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9910-095 (SFD)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 04 W Professionals Code, and my License is in full force and effect. �; =5 ch License # Lic. Class Exp. Date r—C3 LO I LU r` r- 638535 B 02129/2( oZr- Date Signature of Contractor (ID O r` J U � OWNER -BUILDER DECLARATION HUJrD_ 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 (Sec. 7044,. Business & Professionals Code). () I am exempt under Section B&P.C. for this reason O N Date ' Signature of Owner rn d Q WORKER'S COMPENSATION DECLARATION C) CE I hereby affirm under penalty of perjury one of the following declarations'. Lo FZ O () 1 have and will maintain a certificate of consent to self -insure for workers' X w LL compensation, as provided'for by Section 3700 of the Labor Code, for the O J Q performance of the work for which this permit is issued. a m Q CJ ( ) I have and will maintain workers' compensation insurance, as required by I O (-) Q Section 3700 of the Labor Code, for the performance of the work for which this 0 Z permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier STATIC FUND Policy No. 22499-0909671 00 5 r- C) 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 1 should become 3 subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with 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 construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) Date BUILDINGPERMIT PERMIT# DATE VALUATION LOT 9910-M TRACT 0"MM� S92MAID I f� BIXK. 99 JOB SITE ` ADDRESS } APN 52,.3900 F.T,Sk NHOVVMJ3. Dff—. 77X271 -W7 OWNER 1 CONTRACTOR / DESIGNER / ENGINEER A.W&ND TiU'.f DERS LIM.EL Mr.liffas PO BOX 450 54-090 AY:fr.WDA' ALA LA,QUINTA CA 92253 LAQT_11 NI;A NA 92253 (760)564-1866 CBL# 8,159 USE OF PERMIT MOLE E FAiv LY MJ+1.IING 1 u SFD - P2RM1'rptJES Naf 114CI.UDE, BLOCK WALL OR POOL. (93-H-1 MASTER) i I � y ` TRACT CON9TRUCTIUN 1,492.00, SF POkCHIPATIO 90.00 SI' C'I,ARAMUCA1 PORT 463.00 ST 5 rr. WOOD 1FF114cs >30R.t o LF EbMMATED COST OF COASI.NUMION 92,987.40 I FJRWr 3 kX 03AMARY CONSTRUCTION ISLE 101 -OW -418.000 $609.00 PLAN CHECK YKE 141>4I0(3-QI39 31�, $3it3-39 WCHANICAL FEF 101-000-421-000 $53.50 FLECTRWAt.. F'FP 101-000-4,20-000 $1.34.93 PUIMRINO FEB 101-000-419-000 S110.75 STR,OIJ40 MOTION FM a RESID 101-000-241-000 S9.310 GRADING F10,� 101.000-423.000 $20.00 DEVELOPER IMPACT FEE $1,9tt': oo PRECISE PLAN 101.000.441.345 M0,00 FFZ DEPOSIT 101-400-439-318 • 250.00 SM -TOTAL CONSTRUCTION Aryl'? R1,AN Ck-11QCK $3,1.48.06 LESS PRE-PAT.DF.FXS 4250,00 TMA -1i P_RWIff IMES DUF N4W 01,190,06 RECEIPT DATE BY DAT F LED �� ^^ INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade pReturn Air Steel Combustion Air Roof Deck Q0 7 Exhaust Fans - ansO.K. 0. K.to Wrap —,_ c W F.A.U. Framing ! -CZD -57 Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath —( —OLD Drywall - Int. Lath Final Z��L� BLOCKWALL APPROVALS Final 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 j 6eg Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection �/ Gas Piping Gas Test Encapsulation Appliances Final COMMENTS: Final l Utility Notice (Gas) 12 ELECTRICAL APPROVALS Temp. Pourer Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power 't. Final _ Utility Notice (Perm) =l Building ��•� Address Owner l _y ,l Mailing f ' Address.i Tiht 4u�N�Gv a cd a -D P.O. BOX 1504 " 78-495 CALLE TAMPICO APPLICATION ONLY � ��- L^A'f1UJ.NTA, CALIFORNIA 92253 0-5 BUILDING: T P C�� OCC. GRP. A.P. Number �//7-' / 7/�. . Zip Z?` Tel.. If Legal Description L.la( f l.0 1"LGX Oil State Lic. �- City & Classif. , [02"4,� C-3<: I Lic. # Designer Address Tel. CityI Zip I State I 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, atter, 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, 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 II' as owner of the property, am exclusively contracting with licensed contractors to con. strut( the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law doesnot 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.) I? 1 am exempt under Sec. B. & P.C. for this reason Date Owner Description Sq. Ft. J ` - 4 _ - S . Size New Add ❑ Valuation PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Driveway Enc. Infrastructure 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 (7 Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for ode hundred dollars ($100) valuation or less.) I certify that in the performance of the work•for w ch this permit is issued I shall not employ any person in any Ener o.as>to-b co ei b'je 1 to:thA�#drkers' , orhei"isation Laws of.,Cahfornia. �t ' Date •.0 A .(Owner NOTIC TO APPLICANT: If, alter making this Certificate of Exemption you shoultlotecoma subject to the Workers' Compensation r.visions of the Labor Code, you must forthwith comply with such provisions or this permit be deemed revokep� /comply with such provisions or this be deemed / J /�(-'t j -(�(� i (( I I , rr CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is iss ed. (Sec. 3097, Civil Code.) Lender's Name— Lender's ame Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it 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 sof this city to enter the above- mentioned property for inspection purposes. Signature of a0plicant —Date— Mailing ateMailing Address City, State, Zip No. Dw. Units Alter ❑ Repair ❑ Demolition ❑ AMOUNT t .J�" / x'14 -J • �r.�... 1 ' r 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: { WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Notice: Document Cannot Be Duplicated Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE Date 5/2/06 APN # 773-271-007 No. 20380 Jurisdiction La Quinta owner NameArend Builders Permit # 9910-095 No. 51-390 Street Eisenhower Drive Log # City La Quinta Zip 92253 Study Area Tract # BLCK99 Lot # 16 Square Footage 1492 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 1,492 or $ 3,058.60 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 Check/Wells Fargo Bank/Mike Brauckmann Telephone• Name on the check v By Dr. Doris Wilson Superintendent `w Fee collected /exempted by Mary Ann L. Bora Payment Received Check No. 0689030971 Signature NOTICE: Pursuant of AssembWl 3081 (CHAP 549, STATS. 1998) this will serve to notify you that the 904ay 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 Dlstrict('s)(s') behalf, whichever Is seller. 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 RDING REQUESTED BY: f4ONWEALTH LAND TITLE COMPANY .9151DT 6006869 THEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW, MAIL TAX STATEMENTS TO: Michael Brauckmann and Julie Brauckmann 26465 Mirar Vista Drive Mission Viejo, CA 92692 M S U PAGE SIZE DA POOR. NOCOR SMF MISC. A R L COPY I LONG REFUND NCHG EXAM GRANT DEED APN: 773-271-007-q T,2A Q.20 -0/7 The undersigned grantor(s) declare(s): Documentary transfer tax is $12.10 j T (XXX) Computed on full value of.property conveyed, or ( ) Computed on full value less.liens and encumbrances remaining at time of sale. ( ) ;3nincorporated area: (x i C3ry of _ iand FOR A VALUP_5LE CONSIDERATION, receipt of which is herebAr acknowledged, Stephen Cross, hereby GRANT(S) to T Michael Brauckmann and Julie Brauckmann, husband and wife as joint tenants the real property in the City of La Quinta, County of Riverside, State of California, described as: OLot 16 in Block 99 of Santa Carmelita at Vale La Quinta, Unit No. 11, as per map recorded in Book 18, Page 75 of maps, in Riverside County, California. Dated September 3, 1999 !' State of' -^tea (_ / Coun y • Of � (�� (1(�+L �l, _} S.S. Steph n ross On L_I CL 19 9 before me_ NAM—: YY\UMIle / 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/ate subscribed to the within instrument and acknowledged to me that he/sie/t.W executed the same in his/t�r%their authorized capacity(ies), and t. -'at b}- signature's) on tl�e 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 STATEMENT T l 1111111111111 VIII 11111 IIII 1111111 IIIA III VIII 1111 IIII _ 1.999-442655 (This area for official notarial seal) OFF CIAi SEAL '; D� : TARY PLICi(GOREOOAI I1L.�'c� .,a .. e v 5 cF'yOF TN�� DATE: OCTOBER 13, 1999 TO: MARK HAROLD, BUILDING & SAFETY MANAGER FROM: LESLIE MOURIQUAND, ASSOCIATE PLANNERa4M VIA: CHRISTINE DI IORIO, PLANNING MANAGER SUBJECT: REQUEST FOR ARCHITECTURAL INSPECTION FOR 52-390 EISENHOWER - LENDEL VENTURES, INC. The above referenced request consists of elevations are not included in the approved Cove Master Design Guidelines for Lendel Ventures, and cannot be constructed by the applicant until the elevations are approved by the Planning Commission. C*. Betty Sawyer, Exec. Secretary CAMydata\memo 10-13-9952-390Eisen hower.wpd ry Certificate of. Occ* upancy 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: 52-390. EISENHOWER DRIVE Use Classification: SFD Bldg. Permit No.: 9910-095 Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC Owner of Building: AREND BUILDERS Building Official Address: P.O. BOX 450 City: LA QUINTA, By: STEVE TRAXEL Date: 07-19-00 POST IN A CONSPICUOUS PLACE CA. 92253 B-1 ELECTRICAL LOAD CALCS DESCRIPTION CKT VOLTS CKTNO. AMPS OF JVOLTS-AMPS UNITS PER UNIT TOTAL VOLTS -AMPS 120 V. MULT OUTLET CKTS GEN LTG @ 3 W PSF 120 15 1475 3 4,425 SM APPLIANCE CKTS 120 20 2 1,500 3,000 GRI CKTS • 120 20 1 1,500 1,500 SUBTOTAL 8,925 120 Y. SGL OUTLET CKTS DISPOSAL 120 20 1 2,400 2,400 DISHWASHER 120 20 1 2,400 2,400 LAUNDRY 120 20 1 2,400 2,400 HOOD 120 3 1 360 360 SUBTOTAL 7,560 FIRST 10,000 V-A @ 100% 10,000 BAL V-A @ 40% 2,594 SUBTOTAL 12,594 RANGE 230 40 1 9,200 9,200 A/C (LARGEST-FAU OR A/C 230 30 1 6,900 6,900 TOTAL V-A 28,694 SELECT SERVICE SIZE TOTAL V-A 230 VOLTS 1 28694 230 1 124.7 AMPS QLI PLAN: B-1 4/5/99 ATTIC VENTILATION ATTIC AREA: 1,475 SQ FT + 463 SQ FT =-1,938 SQ FT 1938 SO FT = 300 6.46 SQ FT REQUIRED 8 VENTS - 14" X 18" VENTS 8 X 1.17 SQ FT X 1.5 SQ FT = 14.04 SQ FT LESS 50% VENTED AREA_= 7.02 SQ FT ACTUAL NET TOTAL SHOWN 7.02 SQ FT PLANS SHOW 8 VENTS PLAN: B-1 ATTIC VENTILATION ATTIC AREA: 1,475 SQ FT 463 -SQ FT TOTAL 1,938 SQ FT 1,938 SQ FT / 300 = 6.46 SQ FT REQUIRED 8 VENTS / 14" X 18" VENTS (1.17 SQ FT X 1.5 SQ FT) 8X1.17SQFTX1.5SQFT= 14.04 LESS 50% VENTED AREA 7.02 ACTUAL NET TOTAL SHOWN 7.02 77 w. 'PLAN`SHOWSI&VENTS' ri I LENDEL: EXCEMY DOMCALMATTIC B7 10/25/99 4 DESCR-IPT,®N M: V® a TS AM�P�S� C_� 1NIT® KP�R l�1Nli' : ISPF12.1 vV, O�T9Af�(= 120 V. MULT OUTLET CKTS GEN LTG @ 3 W PSF 1201 151 1,4921 31 4,476 SM APPLIANCE CKTS 1201 201 21 1,5001 3,000 GRI CKTS .1201 201 11 1,5001 1,500 SUBTOTAL 8,976 120 V SGL OUTLET CKTS DISPOSAL 120 20. 1 2;400 2,400- ,400DISHWASHER DISHWASHER120: 20 -1 21400 2;400 LAUNDRY 120 20 1 .2,400 2,400 HOOD. 120'.. 3 1 360 360 SUBTOTAL 77:560 FIRST 10,000 V—A @ 100% 10,000 BAL V=A @ 40% 2;614 SUBTOTAL 12,614 RANGE 2301 401 9,200 9,200 A/C (LARGEST FAU OR A/C) 1 2301 30 :11 6,900 1 6,900 TOTAL V—A 28,714 SELECT SERViI,sE'SIZET®TAL\°/A��528,714r x a 1248;AMPS z� rx.a LENDEL: EXCELWY DOMCALMELEC B-1 10/8/99