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0309-067 (SFD)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 y� f 799449 r Daa tes [ f c 7 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). ( ) 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. ( ) 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. MIMPT (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' compensationfprovisions�of Section 3700 of the Labor Code, I shall forthwith comply with t'ps provisions. Date: �E Applicant �/! _�7 I 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 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 representatives of this City to enter upon the, above-mentioned propert or innsp,eetion purposes. Signature (Owner/Agent)1�����r/ 2/_Date7- ,?;%.F, BUILDING PERMIT PERMIT# DATE VALUATION LOT 0 JM' -06 1 TRACT 14 4841o.1 JOB SITE APN ADDRESS 78-400 COY01 r C"YOR COURT OWNER CONTRACTOR/DESIGNER/EN (NEER jC) m & Ei,m, Dy—'WEESE 1~'3:1M L JA! Mt S L QUN-M r,'A .92253 cm -o i'i7-wil culo 66 1.4 USE OF PERMIT ��+ ►�.`i\1'.4t+T+' ��f9A�:•Lf.�.lr � 7Y -L° Ju1d1.Ltl \� . SPI),W,Xt.; ,J[)' Z' WA.1 d JPC)OI.,6ORIV.P.•'iAiAY ,AY)l'.,°CO.MPU,ANCY, WITIN ,A14 0131 R�� �Q �3SA'S'lr 1�A 3l�C;i.1�1�1NC1 `C"'iii L fA,'�fC63�:.d+' l' C't �; 401 OF 1.97.3, PF A)1PL1Cd+,FiLZ1S RZQUIR91). CUS110M 0 101'RiJCT10N -�006,00 3F PORC3i11 AMO _pg5m St+' C1A.it�C�ul�`•.�1�.1"�►RSt !,3'#�.(3i! F1)� ' Xgi RTY–D COf–MOff?' C0Tqkr11zEfM1 ON P.�:RP► 'r VEY KCAMARY C;ONSTYWC11Oa1 FT -Le 1t91.001C}-42I3.00:Et a1, y ,0'� PI,P.14 CHiiCr."". FEF, 3331-t?�i4-�R�1�-31u^ $I,d9fr.�t3 ME DEPOSIT 101-000-439-318 -$1,000,00 MFCf1Fi.tQICA,1, FEZ 101-000-421-000 $109.50 t;1.1;CI'M (,%A a Mfr 101.000,420-000 SM109 PLIUl 411 -NO 115F, 101_000_411r4_000 W53.5 STRsu►NO MOTION Fir.1 QI 4.)O -Zi l -100 (1:111 ANO Y–PE 101-0004Z4-000 1.5.a1i DF.'�'Fi.( PEP' IMPA..CT FEE A VIN PA311),oir LACNO, 12M11270-000-445-000 $616.75 MID TOTAL CON- Sze'UG1110ty AN2?PLAN LF• `"f D ° SAL PRIUM� FEMS 3>`4�'e l(OW 46,113m ° MAR 2 2 2004]. CITY OF LA QUINTA FINANCE DEPT. ` RECEIPT DATE Z 621,1 ABY f ''�. DATE INAL D 7 ps-- INSP C OR (L INSPECTION RECORD J OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs — ? �y Underground Ducts Forms & FootingsJ Ducts Slab Grade_ ReturnAir Steel s Combustion Air Roof Deck ZO Exhaust Fans O.K. to WraD Z_ of —7 F.A.U. Firep Face P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final S/dS BLOCKWALL APPROV Set Backs Footings Bond Beam POOLS - SPAS Steel Electric Bond Main Drain Approval to Cover Equipment Location Underaround Electric Final I I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines y— Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure ShoweLeans O.K. for Finish Plaster Pool Cover Test Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole 5 a Underaround Conduit Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Notice Final COMMENTS: CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING =`' ' CF-4R Project Title00 Date /'�r440 r5o� ©!-Z cf; N y ��•� G7 L� Q /0-0- P for eft Address Builder. Name, Builder Contact pp Telephone Plan Number J /n. G2rMDa/� 170) �/0- 5-72 3 HERSater ,t ,. T lephone Sample Group Number ,Coifying Signature 'Datd Sample House Number (firm: '17C. HERS Provider: -� Street Address: %1qb1bbffYaLY� (f/Ye�� City/State/Zip: u �y�171a Copies to: Builder, HERS Provider ttrt4 ti HERS RATER COMP IANCE STATEMENT The house was: Tested ❑ Approved as part of sample testing, but was not tested a-- As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form coma 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 lieu fes-. ••: of ducts) Where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. iT. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM If fan flow is calculated as 400cfm/ton 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) = 7l Check Box for Pass or Fail (Pass=6% or less) ca? ❑ Pass Fail (THERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent t- Yes ❑ No Thermostatic Expansion Valve (or Commission approved - _ equivalent) is installed and Access is provided for inspection ❑ Yes is a pass Pass Fail ❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT r� 1. ❑ Yes ❑ No ACCA Manual D Design requirements have been met — (rater has verified that actual installation matches values in x CF-1 R and design on plan. _ 2. ❑ Yes ❑ No TXV is installed or Fan flow has.been verified. If no TXV, _ verified fan flow matches design from CF-1 R. Measured Fan Flow = ❑ ❑ Yes for both 1 and 2 is a Pass Pass Fail 11/11/03 13:2.7 FAX -818 110 7855_ VLY CML CONTR 0 001/001 Pirst American Title ' 'r)wrance Compaq O�Q 1 Wet go; = 2084054 -EL F'ECE'VED FOR RECORD . escrow No. M1010 Loan No. AT $:o o RECORDED WHEN P A I D MAR - 5 1998 T'O: Doc. Trdnsler Tan MR. h MRS. "D�E WEESE 2403 STAFFORD -ROAD R-tv, CC), Recorder r'd= QMI% * i4 THOUSAND OAKS, CA 9I3b1 Re Fees $ DR MAIL TAX-STATENM14TS TO: Space above this line for Recorder's Use DOCUMENTARY TRANSFER'I.AX S �• C� 1 Computed on the consid-ration r value of.prope l conveyed; OR SAME AS ABOVE — - -�nnputedbn the cbnsU1erafion or varue-lcss lieiic or—' ' encumbrances remaining at time of sale The Undersigned Grantor _ Signature of Declarant or Agent determining tax -Firm Name APN: 769-162-001 TRA-: 020-015 GRANT DEED FOR VALUABLE CONSIDERATION, receipt of -which -is hereby acknowledged, TRADITION CLUB ASSOCIATES LLC, a Delaware limited liability company hereby GRANTS) to JOHN A. DeWEESE AND -ELSIE M. DeWEESE, MUSTEES OF THE DeWEESE FAMILY TRUST DATED APRIL 21, 1-985 -the real property in the -City of La Quinta County of Riverside:State of Califomit, desciibed io ---Lot- - 54 TTaet 28479-4=(Seel:xln'bit'"A"Attaclrezi'Herero) = - _ .__. - - .--------- .Dated: JAI»ARY 22, 1998 State of California. ) County of On. �' before -me, &LY -'a .� z -res /Vol personally appeared. m _ _ _ personally known to -erideaee) to .be the.person4+whose .name(( isAme subscribed to the within instrument and acknowledged to me that he4heXAexexecuted the same in, his/kg�authorized capacity(46), and that by his/#*F4heia• signaturcH on the instrument the person*or the entity upon behalf of which the.person acted, executed the. instrument-- WITNESS nstrument_WITNESS MY HAND AND OFF CIAL SEAL TRA131 I ASSO LC a Dela'ry d iiab'b co any `,� By: By: Its: W FA (This area for official notarial seal-) Comments 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 5,006 S.F. or $10,712.84 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/Pacific Western Bank - Peter L Jacobs Name on the check By Dr. Doris Wilson Superintendent Fee collected Signature ron McGilvrey - Check No. 209395 Telephone Funding Residential Payment Recd $10,712.84 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 //// //�� olnolqCITY OF LA QUINTA $UB -CONTRACT R LIST/JOB ADDRESS 7949 �-o rt%� �a- PERMIT NUMBER _ OWNER ew& BUILDER cez/1) This form shall be posted on & iob with t e Building Inspection Card at all times in a corispicuousplace. Only persons appearing on -this list or their emplo ees 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 OT building permit. I -or each applicable trade, all intormation requested below must be completed by applicant. "On File" is not an acceptable response. ,:.. _.Tsi1n /l11�cc.f.i•tifinn - .'.:-�::.L`nnf.�nfnr <.. - - :i' ...,.. ...C��fn.:r- Marfn�'. c.l:�.:e'e'�'ee'':: .. .. ... ..... .. .. .... .....1AIwLla. Company Name EARTHWORK (C'72►. CONCRETE IC 81 _ � epi, LN IuvvJ r Classification License Number Exp. Date Carrier Name (e.g. A, B, C-81 (xxxxxx) (xx/xx/xx) te. . State Fund, CalCom ) s I I I» p G 12 /9C2C2S"- 3/`0il Cffa �� �� 3/1 a l Certificateam k rcu of Occupancy o F O F Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 78-460 Coyote Cannon CourAle- t Use classification: Single Family Dwelling Building Permit No.: 0309-067 Occupancy Group: R -3/U-1 Type of Construction: VN Land Use Zone: RL Owner of Building: John &Elsie Deweese Address: • City, ST, ZIP: By: Daniel P. Crawford Jr. F Date: 7/15/05 Building Official • POST IN A CONSPICUOUS PLACE Certificateam k rcu of Occupancy o F O F Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 78-460 Coyote Cannon CourAle- t