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9609-178 (SFD)F1 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 c 487584 B C-10 2/ Ii98 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 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 isrisstieAfvly"vW&' compensation insurance ckrrPe4r&'polfcytnto. are: Carrier Policy No. (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 3700 of the Labor Code, I shall forthwith complyWth 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 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 coristruction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) Date BUILDING PERMIT PERMIT# °°NTR°`# 157 DATE 9/26196 VALUATION Sl,".6t3+ ,q) LOT 42 TRAjQT„�, (y1,(jti JOB SITE50-795 CtVL1,E �s�;1�►�I�i�' A.S ADDRESS APN 699 075MW OWNER CONTRACTOR/DESIGNER/ENGINEER A& Al CONS'T12€ IC110N1 .A&M CON.TrRtJC".'S'iON J. ig-070 CAL1,13 CADIZ 113-070 CALL :1•: CA:01 : LA 01.0r1.'A CA 3'x253 1,A. t; UIN1'A CAF 922" (V 1 ���5tS4HIR32 `.,n -I)1..54 �AZS USE OF PERMIT :.12vC rl,l PAIR,1' 1►V4E1,1ANG "F0 ONLY 0ARAilWCA1tPO14'1' k`tititi `tF I'IEA4""f' aft )N`3`� N C1�:17i ),�h1I,INf S.M a;✓�'IVNI���cEM cun, of cowrRoc'.res�N 1.50,60.50 {��+,(�! 110'31r*t1 's' 1�'i+1><�,.;%�,� IM �.RY C ON T1147K:"TION FRE 101-000-41940) S.�ilf3:(►t� 1'LA&T Cl -!F 't FEL, 101.OW,439-319 Rl� MWMIT 4250.0 IMli'04 NICAL F kff 10 twt)M-421.0()0 G"C]�1(ti(C/�A.{LI,.{{,ffri, 1.01-000-420-.(0) $159.05 . 4�E,L P1.1.✓ii1BINICi' FEE 3155.25 ,S7r0 j ,&ITYr.rv14 TRs - JRusir) 101-000-241-000 S BA VI i"iiiAOING FRE 101 -000 -42:3 -OW $.°t1SO IN'IwRAS'.P1tIfCTIJRFFEE 2'25-W)0.44_A-342 PRECTSF PLAINT 101-0()0.441-:345 325.00 AIT TN PUBLIC KACB3 - Rrsri. iU I�Ot3,'7-235-w 3120.52 51113 -TQ I XL, CON S%'l U MOA:..r\ND MAN CHECK $5,2£11.80 -_ i..ES. 1'ttlr-i'A11)1741S 4210,00 1 D RitiiT . 451>1 ids 1�C'flS.i1Jl.+T!} i SEP 3 fj 1996 RECEIPT t DATE BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS - Set Backs S Underground Ducts Forms & Footings 4L Ducts Slab Grade 1h A Pit Return Air Steel Combustion Air Roof Deck /Al Exhaust Fans O.K to Wrap F.A.U. Framing 1 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 POOLS - SPAS BLOCKWAL AP ROVALS 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 Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final hf Utility Notice (Gasy- ELECTRICAL UPROVALS .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) 9609,-1.7� Tityx 4 P.O. BOX 1504 APPLICATION ONLY Building �d — 717 � 78-105 CALLE ESTADO Address ! LA QUINTA, CALIFORNIA 92253 Owner B Mailing -P d �� / A Address j/ City Zip Tel. Contractor k o A / �� + Pr City (Zip I Tel State Lic. Fic.# ity & Classif. ( g 758 624 Arch., Engr., Designer Address Tel. City �/ (Zip (State Lic. # J.rIC NSED CONTRACTOR'S DECLARATION I hereby affirm that I aLm 1censed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the?usigess and Professio s.Code-and my=ligense is in full force and effect. // ..CC OWNER -BUILDER DECLARATION I hereby affirm t 't 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). [*JT 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. 1 1, 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.) 17 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPE 7ATION DECLARATION I hereby affirm that I have a cenific eiof consent VS`self-insure c.,i certificate of Worker's Compensation Insurance, or a ce ified copy thereof AL•atior Code.) Policy No. Company n Copy is filed with the city. O C rtified 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 thg 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 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 L Lender's Address i This is a building permit when properly filled out, signed and validated, and is su ject to expiration it work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information 1 correct. I agree to comply with all city and county ordinances and state laws relating t I building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date. y- Mailing Address City, State, Zip BUILDING DIVISION UILDING: TYPE CONSTT.., •-� OCC. GRP. P. Number 76 t — 6 r 57— o Le Description oject Description Sq. Ft. Lei �10 No. No. Dw. Size Stories Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep.J �® 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 Prop. Line Side Street Setback from Center Line Side Setback from Property Line ' 1FIN7 A 1fX II � INSPECTOR IsSiiPrJ Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. @ $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM. 2ND FL. SO. FT, FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. @ GAS (ROUGH) METER LOOP GAR. SO. FT. @ I POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO. FT. @ GROUT WATER HEATER WALL SO. FT. @ FINAL INSP. DRINKING FOUNTAIN SO. FT. @ WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ =$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING 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. SO. FT. @ c BATH TUB LATHING SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 11A c SEWAGE DISPOSAL SO.FT.GAR @ 3/4c HOUSE SEWER FINISH GRADING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE = ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING 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) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. g plus xS =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION --- FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESJINITIALS GARDEN WALL FINAL Desert Sands Unified School District Notice: 82-879 Highway 111 Document Cannot Be Duplicated Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE Date 9/27/96 No. 14886 Owner NameA&M Construction No. 50-795 Street Calle Guaymas City La Quinta APN # 769-075-004 Jurisdiction La Quinta Permit # Log # Zip 92253 Study Area 125 Tract # Lot # Square Footage 2431 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 1.84 x 2,431 or $ 4,473:04 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 Palm Desert National Bank Name on the check By Dr. Carol McGrew Telct%hcne564-48.2 4pj: .1jJ -� = '_ Administrator in Charge ,y � •; o 1 4Z ; Fee collected /exempted by Ellen Patino Payment Received Check No. 5515 SignatuW 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 RECORDING RF.QUESTE' 'AY UNION LAND TITLE COMPANY AND WHEN RECORDED MAIL THIS DEED AND UNLESS OTHERWISE SHOWN BELOW ltMAIL TAX STATEMENT TO: arrreA & M Construction Street 40dressP.O. Box 366 14ilyBLa Quinta 0 State Ca, 92253 NameSAME AS ABOVE Street Address City 8 State TITLE ORDER No.2 0 2 7 4 0 TO ESCROW NO3 7 9 7 —J C NO COR FILED 0C WW�C cc Q y ♦ `0..!r== O ` �- cc J Cn c a W A U CID_ ; v ..�.. 00 C..0 U m v U ..� • up C� 3 aC u SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX IS $ U 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 - U cityof La Quinta , AND FOR A VALUABLE CONSIDERATION, receipt of.which is hereby acknowledged,. . . . .. .. .. .. o Howard, a married man as his sole and separate property hereby GRANT(s) to & M Construction, A California Partnership the following described real property in the City of La Quinta County of Riverside , State of California: Lots 33, 34, 35, 39, 42, 43,- - 44,- 45,- 113, 115, 131, 135, 138 -of DESERT CLUB TRACT UNIT NO.5, as shown by -Map on file.in Book 21 Pages 61 and 62 of Maps, Records of Riverside County, California. Dated Jan. 4, 1990 STATE OF CALIFORNIA COUNTY OF LOS /+ AJ PZ 1 Cl—::7S SS. On this day of J 4aW 6n?f±1 in the year 19: , before me, the undersigned, a Notary Public in and for said State; personally appeared Lc=o hLpwq,u) , personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument, and acknowledged to me that — he — executed it. WITNESS my hand and official seal. Signatur a–) NOTARY PUBLIC IN AND FOR SAID STATE Leo Howard °.;r_ OFFICIAL SRAT, RHODORA E FRANK a r NOTARY PUBLIC - CALIFOf'NIA 11 1%311 LOS ANGELES COUNTY 4,•o�:"" Illy comm. expires AUG 28, 1992 CO -441 (REV 4/85) MAIL TAX STATEMENTS AS DIRECTED ABOVE. (This area for official notarial seal) CARLOS ELIAS REGISTERED CIVIL ENGINEER 38825 Charlesworth Drive Cathedral City, California 92234 Telephone (619) 328-7271 November 21, 1995 City of La Quinta Department of Building & Safety 78495 Calle Tampico La Quinta, Calif. 92253 Attention: Mr. Mark Harold Re: Plan Check #9510-089 Gentlemen: This letter concerns the res.ide*nce to be constructed at 50700 Calle Guaymas, La Quinta, California. The design of the roof trusses by Spates Fabricators is in accordance with my structural design. CE: j J Very truly yours, Carlos Elias Fitch Engineers Inc. October 23, 1996 City of La Quinta '78 .495 Calle Tampico La Quinta, Ca. 92253 SUBJECT: 50 795 Calle Guaymas, 'La Quinta, Ca. Gentlemeni I hereby certify this day that the finished floor elevation is set at 36.6. The finished floor is 1.1 feet above the curb at the center of the lot. Respectfully, WM. H. FITCH R.C.E. 12571 @RQFESS10 A yak® rn n s. s rC9 No. 12571 CIVIL ENGINEERING - PLANNING - SURVEYING DESIGN P.O. BOX 4551 PALM DESERT, CA 92261 (619) 345-7667'