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9910-105 (SFD)LICENSED CONTRACTOR DECLARATION •1 hereby affirm under penalty of perjury that I am licensed under provisions.of Chapter 9 (commencing with Section 7000) of Division 3 of the,Bdsiness and Professionals Code, and my License is in full force and effect. License # L`ic. Class Exp. Date 6349,,81 l)"'10 � . jrva ` I/D e�; 0 Signature, of Contra �t �.r .-OWNER-BUILDER DECLAR 7:10 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). a () I am exempt under Section B&P.C. for this reason Date Signature of Owner J.• 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 becomeo' supject to the workers' compensation provisions of Sectiony3700 of the Labor Oode, ,shall Lort��[ith comply with those provisions` Date: �U% I, ( Applicant r� �k Warning: Failure to secure Workers' Com • e ytion 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 whosesequest 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 Quirita, 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 certifythat 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 represe�ntativ`es of ­this City to enter upon A above-mentioned property for inspection purposes.;'. Signature (Owner%Age t) `' h ry . ' (r ��� '"^-� Date —11 BUILDING PERMIT PERMIT # DATE VALUATION 38,245.540 LOT TRACT 141 Fild- F JOB SITEAPN ADDRE�s. 51-785 A,� SC0 � 7.34113-0.11 QV,VNEA CONTRACTOR / DESIGNER / ENGINEER 1,A (jUIN"IA �N'1 R.-TNE RS Cl?T3:C�;'�ri, 51370 "E b9Mf:tJDAS. 51-540 i:ISEi+YHrJWER ]C R. LA {jLJT1+PrA CA .92 253 TA Q' JJId l:A CA 91225 �7.t�i)35`a,�csie4 t,�}31:�t �2E3 USE OF. PERMIT SN71E RAMIL IDWEIF�IG . at"'D - PRP—AdT 33OeT S NOT IUDr, KCaCK, WALL OR PWL. >! 11400 M Si Ala Gf % AdS� 'UIC'.f' 518.00 33^ X's PPERMIN rEE SUA+> MItay C,`ONoTIR C"'l.iON FEE 1576,50 tic AW rl, �_rc"V, 1±3`i. tJT?-fltif)-439-3.#. 1,490.71.42500) " IF D M.0311' 1014, • _w~1����arc;��3.•�'�� :.i43i�t1••d2i••4piY<J ��.cn� �'' <--- -. . , 11r:C'.7'.Fi IC AJ. ME ?=i:,FJ�!l�3T�'1 &'�T • i41�-�9�-419-Ui}� 57�.?:S i. � { 'i �,,,! i "31 Ito NG 110T!ON FM -1 ES W y ll.i• • f?i9tY 24;°. -= $8.52 1311ADJ'NO My 101-000423-400. '""� �.�►, . 1?�1t1:'i..C73+'.§�t.3fW3L".r1.C`d',h1�: S1,JrJ'I.t30 • bJA;;F� %�.Y'1..L'•l3Y�i� iYAi 7,',ri„l ,•':�f.�A..Ni.Vi/ TOTAL VIIMMIT FERS O>tJCNOW $3,1611.71 •r�� �J,i RECEIPT DATE BY DATE FINALED INSPECTOR o Mil14*4 l►� OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade l' Return Air Steel Combustion Air Roof Deck Exhaust Fans 0. K. to Wrap F.A.U. Framing 1y I 57 Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall insulation Condensate Lines Party Wail Firewall Exterior Lath Drywall - Int. Lath e7 A —/ Final Final POOLS -SPAS BLOCKWALL APP`AROVALS steel Set Hacks Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Water Piping 7 Heater Final 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 ?i Utility Notice (Perm) - - �O Building Address 571 _ Owner a Mailing Address ,ems ,. City I'5+'allvlw ress BOX 1504 APPLIC N I S 78-495 CALLE TAMPICO P �ASGn LA QUINTA, CALIFORNIA 92253 en (44C Zip ip I Tel. 1m;V010 1 1 *?,e State Lic.}. City 8 Classif. i 1. .7 2 9 Lic. # Arch., Engr., Designer Address Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that Lam°licensed under provisions of Chapter 9 (commencing with Section 7000) of Dlv_isio_6Ahe Business and Professions Code, and my license is in full force and . • effect—Pe- 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 r Code. or that.he is exempt therefrom, and the basis for thealleged 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 ($500). 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 Cotle: 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 orimprovement 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.) 1 1 I, as owner of the property, am exclusively contracting with licensed contractors to con - sl ruct on•strucl 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 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 r7 Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed it the permit is for one hundred dollars ($100) 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, atter 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 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 ailing Address City, State, Zip BUILDING: TYPE'CONST. OCC. GRP. A.P. Number "% -7% If 7 "17 Legal Description I. er►a Sq. Ft. p No. r No. Dw. Size - f ( Stories y Units NewX Add ❑ Alter ❑ Repair ❑ Demolition ❑ �onfj-A�7. �aeeY S icas SG4- 8470 PA�n 11 1 y a 5 t Estimated Valuation PERMIT AMOUNT 1 Plan Chk. Dep. gxS(1. 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 -Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quints, CA 92253 �. Document Cannot Be Duplicated 760-771=8515 {{' CERTIFICATE OF`COMPLIANCE .{� - • It Date 10/15/99 APN # . 773-173-031 't i No. -19475 , �' „Jurisdiction La Quints , Owner NameLa Quinta Partners . o Permit # " No. 51-785 Streit" Avenida Velasco ' �- • , I:og # City La Quinta � ,,.,'zip 92253 . Study Area Tract # B61' U5 Lot # 2Square Footage; 1355 Type of Development u Single Family Residence ` t : No. of Units 1 Comments. • � - 154 t •.. • � - - 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: . _' fir' ,;` t r• + - � ' - 1, ; , EXEMPTION NOT APPLICABLE 4 This certifies that school facility fees imposed pursuant to. Government Code 53080 in the am JoTkit-of =1i;L. uy-fes. ti,^ 1.93 X: 1;355 or $ 2,615.15, the property listed above and that boildvig . permits and/or Certificate's of Occupancy for this square footage in this proposed projectmay nw:-b oeJssued; � r °it Fees Paid By cc/VIB/Thomas Buffin - Coronel Construction Telephone $604 ;r 564" Name on the check' �Ee�'A ,F�;� i�• By. Dr. Doris Wilson ' N1 Superintendent' Fee collected /exempted by 'Juanita'Green Payment Received ` $2,615.15 r Check No. 202458 Signature NOTICE: Pursuant of ssembty Bill 3061 (CHAP 549, STATS. 1996) this will serve to nottty 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 sssued or on which they are paid to the District(s) or to another public entity authorized to colied them on the Distrlct('s)(s) behalf, whichever is earlier.^ Collector: Attach`a copy of county or city plan check application form to district copy for all waivers. �Y Embossed Original- Building Dept./Applicant Copy-, Applicant/Receipt Copy - Accounting } ,k � it i•i i'aS n.L. ,} ,. � I,. .r�i'.. G 3i ft oil r . . rr.. /+' rr .. � l,.'ci ,..qtly ,�' i.i �:4 ,xi:: t,j1r•7j''t'. ' f /' : i 'i $' rF_r � . P:r• (T . ,>4r.<'�+. n.: ^. �. ,.. n r ' ! . I; ., SALE ESCROW INSTRUCTIONS - THIS DOCUMENT WILL AFFECT YOUR LEGAL RIGHTS - READ IT CAREFULLY! {- TO: COMMONWEALTH LAND TITLE COMPANY Escrow No.: 99.8876KC -72855 Fred Waring Dr. Date: 06/03/99 -,Suite A5 Page: 1, r` , Palm" Desert, CA -92260 (760) 836-3726 '''} � Escrow Offi-cer-:- Kelly Collier THE ESCROW,HOLDER,IS COMMONWEALTH LAND,TITLE.COMPANY WHICH IS LICENSED BY THE CALIFORNIA DEPARTMENT OF INSURANCE. Buyer, or his agent, will hand you or cause to be handed.you upon signing of, these instructions a deposit in the amount of.. ..... .........$ 500.00 Buyer will hand you additional funds prior to closing in the amount of .......... $MINIMUM Proceeds from loan to be procured by Buyer (First Trust Deed)...................$FHA MAX TOTAL CONSIDERATION $ 105,000.00 and any additional funds and instruments required from me to enable you to comply with these instructions, which you are to use on`or before September 27, 1999, and -when FIDELITY NATIONAL TITLE COMPANY can issue a Standard Policy of Title Insurance Owners form, with liability of $105,000.00, on real property,in City of LA QUINTA, County of Riverside, State of;CALIFORNIA viz: s •. t Commonly known as: APN 773-173-031, LA QUINO' CALIFORNIA 92253 Lot 2, Block 61, Unit 5, TractySanta Carmelita at Vale La Quinta, as per map recorded in Book 18, Page(s) 63 inclusive of Mi sce,l/1 aneous •Ma'psI. , in the office -.of the County Recorder of said county. Except any reservations of record of minerals, oil, gas, water, carbons and hydrocarbons. Showing title vested in DONALD OSMAN and THERESA OSMAN, husband and'wife Free from encumbrance except: A. Current general and special taxes for the fiscal year in which this escrow closes, and taxes for the ensuing year, if -any, a lien not yet due or payable. B. The lien of supplemental taxes, if any, assessed pursuant tothe provisions of Chapter 3.5 (commencing with Section 75) of the Revenue and Taxation .Code of the State of California. -C. Special improvement assessments, if any. D. Easements; rights; rights of way, covenants, conditions, restrictions and reservations of record. E. Deed of Trust to,record in the amount of FHA MAX, in favor of a lender to be determined. Buyer R Di ' ci - Pl nni vi Fnrm�/44oC % - eRF Z? This form is to`be used.by.CDD staff for.review'of single family dwellings in -the -RC (Gov3e,� Residential) District, in.oider 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: LA QUINTA PARTNERS r s. T: , �: - .• 51=785- - ,.. , .. - •. PROJECT , ADDRESS: 51-7,f� Avenida Velasco -- -- - '. o 773-173-31e APN: T '. LEGAL:. LOT — 2 BLOCK , 61 ,"UNIT5 S.C. @ V.L.Q. C'D BY .. Greg Trousdell K: . CASE NO. 979-106 _ CHECK -DATE: 131N N0:. 7 2 _ _fnfiorm-the -assigned -Building-plan-checker-'upon,.-y-our_.assignment:to.-this case. The CDD Executive: Secretary maintains a=log book-to7track-applications--and-assign-case! umbers.. - WOO- . - . � ............. - -': ' Consistency -with-street/surrounding area: P "r �;;. .. Colors j� Material'skqO• Architecture OTHER REQUIREMENTS: The zoning code, yarchitectural and landscaping manuals, and/or assigned inspector should be consulted where uncertainties arise. The completed' checklist shall be maintained in the y 111 _ `T i , A Building & Safety address *file.