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9905-197 (SFD)• r, .r H U) 04 O� U-) i LLJ oZ� ((D 0.1 JC)(0 ww, 1- a U) = °Z a LO N Orn Z Lo Q O XWLL: O =X:Q CO < U C ' O.0 Q "30) H Z -00 r 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 1- 'Professionals Code, and my License is in full force and effect. License # . Lic. Class Exp. Date 425381 1B DateMtSignature 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). ( ) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). O I am exempt under Section B&P.C. for this reason Date. '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. �,1 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). ( ) 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 Code, I -shall forthwith comply with those provisions Warning: Failure to secure Workers' Compendion coverage is unlawful and shall subject an employer to criminal penalties andcivil 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 ona 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, indemnifyF & hold harmless .the City of La Quinta, its officers, agents and employees: 4.2. 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)L � 1<C� r ' ` *\ Date'-, V. 4\ • J 3 ' BUILDING PERMIT PERMIT# ' (j7 DATE VALUATION LOTTRACT .— $91,638.7{1 (�'(' 1. 9 131X JOB SITE —' APN _ ADDRESS •.1_915 AVKt-J-I);)A CORi"fL7, '� 73- t�z•�1`�Y1 . USE OF PERMIT CONTRACTOR/DESIGNER/ENGINEER .P Ac,,,iL•nits'vt.a.c 1719 5-.1"etElblvNE' S OCEANNSWE CA 92054 ('760)967-0066) 011.1! 1955 SWC -18 FAtylx.i.`'r' DWELL,TI` O ,5 iD-11i+.lia IT WES MDT NCLUDE t`3J'.00K 1aJALL OR POOL TItACT CC,N113IRttCTei.N 3,475.00 S1:` PGRC:IfiPA.1'IO 58.00 SF UAl.+.AC-1 lC:ftiRPi.; WL' 463MU pit•' 5 F11. WOOD FENCE 200,00,LF E= I MATED COST 0.UC:'ltZ'STRI Il -7 10 -NI (II'A Nil T FITXNUNIM ARV Ct7Id.S^1'RUr f ION PC•:l; 101 -OW -418-000 $6(63.5(6 (11.A.Af C,W-'CK F ((j9-(if)f)-d't4 • $,Sl4. W wi7i��t!�'�fts•'iti��y Xt��y�,.�.1^«�>��fs l U!-,1�1�0q�6'7� ^�992p�t}-(1!{l��tyl �ri.3wL..�3. e�1.Fw,f01+ .CI;.I.: t �,� "�! V6F' �i•L\7�llLJ e��c.6��r�i.5�(!?� .D L.BFl.J9 t �l.t:ilT�sxt• i� C?ti' 1111-�20t1••d i 9=t1i11? $1'�:3.5tr �a �6anfcaVICY17TOWf�17 IF_raESr►► Ills-tl0rt-��I»f►fffl v,rf GRAD t`t401,4111 I'M. NWRASf.Fti1CI't✓R.a FT -,8 22.5-C3t`lM04431-342 s ,i►"..216 €ARK_ i8F-P.LAN $25.(1('3 F141, 0FPOA11r i 10] .-WO-119-MR 47-50,00 RE-11AH.) FE 42500) IPT . ( DATE,/ BY j'` DATE FINALED JINSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap B - f - F.A.U. Framing Y F 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 2a Final Final 1 00 BLOCKWALL A PROVALS 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 —28— 57 Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) QrJ ELECTRICAL AP ROVALS 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 Final UH14 Notice (Perm) �y COMMENTS: . .. „. -.. -. r. ^.��.n.-�r. _ , -,�-• r`Y-.rti..,—......-.w...-�t,�,..-4,c;::. ���7y.�,�._.�.j�l...-`+-..�..-r•".'`t.,f"'r.�,S^..-.r'�3.�w-wti�µi^..[`.-'ti.-r .:..:��y��:��=y,,,�- �.�.--.-+�+.. 40oilll Ple�c s e See Q Id T4'1t 4 4 t+G�rti�v s+� �� P ( P.O. BOX 1504 APPLICATION ONLY 0,� S Building J 78-495 CALLE TAMPICO Address / 11;�_ILA QUINTA, CALIFORNIA 92253 Owner t " ci [IQ S S Address City Contra' t�or ���1f t� Address City P0 \ it <t, fL, 'AJ..) Zip Zip BUILDING: TYPE"CONST. OCC. GRP. A.P. Number -)-)3 1 t 2 ` v> 1 " `a j— (� .,,Legal Description w T I , 1 V Project Description . r - V`) . BA1. )Cel rrzC d -0,-R.? i Tel. , State Ljc.I " C8 Classif. � � , City Lic. q Arch., Engr., Designer Address Tel. City Zip State Lic. # y rLICENSED CONTRACTOR'S DECLARATI$'N I herebUaffir that I am, licenced under provisions of Chapter 9 (com encing with Section D00) of ivisron cf thkBus(Ress and Profusions Code. and,jnytis nse is in full force and 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 peril to construct, after, 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 2031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I-1 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.) I l I, 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 contractors) licensed pursuant to the Contractor's License Law.) 17 1 am exempt under Sec. B. 6 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 if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thF 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 or Exemption you should become subject to rhe 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 a0plicant Date Mailing Address City, State, Zip 9� Sq. Ft.1 U No. No. Dw. Size Stories Units New ❑ Add ❑ Alter 0 Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep.' —� Plan Chk. Bal. 1 Const. Mech. Electrical Plumbing S. M.I. Gradina Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: I Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line 4 FINAL DATE IN�S7C- R a Issued by: DaePermit 1 it. Validated by: APR 2 6 1999 *� Validation: _ �I J WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING.DIVISION Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 6/4/99 No. 18854 Owner NameDavid Miller No. 51-915 Street Avenida Cortez City La Quinta Tract # BLk 29, u2 Lot # 9 Type of Development Single Family Residence Comments APN # 773-152-021 Jurisdiction La Quinta Permit #9905-197 Log # zip 92253 Study Area Square Footage 1475 No. of Units 1 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: Add. of Sq. Ft. to New Construction EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.93 X 1,475 or $ 2,846.75 1 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 Pacific Trades Construction Name on the check By Dr. Doris�W-I'J.sb11111 Superintendent Fee collected</Exempted by Julie O'Neil Signature :`66 Telephone Payment Received Check No. 13500' $2,846.75 NOTICE: Purs of Assembly Bill 30811(CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identifiedbove will beg to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to collect them on the District('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting RC District Plannin+�► Review Form 3g This form is to be used by CDD staff for review of single family dwellings in the RC (Cove Residential) District, in order to determine the applicabitity of compatibility issues or need to require the filing of Master Design Guidelines by the applicant. It shall be transmitted to . Building & Safety as your correction list. Please attach additional explanations as necessary. APPLICANT: Pacific Trades PROJECT ADDRESS: 51-915• Avenida Cortez APN: 773-152-021 LEGAL: LOT 9 ,BLOCK 29 _ UNIT , S. C. @ V.L.Q. QVD BY: Stan Sawa BIN NO:. CASE N0. 99-63 CHECK -DATE: Inform the assigned Building plan cFieckef upori your assignment to this case. The CDD Executive Secretary maintains a log book to track applications and assign case numbers. REQUIRED ITEM Y . N COMMENT/CORRECTION 4:•'ti... •♦'t.•�:..:i'.{{?;:;?>:;:;;..:i',tiF�:i:^:%22>; . ,.., . ,\Ca . ,iR :..ii.::}.};:::.?.!.'•}.,!, :, :a..v .:i .. �. t}:•.v.�:.:.wb}.::•::.:.Sk\:;:\•:?:v..i.^.i::•.};>?X:}•:.: .}a{::: •�:a:�.4.::a.2x };?}%}.}A'•:;};!::A\.:.::v.Irv:A:;:.t•\,..:...::..r...::'•.rS?}.y?M}:•}::?1:Yin:!'•}:?!:i:.}• :$::;A� \,}::.}:. ....}qtr%i�''\\\::<�•'nLi:'\\\4 nh�::?:}1�iK?�{nS:;ri:twti:;\�':L•'?;:{ti':`,v}'aa�'a i?.:}:!::}:M1ki{i.{:.::�:.w.�:?•'�•.}:. vi•�.}p\}}:i}}::}.\•i!i}�}::Fv:4\,:}\n... {�.y-L iy� FF Y v n\:�:.:t}: }} .}\.:.; •v;v}:}::}}\\1!:\Ci}\ .:•}ria::?.n:?r :.::.: �:};y:�,: N :: r,{4i:{Y:ti:ti�4:+ ',��.5!l•�I.•:.�iM���tI.•:v:�:.•.:..•:::.v:::1,.}::::}:}:.�:�.}v.:::.,.:i}.�:.i.:..:n•:nv:. �::L:•:.:::•. n...:. �i�.\..:........::..::.: }.............:.... ... \...�.. Case logged and number assigned Verify legal and APN information Consistent with MDG on file las applicable) MDG filing required (5+ filings since 9/3/98) Consistency -with-street/surrounding area:. Colors Materials Architecture v ®a OTHER REQUIREMENTS:OCII O� .The zoning code, architectural and landscaping manuals, and/or assigned inspector should be consulted where uncertainties arise.. The completed checklist shall be maintained -in the Building .& Safety address file. Ac,r,.20. 1999 7:39AM POWER BROKERS 'ORANGE MAu i ► iTLE uL--� afto=COST TMS COMIAMPANY 99,8483= A-1751381 �9 QT�OR a eo MMOMP MM 20 asATEM123 261 DAVID AGES NZIA tR 1719 S. TCM": s. Oeeanefder aA 97054 No -0116 P. I -r,-ozoo17 GRAKDE�D - 1 -DT --9 5i -Q15 Corz The undersioned aator(e) d% (a)I Docuarenta traniler tax ie convoyed. or (SUCI ated on full value of prmrty I i Hain tea aoan full Value lease, no and euuadtrances remainieg at Cime•aandala. ated aseaa t )t► of FOR A VAUUMS �198iA1sMTi01t, receipt of which to hereby aeknowladged, JAMt39 A. ilO=. , 1t,D., ZNC., mm FaRams pmm:ox PLAN hereby WAST(S) to DAVID Ao9S X%ZJAR, A VJMM MVA Af M SOL" A'M 63PMM PRA1BITY • the real property in the City 09 Lh Qt m*%, Comty of Riverside, State of Ceiiforal.al described as i a AND 10 = BL= 19 OP WrA CMMM AAT VALE LA QDAPAI, UNIT No. 1. \�\l A9 12L 1(AP RECOM D IN soon 281 PANS 66-66 08 Wad tt8Q0 S oP PIVSRSIDB COIC1Pf'1f, CALIPORNIA Doted Yebraa:lr Me 1999 state of CalR re beta= t 01f � pe eo�� l appease personally known to pt! (or proved to to GA. the hula f 6atasp amral► w}dance). to be ,ubscr� the psrtoa f 1lhase Sam+ ) fie to the ri�1► iaatrttmsnt uknavledged to that �Shs44bW executed the eme in autbarimed aspaoi (N), and that by �m mi iQtiacure { oa the inotrumat the peraoa�@ f, = the tity upon behalf of which the p4 =s ) acted, aleaolleed the inetsumnt. lggggg fficial se Signature Om TAX pwkIMONpB sot AM AS ASM Jam D. gplowD, m'O., Me. we itis I Same/Title 9HMON COIYRN CommlsslenYt16�0a1 Notmy Pumc • CoBfanfa ux ArSSIM Courtly Mvcan�n.a�itet Jen t. y002 ('11+is area for official Mterisl eeall U 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: Use Classification: SFD Occupancy Group: R 3 51-915 AVENIDA CORTEZ Bldg. Permit No.: 9905-197 Type of Construction: VN Land Use Zone: RC Owner of Building: PACIFIC TRADES CONSTRUCTION Building Official Address: