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0010-157 (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 �3 °a 131 d Date g ature of Contractor— OWNER-BUILDER ontractor 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. STATE FUND' MOLIDD UNIT 001109.0 (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 tho "~provisions../ Dateu�Applicant f -* J f •� Warning:. Failure to secure Workers' C mpensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,0001 -in addition to the cost of compensation; damages as provided for in Section 37.06. of the Labor Code, interest and:atforney's fees. IMPORTANT Application is herebymade to the Director of Building. and Safety`, for a permit subject to the conditions and restrictions set forth on .his application. V• 1. Each person upon whose behalf this application is made,&4eadh person'a't 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 property for inspection purposes. Si nature (Owner/A ent) �r / Date BUILDING PERMIT PERMIT DATE VALUATION LOT€�_'� TRACT JOB SITE ' ; ` APN ADDRESS ( OWNER CONTRACTOR/DESIGNER/EN INEER Ihry�EC[iy"lpp9" 7[?�►p .Cff(i�dE3`�:k UC-'�gC`�,llly:o�r�p y��a��i(:�6?{a�/,yry��y� r� 6.t�`-995 .TD�"'e1.y33tTL'"hdKl."wt 1. 077 5�fr-995 i VEIMA lg.4fsi1'��J.!OZA / JA QLJWrA CA -.92253 LA QyftTrA CA. 92253 (7G0)5ei4-30—?3 C"BI'� 5-537 USE OF PERMIT MOISFAWLYMMUNG SF'D.PXRMi�'.'r,kOES1 t�TOT rX LUDE 31DCIC'�ti'.�t,UP001jC1i.1VLr'�FAY t TRACIT e-WITM.UCTION. 1.1409.00 9F 0A1�.r'9�1�CwARPOR,'1' ;;1� 10,1'72,40 9 FT, WOOD PIENC Z. ; � 200,09 F s j s CONSTRUC:TiON' f' E 101d009�18.000 $590,0€1 PLAN CM�rCi'ti PEER 101-(),?S1-dd39-318 $491.21 1r�ECHMICr! L ME 101-000.423.000 1,.f..W.'T I �:LFEE.. �tTl-a0��S2tJ�t��(1 .$12-9.20 i�Li�A'd1Yd4,°�S? 5TR.Crti40 AOTION FREP RESAI 3 100.1000-241 _00 0 $8.84 ; i13.�ADINO F 101-000-43-000 $20,00 Y UL�fP'd,�3E�ER,1Y�R.►�.F�CT irZZ $5,5107 G0 , : PLAN 101 -000 -meg �-3�� FEE OF -POSIT 3.0;-f1i3a-d - 1 fi -$a o.0is S1:J'1�T'�G�TAL C:ONVgI ,ir2LIC.";�`IO AFAR PLAR, CIOXX UEPOW RECEIPT DATE BY qj DATE FINALED INSPECTOR 9 9 , INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings _ _0 ` n �` Underground Ducts Ducts _(� �� Slab Grade Return Air Steel Combustion Air Roof Deck .gam Exhaust Fans O.K. to Wrap y_•�D F.A.U. Framing i'L • [�'-d1t� S� Compressor Insulation �2 ., • e� Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int.1ath �y • ?� a0 5' Final I Final POOLS - SPAS BLOCKWALL APPROVALS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines O Elxi 5� Heater Ficial Water Piping —Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS 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 ( 7 Utility Notice (Perm) Z , Z , O s'7 uulttCv 1/26 P.O. BOX 1504 APPLICATkA ONLY Buil Ing 78-495 CALLE TAMPICO Ad ress 1-- ,i" V fG 1 jr� QUINTA, CALIFORNIA 92253 _n �C Ow l �^v BUILDING: TYPE'CONST. OCC. GRP. [ Mailing Address "2— A.P. Number 401 City Zip Tel. LN mit, L. -L-L S"5 ._ Z —T -s. Legal Description t If" t.�✓jl� !i '1 t 9 I�1 T G Contractor Project Description --2s '1a_+1� � K te' Z. 4G>+.�ST l t� cL 1 A LAI( P � eno r N[)o Address , Tel. State Lic. City & Classif.� Lic. it Arch., Engr., Designer 4- e ` rJ Address Tel. CityI Zip I State I .._ „ . r .. � Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE 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 permit to construct, alter• 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 the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500). I: 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 1 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 contractor(s) licensed pursuant to the Contractor's License Law.) I 7 I am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have acertificate 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 r7 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 (S100) valuation 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. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the 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 it 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 applicant Date Mailing Address City, State, Zip I Sq. Ft. Size No. Stories No. Dw. Units �`Q0,q New t Add O Alter ❑ Repair ❑ Demolition ❑ v A L� 0, AAA 2 -/L1AsA&&_ IO Estimated Valuation PERMIT x //�Lj��jjJ AMOUNT Plan Chk. Dep. 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 Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION f ' 7 •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 F a Date 10/31/00 APN # Not Available No. 21155 Jurisdiction La Quinta 71 Owner NameAugustine & Eva Paz- Permit #0010-157 No. 51-535 Street Avenida Velasco. Log # City La Quinta `' zip 92253 ' Study Area 'Tract # Lot # Square Footage 1409 Type of Development Single Family Residence No. of Units 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 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: rA EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 2.05 X ' 1,409 or $ 2,888.45 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 / Valley Independent Bank / Augustine Paz Telephone . 760-564-3023 Name on the check By Dr. Doris Wilson Superintendent ' y\ Fee collected /exempted by Annette'_Barlow •Payment Received $2,888:45 • • . Check No. ..227508 f Signature , f OTCE: Pursuant of Assembly'Bill 3081(CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees orother payment identified ove will begin to run from the date,on which the"building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to llect them on the District('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers: Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt _Copy - Accounting �. • e Sep -15-1000 01;14pm "From-COUHEALTH LAND TITLE +7609415215 T-651 `P.001/001 F-58 ■ ■ 23000ZHa UXOMST30- sY: OLD REPMLIC TITTLE COMPACOMPANY _ •99_B886KC 123083-13 I i 4 1 a. Tfi« FACOM90 KUL THIS DXZD MM unlas . 9419. TAX0STARTRUMTS Bxm 'Eta ss CN. AGUSTIN PAI EVA PAZ u ASga nZ9 LXn 20 GRANT DEED The undersigned grantor(S) declare(s)e ' 'Documentary zranafer tax isj (Xxx) Computed on full value,of property conveyed, or 1...► Computed on full Value less -liens and encumbrances remaining at time of sale.. ( > Unincorporated area- ( ) City of and FOR A VALUABLE CONSIDERATION, receipt ot.which,te hereby acknowledged, f WILLIAM R. RILEY, TRUSTEE g hereby GRANT(S) to AGUSTiN PAZ and EVA PAZ,'hu$band and wite as joint tenants, Ime real.property in the Cijy of LA QT]INTA,•County of Riverside, State of Caliiorr►1a; des 'ibed, LOT 1-1 N .BLOCK :52 0 A CARMELITA •AT VALE LA gJINTA,. UNIT •N'0. 5', AS SHOWN_0 B IN 00 18, PAGE 63 OF MAPS, RECORDS OF RIVERSYDL COUNTY, FORNIA ' -Dated ;i;eptatber 15; 2000 State a)2 CaT:stornie ` County of. } 9.9. WILLIAM R.-RILEY, TRUSTEE On before me, personally appeared personally known to me (or proved to me on the basis ofsatisfactory evidence) to be the persona) whose name.(s)is/are subscribed co .the wi.chin instrument and acknowledged to me�thac he/she/they executed the same in his/her/tr►eir'aatnorized capacicy(ies), and that by his/her/their sighacuse(s) on the. instrument the person(s), or ahs entity OPOn behalf of which the person(s) acted, executed ' the instrument. WITNISS my hand an4 officlal° Seal. Signature (This area for`off%cial notarial seal) xAIL TALC STATZWM(T9 T0: AMSTIN PAZ XVA aA� or ' d 8699' ON S0,IC88. 8.3MOd MO: l •0002 RC DISTRICT - PLAN'NING REVIEW FORM This form is to be used by CDD staff for review of single family dwellings iri 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 PAZ CONSTRUCTION/LA.OUINTA PARTNERS s SITE ADDRESS 51=535 Avenida Velasco APN - 773 _ 133- - 013 BIN NO.: CASE•NO.: 2 0'0 0 - 318 LEGAL: LOT 1 •BLOCK 52 UNIT 5 S.C.@V.L.Q.' CHECKED BY: Fred Baker DATE: Inform the' assigned Building planchecker 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 Consistent with MDG on file (as.applicable f MDG filing required (5 filings since 9/3/98) Consistency with street/surrounding area: 'Colors Materials Architecture .ROVED Sy COMMUNITY 0 'OP E -DEPT' y CASE N0.- 0 Other Requirements: Certificat6-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 fol%wing: BUILDING ADDRESS: 51.-535 AVENIDA VELASCO . Use Classification: SFD Bldg. -Permit No..:. 0010-157 Occupancy Group: .133 Type of Construction: VN Land Use Zone: RC Owner of Building: AUGUSTINE '& EVA PAZ Address: 52-995 AVENIDA MENDOZA. ` City:. LA QUINTA, CA 92253 By:. STEVE TRAXEL l bit Date: 02-22-01 Building Official POST IN A CONSPICUOUS PLACE