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9606-016 (SFD)I— N Cf) W O 0 c') r�0LO W r— Z nT O 1 (0Pa) W W co U) Z CO LO N ON U °) as Cr T Q 0 LL 0 JJ m<0 O 11 rn H Z_ ob �0 Q J :- -•--! 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 acid effect. License # Lic. Class Exp. Date 487884 8 C-10 ♦ 211/98 ate 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 is &s �ued1;My wiorrk�ei;s' compensation insurance casriet,&,poheytno. are: Carrier Policy No. (This section need not be completedif the ermit valuation is for $100.00 or less). () I certify that in the performance of a work for which this permit is issued, I shall not employ any person in any anner so as to become subject to the workers' compensation laws of Cali la, and agree that if I should become subject to the workers' compensat' provisions of Section 3700 of the Labor Code�hal1forthVith comply with ose provisions Warning: Failure to secure Wor ers' Compensation coverage is unlawful and shall subject an employer to crirAinal 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 180.0ays will subject permit to cancellation. I certify that I have read this appli correct. I agree to comply with al construction, and hereby author': ,�t e above-mentioned property f Signature (Owner/Agent) ion and state that the above information is ity, and State laws relating to the building representatives of this City to enter upon purposes. BUILDINGPERMIT PERMIT" CONTROL# 9606.016 6 3668 DATE VALUATION LOT TRACT , a1 S. Ci,f }13 719/4),6 $1.50,606-511) .13JOB SITE ADDRESS 54"015C".ALLEGUtiYli`it1�S APN 769-075;-0115 OWNER CONTRACTOR/DESIGNER/ENGINEER A cit M CONI ! I' .A&Af CON STPU.)c LION P.O. BOX :3ti 78-070 CALLE OEli3iz LA. QLffN rA. C;A. 9111251 LA QUINTA CA 92251 (61! )5564-48:12 C'€ L4 626 USE OF PERMIT S SKYLt FAltEfi'LY OWEILIN SEri) ONIX t:RA.Cf C0K!irkC1M0t4 2,431.0) 3F c'AItAC' JCA3Z:#>+`tRT 123,(iCi C *:S"D'.i_ttVV1'1i3O COST OF (VISiY.fftt CTI[ON 1.50,60 6.50 PCOM111TV"CE SUMMARY C0:t•IS'I R1A"1 t0N Ff:.f JUA-000-118-WO $818.06 PL.kN CHECK FEE E 101.000-439-318 $16 33,121a , t/iit 10VOSIT 42ii) ilii ME 'NANICAL 1413 `I(111_00("4 t-00 E1XI "TRICA) FFY 1.017600-42040) S139AS 111tR'13.tNG SEE 1(11-Ofl0.419.4w S1115.25 g7'ONG MOirIC.'r'N Hai - ItEMO 1.01 -000.241 -ow itV,14 (1I4 A) fl Nil F4E 1 U 1-00-42.-3-d1t10 $20.00 INFRAS't`RCTCTIJFtF f E1.3 22540)-443-:142 33,200.72 P1tIE071 3V 11,AN 101.000-4-11-315 325,003 Alt'1' iN P0131,140 I<ELt\CES - 1.2 iSit: 701-,X14-255-000 $126.32 UP., -TOTAL CON 11WCT:ON A:LNI3 ;PLW C1.iECK $5,281.80 LESS PRE -PAID F - .8 5", .$250.00 T NOW sa13`mm) JUL 0 9 1996 lBy RECEIPT DATE BY�ff 77 1� DATE FINALED INSPECTOR 7777-•-�:{- 7777-- —7777-- --..—.__— . . INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs /d Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans p F.A.U. Frarn e/z wsa— e0w Compressor insulation Q 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 BLOCKWALL APPROVALS POOLS - SPAS 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 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 / 9 Utility Notice (Perm) COMMENTS: Building 5 0 -13oz � T4'!t 4 4 intra P.O. BOX 1504 7&105 CALLE ESTADO �VMA.S. LA QUINTA, CALIFORNIA 92253 Owner Am t w� 1' I Mailing n D Address t_ City L Contractor A Address d City L Z State Lic. '�C/ & Classif. 4lz% 3 (o RD .. I Designer Address City Zip 1.5 0`l-4 %3 Z C. T FY APPLICATION ONLY . //r r BUILDING: TYPE CONST. 5 F D OCC. GRRP. - \ A.P. Number -7� — 0 -7 5 — ©0J Legal Description L v? ct ?J V A I ed e- L W 1j 4L 5 v Project Description— Tel. escription Te 5&A -4g -3-Z_ City Lic. # Sq. Ft. u �� No. No. Dw. v Size Stories Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Tel. State Lic. # I If LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under prdvisions of Chapter 9 (commencing with Section 7000) of Division 3 cUthe Bysiness and Professions Code, and my license is in full force and effect. it Y OWNER -BUILDER DECLARATION I hereby affirm at 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). 1 ; 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 I I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Busine nd 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. B. & P.C. for this reason Date Owner WORKERS' COMPEN ION DECLARATI&I I hereby affirm that I have a certiticat f c ln!�sent to self-insur r-a-oa tificate of Worker's Compensation Insurance, or a certif d c Y thereof ,(„Sec^3800, La ode.) Policy No. Company (] Copy is filed with the city. ❑ Certifi 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 (5100) 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, atter 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 -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING DIVISION mated Valuation PERMIT AMOUNT Plan Chk. Dep.'" Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure fl r, Af- TOTAL 'J) REMARKS 'r' C i �'. Y `i. lqq,) J 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 FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMRIN¢�FEES" A.C. UNIT COLL. AREA SLAB GRADE 1ST FL. SO. FT. @ $ UNITS HEATING (ROUGH) 2ND FL. SQ. FT. @ FORMS YARD SPKLR SYSTEM ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. @ GAS (ROUGH) METER LOOP GAR. SO. FT. @ IPOVVER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SQ. FT. GROUT WATER HEATER WALL S0. FT. FINAL INSP. DRINKING FOUNTAIN SO. FT. g WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION S WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(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 SO. FT. ©c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID 1 V. c SEWAGE DISPOSAL SO.FT.GAR 3lac HOUSE SEWER FINISH GRADING 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 R 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. $ Plus -X$-=$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING N REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL 71 Notice: Document Cannot Be Duplicated Date 7/8/96 No. 14665 Owner Name AM Construction No. 50-805 City La Quinta Tract # Desert Sands Unified School District 82-879 Highway 111 Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE Street Calle Guaymas Lot # Type of Development Single Family Residence Comments APN # Jurisdiction La Quinta 769-075-005 Permit # Log # Zip 92253 Study Area 125 Square Footage 2431 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: 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 cc/1st Community Bank/A&M Construction Name on the check By Dr. Carol McGrew Administrator in Charge Fee collected /exempted by Pauline Pearson Tele0hone 564-402 Payment Received $4,473.04 Check No. 20967 Signature o nn Q � R AkA A SSV \'— 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 "_;0_ b r. j ¢REC4. ORDING RF.OUESTF" 'i'I .11MON LAND TITLE COMPAM AMC WHEN RECORDED MAIL THIS DEED AND UNLESS OTHERWISE SHOWN BELOW MWL TAX STATEMENT TO: I�tlameA 6 M_Construction SSeeI 1-":rP.O. Box 366 "t'itysLa Quinta �slateCa 92253 MAIL TAY. STATEMENTS TO - NarneSAME AS ABOVE; Street Address city 8 state TITLE ORDER N0.2 0 2 7 4 0 Esc®ow NIIJ 7 9 7 -J C C:) ccC. W X '` z o Q O o` C it ate. F - to �\ SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED THE UNDERSIGNED GRANTOR(S) DECLARE(S) DOCUMENTARY TRANSFER TAX IS $ rr�. `SD +� 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 i xD cityot La Quinta AND FOR A VAL.UABLE CONSIDERATION, receipt of which is hereby acknowledged. =o Howard,�a married man as his sole and separate property a hereby GRANT(s) to & M Construction, A California Partnership the following described real property in the City County of Riverside Lots 33, 34;,-35, 39, 42, 43 44, 45, (CLUB TRACT UNITPNO.5, as shown by Map lof Maps', Records of Riverside County, Dated San. 4, 1990 STATE OF CALIFORNIA 5 ti �tQCL SS. COUNTY OF ---------�-�-5-- ----- On this day of. - R ^� u in the year 19 2-0, before me, the undersigned, a Notary Public in and for said State, personally appeared —personally known to me (or proved to me on the basis of satisfactory evidence) to be the person _—. whose name —. i5 __--__ subscribed to the within instrument, and acknowledged to me that _.— he --- executed it. WITNESS my hand and official seal. of La Quinta , State of California: 113, 115, 131, 135, on file in Book 21 California. r J 138 of DESERT Pages 61 and 62 ✓c c 7 Leo Howard `^ gf ' RHODORA E FRANK LCS ANGELES COUNTY My comm. ex; ires AUG 28, 195" -� � Signatur __..— NOTARY PUBLIC IN AND FOR SAID STATE CO -441 (REV 4185) MAIL TAX STATEMENTS AS DIRECTED ABOVE. (This area for official notarial seal) Ldp - l3 - Malo Fitch Engineers Inc. July 13, 1996 City of La Quinta 78 495 Calle Tampico La Quinta, Ca. 92253 SUBJECT: 50 805 Calle Guaymas, La Quinta, Ca. Gentlemen: I hereby certify this day that the finished floor elevation is set at 36.6. The approved plan established the finished floor at 36.5. The finished floor is 1.3 feet above the curb at the center of the lot.. Respectfully, WM. H. FITCH R.C.E. 12571 ��. �U RR -61, CIVIL ENGINEERING — PLANNING — SURVEYING — DESIGN P.O. BOX 455 / PALM DESERT,,QA 92261 (619) 345-7667