13479 (SFD)Building 52- 975 Ave. Vallejo
Address
Owner D & p Construction
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address Akl--975 Ave. Herrera
City Zip Tel.
La Quinta, C 92253 1 771-•1561
Contractor
Michael llietrick/D 6 Q Construction
Address
Same
City lZip I Tel
State Lic.B 6$1Q12 I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that.I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 ot}f��the
�,,,Business and Professionys CCode?and my license is in full force and
effect. f rvo wr l O Q 1\ i� 1- "- 7 'Al
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 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 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 five hundred dollars ($500).
❑ 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, 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.)
O 1 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 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 it the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as;.to become su
Laws of California. -3 bject to the Workers' Ciimpensation
/ i i
Date . t, i •i Owner > �rYL�16V2'! )J_r
NOTICE TO APPLICANT: If, alter 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
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 sof this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant_ Date
Mailing Address
City, State, Zip
No. 13479
11LDING: TYPE CONST. VR OCC: GRP. R3
P. Number 773-323-030
Legal Description trot 13 & * of i.,ot 12 Block 159
Project Description SFS
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 PropeQLine
FINAL DATE I
Issued by:
Validated by:
Validation:
Sq. Ft. l8ll
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Permit includes all block walls.
Pool permit
to be obtained separately.
Estimated Valuation
$111t960.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
i i.2 G
Grading
Driveway Enc.
Infrastructure _ (� rrjp �'� •
A M • w 1 AA
*" L'J iYY JCYUY>L>r YLt14.1•.'Lf .G0 • %V
rrrlf<.,i4Yiwr ir�clt
�y.�titt
TOTAL
1 * 21. 4
REMARKS
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 PropeQLine
FINAL DATE I
Issued by:
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMOING FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
ROUGH WIRING
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
GAS (ROUGH) it —3
.
DRAINAGE PIPING
CAR P. SQ. FT.
REINF. STEEL
GAS (FINAL)
TEMP. POLE! } ��
DRINKING FOUNTAIN.
WALL SO. FT.
GROUT
WATER HEATER
URINAL
SQ. FT.
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
LUMBER GR.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING / l !!l (�
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN 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.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBINGlf 413-1!
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. /
GAS (ROUGH) it —3
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE! } ��
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. /1_3_jep
[
FRAMING �_13�y
FINAL INSP.
ROOFING / l !!l (�
�//� 9.._�y(� /A
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND6.i/S 9y(V
FINISH GRADING
FINAL INSPECTION /
-,CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
4
P.O. BOX 1504 APPLICATION ONLY
Building7&105 CALLE ESTADO
Addres7$" VAL, LA OUINTA, CALIFORNIA 92253
Owner
BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address _ A. P. Number 7 7-3 " ,32`3 .... � �
City Zip Tel. '
Legal Description 4 Its d'
Contract r Project Description
Address -
City Zip Tel.
State Lic. City
& Classif. Lic. # Sq. Ft.No. No. Dw. 46 I
Size (�JT Stories Units
Arch., Engr.,
Designer S jft4 le New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licen d untler provisions of C apter 9 (commencing with Section
7000) of iv'si9n of the Busi a Profess' n o and my license is in full force and
effect.
SIGNATURE 1`. 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, of 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
rho provisions of the Contractor's License Law, Chapter 9 (commencing with Section 70001 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 live hundred dollars (8500)•
' I, as owner of the property, or my employees with wages as their sole compensation• will
do the work, andthe 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 properly 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. It, however, the building
or improvement is sold within one year of completion• the owner -builder will have the burden
of orowng that he did not build or improve for the purpose of sale.)
I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the proiact . (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 contrac(orls) licensed pursuant to the Contractor's License Law.)
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 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 lot one hundred dollars ($100) valuation
Of
lass.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner sq to becom ubi t to the orkers' ompensat ion
Laws of California.
Date OwnerI/;G 0� Q
NOTICE To APPLICANT., If, after making this C r ate 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 revolted.
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
Lenders 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 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
mated valuation
PERMIT AMOUNT
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 Pro Line
Side Street Setback % ente� e
Side Setback from F;roperty Lined r�,,
FINAL DATE INSPECTO /ate
Issued by: Date `�� ) rW
Validated by:
Validation:
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio; CA 92201
Document Cannot Be Duplicated 619-775-3500
3 Date 5/6/94 Type of Permit La Quinta
No -.,112815 I Permit #
Log
Owner Name D & D Construction
No. 52975 Street Avenida Vallejo
City La Quints zip 92253 Study Area 112
APN #_ Tract # Lot # 0 Square Footage 11818
Type of Development Single Family Residence No. of units 0
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 1.65 x 1818 or $ 2,999.70 have been paid to D.S.U.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 Double D Construction Telephone 77171561
Name on the check
By Dolores A. Ballesteros
Superintendent
Fee collected/exempted by' Vickie J. Durrett
Payment Received'-' . � ..
Signature
.�"Ch eck 14o',, 1014
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 Accdcanting, - ,
Order No. 2010188
TITLE TO SAID ESTATE OR INTEREST AT THE DATE HEREOF -IS VESTED IN: b
BRENT PETTY,.
A SINGLE MAN
THE ESTATE OR INTEREST IN THE LAND HEREINAFTER DESCRIBED OR
REFERRED TO COVERED BY THIS REPORT IS:
IN FEE
THE LAND REFERRED TO IN THIS REPORT IS SITUATED IN THE STATE OF
CALIFORNIA, COUNTY OF RIVERSIDE, CITY OF LA QUINTA AND IS DESCRIBED
AS FOLLOWS:
THE SOUTH 25 FEET OF LOT 12, AND LOT 13 OF BLOCK 158 OF SANTA
CARMELITA AT VALE LA QUINTA, UNIT 16, AS SHOWN -BY MAP ON FILE IN
BOOK 18 PAGE 99 OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA.
AT THE DATE HEREOF EXCEPTIONS' TO COVERAGE IN ADDITION TO THE
PRINTED EXCEPTIONS AND EXCLUSIONS CONTAINED IN SAID POLICY FORM
WOULD BE AS FOLLOWS:
1.� GENERAL AND SPECIAL COUNTY TAXES FOR THE FISCAL YEAR 1994-95,
A LIEN NOT YET PAYABLE.
2. GENERAL AND SPECIAL COUNTY TAXES FOR THE FISCAL YEAR 1993-94.
FIRST INSTALLMENT $326.96 DELINQUENT, PENALTY INCLUDED. SECOND
INSTALLMENT $297.25 DELINQUENT, PLUS PENALTY $29.73, AND $10.00
•COST. CODE NO. 020-071. ASSESSMENT NO. 773-323-030-4.
3. THE LIEN OF SUPPLEMENTAL TAXES, IF ANY, ASSESSED PURSUANT TO
CHAPTER 3.5 COMMENCING WITH SECTION 75 OF THE CALIFORNIA REVENUE
AND TAXATION CODE.
4. MUNICIPAL IMPROVEMENT BOND, NO-. 90-1 FILED IN THE OFFICE OF
THE MUNI FINANCIAL SERVICES. BOND AMOUNT TO FOLLOW.
5. A RIGHT OF WAY FOR DITCHES OR CANALS CONSTRUCTED BY THE
AUTHORITY OF THE UNITED STATES, AS RESERVED IN UNITED STATES PATENT
'RECORDED MARCH 19, 1930 IN BOOK 9 PAGE, 440 OF PATENTS RECORDS OF
RIVERSIDE COUNTY, CALIFORNIA.
6. AN EASEMENT FOR PUBLIC UTILITIES AND INCIDENTAL PURPOSES, AS
SHOWN ON THE MAP OF SAID TRACT, LOCATED WITHIN THE REAR 5 FEET OF
SAID LAND.
Page 2
OF
014 of 41a '011 t* lit a-
itt�I1t111 allb .�Safvt 13 11i
This Certificate issued pursuant to the requirements of Section* 306 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 52-975 Avenida vallejo
Use Classification Single Family Dwelling Bldg. Permit No. 13479
Group R3' Type Construction VN Fre ion*' Use Zone SR
Owner of Building D & D Construction Address 51=960 Aveinda: Herrera
City La Quinta, CA 92253 By; Mark Harold
December 14, 1994
Date;
Building Officio
POST IN A CONSTICUOUS PLACE
�I