0009-139 (SFD)i► LICENSED CONTRACTOR DECLARATION
tCr I hereby affirm under penalty of perjury that I am licensed under provisions of
cf 1- 'Chapter 9 (commencing with Section 7000) of Division 3 of the Business'and
04 W Professionals Code, and my License is in full force and effect.
O c,) License # Lic. Class Exp. Date
r, d LO
LLJ
r r533670 B
oZr,-Date T �a"'�6jgnature of Contractor
CIO O_ t0
J U CD OWNER -BUILDER DECLARATION
HW r- I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following reason:
Z ( ) 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'I(Sec. 7044, Business & Professionals
Code).
C0 () I am exempt under Section B&P.C. for this reason
141)
N Date Signature of Owner
O N _
rn '
Q WORKER'S COMPENSATION DECLARATION
< z cc I hereby affirm under penalty of perjury one of the following declarations:
FZ0 () 1 have and will maintain a certificate of consent to self -insure for workers'
K. W ILL. compensation, as provided for by Section 3700 of the Labor Code, for the
D J Q performance of the work for which this permit is issued.
n Q. U ( �I have and will maintain workers' compensation insurance, as required by
Q Seo
tion 3700 of the Labor Code, for the performance of the work for which this
L � Z permit is .issued. My workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
cb cb O W.1.,DRW &&%CPO VVIC 32;43 a9 ,0 6
J
(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 provisio,s of Section 37 0 of the Labor
Co e, I shall forthwith comply with those provisions. f
IDae: - 4 Applicants
b 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. Y ;
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
17 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 1 -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 ffor,i�nnsp�ection, purposes.
1-75' ell
gignature (Owner/Agent) r �''!��• �`�--`'�� Date
.._. , :.. 4444•.._.. .>., ... _. , ..M,� -
BUILDING PERMIT PFRMT#
DATE VALUATION LOT , TRACT
A y1I yr ��p� yR� :7 I iTJ16 6
1 f n. r /k ?i6Rro7�w7af V 13
JOB SITE t '
APN
ADDRESS
52- MM AVEMA .433f.RWRA
773P -M-01.1
OWNER
CONTRACTOR/ / EN INFER
Nth ru'VEL
9 . HOSE Ci7RPc: R-AlION
PA12d DESU.< CA 92260
C160)345N7186 CB110 1137
USE OF PERMIT
MhPt?IZMIT I.4d, 'NOT IiOC,1,01)L 8L0C..7PA"f.:1 K'Ji7l.,ft?T2It}'I:'F1i AY
APPROACH.
H. �• .
RA.OT CONSTRUCTION 31F
PORC'1MMA1110 35.QL+ S
,X40F4C ATfflP0RT 3,702.40
5 FT. WOOD PEINCE, 200.06 LF
k"i4'nMATM) C01, T OF L:'fJMTRUP-7'I0'"N
106.9w,20
PaUuvrybly
C OXISTR A1C TION M 101.0004181,000 � �66r4,Wb
. 'MAN CHEMC .i ? 1017 40' 0-4.39-31 a
MEC.13:&NI'CAL M, 101 ^WO -411.000 8%00
91,9CCKdt"AI; FFR 101-,000420-000 -1-134.:7
P1AIMBINO R-9 101-bOO.4 19.000 x'1101
MO1' O MOTION YEE - R= D 101 _0004A 1-000 $14.69
ORAIDIM R9 101-000-423-000 S20A
D1r, PM.P.3PFA IMPACT ".2 $1,9Q7.09
M90399 Ike;`. 99 P.1.; 14 101-000,,441-345 $10.00
ME 1313P ' ISIT 101 -M-439-131 1 f> .$'130.09
;
;3C k3-17MA L COMM ' OW AND PLAN CUMCK
sr, ,665.3 i
IMW PRE-PArDVR S
4210100
RECEIPT
DATE
BY j
DATE FINALED
INSPECTOR
f -
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
_ BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs I �i�
Underground Ducts
Forms & Footings_�1�–
_
Ducts
Slab Grade
-�
Return Air
Steel
Combustion Air
Roof Deck
(2_bip o
q
5/
Exhaust Fans
O.K. to Wrap
p0
S�
F.A.U.
Framing
CLit� , —0
Compressor
Insulation
_ a_ _a_ao
y
h
Vents
Grills
Fireplace P.L.
L
✓
Fireplace T.O.
C
Fans & 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
�(Z�
Footings
Main Drain
�$
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
a •
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Water Piping
_ _
fif 60
_
Heater Final
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer ConnectionL�-��•�
_
Encapsulation
_
�7
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.FA.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
–�
Building
Address J 7 6
T4hf 0 4 "
P.O. BOX 1504
78-495 CALLE TAMPICO
ftA LA QUINTA, CALIFORNIA 92253
add►ass 7?— S 4 S' Jr- Lei R -s D A AJ Ar
CityZiRR Tel.
P fEur 7ZZi 1 - >
Contractor
Address
7 Z— �"D a�rPgA Art.
citylp.4c� _ Ek Zip �ziGu Tel
State Lic. City
& Classif,r3 3 G 7G Lic. # 13
Arch., Engr.,
Designer
Address Tel.
City (Zip (State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I 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.
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 not more than five hundred dollars ($500).
I: I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure i5 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. IL 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, 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 contractors) licensed pursuant to the Contractor's License Law.)
I l I am exempt under Sec.B, g P.C. for this reason
Date Owner
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
n Copy is filed with the city. ❑ 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 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
Ihereby 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
APPLICATION ONLY
BUILDING: TYPE'CONST. OCC. GRP.
A.P. Number 77 y-119 ^aI
Legal Description i.O T 13 D e- K -2- 4 Y
/41R TE
Project Description � S' 2 / T1, ✓E" L L
A - F4 EV
I
Sq. Ft. No. No. Dw.
Size g Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT Z
Plan Chk. Dep.
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
I,
FINAL DATE INSPECTOR
Issued by: Date Permit
ti
Validated by:
Validation: f
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
9
CW
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 10/20/00 APN # 773-294-011
No. 21125 Jurisdiction La Quinta
Owner NameMark Tuvel Permit #
No, 52-698 Street Avenida Herrera Log #
City La Quinta Zip 92253 Study Area
Tract # BLK151U16 Lot # 13 Square Footage 1771
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 1,771 or $ 3,630.55 the property listed above and that building-
. L ,
permits and/or Certificates of Occupancy for this square footage in this ptoposed project may now. be issued
Fees Paid By CASH - Mark Tuvel Telephpne
Name on the check
By Dr. Doris Wilson -
Superintendent
Fee collected /exempted by Annette Barlow
- _��4
\ V'41U
Signature 6r'�o
Payment Received $3,630.55
Check No. N/A
IOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 9D -day approval period in which you may protest the fees or other payment identified
bove 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 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
e p --r9 00 09:51a
SEP. -19' 00 (TUE) 08:31.
.A
MORo:INLi REQUESTED or
Ola REPUBLIC TITLE M
ANO AtO RECORDED, MAA. TO.
Mark F. Tovell
r�
ASSESSOR'S PARC No: 773-294-011
7"M
TITLE ORDER NO.: 9-13
ESCROW NO.: 63304DS
GRANT DEED
(760) 341-9606 p.2
TEL:90918i4966 P.002
Ail i:�qlm
w peA
Ok q a
DOC N 30 W-33143 L
pM M:aM laa:a.M
alga 1 of a 0av T Tar Pali
�aneNW /n W10441 N~d6
GwAAV or ji-owaide
Berl L. OF"
�......, Crew Clark a Reaord.r
Y u Nd ® e, 4001 Meeh r ,wp
i a -
The und0f*11ed Grentolsl declare thal the DOCUMENT TRANSFER
TAX 19:
5 19.25 County S Gly
zx eamPuted on the NO value of the glterest of property conveyeu, or
_computed on the cult value less the value of liens or encumhrances
remaining ltvreon. aI the "@ of sale.
,OR Wriefar Is EXEMPT IMm tar for the following reason:
FOR A VALUABLE CONSIDERATION, raosipt of which is hareby-alcknpwltldw, -- -
Timothy F. Duty, a maMed matt) as his sale and sepamtle properly
hereby GRANT(S) to Mark F. Tuvoll, a manned nun" his Sella and "pangs propanfy
all that real propefly situated in tho City of La Oulnia County of Riverside. State of C.aiifomia, described as:
Lot 13, In Block 151 of Unit No. 16 of San amtelita at Vale La Ouinta, in the city at Le QYMMa, County of Riverside.
in Book 1a, page 99 of Maps, in the Ot11eo of to County Recorder of said
Dated August 10. 2000
STATE OF CJ1l, MPA
COUNTY OF Binn3� -00
0'Re nib ,� /�_ .� Ry ,1K�9C►A An ltyti�. Ttrtwthy F. puffy
%x , —ry f� p> evveaad
Mlwab know+ to em (ar proved to ow an m4 boa d sdiejw ry or,d .. I
It IN me p0'Srdnoes EI>I
I ku6mom le"won w0wod and
�n0wpm-" le na filet MWff#fflV erieurd eM o.m. in "or
endNonrad capeaMtt�, rrd Ire Oy Men4pu
on try Inatrurrset
er pa-nN, or I:y shay upon bgW el which " 0111'"t, &&Ad. w.cur.d
dy "Am'11nd
WITNess my ryro std alio" tint:
Sgnatwe
MAIL TAX STATEMENTS TO: 1T� vw lea aftai nowt' 6ea1)
Mane F. Tuvall - 72805 Somera Road, Palen OdserL CA 92260
rim
16367)
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 Safety Department as your
correction list. Please attach additional explanations as necessary.
APPLICANT MARK TUVELL - SUNROSE CORPORATION
SITE ADDRESS 52-698 Herrera
APN 773 _ 294 _ 011-BINNO.: �g CASE NO.: 200-326
LEGAL: LOT 13 BLOCK 2 Z UNIT S.C.@V.L.Q. ---
CHECKED BY: Greg Trousdell DATE:
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:
t4ar
CWdrj
e'as
Vci e e
< '
Other Requirements:
W�� `� r '�
+1 tO
1:7q-7
i/