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0311-146 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of `�Chapler 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. "Al License # Lic. Class Exp. Date 1129976 B HIC �, 05,131121 � /D tem/ignature 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 dcertificate 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 SM, F FUND Policy No. 040-02-0009059 (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 ofS ction 3700 of the Labor ,Css ode, I shall forthwith comply with thoorovisionsol Dater -1,Applicant 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. 4. 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 �!pyrposes. Signature (Owner/Agent)'''' [ -dDate-' J �✓ BUILDING PERMIT PERMIT# 031,4-146 .. VALUATION 2,699 �0 LOT 31 y TRACT 27726 DATE 02417�4e JOB SITE q .yy�F, ��..pp�� ryry +��y ADDRESS V 9"I .Y. iiM. .i.T�.4 7,10 T. NF e�'9Yd' `J J[..i ' - y�p� SOU APN i31—MI OWNER 72 CONTRACTOR / DESIGNER / EN (NEERYA� - Q ,aO REED A NAX HA%a,MO N RW DEVE .OP%+1.E:1,TV 1820 VIA A1;TA '75.161 SE, GO LANE., SUM. F-3 PALO81iL IVES MPE14 CA. 90274 PALMA DFZ.(KR.r CA. 92211 (7w)568.9,335 C.B1.6 6811 USE OF PERMIT M012 rrAMUf T3i1J_.-JJ D1G 5327 Sty SMIPPERMIT Df,DW;INOT fNCLUDE POCIUS:PA, BIXJCK 1f4ALI,S OR DRIVKWAY APPROACH. 2001 C -8C, CUSTOM CONSTRUCTION snub sr, POR_CWPA ID IM.00 SIp f; lARACjRli:;ARPO T 924.00 SF EWMATM C0,1W OF COMB" U(M.'ON 442,09.,60 ME AT ri SUA0 "Y C,OT79TRUCTIOV FFE 10 1 -000.41 8.000 $1,840,00 PLAX CHECK FSE 101-000-439-318 $1,49-663 FEE 08POASIT 101.000.439-318 -31,000.00 MZCW, 4 1 CA 1, F812 ,01-.000-421.000 $14.2.50 &WTRICAL FES: 101-000.420.000 $207.43 PLUNIKId O FEE X 101-000414.0f3.0 szr7.00 STRONCI MOTION 7911- RESID 101- 00441-000 144.n ORADINO YZR i 01-000.423-000 $15.00 i)WELOPER IMPAC'T IFEE $2,405.00 MIMP PLAN 101-000-441-345 $100,00 ART IN PUBLIC PTACES -..' 811u 270-00" 45-000 $606.75 SUB -TarAL CO�1'is 1'SC'I:1OMONMD PY-AW C'1;MM $7,210.28 IMS PRB-PAMFMS -$1,000,00 MAI, �'31:l;iliu'�"�4' 1<+5i9rl'� Fv"C+S�"J=9 1'4 2004 tF CITY OF LA QUINYA FINANCE DEPT. 7_7_1 RECEIPT DAT BY DAJ/E�01 ALED INSPE�C?TO d t7 INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade zB Return Air Steel Combustion Air Roof Deck o 4 Exhaust Fans O.K. to Wrap A V F.A.U. Framing Compressor Insulation Vents Fireplace P.L. 7 41 Grills Fireplace T.O. Fans & Controls Party Wall Insulation Party Wall Firewall Condensate Lines Exterior Lath v L� Drywall - IM. Lath 97 Final Final BLOCKWALL APPROVALS POOLS = SPAS 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 Heater Final Water Piping _ Plumbing Final Plumbing Top Out _ Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection JL Encapsulation Gas Piping Gas Test Z7j v Appliances Final Final Utility Notice (Gas) ELECTRICALAPPROVAL 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) COMMENTS: GAS L AW4L�st/' - S 64 T4hf 44QUMAJ I I - P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 November 17, 2005 ` Ms. Esther Sanchez Riverside County Assessor's Office 3255 E. Tahquitz Canyon Way, Suite 114 Palm Springs, CA 92262-6962 Dear Ms. Sanchez: - BUILDING & SAFETY DEPARTMENT (760) 777-7012 FAX (760) 777-7011 Please be advised the following permits had been issued incorrectly: .Permit # Date APN # 0403-040 3/3/04 761-531-008 0311-146 02/17/05 761,531-008 04-5937 8/13/04 766-041-006 I have enclosed copies of the permit for your files The correct APN and address are: Address 79-091 Tom Fazio Lane S 79-091 Tom Fazio Lane S 79-091 Tom Fazio Lane S APN: #766-041-007 Lot 31 Tract 27728 79-121 Tom Fazio South Please make the appropriate changes. If I may be of further -assistance, you may contact me directly at (760) 777-7074. Sincerely, Therese Vella-Finorio Senior Secretary Attachments Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, 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 5,327 S.F. or $11,399.78 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/Provident - Mark Coyle Check No. 112893 Name on the check Telephone 760/485-4035 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Shar MCGIIvrey Payment Recd 1$0.00 $11,399.78 Over/Under Signature c t 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 DepartmentlApplicant Copy - ApplicanVR ceipt Copy - Accounting p- CERTIFICATE OF COMPLIANCE Desert Sands Unified School District ��1Fi�sc - 47950 Dune Palms Road Q BERMUDA DUNES r' Date ' 2/17/04 � La Quanta CA 9225) >' rn RANCHO MIRAGE {� INDIAN WELLS ^r No. 25507 (760) 771-8515 dPALM UISANT�y 'QINDIO yr J1 0 Owner Reed & Nan Harman APN # 761-531-008 Address 1820 Via visolia Jurisdiction La Quinta City Pals Verdes Zip 90274 Permit # Tract # Study Area Type Single Family Residence No. of Units 1 , Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 31 79091 Tom Fazio Lane 5327 Unit 6 . Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10. Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, 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 5,327 S.F. or $11,399.78 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/Provident - Mark Coyle Check No. 112893 Name on the check Telephone 760/485-4035 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Shar MCGIIvrey Payment Recd 1$0.00 $11,399.78 Over/Under Signature c t NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or other. payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building DepartmentlApplicant Copy - ApplicanVR ceipt Copy - Accounting NOV 12 2003'09;51 FR FIRST AMERICAN TITLE TO 17607764096 P.03iO4 dicaum as8t1 vwm my P1b2ury-.NA710NAL Tr= Ap1tD 1f'ItDI ItLCo>IRTAbtA1t, Tqr � . - REEA L.. HARMAN AND NAN M. HARMAKI RUSMES 1820 VIA VIMLIA PALOS VERDES ESTATES, CA 90274 psa AtKwv TAts Lie (or.ltocankr's Use ONy A.P.N.: 761.531408. TRA I:• 020415: Or+da No.: 17439 Escrow No,: 2-29"S GRANT DRED T119 YNDWIdNED GIMTORts) 01CWtR(s)? 1Ar 00CVMONTARY TRA NZIt TAX L& COUNTY ( X) cotaputod oo fu11 t+alua o[ p 000veyed, or 1 I .wp�wcd on fW1 •ahK ICU vs ug of "lle"ire ' nmmb i.tatu�iaiu1 at timD of gala. 1 J wtl�roud Inc i X) city of y FOR A VALUABLE CONSIDERATION, Raaipt of wbieb is bcrcby oeltttow1c4p4, JOIN J. B'YRNE M. a Mudd Mom his Scic cad Separste Pevpaty hardy GRANT(S),la. REED I,. BARbL4N AND NMI H. BARMAN, TR1=F5 UNDER TM V18ALLA ' DECLAIiAIMON OF-TRW DATED 143!97 1ho following daaithtd property in rite City of LA QUEffA. Co(mty of Riverside State of Glifcmia: LOT 31 OF TRACT 27726, IN JIM CITY OF LA OUN i'A, COUNO OF XMR$n)E. AS PER MAP r REOORDIM IN BOOK 249. PAGES I THROUGH' 17 OF MAPS, RECORDS OF RLVMRStDZ COUNTY. CALIFORNIA. DORS PARTICMALLY DKSCtt189D IK LEGAL DI6SGAIPTIou A'LTACm t3ERsTo) E 1 J.9YAN Document pate; October 25- 19% QAT'Eo � Llt'ruN_ - �ss - Oa bsiaro ttc.� Q ►J 1 �f k li t tw►��b eppQaMO t t wwudly r,iowi tons (a reved.te om ea the bash •t 84dwoqryry {vrdege{) to b{ ow Masao({) whose "mels)WN whscribad.m Mr wisi" iasuumtot use slYnawit+dj{I to 1118 1hN hd{bahhey aa{aad th{ senn b hiarherhbeir w>♦wAnti apuiry(ica) and ingi by AivbarWteir sila{ruRls) an au •inaWmmt On pirmise) ar the sttt)q Plan b{bdf of whish the p moa(i)uad. samsed U in{wewnt. wRNtiSS toyltwt Ittd olfKilt slssl. . Thio arse for a(rKid Aporia) r{al. .: •I�l��l'�iIf�1111101��1�l�lltt;� � ��..� ; ,, . •. r; , at6nr9sia2nni , Mail'TA;t Statements to; SAME AS ABOVE or Address Notcd Bclow i DescrlpUon: Riverside,CA. Documerlt-Year.DoclD 1999.806033 Page: 2 of 3. Order 11%12-2003'09-40.02 AM Comment JEN - . NOV .12 2003 09:52 FR FIRST WER I C'=1 q TITLE TO 17607764098 �. . Order No. 17438 EXHIBIT "ONE" PAFtCEl�12 • Lot 31 of -rrect No. 27728, in the City of La Guinte. as shown by Map cn' file In Book. 2490 Pages) .1 through 13, Inclusive of Maps, in the Office of the Covnty Recorder of. Riverside County, California. Except one-half of all oil, gas and other hydrocarbon substances and all, minerals; whether metallic or nonmetallic which may be extracted or removed provided,, however, that the said Granter, her successors or assigns, shall not use the surface of said land or any part or parts within 500 feet of surface thereof and In the exercise of such rights shall not disturb the surface -6f said land or any Improvements thereon, or Insure or Impair -the lateral or subjacent support of sold land of any Improvement thereon, as reserved'in the deed from Ethel S. Sokolow; it married woman, recorded September 2D, 1960 as Instrument/.He No. 81986 of Official Records. Also, except therefrom all oil, gas and other hydrocarbon substances and all minerals. whether metallic or noh-metallic, in, under, or on, or which may be produced. extracted or removed, as contained In the deed recorded October 15, 1951 in Book 1310•of Official Ftocords. PARCEL 2: A non-exclusive easement appurtenant to Parcel 1 above, on and.over the "Common Area" as defined In the Declaration for access, use, occupancy, enjoyment, ingress and egress of the ornenities located. thereon. The Common Aroa.is for the use of the owners of Iota which aro subjoci to the Declaration and Is nct for the use of the general. public. One Class A Membership in the Quarry at La Quints Homeowners Association, Inc.. a California nonprofit mutualbenefit corporation, ("Association"). I�� USI! �U f�ltl f 111 ill lll��l 111 llil�•I�l�l� r �;r>;�'� 2 DascrlpNon:•Riverside, CA Document-Yeer.0oc1D 1999.506033 Page: 3 0(3 prVer» 11-12_Y003 09-40.02 AM Comment.•. JEN P.04/04 I ** TOTA! PAGE. 04 .�:* YOUNG ENGINEERING SERVICE.' 77804 Wildcat Ur.. Palm Descm C.4.'92211 ('t60) 360-5770 (760) 360-5719 September 3, 2004 Tom Hartung Building Official City of La Quinta Re: Harmon Residence- 79-091 Tom F(gio Lance Lar�Linto CA Dear Tom, We have performed structural observa:ion with regards to the framing for the above referenced project and find it to be in general conformance with the approved structural plans. This structural observation does not rei leve the City in any way from performing their standard structural inspections nor is it in lieu of any code required special inspections. The structural observation performed should not be construed as E, detailed structural inspection but as a structural observation for general conformance as per CBC 1702.220. If you have any questions please call. Sincerely, 1. Jeffrey B. Young. S.E. Z0 39dd 3S 9NId33NI!)N3. 9Nn0h 0 6TL909609L Eb:ET 000Z/60/60