The URL can be used to link to this page

0102-129 (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 - 425.381 B � �`�. ..�.�W41 112( "�, Date , _ 14' ^� Signature of Contractor OWNER -BUILDER DECLARATION'* I hereby affirm under penalty of perjury that I am eiempt'from the Contlactor's License Law for the following reason: ,( ) I, asowner 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 & Professiori_als Code). r () 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. ,r TZ FUND 7Z30+J�0•b1 (This section need not be completed if the permit valuation is for $100.00 or less). ( ) (.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' compensationj provisions of Secti• 3700 of the Labor Code, I shall forthwith comply with those provisions. Y� i Date: '~ + Applicant �� ` Warning: Failure to secure Workers' Compensation coverage is�unlawful and shall subject an employer to criminal penalties a4civiNines 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 property for inspection purposes. Signature (Owner/Agent) 3��` `+ Date PERMIT# BUILDING PERMIT' :.. DATE VALUATION LOT,' Zj>�,—�� TRACT 3 UIC16LU1C JOB SITE ADDRESS52-170 APN ,tJ{�.p V1 (�) OWNER CONTRACTOR / DESIGNER / ENGINEER I'. is _ ' DAVV1) ROSS 1 , YA PAC;`�i1a"I.C" MDU C:ONMU(7170N Ili) 9 a TWE"MONT 11'11,9 9'rpimO.-gr ; t'.".A. 502054 S 0aw: k3 YE C -A. 922054 ,. (16t))96,7.006P O'BIR 1935 i USE OF PERMIT SF17 74' R8,TAJNrNCfWAU CITY STAM.A1*.1' -PERMIT DOES NOT 04c"t1: UO POO( ff)Rh+'FWAY' A.p'Pit:lyAO1 t1 MASTEiP. S-1 "T'R.Eit°T C010,'i: RUC.3010M 1,014* OF Mr CHIPA.11G r •° 1:',. •>'. , '' 36.09 sw ' ��!•*�t.ACfWARP011.'T' t i&"Z 9',f MOtt 5 -Ft. WOOD FENCE, mg.00 LF I+;io'}', JIMAI';!i. D COST till' CONfSIRLAMI GN � T�r��a31rD :g'1�';s'E'� 4:<)NS RUCT10A1 FEE 101.0110-4.38.000 $594.59 PLAN CHECK ;41,19 101-000-439418 91,ft i a MECRAMfll•,'.4' 1.1 FEE 101-000421-000 3$0.00 faLEC'1'MAs; V10— 101-000420-000 $1;R:4 Pi.tiiM1 INOREZ 301-000419-000 5110 IS , .`1°6°13.C'J1+ O MMNON FEE M REBID 101-000-241-000 0.93 L9Fi>f41✓INO WX 103-000m42:3-000. Sat► 00 : DEVEW;PER MP,ACT FtlEw. y; PUMUN PLAN 101-000.441-345 $190.00 � 'C', , CrIO.Pi i`id.V.Cyj FS.AI"9t (MEM�%• —�` 1;x..33 r 'PAM E+ IS FEES DUE NOW $3,00.74 RECEIP D .E! BY DATE FINALED INSPECTOR {� lip OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs / Underground Ducts Forms &Footings/G�/� —?� Ducts Slab Grade Return Air Steel Combustion Air Roof Deck —C - O ( Exhaust Fans O.K. to Wrap — 3 . O l F.A.U. Framing — 3 _al Compressor Insulation _ ��L _ Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs ? I O_ T 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 , p i �j� Heater Final Water Piping Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection 2� eZ 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 Utility Notice (Perm) �� !/CITY OF LA•�QUINTA' BUILDING & SAFETYfiEPARTMENT '777-7,012 =.. / INSPECT04•REQUEST LINE -7153 Owner, DAVID R 'SS MILLER Contractor,.. PACIFIC TRADES Permit Number. :/ 0102-129 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 52-770 AVENIDA VELASCO SFD & Wk 24" RETAINING WALL CITY STANDARD - PERMIT DOES NOT INCLUDE POOL OR DRIVEWAY APPROACH (MASTER S -I) TYPE OF INSPECTION DATE INSP. FOUNDATION 8 -SETBACK FOOTING STEEL LrptL V MAIN GROUND SYSTEM GROUND PLUMBING 7 ` PRE-GUNITE Iv DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB 677 JOISTS & GIRDERS ELECTRICAL GR UND WORK 5.57 ' DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC ROUGH PLUMBING ROUGH GAS & GAS TEST - D� HEATING & VENT- A/C FIREPLACE ROOF -- BOND BEAM O.K. TO WRAP - J9 GROUT 0 4' Cl 8' FRAMING p INSULATION PRE -ROOF COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED DRYWALL INTERIOR- EXTERIOR LATH POOL PRE PLASTER POOL FENCE & GATE SEWER SEPTIC TANK 7 O/ I FINALS ELECTRICAL - - 62/ PLUMBING FINAL GAS TEST HEATING - A/C HOUSE NUMBERS JOB COMPLETED TEMP POWER ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING r Building Address '5 ?""7 70 Owner e ' P.O. BOX 1504 78-495 CALLE TAMPICO 1. LA QUINTA, CALIFORNIA 92253 Mailing Address /7 /y S, T�7L G,ef City I Zip 9 Z U 5 t( Tel. 617/ :A ,t-9 /- [ I en • 1 7(00 - 9io-6069 Contractor JAG --1� _ Y/'I111 J M T 1211 5 Address City Izip State Lic. City & Classif. 8!/ 7 Lic. # � Arch., Engr:; Designer Address ' City (Zip (State I Lic. # LI ENSED CONTRACTOR'S DECLAMATION I here ,aifir that a I cengsed under provisions of 'Chapter 9 (commen"ting with Section 7000) of vision 3 of a eii iness and Professions Code, and my license i% in full force and effect. \ • ft -C e \ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Susiness 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 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 (5500). 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 11, 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 contracror(s) licensed pursuant to the Contractor's License Law.) C) 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 sell -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company t7 Copy is filed with the city. 0 Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed 0 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, 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 Ihereby 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 1 have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and slate 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 APPLICIN ONLY ' BUILDING: TYPE"CONST. OCC. GRP.- A.P. Number -7'7 -S - -3- Z G "b D 2" Legal Description 2,-, 13zcy,, - ,16 Project Description Sq. Ft. Size New 0 No., No. Dw. Stories Units Alter 0 Repair 0 Demolition 0 Valuation PERMIT 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 Setbac�fr��p rty Line FINAL DATE --INS I S�EEQTPR Issued by: T JAEkte. Sul it it Validated by: �� 1 : li� L • uy Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Notice: Document Cannot Be Duplicated Date 7/16/01 Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE APN # 773-326-002. No. 22260 Jurisdiction La Quinta Owner NameDavid Ross Miller No. 52-770 Street Avenida Velasco- city elascocity La Quinta Zip 92253 Tract # B 161,U16 Lot # 25 Square Footage Type of Development Single Family Residence Comments Permit # 0102-129 1,og # Study Area 1421 f fed a cashier's check in the amount of $2,913.00 and .05 cents. No. of Units 1 At the present time, the Desert Sands Unified School District doesrnot 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: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080'- in the amount of 2.05 X 1,421 or $ .2,913.05 the property listed above and that building t, permits and/or Certificates of Occupancy for this square footage in this proposed project may now -be issued, M1 4 44i✓ w Fees Paid By CC/Capital Bk of North County-J.R., -Pacific Trades Telephone 7.60-967-0069 Name on the check f6;, y c By Dr. Doris Wilson y r l Superintendent • �• Fee collected /exe pted by Annette Barlow w Payment Received $2,913.05 - Check No. 082791 Signature IOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified bove 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 t ollect them on the Distdct('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 ,0,1/09,/01 11: 33 FAX 17608049062'COWIONWEALTH TITLE 2009 — —_ -- --- t4.. ViCC,q . RECORDING REQUESTED BY; AND WHEN RECORDED MAIL THIS DEED AND,OTH ERWISE SHOWN, BE, UNLESS AIL TAX STATEMENTS TO LOW, David Ross Miller 1719 S. Tremont g. Oceanside, CA 90254. SPACE ABOVE THIS LINE FOR RECORDER'S USE Grant Deed A.P.N. ' 773-326-001 and 002 Ue,P,osc� ir�. The undersigned grantor(s) declare(s):. L�Z 7%0 Documentary transfer tax is $ (Y) computed on full value of property conveyed, or and '* (. ) computed on full value less value of liens and encumbrances remaining at time of sale. //�—V� ( ) Unincorporatedyaree; ( ) City of FOR VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, MICHELLE EICIISTLDT; a single woman LER,,a a married man as his sole a.Ad separate prope hereby GRANTS) to DAVID ROSS MILrty County of Riverside the real property in the City of La Quirtta State of California, described as Lot. of Block Unit No. Lh Santa Carmelita at Vale La Quinta, •. as p.er map reck 1S Pages qA tiff Maps, Records of Riverside County, orded in Eoo California Signature of Grantor . Dated Jaunar 5' 20 1 State of California )SS. county ofMichelle Eichstedt On before me, personally appeared. personally known to me (or Prwhc eome on nam (s)tsiiarhe be stub cribed tos of the evidence) to be the person(s) ^��, ---- within instrument and. acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/herltheir taignature(s) on the inswment the person(s)..or the entity — `upon behalf of which the person(s) acted, executed the instrument: WITNESS my hand and official seal Signature, MAIL TAX :STATEMENTS TO, P RC DISTRICT - PLANNING REVIEW FORM 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 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 PACIFIC TRADES SITE ADDRESS 52-770 Avenida Velasco APN 773 _ .326 _ 002• BIN NO.: CASENO.: 2001-392' LEGAL: • LOT 25 BLOCK 161 UNIT S.C.@V.L.Q. CHECKED BY: Greg Trou" dell DATE: Inform the assigned Building plan checker 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 / MDG filing required (5 filings since 9/3/98) Consistency with street/surrounding area:t Colors b Materials Architecture 11c 0 �� Co o G O \Ok Other Requirements: ZL f y 6-D 119 wtificate of Occupancy .City of La Quinta Building and Safety Department �oFti 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: 52-770 AVENIDA VELASCO Use Classification: SFD - . • Bldg. Permit No.: 0102-129 Occupancy Group: R 3 Type of Construction: VN . Land Use Zone: RC Owner of Building: DAVID ROSS MILLER —r&-&... Building Official Address: 1719 S. TREMONT City: OCEANSIDE, CA 92054 By: STEVE TRAXEL Date: 11-07-01 POST IN A CONSPICUOUS PLACE