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0211-126 (SFD)H N CO W o�c+� W OZr� moa H t0 tea~ Z � Ln N O� UQ o�Z rH0 XW!L mU0 O a rn 1Q- qtZ ao 5 r0 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 Q fi3��tfi B. 1`11C 08M. 112( 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). O I am exempt under Section , B&RC. 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: EXEMPT Policy No. (This section need not be completed if the permit valuation is for $100.00,or!less). O 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 provisiir(s^ Date!'? Applicant -, "` " t�=ipf Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for "a permit subject to the conditions and restrictions set forth on his application. 1,. Each person upon whose behalf this, application is made & each person%t Whose request and for whose benefit work is performed under or pursuantto any permit issued as a result of this applicaton agrees to, .& shall, indemnify & hold harmless the City of La Quinta, Is officers, agents and employees. I Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have, read this application and state that the above information is correct. I agree to comply with all City; and State laws relating to the building constructiQn, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent)`�F" 3:5)ate` BUILDING PERMIT PERMIT A! R.1'�E GLr DATE VALUATION LOTw TRACT 49 JOB SITE APN ADDRESS "9 _34,q' CQucir V. 4 A OWNER CONTRACTOR/DESIGNER/EN (NEER b& S. TOTA Pair` UNKOi1TC; i C ,lr'tlsE'k ' F � � rl�e' iii:}:a.i f r7T2P� rrz fi, f iC�P ' MXAN W .3.110 CA. 92210 QGY)773.9574 C.aUl 3919 USE OF PERMIT SYNG:i. 1 FJWTLN 7G' ,►`�.1 3:IP7'C:4 SFI-11 NXCi..1DIDS INA11.ZIP001it",R .TMa AY AlatdROA C MIC:OMPL6AIJCX V TH ,ALL ISI?lMAI, it.0`tAU LAWS, I'R+iCL{ti7rOO ` HY. l;r-10 OClERED Wn-NEIS, ACT OF W73 WA1tPL; CABL41$ REQUIRED. CUSTOM CONO`I'R1JCTION 0,59h.OD 9F POR.Ci` IPATIO 1,186,00 :5 CiARA.010CANPO1'?T I'l-aw +1r ES'l.'.�p►A l AM. COST OF IC"t3Nt5:!'RIN'''rTa.FI'c 551, iM 0 I?FZ11fT1T' F +1.51[ WAARY' COWSTRUCY10)4FEE'' I0I.000-41 00 $2,lgi'sm PLAN CHECK viRS 101-000-439-318 �I,?fiz7a FEE DEPOSIT 1(11.000-439-3I 6 44250.00 " 1► ECH.A.MtCAL FEZ 101-0100-421-000 21-000 slaw ELL+CTIUC A -L FFE 191.000.420-000 S3"sd. Z S Pl-UMBINO FEE 101 -000.419 -ON STRONG N$s.7'(][00 FEL! - HOAD 101 -000t 241 -000 $55: H CIUIDiNa Fk.L' 141-006.4.23-000 $15.00 I;ai:V'i!:LOPER.IMPACT PUT $?,40,5,00 - ,AR. TTia PUBLIC; I'LAC.K'- - RESSI 270-000-445-000 %6 4i.4$ t SUB.-TO'TAf f.°CI {'c` L CJC~i�O1MTall It PLAN' Q:�LCE�' ` 8,1 5t?.5!� /'&-\ n � ' ' � � �3��1 O B LI M- 9�.liJ.AL:. E F L�."Xi S I)IT9 fVO tS1J fLl:c��; FEB 2 g 1003 L CITY OF LA QUINTA FINANCE DEPT. DATE BY DATE FINALED INSPECTOR .RECEIPT @NSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs — Underground Ducts Forms & Footings Ducts v Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap Jf F.A.U. Framing Compressor Insulation -O 3 T 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 POOLS a SPAS HLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBWG 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 d Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Q�'�2tJQ0• `�"'�7 �'�t' F 6�1� u Atm a6 —SK ATv'e 101(0/63 — I Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring�I�(� Low Voltage Wiring Fixtures Main Service Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) 1V/1 _ � • I A ', PO. BOX 1504 APPLICATION ONLY ` Building -1 D_3� LUv� ^kqtg PT 78-495 CALLE TAMPICO Address LA OUINTA,, CALIFORNIA 92253 Owner N1i�,si. MSS. Address {. Contractor - 1 I Ce,I TPLh t kv.-1,�dte„rs,n1` I'm 1.„ ✓ Des gner9r„ �"©l��{ N V V l._ Tel. hILF-5SJ4 NDRa STS' TYPE'CONST. U�l_Occ. GRP. `_ -5 Number Description-rrucj u :t Description NP,w CuT4om Hems f►O3 Sq. Ft. 6 1 No.. Size SStories City GIZIp l�Pc+ I Lic.t � # e--' 1 Z► 1 LICENSED CONTRACTOR'S DECLARATION 1 affirm that Lam licensed'under provisions of Chapter (commencing with Section 7000) of Division, 3 of the Busineas,and Professions Code„ and my license is In full force and effect. SIGNATURE. DATE OWNER -BUILDER DECLARATION 1 hereby. affirm that I am exempt from the Contractor's License, Law for the following reason: (Sec. 7031.5;6usiness and Professions Code: Any city or ,county whkh requires, e permit to construct after. Improve, demolish, or repair any structure, pdor to'Na Issuance also requires the applicant for such jrml to Nle a dense statement that he is licensed pursuant to the provisions of the Contractors Lleense Law, Cheerer 8 ,(commencing WO Section 7000) of Division 3 of the Business and Professions Code, or Mat he Is exempt rhershpm, and the basis for the alleged exemption. Any v/o/auM of Section 7031.5 Gy any applicant for 'a Permit subjects the applicant to a, civil penalty of. not more than five hundred.dol/am ($500). C' I, as owner of the property; or my employees with wages as their sole compensation; will do thework, and the structure I8 not Intended, or offered for sale. (Sec. 7044, B&ISness''ind' Professions Coder The Co'ntractor's License Lew does riot apply roan owner of property who builds or Inproves thereon endwho does such work hlmseff or through his own employees, provided that such "rovements are not Intended or offered for sale. N, however, Me building or irnprovgor ent is 'sold within one year of completion, the owner -budder will ,have the burden of proving that he did not build or Improve for the purpose of sole.) I'1, 1, as owner of the property, am exclusively'contracting with licensed contractors to con- struct oo-struct the, project. (Sec: 7044, Business avid Professions' Code: The. Contractor's License Law does,not apply to an owner of pioperty, who builds or Improves thereon, and, who contracts for such Aocts,witha contrector(s) Ilened pursuant to the. Cntractor's.License Law.) 11 I am exempt under Sec. 8. 6 P.C. for this reason Date owner WORKERS' 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, LaboiCode.) 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 (he. permit Is for One hundred dollars L(S 100) valuation or less:) I certify that' In the performance o4 the work for which this permit Is.issued, I shall not =any =n in any manner so as to become subject to the Workers' Compensation Laws of-Calitornla. Date Owner NOTICE TO APPLICANT:, N, after making this Certiftate of Exemption you should become subject to the Workers' Compensation provision of the Labor Code, ,you must forthwith comply with such Provisions, of this permit.shalfbe deemed revoked. CONSTRUCTIONLENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work ,for which this permit is issued. (Sec. 309 7, Civil Code.) Lender.+s Name Lander',s Address This is a building permit whenlpioperly filled out; signed and validated, and Is.subject to expiration if work"thereunder is',auspended,for 180 days: I certify that'I have read this application and -state that the above:dnformation'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:applicant 'Date Mailing Address City, state, Zip M New X Add Q Alter ❑ Repair ❑ Demolition ❑ PERMIT Plan Chit. Dep. Plan Chk. Bal. Const. Mach. Electrical Plumbing S.M.I. Grading Driveway REMARKS AMOUNT 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 a FINANCE' YELLOW o APPLICANT PINK ,= BUILDING DIVISION Comments At.the present time, the Desert Sands Unified School District does not collect fees on garages%arports, 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. W has been determined that the above-named owner is exempt from paying school.fees at thistime; 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 6,581 S.F. or $14,083.34' 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/Wells Fargo Bank -Lori Hatzopoulos . Check No. 0668924969 Name on: the check Telephone By Dr. Doris Wilson Superintendent Fee collected lexemptgd by Patricia Signature Funding Residential $14,083.34® Payment:Recd Over/Under NOTICE: Pursuant to Government Code Section 66020(d)(1), thiswill serveto 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 Distria(s), or to another public.entity authormsd to collectthem on the DistriclCs) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting Jan -i4-03 12:30P RECORDING REQUESTED BY: Fidelity National Title Company Eacrnw No. 4833 -CAH ThI16 Order No. 9782694 When Recorded Mail Document and Tax .Statement To: Mr. and Mrs. Torn Marinkovich 9011 N.E. 38th Place Yarrow Point, WA 98004 P.01 ®OC " 2001—Zit31084 06/21/2001 08:00A Foo:9:ee Pape 1 of Z Dee T Tax Paid Recorded in Offlelal Records County of Riverside Gary L. Oras Assessor, County Clerk i Reoerdar 1111111 1111111 ISI IIIII IIID VIII 1111111 IIIA Illi IIS N I S U MGE 47t W �rpq •OR :NG w.G. A wRiT.-g7o :.g417 -f. i "'' j' a L ea.r wn.: ac -U In rre�v r E GRANT DEED ' rko•- a,;L- 7` The undersigned grantor(s) declarefs) Documentary transfer tax is $990.00 Ata ( X 1 computed on full value of property conveyed, or I ] computed on full value less value of liens or encumbrances remaining at time of sale, ( 1 Unincorporated Area City of La Quinta FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged. George I. Middleton, A Married Man as his Sole and Separate ,Property hereby GRANT(S) to - THOKAS A. MARINKOVICH AND TF.RESA F. MARTNKOVICH, HUSBAND ANI) WIFE AS COMMUNT'l-Y PROPERTY the following described real property in lire City of La Quinta _ County of Riverside, State of.California Lot 49 of Tract 28470-1 filed, as shown by map on file in book 263 pages 76 through 90 of maps, records of Riverside County.- California. DATED. June 14, 2001 STATE OF C-AHFGRP-Mok prrrarvn. *TR COUNTY OF wA.tHuvcyenr VON ,�yNt rs_ i,wi before me, Jonat toT n II: aspen personally appeared George 1. Middlelun 14 personally known to me for proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) islar4 subscribed to the within instrument and acknowledged to me that he/slI executed the same in his/het/theic authorized capacityfies), and that by his/befItha r signature(s) on the instrument the person(s), or - tho entity upon behalf of which the person(s) acted, executed the instrument. Witness my hand and official seal. Signature .. M1._...�..� - --',;'EF• rte. ►CffARrPUULK;.-rp►B t ' F�9WIE8a f0•2T3 (Rw 71961 MAIL TAX STATEMENTS AS DIRECTED ABOVE GRANT DEED From: Brian Gottlieb To: Jimmy Hotzopaulos Date: 111812003 Time: 11:57:48 AM Page 2 of 3 "w B.G. STRUCTURAL ENGINEERING BRIAN GOTTLIEB - CIVIL ENGINEER - Lic. No. C33047 45-535 Via Corona Indian Wells, CA 92210 (760).568-3553 (760) 568-5661 Fax November 8, 2003 Mr. Jimmy Hatzopaulos Cal - Tech Development 75-352 Palm Shadow Drive 'Indian Wells, CA 92210 7 R- 75y� CoY �T 6 (,9-'X&' RE: Marinkovich Residence — La Quinta, CA Dear Mr. Hatzopaulos The purpose of the site observation work undertaken by B.G Structural Engineering for the above named project was to confirm that this project has been constructed in general conformance with the structural drawings and .as required by the 1997 UBC Section 1702.. Observation of the construction of this project was- conducted or .supervised by Brian Gottlieb of this office. These observations were to establish the conformance. of several items including, but not limited to: conformance of framing to framing plans; the assembly of shear walls, wall sheathing, drag straps, holdowns, detailed connections and limited observation of footings prior to concrete pour. Corrections and or lists were provided after each observation to communicate the items of concern to the builder. Subsequent re -checks of the structure for compliance were performed until all outstanding correction items were resolved.. .In conclusion it is the opinion of this office that the construction of this project is in general conformance with the requirements of the structural drawings. From: Brian Gottlieb To: Jimmy Hotzopaulos' Date:1118/2003 Time: 11:57:48 AM Page 3 of 3 r Marinkovich. Residence — La Quinta, CA. November 8, 2003 Page 2 of 2 The conclusions reached above are based solely on a visual review of the structure. Due to the visual nature of these observations, and limited access to structural elements, not all of the structural elements or connections have been observed. No tests have been conducted on any materials or soils and no warranties are expressed or implied. The opinion above is based upon widely held engineering principles and judgment, and it follows a standard of care which defines a level of skill and competence ordinarily and contemporaneously demonstrated by professionals of the same discipline practicing in the same locale and faced with the same or similarr facts and circumstances. Please .call me at (760) 568=3553 if you have any questions or would like to discuss this matter. sincerely, 4 �O,�gOFESS/pNq Gorr Brian Gottlieb, P.E. cc: A Pap 2 s�, CIV1L PP