10368 (SFD)Building
52-770 Vallejo
Owner
J. S. Gary
Mailing
Address 2674. Raymond
City Zip
Signal Hill 90806
Contractor
Owner/Builder
Address
P.O. BOX 1504 t
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253 t iii
. 4
BUILDING: TYPE CONST.
Ave.
fel. '
213/424-0957
City lZip I Tel.:
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State I
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 rile 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 rive hundred dollars ($500).
O 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, Bussness 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 safe. 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.) -
%, 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.)
❑ 1 am exempt under Sec. -B!_8 P.C. for this reason
Date Owner 4 /
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
. ❑ 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 ($100) valuation
or less.) /
I certify that In the performance of thg work fordwhich this permit is issued, I shall not
employ any person in any,nOnner so as,to become subjec Y ti'e.,Workers' Compensation
Laws of California. C/
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you • should become
subject to the Workers' Compensation°provisions of the Labor'�Coile, 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 applicant Date
Mailing Address
City, State, Zip
A.P. Number 773-'324-001
r
No. 10368
OCC: GRP.
Legal Description
Project Description
Block 159 lot -26
S D
Sq. Ft. z
Size A.232
No. No. Dw...
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ 'Demolition ❑
Permit does
not include any block walls
or pool. LiSt of subs must be posted
on job Site
at all times.
Estimated Valuation
74,621.40
PERMIT
I AMOUNT
Plan Chk. Dep.
25-0.00 -
Plan Chk. Bal.
206.25
Const.
527.00
Mech.
62.00
Electrical
114.74
Plumbing
141.00
S.M.I.
7.50
Grading
20.01)
Driveway Enc.
20.00
Infrastructure
1594.75
TOTAL
2943.24 2693.24
REMARKS
' nt.Y,'.(::rtex e: Gt,s a.-+.; I"t!a M'"As t��n-, r .•s .'n5: (
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO. FT. ® $
UNITS
y
2ND FL SO. FT. ®
-
YARD SPKLR SYSTEM
�
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. @
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEGUIP.
DRINKING FOUNTAIN.
SO Fr. ®
TEMP. POLE y
t
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DIS H)
APPLIANCE DRYER
FRAMING { a
J
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
P"wCID
!/1
J t ? LJ J
`f?
��^don�— 1,1
I �_`( ~ Kl� 21,1;L 1,0
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REMARKS:
IKITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Yi c
SEWAGE DISPOSAL
SO.FT.GAR ® Wic
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE l PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR-
. 9
SETBACK
GROUND PLUMBINGSA/Rz
149UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ou
R(6UGH PLUMB�A+ ICL,
/
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER (ROUGH
WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER COOP
HEATING (FINAL)
OTHER APPJEGUIP.
REIN F. STEEL
GAS (FINAL)
TEMP. POLE y
t
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. of ��
FRAMING { a
J
FINAL INSP. 9
l
OOFINGC l (
� � �
P"wCID
!/1
J t ? LJ J
`f?
��^don�— 1,1
I �_`( ~ Kl� 21,1;L 1,0
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING cl
MESH
INSULATIOMSOUND
FINISH GRADING
FINAL INSPECTION•
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
` DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 1/17/92 Type of -Permit La Quinta
No. 11124 Permit # 110368
Log #
Owner Name J. S. Gary
No. 52-770 Street Vallejo
city La Quinta Zip 92253 Study Area 112
APN # Tract # Lot # Square Footage 11232
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:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.58 X 1 32 or$ 1,946.56,' have been paid to D.S.0 S.D. 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 _ Joseph S..Gary Telephone 213-424-0957
Name on the check �..
"
y
By James E. Lively
Assistant Superintendent, Business Services
. • ,,:, gin.
Fee collected /exemp d by Kathleen Emmerlin
Payment Received'
Signatuxec?"
Check 'No. 122
Collector: Attach a co county or ci plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
7.
'0". RECORDING REQUESTED BY
IV
AND .WHEN RECORDED MAIL TO
NAM.Joseph S . Gary ,.
0 A„Rass 2674 Raymond Ave.
Ln cTr . Signal Hill, Ca. 90806
M�
STAT[ L
• r
MAIL TAX 111TAT11IM[NTO TO
NAML
ADORces Same as above
CITY 6
STATE L
1
J
J
.............. .................................................................... :.........
Signature of declarant or agent determining tax . firm name
❑ Unincorporated area City of..La... Q.uimta .........
Grant Deed
This form furnished by Orange Coast Title Company
FOR A VALUABLE CONSIDERATION, receipt of which is hereby, acknowledged, .
PARCEL NO 773-324-002
JAMES W. SMITH.AND RONALEE SMITH, Husband and Wife as Community Property
hereby GRANT(S) to
JOSEPH S. GARY., an unmarried man
the following described real property in the
county of Riverside , state of California:
Lot 26 in Block 159 of Santa Carmelita at Vale La Quinta, Unit 16 as
map recorded in
book 18, page 99 of maps in. the office of the County
Recorder of Riverside County, California:
Dated , October 4. 1991
STATE OF CALIFORNIA
COUNTY OF Riverside SS.
On November 4,_1991
--. - __before me, the under.
signed, a Notary" Public in and for said County and State, personally.: .
appeared James W. Smith and
Ronalee Smith
- - --- - - - known to me
to he the persons _.whose name are subscribed to the within
instrument and acknowledged that-A—he-Y_eitecuted the same.
Signature ofotary
.Brenda.S. DeLeon
Name (Typed or Printed) of Notary
Title Order No.
1
FOR NOTARY SEAL OR STAMP
OFFIC:IAL SEAL
Brenda S. De Leon
NOTARY PU13LIC
RIVERSIDE COUNTY
OR�IA
• _ — Mr COMM Exp,es Ocl 29. 199.1
Escrow NO.
MAIL TAX STATEMENTS AS DIRECTED ABOVE
a
r
7 -- g
'..
�.� rn N
O
9 F CG r
$o �Z
CAILij
g cg
t !R �p
3
U.
U.
/
SPACE ABOVE THIS;LINE' FOR RECORDER'S
Documentary transfer tax.$ ......
1 ................•
Computed on full value of property conveyed, or
❑ Computed on" full value less liens K encumbrance,
remaining thereon at time
of sale.'
.............. .................................................................... :.........
Signature of declarant or agent determining tax . firm name
❑ Unincorporated area City of..La... Q.uimta .........
Grant Deed
This form furnished by Orange Coast Title Company
FOR A VALUABLE CONSIDERATION, receipt of which is hereby, acknowledged, .
PARCEL NO 773-324-002
JAMES W. SMITH.AND RONALEE SMITH, Husband and Wife as Community Property
hereby GRANT(S) to
JOSEPH S. GARY., an unmarried man
the following described real property in the
county of Riverside , state of California:
Lot 26 in Block 159 of Santa Carmelita at Vale La Quinta, Unit 16 as
map recorded in
book 18, page 99 of maps in. the office of the County
Recorder of Riverside County, California:
Dated , October 4. 1991
STATE OF CALIFORNIA
COUNTY OF Riverside SS.
On November 4,_1991
--. - __before me, the under.
signed, a Notary" Public in and for said County and State, personally.: .
appeared James W. Smith and
Ronalee Smith
- - --- - - - known to me
to he the persons _.whose name are subscribed to the within
instrument and acknowledged that-A—he-Y_eitecuted the same.
Signature ofotary
.Brenda.S. DeLeon
Name (Typed or Printed) of Notary
Title Order No.
1
FOR NOTARY SEAL OR STAMP
OFFIC:IAL SEAL
Brenda S. De Leon
NOTARY PU13LIC
RIVERSIDE COUNTY
OR�IA
• _ — Mr COMM Exp,es Ocl 29. 199.1
Escrow NO.
MAIL TAX STATEMENTS AS DIRECTED ABOVE
CALVIN C. KAMINSKAS
Asslslanl commissioner
(714) 275.3000
V, a
°
OFFICE OF
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE, Commissioner
83-612 Avenue 45 Suite 7
Indio,. CA 92201
(619) 342-8291
DAN RILEY
Sealer. weights & Measures
(114) 2753030
DATE CASE NO. p C- 1--S
DEVELOPER'S NAME:
ADDRESS.
310
'TELEPHONE:
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ from plant material listed, this office must be notified
imnedia to ly
Thank you for protecting and preserving the Coachella Valley's pest -free environment..
G�
Agricultural 'olimissione Office
cc: Indio and Riverside
4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 — FAX (714) 275:3012
10