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9909-151 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of ;W Chapter 9 (commencing with Section 7000) of Division 3 of the Business and c14,�=.j Professionals Code, and my License is in full force and effect. 0'5 C.,) License # Lic. Class Exp. Date - Lu C:) Z r tr ate Signature of Contractor co _ r- p OWNER -BUILDER DECLARATION UJ W I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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). q' t ( ) I, as owner of .the property, am exclusively contracting with licensed >' contractors to construct the project (Sec. 7044, Business & Professionals Code). C'') () I am exempt under Section B&P.C. for this reason Ln N Date Signature of Owner O N 0) d Q WORKER'S COMPENSATION DECLARATION C:) 2 .Z I hereby affirm under penalty of perjury one, of the following declarations: Lo H O () 1 have and will maintain a.certificate of consent to self -insure for workers' X W compensation, as provided for by Section 3700 of the Labor Code, for the Om J Q performance of the work for which this permit is issued. Q 1 have and will maintain workers' compensation insurance, as required by O'U Q Section 3700 of the Labor Code, for the performance of the work for which this 11 L6 H permit is issued. My workers' compensation insurance carrier &'policy no. are: ,It Z Carrier Policy No. ao 5 STA'1 1- TKU iMr%o 0 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 provisions of Section 3700 of the Labor C9 de, I shall forthwith comply with those provisions. Rr7 te: 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 the above-mentioned property for inspection purposes. • /Signature, (Owner/Agent) Date. , BUILDING PERMIT PERMIT# DATE VALUATION SR,9.26i! 60 - LOT 12 TRACT A11K 2Y? U22 JOB SITt 83ADDR -9 % INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings r Ducts Slab Grade Return Air Steel Combustion Air Roof Deck 7, Q Q Exhaust Fans O.K. to Wrap F.A.U. _ Framing Insulation _ _ ����rQO S7 Compressor 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 BLOCKWALL Set Backs APPROVALS jrf. 57 steel 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 ' Water Piping 10 Heater Final 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 Underground Conduit Rough Wiring 'Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors _Temp. Use of Power Final y 00 Utility Notice (Perm) .iz' a�ti::, �/%�7�.+'ti.� - -,.,,�,;+.c:+r.'"''�T•`�i.+i�id,u;,s. '+m�.r—..11. 4 P.O. BOX 1504 ',�� 78-495 CALLE TAMPICO Addrress �( LA QUINTA, CALIFORNIA 92253 Owner ' Mailing Address `� City lZip Tel. Contractor � 4 '�. Cs��(, Z � Address ,r^ State Lic. City & Classif. �� � tv Lic. # t q Arch., Engr., Designer Address Cit Zi State `� p Lic. # CONTRACTOR'S DEC4ARATION under provjsions of Chapter 9 (commencing with Section and Professions Codesand my license is in full force and v OWNER -BUILDER DECLARATION I hereby affirm that1 am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Busi @@ss and Professions Code: Any city or county which requires a permit to construct, alter, imdrove, 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). f-! 1, 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, 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 1 1 am exempt under Sec. B. 8 P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION Ihereby 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, 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 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 1 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 PPILIC N ON!LY �.� BUILDING: TYPE'CONST. OCC.GfRP. A.P. Number A i %`Y • Legal Description Project Description Sq. Ft.% No. No. Dw. Size / 14 Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: A Front Setback from Center Line Rear Setback from Rear Prop. Line y Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPE03�0,.YR�gStt I M A ,y 'J R Issued by: Date Permit Validated by: AUG 2 7 1999 Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District 47-950 Dune Pahns Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 Date 10/15/99 No. 19477 CERTIFICATE OF COMPLIANCE APN # 774-163-024 Jurisdiction La Quinta Owner NameDavid Miller No. 53-995 Street Avenida Herrera City La Quinta zip 92253 Permit # 9909-151 Log # Study Area Tract # BLK237U22 Lot # 12 Square Footage 1409 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 1.93 X 1,409 or $ 2971937 the property listed above ao`that building r .� permits and/or Certificates of Occupancy for this square footage in this proposed projectas11ay no, �be issued Fees Paid By cc/Capital Bank of No. County/David Ross Miller , `Telephone Name on the check - '/ By Dr. Doris Wilson Superintendent Fee collected /exempted by Juanita Green Payment Received $2,719.37 L1,01 Check No. 15325 Signature NOTICE: Pursuant of Xssembty Bill 3081 (CHAP 549, STATS. 1998) this will serve to notify you that the 9G -day 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 SEP.21.1999 3:17PM COMMONWEALTH RECORDING REQUESTED BY: ORANGE COAST TITLE COMPACOMPANY 99.9027KC R-177098-1 WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW, MAIL TAX STATEMENTS TO: DAVID ROSS MILLER I GRANT DEED NO.648 P.1i1 1 r THIS LINE FOR RECORDER' APN: 774-163-024-2 The undersigned grantor(s) declare(e): Documentary transfer tax is (]CSX) Computed on full value of property conveyed, or ( ) Computed on full value less liens and encumbrances remaining at time of sale. ( ) Unincorporated area: ( ) City of , and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, BRUCE FRANKLIN'and KRISTY A. FRANKLIN, husband and wife as joint tenants hereby GRANT(S) to DAVID ROSS MILLER, A MARRIED MAN AS HIS SOLE AND SEPARATE PROPERTY the real property in the City of LA QUINTA, County of Riverside, State of California, described as: Lot 12, Block 237, Unit 22, Tract Santa Carmeliat at Vale La Quinta, as per map recorded in Book 20, Page(s) 24 inclusive of maps, in the office of the County Recorder of said County. Dated September 21, 1999 State of California County of } S.S. On before me, personally appeared personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature MAIL TAX STATEMENTS TO: BRUCE FRANKLIN KRISTY A. FRANKLIN (This area for official notarial seal) b 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 Building & Safety as your correction list. Please attach additional explanations as necessary. APPLICANT: PROJECT ADDRESS: Pacific Trades -�jW 53-995 Avenida Herrera APN: 774-153-024 . LEGAL: LOT' 12 , BLOCK 237 , UNIT , S.C. @ V.L.Q. CVD BY: BIN N0:. `L? CASE NO. 99-120 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 VNT/CORRECTION .::; M1\w}Y•:::Cx:`:��if• iC '\'C;��.AA...M,+'„`>:,y'Y \ ':�c:, , :hZay{6iSA`+� :.'\+::�::,+• •`` �•` •� ^y��\ 2'�#, (meq. �: \•YY•�\\�\A•.¢iY. �\ \\v.,• \iYti',q Y\ \ \4^+, .,J`d:+iry` ��\ `'d`C v"}h.�:•}..:• �. 4•.)\�,*..`.Y\n• 4•.4\: , ` 00111 "'K%\ ., .\. . .:t„�.4Y •:t nom' :•`Z.`l•. i Case logged and number assigned R Verify legal and APN information 0 Consistent with MDG on file las applic 1 lt 0. MDG filing required (5+ filings since 9/3/98) Consistency,-with-street/sur-rounding area: - Colors Materials Architecture �a OTHER REQUIREMENTS: H 1,4 The zoning code, architectural and landscaping manuals, and/or assigned inspector should be consulted where 'uncertainties arise. The co pleted checklist shall be maintained in the Building .& Safety address file. Certificate 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 in compliance with the various ordinances of the City regulating building construction or use. For the following.- BUILDING ollowing: BUILDING ADDRESS: Use Classification: SFD Occupancy Group:. R 3 53-995 AVENIDA HERRERA Bldg. Permit No.: 9909-151 Type of Construction: VN Land Use Zone: RC Owner of Building: DAVID MILLER Building Official Address: 1719 S. TREMONT City: S. OCEANSIDE, CA 92054 By: STEVE TRAXEL Date: 07-18-00 POST IN A CONSPICUOUS PLACE PLAN: MA -2 ATTIC VENTILATION ATTIC AREA: 1,409 SQ FT 519 SQ FT TOTAL 1,928 SQ FT 1,928 SQ FT / 300 = 6.43 SQ FT REQUIRED 8 VENTS / 14" X 18" VENTS (1.17 SQ FT X 1.5 SQ FT) 8X1.17SQFTX1.5SQFT= 14.04 SQ FT LESS 50% VENTED AREA 7.02 SQ FT ACTUAL NET TOTAL SHOWN 7.02 SQ FT PLAN SHOWS 8 VENTS LENDEL: EXCELVAY DOCS%CALCSWTTIC MA -2 9/27/99 PLAN .MA -2 ELECTRICAL LOAD CALCS 120 V. MOLT OUTLET CKTS GEN .LTG @ 3 W PSF 1201 15 1,414 3 .4,242 SM APPLIANCE CKTS 1201 20 21 1,5001 3,000 GRI CKTS 1201 20 11 1,5001 1,500 SUBTOTAL 8.742 MERINO, DISPOSAL DESCRIPTION 1 2,400 ,IITS ,PERil UaNIT 1`!0 120 V. MOLT OUTLET CKTS GEN .LTG @ 3 W PSF 1201 15 1,414 3 .4,242 SM APPLIANCE CKTS 1201 20 21 1,5001 3,000 GRI CKTS 1201 20 11 1,5001 1,500 SUBTOTAL 8.742 SUBTOTAL 7.560 FIRST 10,000 V-A @ 100% 10,000 BAL V-A @ 40% 2,521 SUBTOTAL 12,521, ,RANGE 2301 401 11 9,200. .9,200' A/C (LARGEST FAU OR A/C) 2301 .301 11. 6,900 .6;900 TOTAL V-A 28,621 120.V SGL OUTLET CKTS DISPOSAL 1.20 20 1 2,400 2;400 DISHWASHER 120 20 1 .2,400 2,400 LAUNDRY 120 20 1 2,400 21400 HOOD 120 31 1 360 360 SUBTOTAL 7.560 FIRST 10,000 V-A @ 100% 10,000 BAL V-A @ 40% 2,521 SUBTOTAL 12,521, ,RANGE 2301 401 11 9,200. .9,200' A/C (LARGEST FAU OR A/C) 2301 .301 11. 6,900 .6;900 TOTAL V-A 28,621