0005-122 (AR)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed atinder 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
�7t1 13 0$/3 -
Date 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:
( ) 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 withflicensed
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:
() ilhave and will maintain a certificate of consent to self -insure for workers'
compensation; as'provlded•forby Section 3700 of the Labor Code, for the
performance of the work4brswhich_this permit is issued. „
( ) I have and;wjll, maintain'wprke_r'•s'tcompensation 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 EX1gM'PT Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
( )f I certify that in the performance of the work for which this permit is issued,
I s/hall not employ any person in any manner so as to become subject to the
wdrkers' compensation laws of California, and agree that if I should become
�Ubject to the workers' compensation provisions of Section 3700 of the Labor
Code, I,shall for�tthwith comply with those provisions e, ^
Date: ` �f l�'YG`w 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
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
th above-mentioned property for inspectio purposes.
Signature (Owner/Agent) '' `�� Date`_
f
n- t ; -BUILDING PERMIT PERMIT#
DATE .�' VALUATION �+ LOT "�TRACT
- ' M,704.90M,704.90M,704.90�
JOB SITE
ADDRESS 49—W5CALLE IMOM.
APN
(l Vl.�
OWNER
CONTRACTOR/[ / EN/•�I/NEER
MIKE BARNM T
Comff tuCy'I'ION L)EuIl G 8 Y91"E .9 INC
49-085 CALIX FWRA
53-,260 AVIUM -IA OL q0N
LAQCiIAlrA CA 92253
LAQMN`i'A CA 92353
Q760Y771-3543 CB -10
USE -OF PERMIT
RE01llKWX A.L ADWION
331 5. F' PWOM AIMIT1014'9'C1 MISTINf3 RBSIDF�NCW
ADDITION 331;00 SF
If;wjffi1L4, J),tv' 0HT OF CONSIRUC-MON
25,784.90
PXRW"FTX SUMMARY *-t
Pz IW CHECK FEE 101.000.439-318 $163.03
CONSTRUC'T'ION FRE 101-000-418-000 $238,50
MIRCRANTCAL FE1? 101.000-421.000
ELEC:TRIC,,i L FEE 4101-000-420-000
PLUMBING FEE 101.000.419.000
STIRC NO MOTION FEF . RE -SID 101-000-291-000 $6.58
GRADING TK, 1? 101-000-423-000
SUB-TCYCAL C014.MA A LY0,710R AiD PLAM 01-31 OC
29.11
LXS2 PRE -PAID F=
$0,00
TOTAL _PTMWJV rI S i3't F NOW
RECEIPT
DATE
/
DATE FINALED
INSPECTOR
3
INSPECTION RECORD
OPERATION 7F
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
j
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Root Deck
7-5-00
Exhaust Fans
O.K. to Wrap
-"'W 92
F.A.U.
Framing
Compressor
Insulation
—--=�—vc
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
7 /5r _Gto : 9
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL
AP ROYALS
steel
Set Backs
Electric Bond
Footings
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
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
jam?/ Od ,
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
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)
Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated 760-771-8515
CERTIFICATE OF COMPLIANCE
Date 5/11/00
No. 20432 Jurisdiction
Owner NameMtke Barnett
No. 49-085 Street Calle Flora
City La Quinta zip 92253
Tract #
Lot #
Type of Development Residential Addition
Comments
31 sq. ft. Room Addition to existing residence.
APN # 658-210-003
La Quinta
Permit #0005-122
Log #
Study Area
Square Footage 331
No. of Units 1
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:
Residential Addition 500 Sq Feet or Less
EXEMPT
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
0.00 X 331 or $ 0.00 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 N/A - Brian Ewing = Telephone
Name on the check yJ
p ti y
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Mary Ann L. Boda Exempt
.$0.00"
I
Signature
Check No. N/A
NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) this will serve to notify you that the 9"ay 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 sssued or on which they are paid to the District(s) or to another public entity authorized to
collect them on the District('s)(s') behalf, whichever is earlier.
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 - Accounting
.16/24/94 08:56 FAX 619 568 9728
gopilested 8y
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stem CIO COZAVOLL LOAM
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Arms •RED VIIIA
Title nr&r I1 i"9A37• ••• t.,t,. 14. -10.91D19
FATCO P.D.
NO CDR FILED ..'1„.
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Grant Deed
Tra meet to 58~1 we
THE UNDFRRIGNED (MANTCL(,) DECLAWO
DOrAIWNTARY TLANAFFI TAI is $-"2.%_
0
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FOR A VALUABLE CONSIDERATION, receipt of which is hereby ackrtoe,ledged.
WALTER BCEZL',INO, R.D., Tsax= OF Tm "LTEE Bmmuma, R.D., INC.
ENFL4TIQ a N 1 11 TRUST
hereby GRANT(S) to
SURIM N INVEalMINlB,'INC. A Cn&ZVCW A CORlCY92M
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• 1114 -}....i-..: }�. �`A•
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the following deefibed reel Broker" in the CIT7 or L QOIWTA
PArfi RIVERSIDE , matt of Glifomia:
z0W 3 ARD 15 OY TRMT 21120, AS IINONI Bt mp ON Plug Is jDDK 160 PAM 81 2MR30= 83,
JECLDSIVS, OF P1AP8, RRLWRDB OP RIVE18IDE COONS., CALIF0RIZA.
PARCEL 2 r
A WX-R= LUSrVX RIGHT ARD EASNIPWT POR (A) PEDESTRIM Atm V=ICUu* ACCESS, 1
AND EORE88. (R) TSE COXSTNUCTIOW, WOWPV"MVPIOs, RIlrfZNA1C$, REPAu1 AND ME OP MUD,
ROADtO►Y AND 92=11 AND (C) TEM Cose"W2101111, INSTALLATION, USE, NAINTERAIC= REPAIR
AND Iww4m rT at, AND ACCE88 OT PUBLIC vrILITT PACILIYIEB, I/CLODIED =Wm'
WRTRR, ff=fncAL, CAB, CABLE 1W.M610111. TURP1011E AND 01 1f11 DTILITT LINEA,
FACILIT128 AND WORKS, COR18 AND OUTTRIS OVER AND ACRO88 TRE "AEDIl• EA8)O W
PROPERTT', A8' sI1DWN ON ZXKtBZT ene AND MAW PARTICOIJIEL= 8NT Pa1e:f1 Z'N THAT CEllAis
RA=Ir AmlMOM DATED JASUART 12, 1987 AS IN8TRU101NT W. 8788 OP OPPICIAL 220=8
0? RIQEM20E COUM, CALIFORNIA.
PAU= 3 e
A BOX-==SIVE EASEM!! POR CMMMUMION, 111=06MOCTIOW AND MZllr*Lu= OP ImmWAFI1
An IRRICiTION p(R10as OVER TEA? PORTION OF u11XD BET 101!8 IN Tel am RROMED
ea?T== 25, 1987 AB IJ<8TRD100r! 0. 278471 OP ORICIAL RROC DE OF RZVMAZV C
CDUM, Cf1LIPORNIA, APPURTO NT 'A LOT 3 OF BUD TRACT 21120.
WALTER BCRILLING, R.D.. Mom OF THE
8082 , U.D., INC. DWLOlEN
Bit �VTRJ
1
Dated- _.I>D„t;¢r4pq3— WALTER BCRILLI ., Imme R
STATE Or CAWFORNIA
COY"" OF 18.6.
on 11111- nne,
a NMI fteft In ud for aaf0 C=q Rid Btor. po wtal a pmww
"artntlq Leon W " (or Proved b "0 an e11 Oda 0 N&ONMV
e►Itrwtoe) 4 be Qr peeeor(n -Nene feertt M War" atAW11nd M ft
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Of •ts I rllalNV/Uri R O tOrlerttl OepeeRl(YItD. and Ors O! NeRrMOMt
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Uro Otww A.ra,ar A
FATCO P.D.
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11s+et�ltetal� 1lclauas+Itie ar ' • . ' 1,,.....`�,
are William alessove roll Galla "we AND. YAGese4!
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luta•' '� &MWIM ITALWY
or.. 45000 t9A1 MIV3
XMIAN VILLS, CA. 937141 J
ATMI Ilse InLADa
Tills oris Mw,19eS03? • trnew Na.... 10.20033
Grant I
5",
?wt Now IV AMP04 OR
THE UNDFRSIGNF.D tMANTMIP) CK ALE(•)
DMAlkitNTA*Y TRANS►ua TAA is
a .ts"' alta Cnr d_
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C7 (rrmp led rM full ralue Im •du nil Iwm v emulfarwe" remiftinj N eune of "It, fail
FOR A VALUABLE CONSIDERATION, tece)pt of which is heeeby ackoorttdget).
,awry scomIeo. N.V., "Van or in talcum scst"Ima. 1I.D.0 lee.
owtom 5111111RIT T110"
hereby GRANTIS) w
stl/oM tNvasTt o", rW. A CILLIPOWU =01lOAATIC11l
the IultoriaA de.rribed real feet*ray in the CI" OF 1A gulam
PA y ii AIV128102 , nate of Califetnit:
IMS
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ROADMT AND STRMI AND (C) I= COMMUCIICN. INSlAMAl101, M' "'Oft"M BWASS
AND yMLACMW Ops, AND ACC7t88 O1• PUBLIC UTILITY lACILITI38. INCLUDING :aroma
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Personally appeared WILLTRa: 6®ILL110, II.D.
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fa be the psraon(e) whose name(*) I&JA W
sub*olbod to the within In*trurnent and ac•
i knowlsdged to me that ho/04 OWsxaeulsd
!1 the some In hlsJmtt authorized
capaoltyties), and that by hlsllRlR111110
signature(*) on the Uswment the person(s),
or the snllfy upon behaM of which the paraon(s)
Mo acted, ellmlled the Instrument.
rt COts �, ftA 731601 yy mmeas � anQ31 a.
CCrMIeR lob?yat
vaQal�+avmsrna
w trttiwmr�lp wC .I1*1
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CAPACITY CLAIMED BY SIGNER
D INONIDUfl.(J0
OPFICERt11
flfl*1tl
G PARTNER(II)
0 ATTOfINEYdM•1►AC:T
® tf1USTEEIa)
p sueetlimm wrtwesa
D WAROW&CONSERY►TOR
t] OTN!R:
SIGNER IS REPRESENTING:
a1M tY R�atiatyAlwrn►tap '
tolLSiR aCllIt.Lil*D. at. D.:
TICIS a OF In aalTNa '
Wf*8%Ad1h-, Won
t; t7T10f110r MOtaA7r a1H01,d1 tM nln nridtotr • Earor. a 0� 1 mU01eFwM A'aOMIr't tnprrM a artr srtaaar • w�OnttO a0t1a�.
HIS CEAnyICATE Tree Typo of 0mument
110 TME OOCUIr1tsNT UST BE ATTACHEDENTNu r of pf"Ps 1 Dale of Dmm m Jay i!. 1993
OESeFtlagO AT RKItfT:' t, Sipflor(si Mat Then Named Above
ohm A46000
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April 4, 2000
CDS/Construction Design Systems, Inc.
Attn: Brian Ewing
P.O. Box 628
La Quinta, CA 92253-0628
Re: Lot 3/ 49-085 Calle Flora
Owner: Mike Barnett
Santa Rosa Cove Estates the Enclave H.O.A.
Dear Brian:
On behalf of the Architectural Review Committee for Santa Rosa Cove Estates The
Enclave this letter approves the request to install a room addition as per the submitted
plans dated February 25, 2000.
Thank you in advance for your patience during the review process. If you have any
further questions please call me at (760) 346-1161. Good luck with your project.
Sincerely,
Carol Calhoun, Property Manager
For the Board of Directors and the
Architectural Review Committee
Santa Rosa Cove Estates the Enclave H.O.A.
Professional Community Management / Desert Resort Management
Post Office Box 4772 • Palm Desert, CA 92261-4772
73-550 Alessandro, Suite 5 0 Palm Desert, California • (760) 346-1161 • FAX (760) 346-9918