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0208-265 (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 y �`�Date �> ter I • 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: ( ) 1, 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 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 STATE {;OMPKHHAT) Policy No. 220.09 UNIT 001"87 (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-�T 00 of the. Labor f)Code,�I shall forthwith comply with thos provisions. ' r• Date: 1' 3� �}?... q, p 5 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: 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 inspectionl�purpose_s. Signature (Owner%Ag,-,,V 1 ; 1 Date BUILDING PERMIT PERMIT# J/ l DATE VALUATION LOTS TRACT / JOB SITE a9 - ADDRESS :J2W ��s APN y 773-3Z OWNER CONTRACTOR/DESIGNER/EN INFER ' RILEY IXMUAI' DAVID L AD7ai90- TOA 52.775 ,Ft+V:�'.t�FMA''J21,1,I~ JO 41-T90 FD' WTAt LMR ' 1:.A QUIMA A C.",A. 92253 BRiUvsT'DA DUNES 'CA 92261 (160>t01, 4526 CITU :3'27..4 J USE OF PERMIT 1#185 ;Jar. SYD, PERMIT DORS 1107 INCLUDE BLOCK. V IALd-S/P00111 walti.�. DR1011WAY APPROACH TACTCONSTRUCTION 1,08, 00 Sy SWRCHI A IO S6.X�ISIC? GAN1t?CAPCPT SP IJUSUTECOST 011'. CONFrI1.7C.O.R .891%:161060 PKIZWA6 T 7MqWAP.Q CONSTRUCTION ZEE 101.000418.000 S594,5D PLAN Cili!C;3G IFEE 101-000439-.318 $494.A PlM DIPOSIT 101.000 439•:318 4250100 M.RCi ANIC:A1, FVE 101-000-421X000 f a. so 1.Tr0! IIiOAT,1 F. 101.000-420.000 $10.61 PLi.1Mi INQ 1111-tMtJ0-X114-x,10 E 1L, t u'1`12ONO MOTION f ER. - R.ESID 11'31.000.241.000 %8 93 G R.P,D1PM:11r`EE 101-1>D 4:23-0130 615,00 DEVELO'< A Ild PACT .fair.%• - PRECISE 1I1 AN 101-000-441-345 SftO.Ctn Slip -3:Y YI C, CC)3+T:1'iIiYb'{:" IC -)X AM PI—PW (MKV_- LES 3 Mr. P= . ¢250. 00 I MAL PXPW1 YVES D'UX :C1'C9W 4�,�►�`T.t2r.� SEP 1 2001 CI'(y.•OF LP►QUINTA FINANCE DEPT. RECEIPT DATE -•. f .BY, ."*' DTE FIN ED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs U Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap G_ O F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath 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 I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Q- OR— G Heater Final Water Piping Plumbing Final - Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection _ z 0 =22-0- Encapsulation Gas Piping Gas Test Appliances _ Final 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) COMMENTS: 09/03/2002 10:18 503-5907931 .,0t1th[2nA TRIA (:nwmiginn RECORDING REQUESTED BY: Southland Title - Inland Empire AND WHEN RECORDED MAIL TO: THE LEBRUNTAMILY LIVING TRUST DATED MARCH 16, 1994, TRUST.R �LA1 !fit A.P.N.: 773.323-020 Order No.: 62600784 Escrow No.: IN2728-KC RICHARD LEBRUN PAGE 01 Vasty. its �o�x—d�eAOd'� 07/17/2002 08:00A Fee:33.00 Pape 1•01` 3 Recorded In Cifflelal Records County of Riverside Cary L. Orae Assessor, County Clerk 8 Recorder • IIIIIIII I 111111 M 1 B 1 U Owce cgzC O^ FCOR NOCOR 5MF MISC. A K L I cuv wHd REFUND NCHO GRANT DEED ;.''. THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER:TAX'IS $ (X) Computed on full value of property conveyed, or () Computed on full value less value of liens or encumbrances remaining at time of sale () Unincorporated area: (X) City of LA QUINTA FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged :::.� .wf+,�►�xi>�t�aG, �,t+�r��./�+��r��arra��c,�►��canx�r�lr�av�D i�no ��94d BRUCE R. CRAIG and LAUREN L. CRAIG, cm_ hereby GRANT(S) to -RICHARD D. LEBRUN AND BARBARA A. LEBRUN, TRUSTEES of THE LEBRUN FAMILY LIVING TRUST DATED MARCH 16, 1994 "Logo gvuvvvuga V=0%A1ucv 1.11VIJIWI .y, 119 L14W vvugg,y vg %jLc3LG vg vaguv1gnq. LOT 7, BLOCK 158 OF SANTA CARMELITA AT VALE LA QUINTA, UNIT NO. 16, AS PER MAP RECORDED IN BOOK 18, PAGE 99 OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA Dated: July 1, 2002 STATE OF CALIFORNIA COUNTY OF 0 } SS. 'Jn.aO before me a Notary. Public In and for said County and State, personally appearedte ren �p Cil /1 . /� to.be the person) whose name($) P r" ' Is subscribed to the within Instrument and acknowledged o m®executed the same in =.t= BR E R. CRAIG authorized capacily(,km) and' that by signatureW66 the instrument the person(sj,.or the entity ' upon behalf of which the personal, acted, executed the instrument. LAURLAURENL. CRAIG WITNESS my hand and official seal. PAMELA L. EVETT k./% Comm. 11201325 �n Signature//4.�. V, NOTARY PUSUC-CALIFORNIA V/ Signature of NotaryEI Dorado County My Comm. Wires Dec. 8, 2002 (This Area for Notary Seel Only) MAIL TAX STATEMENTS AS DIRECTED ABOVE 09/03/2002 10:18 503-5907931 RECORDING REQUESTED BY: Southland Tltlo - Inland Etilplro AND WHEN RECORDED MAIL TO: THE LEBRUN FAMILY LIVING TRUST DATED MARCH 16, 1994, TRUSTR 14300 SW 141st mS ��—i �__a-_ n•7nnw A -P -N.: 713-323-020 Order No.: 62600784 Escrow No.: IIN227228--KC n2 1 -,01"l . RICHARD LEBRUN PAGE 02 DoC tq 2002-31A0tBt�36 07/17/2002 08:00A Faa:27.00 Pape l of 1 Doc T -Tex Paid Recorded in official -Records County of Riverside Gary L. Orso Assessor, County Clark 8 Recorder II I II I I I II� I I ; . i --- - ' . •AL1 T A R L COPY LONG REFUND NCMO MAM GRANT DEED .[ THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX IS $30.25 (X) Computed on full value of property conveyed, or () Computed on full value less value of liens or encumbrances remaining at time of sale () Unincorporated area: (X) City of LA QUINTA FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged WILLIAM L. CRAIG, Trustee and- BARBARA L. CRAIG, Trustee of THE CRAIG: FAMILY TRUST DATED FEBRUARY 18,1993)1yt;l`j3jRjdjZjENj CP Kai$V(YV$(URQTjfA.,lAjfgty/ ,aAA"Krlded hereby GRANT(S) to RICHARD D. LEBRUN AND BARBARA A. LEBRUN, TRUSTEES of THE LEBRUN FAMILY LIVING TRUST DATED MARCH 16, 1994 the following described property, 0 the•County of Riverside, State of California. LOT 7, BLOCK 158 OF SANTA CARMELITA AT VALE LA QUINTA, UNIT NO. 16, AS PER MAP RECORDED IN BOOK. 18, PAGE 99 OF MAPS; RECORDS OF RIVERSIDE COUNTY, CALIFORNIA . Dated: July 1, 2002 STATE OF CALIFORNIA .COUNTY OF /�n[�'L�5 } SS. On before me ,0 r a ftntary uhllr. In ahri fnr cairi•rnirrihr anri Ctnta narcnnally • 1 y personally known to me t} satief"o"videeeeHo .be 'the •person(s) whose name(s) /are subscribed to the within instrument and acknowledged to me that 16/01 /they executed- the same in ty Vr/their authorized capacity(ies) and, that by hid/per/their signature(s) on the instrument the person(s), or the entity upon- behalf of which the persons) acted executed the THE CRAIG FAMILY TRUST DATED FEBRUARY 18, 1993 /a By: WILLIAM.L. CRAIG, Tru e By: BARBARA L. CRAIG, Trustee Instrument. X'/5:111R I( o/ . WITNESS my hand and official seal. BAIZ8ARA .l. KORTZ Commizston # 1196065 Signature & z Notary Public - Colitcmia iQnature of afar Las Angeles County My Comm. E XPUM Oct 9.2002 (This Aron fnr NAtery_saal rinIv)-_ MAIL I All , I A I t:MtN I b A, UIRt»(;TED ABOVE Me CERTIFICATE OF FIELD VERIFICATION AND DIAGNOSTIC TESTING CF -4R Project Title Ag Prt A�1 ress X/V Builde�ontac� . Telephone HERS Rater C Ing Signature Cratd Firm: U2 k Street Address: Copies to: Builder, HERS Provider Datee� -'' //C ///y 41,11, //141-&) Builder Name Plan Number Sample Group Number SampleHouseNumber HERS Provider: V G�'SLL�jj Io D City/State/Zip: .7gea� L4 HERS RATER COMPLIANCE STATEMENT The house was: Tested ❑ Approved as part of sample testing, but was not tested As the HERS rater providing diagnostic testing and field verification, I certify that the houses identified on this form com94 with the diagnostic tested compliance requirements as checked on this form. Distribution system is fully'ducted (i.e., does not use building cavities as plenums or platform returns in lieu f ducts) where cloth backed, rubber adhesive duct tape is installed, mastic and drawbands are used in combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) , Measured Duct Pressurization Test Results (CFM @ 25 Pa) values Test Leakage Flow in CFM 4!!�5 If fan flow is calculated as 400cfm/ton x number of tons enter • calculated value here If fan flow is measured enter measured value here Leakage Percentage 7+ (100 x Test Leakage/Fan Flow) _, 6/3 Check Box for Pass or Fail (Pass=6% or less) ❑ Pass Fail XTHERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent ® Yes ❑ No Thermostatic Expansion Valve (or Commission approved equivalent) is installed and Access is provided for inspection ❑ Yes is a pass Pass Fail ❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT 1 ❑ Yes ❑ No ACCA Manual D Design requirements have been met (rater has verified that actual installation matches values in CF -1 R and design on plan. 2. ❑ Yes ❑ No TXV is installed or Fan flow has been. verified. If no T XV, verified fan flow matches design from CF -1 R. Measured Fan Flow = ❑ ❑ Yes for both 1 and 2 is a Pass Pass' Fail V 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 (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 1,458 S.F. or $3,120.12 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 OC/Washington Mutal Bank - Riley LeBrun 'Check No. 409825006 Name on the check Telephone 774-1127 Funding `Residential. i By Dr. Doris Wilson Superintendent Fee collected /exempted by Juanita Green Signature $3,120.12 $0.00 Payment Recd Over/Under NOTICE: Pursuant to Gamment 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 Department/Applicant Copy - Applicant/Receipt Copy - Accounting CERTIFICATE OF, COMPLIANCE v'rsc Desert Sands Unified School District . 47950 Dune Palms'Road - Q BERMUDA DUNES r Date' 9/10/02 La Quinta, CA 92253 _ Cn RANCHO MIRAGE d No. 23590 (760) 771-8515 AN WELLS �� INDIMDESERT ti PALM DESERT ,y s3Q� o_Ty�� Owner Riley LeBrun APN # 773-323-020 , Address 52-885 Avneida Vallejo '. Jurisdiction La Quinta City La Quinta Zip 92253 Permit # 0208-265 ' Tract # BLK 1.58 Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 7 52885 Avenida Vallejo 1458 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 patios/Walkways, 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 1,458 S.F. or $3,120.12 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 OC/Washington Mutal Bank - Riley LeBrun 'Check No. 409825006 Name on the check Telephone 774-1127 Funding `Residential. i By Dr. Doris Wilson Superintendent Fee collected /exempted by Juanita Green Signature $3,120.12 $0.00 Payment Recd Over/Under NOTICE: Pursuant to Gamment 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 Department/Applicant Copy - Applicant/Receipt Copy - Accounting r 1. �° yr Certificate,. fOccupancy a� O .Aw City of LaQuintal . IM R TW w4 5 Building'and Safety Depa'rtm e*nt =ti° 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 bui/ding construction or use. For the following: BUILDING ADDRESS: .52-885 AVENIDA VALLEJO Use Classification: SFD Bldg. Permit No.: 0208-265 Occupancy Group:; R3 Type of Construction: VN' Land Use Zone: RC Owner of Building: RILEY LEBRUN Address: 52-775 AVENIDA VALLEJO City: LA QUINTA CA 62'253, By: KIRK KIRKLAND Date: 12-9-02 ' Building .Official I POST IN A CONSPICUOUS PLACE I