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0006-251 (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 291728,, B HA7,r 08/11/2( Date VSignature of Contractor��T1� / !< 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). ( ) 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. r have and will maintain workers' compensation insurance, as required by Section 3,700 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 FUND Policy No. 329-00 UNIT 0004483 (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' compe cation provisions of Section 3700 of the Labor Code, I shall fo, Vith comply�witb•those provisions. . Date It 9'� 1I Applicant; -7 Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, ari8,hereby authorize representatives of this City to enter upon the above: entlone property for inspection purposes. -�-.� Signature (O n r/ ent Date BUILDING PERMIT PERMIT# DAT(I/"I _ V,A,LU�TION LOT CW6_24-Sl TRACT U6,337M JOB SITE APN ADDRESS .52-610AVUUDAJ. ViLu A t�•��. OWNER CONTRACTOR / DESIGNER / EN (NEER STARUGM :MAWA.C&N ENT INC 'eV3:t: AAM RUWMA. ROGM PO BOX 3578 56900 J.AC'?480_N 3rT PALM DE "t CA 92260 7TER IAL CA. 92274 (, 60)399.1240 L4 1852 USE OF PERMIT S.Il;TC33...F.' :t7l.�MT1.Y%lh 11.1.MG SI O,,PiRMIT DOV-3 NOT INCI,LII E HxL0VKW.A1A_9 OR P001, TRACT CONSTRUCTION 1,35&00 OF PORCH/PATIO 112.00 SF (IARAGIUC.ARPORT (SI' 9,40$,00 , S FT. WOOD FENCE 200.00 Ill* M'IMIAM COST OF CONS TRUC370N 06:337.00 Jf'IsI;M i1T 1W SOWDURY CONVYRUCTION FEE 101.000.418.000 S32I.1►4 PLAN CHECK 1179 101-000-4.39418 $488.26 , MECH.[iNICA1, FEE 101-000-421-000 $60,00 , EI,ECTRICALV?Z 101-000-420-000 $120.63 PLUMS040 POE 101-000=4'19.000 $11017$ / STR0140 MOTION F'EE - RESID 101-000-241-000 $8.63 ORADIHOIEEE 101.000.423-000 $20.00 ` DY,V )?LOPV,, I2 IMPACT 'FSE $1,907.00 PRECISE FLAW 101.010-441.345 5100,E ' Z 1 51.Tk,-AYtA1, CC` 9STRUC' [OMANI) 1,LAN CURCi? $3,`s" 96.27 t�i� IMS PRE-PAU) MRS $0,00 J'a,rAL 1PKRA ri' 11TNXS DUE I'1OW ~ 4 RECEIPT DATE BY,` B((\ DATE FINALED INSPECTOR .�. > INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck 8— 5 _ Qp S" Exhaust Fans O.K. to Wrap _ t — 00 s—r' F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath ' Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footing.- 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 �(,r, 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 COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole 9' . p0 S 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) . r.' *Certifica* te of Occupancy City of La Quinta Building' and Safety Department 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 incompliance with the various ordinances of. the City regulating building construction or use. For the following: BUILDING ADDRESS: 52-610 AVENIDA VILLA Use Classification: SFD Bldg. Permit No.: 0006-251 Occupancy. Group: R 3 Type of Construction: VN Land Use Zone: RC Owner of Building: STARLIGHT MANAGEMENT INC. r^d�'i. % Building Official Address: P.O. BOX 3578 City: PALM DESERT, CA 92260 By: STEVE TRAXEL Date: 12-14-00 POST IN A CONSPICUOUS PLACE P.O. BOX 1504 APP IC ION ONLBuildin ` t 78-495 CALLE TAMPICO Address J .l • 4 % V 1 i A LA QUINTA, CALIFORNIA 92253 'i Owner _ QL16 R' BUILDING: TYPE'CONST. OCC. GRP. Mailing Address A.P. Number 7 3 c .4 City Zip Tel. —f ��/ • 1(0'1 of Legal Description Contractor Project Description I ) . R. Address City. Zip Tel. State Lic. City & Classif. 1 —7 7 S Lic. q Arch., Engr., Designer L UrIJCi1i S 1 G Address Tel. l- U !74w - City Zip State Lic. #i LICENSED CONTRACTOR'S DECLARATION I hereby affirm that) 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... rri 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 nol more than five hundred dollars ($500). 1: I, as oner 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 orimprovement 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 11' 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.) 11 1 am exempt under Sec.e B. & P.C. for this reason Date Owner r 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 Cl Copy is filed with the city. D 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 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. Date Owner NOTICE TO APPLICANT: If, after 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 1hereby 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. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives •01 this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip Sq. Ft. �',� No. No. Dw. Size Stories Units Newt/ Add ❑ Alter ❑ Repair ❑ Demolition ❑ PERMIT l / AMOUNT Plan Chk. Dep. 1 Plan Chk. Bal. .� Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL (i 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 rom Property Line FINAL DATE INSPECTOR Issued by: Data Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 Date 7/10/00 No. 20686 CERTIFICATE OF COMPLIANCE Jurisdiction owner NameStarlight Management INC No, 52-610 Street Avenida Villa city Palm Desert zip 92260 APN # 773-304-005 Permit # Log # Study Area Tract # Lot # Square Footage 135$ Type of Development Single Family Residence No. of Units 1 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 2.05 X 1,358 or $ 2,783.90 the property listed above and tha_ building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued Fees Paid By Larry Shields Telephone Name on the check By Dr. Doris Wilson i Superintendent ' Fee collected /exempted by Sheryl Simmons Payment Received 12,783.90 Check No. Cash Signature 40TICE: Pursuant of Assembly 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 rbove will begin to run from 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 ;ollect them on the Disblct('sxs') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all wavers. Embossed Original- Building DeptJApplicant Copy - Applicant/Receipt Copy - Accounting n Commo,novealfe. ',,and 11"'lle 72855 FrW WR.6!jq Dr... Suite A5, Palm Desqr�t-A 92260 Escrow il4o.., 97225'r"' Buyer: S'carlight Management, Inc., a Nevada Corporation or (."uminee Prcperty - Vacant - APN: 773-304-705/773-255-011., La Quinta, California 92253 Esc roov Officer: Sharoo Elkins Date: Fldrd, 24., 2000 DESIT CREDIT TOTAL. 0! S: IDM. r-, 1 n- N Deposits f.�y Boyer ('/0 500.30 PROWIONS/ADJ06TAENTS 411 Taxes - A!. -IN: 77,2--304-005 ...... . 1 93 05/0') /00 07/ 1!'(i0 4, 60 days @.79405 per diem Taxes, - APN: 773-255-011...... 151.35 05/61/00 07/01/00 50.45d 60 days @.84083 per them ESCROW FEES, TITLE CHARGES Settlement Charge RECORDING FEES, TRANSFER TAXES Record Grant Deed ADDITIONAL CHARGES Refundable Buffer RECEIPT DUE FROM BUYER BUYER(S) SIGNATURE: Starlight Management, Inc. a Nevada Corporation 29.00 50.00 31,925.09 $32-425.09. —432,425-49 RC DISTRICT -PLANNING REVIEW FORM This form is to be used by CDD staff for review of single family dwellings in the RC (Cove Residential) District, in order to determine the applicability of compatibility issues or need to require the filing of Master Design Guidelines by the applicant. It shall be transmitted to the Building and Safzty Department as your correction list. Please attach additional explanations as necessary. APPLICAAT ROGERS SITE ADDRESS 5'2-610 Avenida Villa APN 773 - 304 - 005 BIN NO.: CASENO.: 20D0-243 LEGAL: LOT /? . BLOCK UNIT S.C.@V.L.Q. CHECKED BY: Leslie Mouriquand DATE: 6- -1 ?I Inform the assigned Building plan checker upon your assignment to this case The CDD Executive Secretary maintains a log book to track applications and assign case numbers. REQUIRED ITEM Y N COMMENT/CORRECTION Compatibility Review Case logged and number assigned Verify legal and APN information Consistent with MDG on file (as applicable MDG filing required (5 filings since 9/3/98) Consistency with street/surrounding.area: Colors Materials Architecture (J�� D Other Requirements: AP 8Y CASE ROVE NO BY EOpq UtVa0P DA ENS DEPT