCTION I'm Do 8F 0A1ZA0VCARP0RT CSF) H:473.00 b ri r, WALL 1Kee LF ISIIA117D (OT OY 43NMUC11(" 107,96210 .PTeR.Mr1rY9k RU9yGyX PJAMN CHECK FEE )OI -M-439-318 $$39,24 111EE L1MPOU111 101-000-1t39S 318 4250.00 M,,FCW\NICALzFRE 101.000-421-W3 t$3,50 )F''C.Xi' R1CALH'E'M; 101-000-420-000 $119,63 F1;rZ1MBINO FMI 101-000-119-000 SI1G.%5 3TIZO14 S A•iDTION „ RESID 10149.10-241 -000 $10.72 Oi¢.i4:.1*141 P F. 101-000.423-000 $20.00 WT I5IY1r 1.t)PF IAP TIEF, $1,4'C'T. o PHA7139FI sPi� 101-000.191-343 $10 .00 (:XIAS'!RUCTIO1~I Val 101 (:0© rl16-000 $067.30 3VB-T(-Xf1�.1, C1A11'1 111:'1"[v?>ti►' ;yi it 1�',L,AM ( -HVI U0.11 PRE: -PAID FE70 rV.350,00 TOTAL MIM.- 1IMS DITE NOW � 291 1.146 RECEIPT DATE j BY DATE FINALEb:;`.'` INSPECTOR M SPIECTM RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR SUL©0NG APPROVALS MECHANR CAL APPROVALS Set Backs �( _ Underground Ducts Forms & Footings �(�' Ducts Slab Grade _ Return Air Steel Combustion Air Roof Deck- O Exhaust Fans O.K. to Wrap -p s F.A.U. Framing -,0( y7 Compressor Insulation 4. of Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls - .Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall -Int. Lath Final Finan POOLS -SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bend Footings Main Drain Bond Beam Approval -to Cover Equipment Location Underground Electric Underground Plbg. Test Final I _ Gas Piping PL UM EH(S APPROVALS Gas Test Electric Final Waste Lines �' Heater Final Water Piping 1 Plumbing Final Plumbing Top Out 111 Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection I .t; 10 Encapsulation Gas Piping�-tt—+-111 Gas Test l - D Appliances Final COMMENTS: Final Utility Notice (Gas) [ELEOT=AL APS Temp. Power Pole p Underground Conduit, Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final O Utility Notice (Perm) p� P:O. BOX 1504 ilding � ) _ Qno P r - 7gSGALLEORNIA.O hiaPss ,I tt n rt-I®QUINTA, CALIFORNIA.92253 -7 G - ©1 QI S"" r_ J. 11 1 Vlll lir dl.\VI trtit�U S� Gd ��: � i -�S'r► So-� �n~q- n City ITel. 13 -,' '4 State Lic. City & Classif.. �� �071� L'iC. # .3 Address CityI Zip I State L'ic. # LICENSED CONTRACTOR'S DECLARATION 1' herebyy affirm that I am licensed, under provisions' of Chapter 9 (commencing -with -Section 7000) oMi'vision 3.of, he Business and Profes,kmwCode, and my'licenewle Infuil force andl e/fact, aIGNATIIRE DATE OWNEWBUILDER DECLARATION I hereby affirm that I am exempt from dire ContrBctora Llcenee Law for, the following reason: (Sec.. 7031.5;Business and Professions Code: Any cal' or county which requires a permit to construct: seer: Improve, demolish, or.repair any structure, prior to'as Issuance also requires the applicant for .such permit to file a signed' statement that he is licensed pursuant fa the provision of the Contractor's License Law, Chapter 8 (commencing with Section 7000) of Division 3 of the Business .end Professions Lode: or that,he is exempt therefrom, and the -basis for the aaeged exemption. Any violation of Section, 7031.5 by 'any applicant for a perms, subjectsthwappllcant toga civilpenalty of not more than. Rye hundred dollsre (;500). I7, 1, as ownerof the property, of my employees with wages as theinsole-compensation, wilt do the work, and the structure is not intended or offered for sale. (Sec. 7044„ Buisness and Professions Code: The Contractor's License Caw does not, apply to an owner of proparty' 'ivho. buildsor improves .thereon and who does, such work lilinsell or through his own. employees, provided that such improvements are not intended or offered foi .sale. a,however, the building, or _pis -sold vAfiln one year of comple0oq,. the owner•bdlldei V019have the burden of proving; fAathe did not'build,orlmprove for the purpose of sale.) I1 I, as.ownerot Ahe property, ani exclusively contracting with licensed contractors to con- struct the, project. (Sec.. 7044, Business, and Professions Code: 'The Contractor's License Lain does not apply to en owner ofproperty who builds or improves thereon, and -who contracts for such projects With a;contractor(s) licensed pursuantto the Contractor's'Lloanse.Laiv:)` 0 Lam exempt under Sea, B. & P.C. for thi&mason Date - Owner WORKERS' COMPENSATION DECLARATION I :hereby affirm that I have a :certificate of consent to selVinsure, or a- certificate- of Worker's Compensation Insurance, or a,certified copy_ thereof. (Sec. 3800, Labor Code.) Policy No. Company 'l7 Copy is filed,with the city. 'O Certified copy.is herebyfurnished. CERTIFICATE�.OF;EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be, completed 'a*the perml( is for one hundred dollars IS 1,00) va4atlon or less.) I certify that7in the performance,of the workfor which this,permlt Is issued; I shall not employ any PFereon in any manner so as to become subject to the Workers` Compensation Laws of Callf0 nla. DateOwner - NOTICE TO A'p"'CANT: a, after mWft this Certificate of Exemption you should become subject to the .Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisionsor this permit shsll be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a:construciton lending agency for the performance. of the work, for which this perniitAs Issued. (Sec.. 3097, Civil Code.) Lender's Name Lenderls Address This Is a building permit when properly filled out, signed and valldated, and Is subject to expiration if work thereunder Is suspendeb,for'180 days.. I certify that 1 have read this application and state thatthe, 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, propertyforinspection purposes: Signature of.applicant Date galling Address - City, State, ZIp l I $- Neq!5 f- S 6-" S (�l APPLICATION (c N�Y PIc,s BUILDING: TYPE"CONST. OCC. GRP. A.P. Number '77 LY — I YZ " OD 3 Legal Description �vY Z7- 51-C , °I ? �. m Project Description F D Fit 9V. Sq. Ft. ri 7 No. No. Dw. Size 4 Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ PERMIT AMOUNT Plan Chk. Dep. p �' Plan Chk. Bal. Const. Mech. Electrical PlumbinG S.M.I. Grading Driveway Enc, Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback' Distances: Front'Setback from Center Line Rear'Setback from Rear Prop. Line @ Side Street Setback from Center Line r Side.Setbalck from Property Line t FINAL DATE P INSPECTOR Issued by: Date a m Validated by: JAN 1.7 _ate Validation:.ir-� WHITE =FINANCE YELLOW = APPLICANT' PINK z. WILDING DIVISION Notice: Document Cannot Be Duplicated Date 2/8/01 No. 21632 Owner NameMark Tuvell Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE No. 53-800 Street Avenida Cortez City La Quints APN # 774-142-003 Jurisdiction La Quinta Permit # 0102-069 Log # zip 92253 Study Area Tract # BIK197 U19 Lot # 22 Square Footage 1787 Type of Development Single Family Residence Comments No. of Units 1 At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is exemptfrom paying school fees atthis 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 2.05 X 1,787 or, $ 3,663.35 the property listed above and that building'- . permits and/or Certificates of Occupancy for this square footage in this proposed project may nt,-lie-issued. Fees Paid By CC - l st Bank - Mak Tuvell Telephone Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Annette Barlow Slgnature4141Z 67411 w� Payment Received • $3,663.35 Check No. 57887 NOTICE: pursuant of Assembly Bill 3081 (CHAP 548, STATS,1 Q* this will serve to notify you that the 90•day approval period in which you may protest the feasor other payment identified above will begin torun from the date on which the building or installation permit for this pmJect Is assued or on which they are.paid to the Districts) or to another public entity:authorized to eolleot them on the Distilot('sj(s') behaM; whichever Is earlier. 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 WHEN RECORDED MAUL TO: Mark Tuvell 76995 Florida Ave. Palm Desert, Ca. 92260 MAIL TAX STATEMENTS TO: SAME AS ABOVE ORDER NO. 510071-13 ESCROW NO.: 6721—DS ASSESSOR'S PARCEL NO. 774-142-003 INTERSPOUSAL TRANSFER GRANT DEED (Excluded from reappraisal under California Constitution Article 13 A section 1 et seq.) -rvVZe_-1I,, S4 v 7-�V 3-3- 94on AvF- Co.tr&C. z THIS SPACE FOR RECORDER'S USE ONLY DOCUMENT TRANSFER TAX IS $ -0- Computed on the conslderation or value .of property conveyed; _ Computed on the consideration or value less liens or encumbrances remaining at time of sale; OR Exempt from imposition of the Documentary Transfer Tax pursuant to Revenue and Taxation Code Section 11927(a), on transferring community, quasi -community, or quasi -marital property, assets between spouses, pursuant to a judgment, an order, or a written agreement between spouses in contemplation of any such judgement or order. Signature of declaring grantor or grantee This is an Interspousal Transfer and not a change In ownership under Section 63 of the Revenue and Taxation Code and Grantor(s) has(have) checked the applicable exclusion from reappraisal; ❑ A transfer to a trustee for the beneficial use of a spouse, or the surviving spouse of a deceased transferor, or by a trustee of such a trust to the spouse of the trustors ❑ .A transfer to a spouse or former spouse in connection with a property, settlement agreement or decree of dissolution of a marriage or legal separation; ❑ A creation, transfer, or termination, solei -between spouses, of any co -owner's interest; or ❑ The distribution of a legal entity's property to a spouse or former spouse in exchange for the interest of such spouse in the legal entity in connection with a property settlement agreement or a decree of dissolution of a marriage or legal separation. xX ❑ Check when creating separate property interest. In,grantse spouse: it Is the express intent of the grantor, being the spouse of the grantee,. to Convey all right, We and Interest of the grantor, community or otherwise, In and to the herein described property to the grantee as his/her soleand separate property. FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Penny Tuvell, a married woman hereby GRANT(S) to Mark F. Tuvell, a married man as his sole and separate property the real property in the City of La Quinta County of Riverside, State of California, described as: Lot 22 of Block 197 of Santa Carmelita Unit No. 19y in the City of La Quinta, as per map recorded in. Book 1.9, pages 33-34 of Maps, Records of Riverside County, California. Dated September 5,2000 STATE OF CALIFORNIA, COUNTY 0F. Riverside ON 12-27-00 , before me Diane Sedin, Notary Public,personally appeared Penny Tovell, personally known to me (or proved to, me on the basis of satisfactory evidence) to be the person(s) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacky(les), and that by his/her/iheir signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) octed, executed the instrument. WITNESS my h and official sea Signature Penny Tuv I DIANE SEDIN. COMM 1.148047 2 Notary Public -California> Riverside County ',Z, M My Commission Expires :►uuw► ►r►:►tr►►►►►Augusii19i 2001 �., ~ 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, in order to determine the applicability of compatibility issues or need to require the filing of Master Design Guidelines by the applicant. It shall be transmitted to the Building and Safety Department as your correction list. Please attach additional explanations as necessary. APPLICANT Sunrose Corp. SITE ADDRESS 53-:800 Avenida Cortez APN 774-- 14 2 _ 0 0'3 ' BINNO. 040 CASE NO.: 2001-397 LEGAL: LOT 22 BLOCK 197 UNIT CHECKED BY: Fred Baker DATE: S.C.@V.L.Q. 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 Compatibility Review Case logged and number assigned Verify legal and APN information PPRQVED B OM NITY DEVELOPMENT D Consistent with MDG on file (as.applicable TE —� XHIBIT MDG filing required (5 filings since 9/3/98) ASE N0. Consistency with street/surrounding area: Colors Materials Architecture Other Requirements: Certificate of Occupancy City of La Quinta Building and Safety Department This Certificate issued pursuant to the requirements of Section 109 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: 53-800 AVENIDA CORTEZ Use Classification: SFD Bldg. Permit No.: 0102-069 Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC Owner of Building: MARK TUVELL Address: 76-995 FLORIDA AVE. City: PALM DESERT, CA 92211 By: STEVE TRAXEL Date: 06-25-01 Building Official POST IN A CONSPICUOUS PLACE