0010-027 (SFD)`LICENSED CONTRACTOR DECLARATfON;.
I`hereby affirm ander=penalty of perjury that l am. licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of1he Business and.
Professionals Code, and my License is in full force and: effect.. .
License # * Lia Class Exp. Date
!'Dated ' •"' ^ Signature of Contractor- '
b
OWNER BUILDER, DECLARATI ,1 ,
I hereby affirm under penalty ofIperjury that -1 am.exrk pt from the Contractor's`
License Law for the following reason:
(') '
1,, as owner of the property; or my employees with wagesAs their sole
compensation, will do the work, and the structure is not intended or -offered -for -
Sale. (Sec. 7044, Business & Professionals Code). .
( : )'' I, aS CWner -of the property, am exclusively contracting wjth Jlicensed
contractors to construct the project (Seca 7044, Business & Professionals
.Code):;"
,) I am exempt under Section B&P.C. for this reason
Date ,p Signature of :Owner
WORKER'S COMPENSATION DECLARATION
Vii,.
I hereby affirm under penalty ;of perjury one of the following eclarations:
O I have and will maintain 6 -certificate of consent to self -Ins_ a for workers'
compensation, as provided for, by Section, -3700 of the Lab r Code, -,for the
performance of. the workJor'which this permit Is Issued.
( ) -Ihave.and will maintain'workers' compensation insurance, as required by
Section 3700'of the Labor ,Code, for the.performance of the work.for which this
permitiis, issued: My workers' compensation insurance carrier & policy no. are:"
Camer, Policy No." j .
,(This section need not be completed if the permit vall dation is for $100.00 or less).
I certify that 'in the performance of the work fdr which this per`mit is issued,
l�: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 provisions.
Date: Applicant
Warning: Failure to'secure Workers' Compensation coverage is unlawful and
-shall subject an employer to criminal penalties'and civil fines up to $100,000, in
addition to the'cost of compensation, damages as -provided for in Section 3706 .
of the Labor Code, interest and attorney's fees:.
IMPORTANT. -Application is hereby made to the Director of Building and Safety'
forv,a'permit .subject, to the conditions and restrictions set forth on..his
application: '
1, Each person upon whose behalf this application is made &' each person at
whose request and for whose benefit work is performed under or pursuant to.
any permit issued as a result of this applicaton agrees to, & shall; indemnify
& hold harmless - the City of La Quinta,. its officers, agents and employees.
2. Any permit issued as a.result of this application becomes null and void if
1.;'work isnot commenced within 180 days from .date.of- issuance of such .
�t"permit,* or cessation of work for 180 days will subject permit to cancellation.
certify that I have read this application and state that -the above information is
correct. I agree to comply with all City, "and State laws relating to the building
construction, and hereby authorize representatives`of this City to enter upon
the above-mentioned property for inspection purposes.
Si nature (Owner/Agent) t >' -Dates a
'BUILDfNG'PER`MIT: PERMTk
DATE :'� ` �_' VALUATION f' LOT'TRACT
'»a(
JOB tifE-
ADDRESS t 1
1
APN
OWNER'
CONTRACTOR/DESIGNER/EN INEER
a- TI...,4•�34 IT'
•:I.A,.OXTUTI..A. ) \ A 92233:
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Y
USE OF PERMIT
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APPROACH.
CONT J d .32b 00 S.i
3AbM SIF
5 ;STIP.WOOD t'#33"dC? 200.80 LY'
•�.jygd..�F4wr cov}.id 1p S. omal-CL�J�...A.Ii.+b'L•-
.001.1 366.110
.--
:�S.JR.W'[.%K.Ld.A. V,VR ID�E�.i�.C�1Y,f�R'LR B.-
C M411"b3'1t3 CITION FES• 101-000-418-V-10 �9t
--
KA1T CHf'C•X VEX 3 -WO -430-33 A �5�a.stz
WCHAVICA1, FER 101 V000-423 -000
���.�.�L',�.'�.��:..11,:i..a� _ ;�{a�}�i^It�-+is�•.{}�F$'� = �1�.�.`r�:1.
,
_'
PL11'13 BIND PER, 5110.75
t .
vjtomy Mo�i'bfm ITT' `;1;'fi�.�fU • 101 -000 -241} -ow $1010
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' COMM%9
PRWISK PL A14 101-10M-441-345' = S100101D
.P,,1: l' IN .PUTAUC: PLACU.- R11, m,101-(3oo-m-000.
";t DEPOSIT 4; na"'
Tr';h 03C�
Y T�C1At�J.��Ii.
5
1.5sly
U®®Ra�PAyyyyROB
$250100
'T YINSIAM NO
V3,n7, 3
RECEIPT
DATE , V
BY
DAT FINALED
INSPECTOR
f ,r
a. .
1t
INSPECTION'RECORD y
,c i _ Q,, -z-'
OPERATION
DATE.
INSPECTOR
OPERATION
-'' DATE
INSPECTOR `
. BUILDING APPROVALS ? !
MECHANICAL APPROVALS
Set Backs
,
Underground Ducts
Forms & Footings_
Ducts t
Slab Grade
/� `�•
Return Air
3
Steel
Roof Deck
= ,
3 _ZZ _� Z , s
Combustion Air
Exhaust Fans _
0. K. to Wrap
.�(( fy L 4
F.A.U. ..
Framing.
l�_ /_� y L;,
Compressor
Insulation6
I '
Vents
.'
Fireplace P.L.
Grills
Fireplace T.O.
i
Fans &Controls
Party Wall Insulation_
d !. '!
Condensate Lines
_
Party Wall firewall
Exterior Lath
Drywall - Int. Lath
Final
i
F
Final
I
POOLS -SPAS,
BLOCKWALL APPROVALS`, jT
{
Steel
Set Backs
Electric Bond •
S
Footings
i , ;;
Main Drain r '
Bond Beam
,
Approval to Cover
i } .
Equipment Location
-:
Underground Electric
Underground Plbg. Test
Final
t
Gas Piping
"
PLUMBING APPROVALS i
Gas Test
4
Electric Final
Waste Lines2'
=
S7
Heater Final
Water Piping
/; ".�-�
,.I
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster ~- ,
Sewer Lateral
f
Pool Cover
Sewer Connection
1 _O s,
_
Encapsulation
Gas Piping
Gas Test
Appliances
I
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS f
Temp. Power Pole
Underground Conduit
i
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service si
Sub Panels
Exterior Receptacles
G.Fa.
'
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
' Desert Sands Unified School District.
47-950 DunePalms Road
Notice r.
• : ; La Quinta,'CA 92253
Document Cannot Be Duplicated 760-771-8515
' CERTIFICATE•OF COMPLIANCE ,, 4
Date 12/28/00 APN # _ 773-182=015"
No.` 21416 R �' _. Jurisdiction t La Quinta
Owner NameWally S: "Miles' ',. t Per:nit# 001,0-027
No. 51-805. Street Avenida Villa , • �'~ Lag # • - • i'
City La Quinta ;t, Zip 92253, Study Aeea
Tract #BLK119 012,.'- Lot # 2
�.. Square -Footage 1526
Type of Development i Single Family Residence No. of Units .1 {
1
t
w a$
At the present time, ' the Desert 'Sands Unified School ,District does • not collect fees on` garages/carports, : covered
t :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 APPLIC"L•=E
` `-This certifies that school facility' fees imposed pursuant to Government Code 53080 in the amount of '
2.05 .. X 1,526 or $ 3,128.30 theproperty listed above`and that building • ,,
permits and/or Certificates,.of Occu anc `for this s uare, footage in this proposed 'Pro -,. iJect mYowbe.ssued
icFees Paid By. CC/Bankof Amera=WallyMiles
Tet�pieone'-w'760-771-4824-
41
• r ,.. Name on the check
By ,Dr: Doris Wilson:_ ': +��""�.;,',' ,
Superintendent 1 tt S i
R Fee collected /exempted by. Annette Barlow K Payment Received ' $3,128.30+
f, 2008126910
{ , Check No: _
Sinature
6, .,
NOTICE: Pursuant ot Assembly Bill 30811(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 from the date on which the building or installation pencil for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to f.
collect them on the District('s)(s) behalf, whichever is earlier. ,
°
'Co . lie . ctor: Attach a copy of county or city.plan cheek application form to district copy for all waivers.
Embossed Original: Building Dept./Applicant Copy - Applicant/Receipt Copy- Accounting °
RECORDING REQUESTED BY
WHEN RECORDED MAIL TO
AND MAIL TAX STATEMENTS TO
NAME Knsty A. Brady
ADDRESS P.O. BOX 1440
CITY La Quinta, CA 92253 a
STATE & Zip -
GRANT DEED
TITLE ORDER NO. ESCROW NO.. APN NO. 773-172-01%4
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY TRANSFER TAX is $ CITY TAX $ `
computed on full value of property conveyed, or computed on full value less value of liens or encumbrances remaining at time of sate,
Unincorporated area: City of LA QUINTA, and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
WALLACE S. MILES, AN UNMARRIED MAN
hereby GRANT(s) to
Kristy A. Brady, an unmarried woman
r L
the following described real property in the County of Riverside - State. of California: :
i
Lot 2, Block 119 of Santa Carmelita at Vale La Quinta Unit Nd.. 12, Tract, County of Riversied State
of California, As per map recorded in book .18, Page 79 & 80 of Miscellaneous maps, in the office of .
the county recorder of said county 773-182-015
Dated ZL
x' WALLACE S. MILES
STATE OF CALIFARNIA / }
COUNTY-OF ///Y''iy�/t�siG/P )S.S. ,. Y
On
f�/k /�/ before me, / `l i C� P Ile I A4 OS' /- 10 74.4
(here i� and title of the officer), personalty appeared IAJoe 114 f / P f
personally known to me (or proved ,to��,mee on the basis of satisfactory evidence) to be the per whose rzarr�e�(6f +sl .subscribed to the within irrsirixnent
and acknowledged to me that h � r executed the same in hisMWir authorized capacity K, and that by his elf signaturq(sf on the instrument
the or the entity upon 6 H of which the personfe(acted, executed the instrument.
WITNESS my hand and official seaL
MICHELLE RAMOS
Commission # 1246.380 Z.
Notary Public -Califomia 7>_ ,
Riverside County
My Comm. 6gxes DeC2D, 2003
Signature .
DOW.%-_ff PROVIDED 8Y STES"M TITLE OF CAUrORMIA. NC. - � GRNTDEED.DOC ,
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application fora building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/Builder" you are the responsible pzrty of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and -to have a business license
from the City or County. They are also required by law: to put their license number on all permits for which they
apply.
If you plan to do your own, work, with the exception of various trades that you plan to suboontract, you should be
aware of the, following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not lic-_nsed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the -State and Federal Government as an employer•and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions'.
There may be financial risks for you if you do not carry out these obligations, and these risks a_e especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific information about your obligations. under Stare
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor,or subcontrator, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building
permit, erroneously implying that the property owner is providing his or her 'own labor and material personally.
Building permits are not required to be signed by property owners unless they are per=orming their.oww work
personally.
Information about licensed contractors may be obtained by contacting the Contractors.' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned'.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760)777-7012
FAX: (760) 777-701.1:
O 'S G ATURE/DA
PROPERTY ADDRESS
PERMIT NUMBER(s)
a
Ce'dific-ate ofOccupan
C.:
a.
o o�
City of L a Qu-in ta
Building.and Safety Department-cF OF.-
This Certificate issued pursuant to the requirements of Section 109 of the Uniform. Bui/ding 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 fol%wing:
BUILDING ADDRESS: 51-805 AVENIDA VILLA
Use Classification- ' SINGLE FAMILY DWELLING Bldg. Permit No.: 0010-027
Occupancy Group: R3 Type of Construction. VN Land Use Zone:-' RC
Owner of Building: WALLY S. MILES - Address: P.O. BOX 604 .
f City: LA QUINTA, CA 92253
By: KIRK KIRKLAND
Dater OCTOBER 10, 2002
Building Official
POST IN A CONSPICUOUS PLACE