9811-052 (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 Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
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 'ham -exempt under Section B&P.C..for this reason s
t
')Date_Signature of Owner 'r,6
WORKER'S COMPENSATIOWDECLARATION .
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,ofrthe 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 t
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 become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those. provins.
Date: % 41' Applicant (. "f
Warning: Failure to secure Workers' Compensation coverage his 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.
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 properly,fo iinspection purposes.
`/ 7 t
VSignature (Owner/Agent), - b � Date
/
PERMIT#
BUILDING PERMIT
DATE VALUATION LOT iS TRACT 1,5
JOB E
ADDRESS
ADDRESS
APN
7Fi 4,E -F)F!
OWNER
CONTRACTOR/DESIGNER/ENGINEER
JOE 13KNARD
0%VNL;0.1.81J1LDT'R
44-525 S.AN PASCUAL ANE
PAL N4 DESERT CA 92260
! - CUO
USE OF PERMIT
SINGLE FAMILY LWELLINi ►
'
Sr~°.[3 WALLS UR POOL.
MAC:T C06,V 1 J�'T1CaN' ;242.r�b sr
' ' PC9TzG1I'r�Tlt7 3511,040 3F
QA1 AGWCA1,'+,k'0RT '167.00 SE'
11 VI,�^�
r�+x rtr+ rs^ce a a, ar�v* YsJnr
*au
e:a�t,.�i��;>xa.y%a.° �.e �g+ �:Ql'v�d*a�iiidr.l.ssty
a aq •a �ca'�►n
e..ryy.vass. rca
P1 WMI! FEE SUM-t�
t; 0N.S1rRLTC111dUN F b Aa ?-U(!i)-4i.ii-4fi0 �+ ►`F9._iti
rU'!, +�N �"+Fh:C'K, f"'• 1(} 9-t�(.?f_D-:1��-3 � i� �55�.7fi
3 IANi'CM, ff L' . 101 -01421 -OW
k i.E(°'i°RICAL FF—F:Y01=4t)l1-$2(i-()(ki $}5ti yi
Ft1:UNPgr4G, HIP,
STRONG )b OIK'):td FEE - MID 101-000-241-000
�`r'li,�.li�N�f:t�CE ' 101-0t3ti-X12$-a3tDti ��i.c�4
.
t 'I?*kA8TKUC'rUREJF
�>Lf2T 143'4�1.J? f.IC P1., f1 `- RhSfr 701 -000.255 -CM M. 29
1',£AN CHECK
$5,009.67
LESS PRE -PAID FEES
'TOTAI,'i'ERKI`9 Fi+;V-4OU9NOW
54,759.67
RECEIPT
DATE
BY'
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
z
Return Air
Steel
Combustion Air
Roof Deck
-�( - QQ
Exhaust Fans
O.K. to Wrap
0- .stcq 57
F.A.U.
Framing
=eq S.r
Compressor
Insulation
57
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
// - —
Drywall - Int. Lath
ST
Final
Final 1-910
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
Encapsulation
Gas Piping
Gas Test
( -
Appliances
Final
Final
Utility Notice (Gas) a -((- r9d
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) - /—
COMMENTS:
" Desert Sands Unified School District
x 4:7 -950 -Dune Palms Road .'
t Notice: La.Quinta, CA 92253
' Document Cannot Be Duplicated 760=771-8515
r :l
' `'
CERTIFICATE OF COMPLIANCE -
' Date `6/1/99 ' APN # 769-061-008,
- No. 18822 Jurisdiction La Quinta
'Owner NameJoe,Bernard Permit #
No. 78-510 Street Avenida Tujunga Y' .. r Log
City La Quinta - zip 92253 : Study Area
Tract # Lot # Square Footage 2,202 ;
Type of Development Single Family Residence - i No. of Units 1
Comments
t
M
At the present time, the Desert= Sands Unified School District doe's not collect fees on garages/carports, covered
patio's/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: .. - j
EXEMPTION NOT APPLICABLE
This certifies that`school facility fees imposed pursuant-to"Government Code 53080 :;. in•the amount of a
1.93- X 2,202.or $ 4,249:86 the property listed above and that, build in; r.
permits and/or Certificates of. Occupancy for this square footage in this proposed protect magi now, be Issued ,•,,
Fees Paid B cc/PS Savin s Bank/Joe Bernard �'
Y� g- Telephgne 73-11:,3.
.
Name on the check
By Dr. Doris Wilson
Superintendent k `• ., "� ''
Fee collected/exempted by. ,Juanita Preen— Payment Received $4,249'.86 -
Check No. 110689543.... y +
Signature r
.. _
C
NOTICE: Pursuant of As mbly 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 or other payment identified
above will begin to run fr m 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
tolled them on the Districl('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
i..` .i ;.�-."� '� ,•;Tlt� ti a,. ,,.,r•!:•�t'.:r+�.-.� :e :s..�. � .� • •. �V � `� VV
k
4� .K •-f first -American a IAsurance Company. r
�il RECORDING REQUESTED BY
"- RECEIVED FOR RECORD
.; AT S:OOAM
AND WHEN RECORDED MAIL TO:
Tr
an
Joe Bernard . } ' T JUL 24 1998 r
X ' Lucie Bernard Co. R
711,cSan Pasqual n,. , .. fMooraotl u, t78iotet Wftce
p' Palm Desert, CA 92260 5. r ro - .:;;, otwr«dd.
#I �` �_, � �,,� n� �/);� ',�;�� +�'p • .,A Fees S�'
Space Above This Line for Recorder's Use Only
N ' A:P.N. 769-061-008-5` .,TRA #:`020016 Order No.: 2107006:" Escrow No.: 13187 -JC
GRANT DEED
t�nr TH UNDERSIGNED GRANTOR(s) DECLARE(s) THUMENTA
AT DOCRY.TRANSFER TAX IS: COUNTY 41.80
" computed'on'full'valuerof propt;rty-conveyed;'or
m computed on full value less value of liens or encumbrances remaining at time of sale,
1 t uniACptpolated area; [ ;T City of La uinta•, and ;... . .
FOR A VALUABLE CONSIDERATION, Receipt of which is hereby acknowledged, ~
(►\.\`^�`\] -..+,n. nAr..,+. e+y e.-'* F+n,, -.a e�"^'F t.lt Y+:4t t ., �•�.�x .t. .;�. 1. i„ s!`,5:`+.✓.
W�� ,t,'iiv., '.,kt'�r'�� vv., ^•'a 7'�,t'L: " is y4 �7• �hyr - p 1 r��y,.tF,rc ..�t{f � y t "�- . %. '� � �Y°v •� f •'�' s, '. ' _ rap t. �. f Fir"•'
•!fi x:4 .�;r wxt�';, •t•o?° `'R -r n.1•tt.i. a.. i .: , �• ...•.-,Y' Y,.•r s_:._.t. �. i:,:+±..11'!{: :v
t:
..-.ROBERT BARTON and ANGELINE BARTON, husband and.wife as Joint Tenants
} > hereby GRANT(S).to ~?ti
JOE BERNARD, and LUCIE BERNARD, husband and wife as. joint tenants..
p ast'- •t�' I.a: .�.:� ip. .A,. a :��. .,. :. .>-ea •: .' i .. , ^s..y, _i:�: .. �
°the following described property. in the City of La Quinta, County of Riverside State of California;
2 x`
(• � �:.,,, .
Lo '15 of DESERT CLUB, TRACT NO. S, in the City of La Quinta, County of Riverside, as 'per ,map recorded in
i J a *Book 21, Pages) 61 AND 62 of Maps, in the Office of the.County Recorder of said County.
111,1V- �+'s - •.a rs - �k`^ 3 - i k; K' Angelus artoII ', •; ''.; • ,.� • x,�tl...x*'.tr i, ��'.�,
��Robert arton': {.}•
4 ' Document Date: • June 24, 1998
' '.•.,ti„ ,�, 'i arca ix•-, tsv�•� .r' ?^'Y `�.- .¢� � •r"'' ., -t.. � , .. . '.x ,4',y .,Y.,". .f �"i� da�,F;,a ,+.�.p ��
,,, �'t��i,�..�4:r-. iii SJ'.t_. i,C k i�S�xJ-s �•'• f'~ r s.:y,"n ctrl .3i`a � 1.,. st # i. l'. -f.,.,-.... -a
STATE OF C L IA .. i )SS • ,\
u c COUNTY OF )
Z O ' ' fl before In ,
' per nail geared
Oil:
personally known to me (or proved to me on the basis of satisfactory a ence) to be the person(s) whose name(s) is/are subscribed to the within instrumei.
and acknowledged to;rne that he/she/they executed the same in his/her/their authorized capacity(ies) and that f! by his/her/their signatures) on the instrumeYthe persoti(sj�or,the,entity upon behalf of which the person(s) acted, executed the instrument. r '
.;WITNESS my_tiand'and :official seal:
i.. .a:: - t ,.'':,;..<c:a•,.�:... �� JUDITH H. IEAVEII 9
i' (^ Signature 3 :�;'/`� V `" Comm.�Z�05RMA
r a t� NOTARNae�de Cowry
j �,x . r; x i Cpttlttl EXD 14f 1998
Ski`Ott i g .ic.,j Ifei�tt.
` X17 • - ; r Mail Tax Statements to SAME AS ABOVE or Addiess Noted Below
1
i', �4 ..,� .. tp vl f .»t - L1„'(%'•; 1•%° :i 11'+'d •'iY r.y.•. �..),s
CITY OP, �4 flINT r
JUN 2.3`REC'D
> W` ' BUILDING
/- ,
Nu bAf'ETY
78-495: CALLE. TAMPICO LA Q•UINTA; CALIFORNIA 92253'— " (760) 777-70.00
FAX (760) 777-7101
' TDD (760) 777-1227
June 23,.1999
M
Mr. Joe Bernard '
44-525 San Pasqual'Avenue'
Palm.Desert, California 92260. •
SUBJECT:-' MINOR USE PERMIT 99-1.48. '
Dear Mr. Bernard:
The Community Development Department has approved your request to installa;temporair chain
link fence 1not exceeding six feet in height -for the under construction home at 78-510_Avenida,-
Tu
_jpgq
Avenida,-Tujunga pursuant to Section 9.60.030(G), of the Zoning Ordinance. Installation of the fence will not
negatively impact the; provisions of the General Plan, and Zoning Code, and no environmental
impacts are anticipated. The temporary fence is permitted during construction `of the single family,
• home, but must be removed prior to a final building inspection. Please obtain a building permit from
----the Building"and- Safety Department prior to installation of the fence. R - -
w
This decision may be appealed to the Planning,Comiinission provided the necessary paperwork and
filing fee of $175.00: are filed with this office within 15 days.
If you have any questions, -please contact me at 760-777-7067.
Sincerely, `r "
JE Y RMAN
C M N Y DEVELOPMENT DIRECTOR -
• 4 ..
G SDELL
t
Associa lanner.
Enc. k
c: Community Development Director -
Building and, Safety Director r i
Greg Butler, B/S Counter Technician
MUPMFence - 34 '
MAILING ADDRESS - P.O. BOX 1504 -'LA OUINTA,' CALIFORNIA 92253
•
JU22
.N .
-c� City .of La Qu in WY . ,
Cotrimunity Development' Department
s :78495.Calle Tampico ,
o� La Quinta, Califomia 92253 -.
Of ,
(760) 777-7125 FAX: (760)'777-7155
APPLICATION FOR`MINOR USE PERMIT.APPROVAL
applications are reviewed and roved b the Community Development Director -'pursuant
' MINOR USE PERMIT app 'aPP .. Y
to Section 9:210.020, of the Zoning'Code. ' The purpose of the review is to ensure that land uses requiring the permit
do not have an adver"se impact on surrounding properties, residents; or businesses.
APPLICANT ! ���
(Print)�/Phn i
MAILING ADDRESS , %�o� _
CITY, STATE21P. Fax No:
PROPERTY OWNER (If different):
MAILING ADDRESS:
,.
..Phone No. +.
CITY, STATE, ZIP: Fax No. `
-/� U
PROJECT LOCATION: 4
PROPO D USE AND/OR CONSTRUCTION (Including eiational ' ormation): _•
4 " (attach sheets if needed)
LEGAL DESCRIPTION (LO TRACT O %A�:P(.N.): '
C 6riifi� t�` of Occu r��! 00
a
Quin
ta
Building, and SafetyDepartment�o:F-
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
,.s e
of the City'regulating bui/ding construction or use. For the following:
' BUILDING ADDRESS. 78-510 AVENIDA:TUJUNGA
Use Classification: `SFD - Bldg. Permit No.: 9811-052
Occupancy Group: R 3 Type' of Construction: VN Land Use Zone:. RL
Ownerof Building: JOE BERNARD Address: 44-52.5 SAN PASCUAL AVE.
` City: PALM DESERT, CA 92260; _ ,•
By: STEVE TRAXEL '
Date: 02-11-00
Building Official
POST IN A CONSPICUOUS PLACE