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15719 (SFD)«f P.O. BOX 1504 N o • 15719 Building 78-495 CALLE TAMPICO I Address 52-530 'Eisenhower Drive LA QUINTA, CALIFORNIA 92253 Owner Mailing 1' i i` an LT Cox BUILDING: TYPE CONST. V -N OCC: GRP. R3 Address P.O. gox967 A.P. Number 773-301-002 . City Zip Tel. Desert Hot spri gs 32234 Contractor Same a 3 above City State Lic. & Classif. 1433957 Arch., Engr." Designer Address Tel.: Legal Description W oCk 144. lot 22 Project Description SFD City Lic. # 1265 Sq. Ft. 1257 No. No. Dw. Size Stories Units el. 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 aid - effect. tO* ;�•` `; 1 ! t 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, 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.) O 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 contractor(s) Licensed pursuant to the Contractor's License Law.) 0.1 am exempt under Sec. B. & 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 IVCopy is filed with the city. O 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 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 Date - Owner NOTICE TO APPLICANT: ff, 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. WARNING: FAILURE TO SECURE.WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. 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, end hereby authorize representatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant __ Date Mailing Address City, State, Zip NewX Add ❑ Alter ❑' Repair ❑ Demolition O Pe nt- does - Y1o'*~ include blorx c1> *1 t or pool e Estimated Valuation $7$;621.00 I PERMIT AMOUNT Plan Chk. Dep. 9 Plan Chk. Bal. Const. =° • 'Uri' Mech. Electrical 117.10 Plumbing Iiz. UU S.M.I. • o Grading Driveway Enc. Infrastructure r • 42 TOTAL }J • 72857.39 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Cegtj� ne Rear Setback from Re�16P op. Line Side Street Setb�a - I rom Cente�t Side Setback frPropl3t.Line FINAL DATE IMPECTOR I? Issued by: Validated bv. Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 1ST FL. SO. FT. ® $ UNITS ' 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SO. FT. ® DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEOUIP. DRAINAGE PIPING CAR P. SO. FT. TEMP. POLE WALL SO. FT. ® GROUT DRINKING FOUNTAIN SO. FT. ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES ROOFING /d -5- VENTILATION WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Vac SEWAGE DISPOSAL INSULATION/SOUND FINISH GRADING SO.FT.GAR ® 3/4c HOUSE SEWER 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 & AIR COND. SOLAR SETBACK / GROUND PLUM UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE `� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS�� /�J SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. /0 �• S GAS(ROUGH) v 7 METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL 6 �� �,N ----------------- GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. FINAL INSP. / 2d� GRADING cu. yd. $ plus x$_$ LUMBER GR. FRAMING 11 13 95- ya ROOFING /d -5- VENTILATION 6/ 611 %0�� } REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL' INSPECTOR'S SIONATURESIINITIALS GARDEN WALL FINAL Building Owner Mailing Address k e5;;4 CZm T ,UCS P.O. BOX 1504 APPLICATION ONLY � 7&105 CALLE ESTADO :7 _aJR LSA QU.CNT'A, CALIFORNIA 92253 Zip ITO Contractor Address , City Zip Tel. State Lic. City & Classif. /� � Lic. # Arch., Engr., Designer. �- p� � -),-- Address Tel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARXION I hereby affirm that I am licensed (oder provision4f Chapter 9 (commencing ith Secti n 701X)) of Division 3 of the Bysi _q... nd Pro a ions1Cod # and my license is iifllforce ��� effect. �r it 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). 1,1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, andthe 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 suchimprovements 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.) II 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 contractor(s) licensed pursuant to the Contractor's License Law.) I1 I am exempt under Sec. B. & 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. 13 Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE (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 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. 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 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 BUILDING: TYPE CONST.—OCC. GRP. A.P. Number / % - ` 3 r CO2 Legal Description Lh 7— Project Project Description 15 -1 -1 - Sq. r" Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add O Alter ❑ Repair ❑ Demolition O Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL v-3 42 % 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 FINAL DATE INSPECTOR Issued by: Date i-- Permit Validated by: Validation: lip� it j ; (_• L By CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. lei, $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. @ FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. @ GAS (ROUGH) METER LOOP GAR. SO. FT. @ 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.COOL 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, TEM/PERM 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 © 11/. c SEWAGE DISPOSAL SO.FT.GAR @ 3/<c 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 & 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 x5 =$ LUMBER GR. FINAL INSP, FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING t MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated 619-775-3500 Date 9/12/95 1 Type of Permit I La Quinta No. 113678 Permit # Owner Name William J. Cox Log No. 52530 Street Eisenhower Dr. city La Quinta Zip 92253 Study Area 112 APN # 773-301-002 Tract # Lot # 22 Square Footage 11257 Type of Development Single Family Residence No. of units 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 1.72 X 1257 or $ 2,162.04 have been paid to D.S.U.S.D. for 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 William J. Cox & Aons Teleph$Eie ,*,?. Name on the check By Dolores A. Ballesteros Superintendent Fee collected /exempted by Pauline Pearson = o Payment Receive& � Signature $2,162.04 Check No. 5076 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 REQUESTED BY CHICAGO TITLE COMPANY AND WHEN RECORDED MAIL TO (--WILLIAM J. COX P.O. BOX 967 PALM DESERT, CA. 92261 1'78820 RECEIVED FOR RECORD AT 8:00 O'CLOCK P pts Transtet Tax JUN 5 -1995 � K, JOHNSON aN Co Pecorde Rmo dw h am" %wm% a wr.ne. cotM.tr. cMat+ta Plecardw Escrow No. 85400 -23 Order No. 582350 - 14 SPACE ABOVE THIS UNE FOR Assessor's Parcel No: RANT DEED 773-301-002-1 THE UNDERSIGNED GRANTOR(S) DECLA T�'A ©a� _O DOCUMENTARY TRANSFER TAXIS 14.85 SIGNED IN COUNTERPART ❑ unincorporated area M. Cityo a Quinta XC, computed on the full value of the interest or property conveyed, or is ❑ computed on the full value less the value of liens or encumbrances remaining at time of sale, and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, AMERICAN RESEARCH BUREAU, INC., A CALIFORNIA CORPORATION, AS TO AN UNDIVIDED 15% INTEREST; AND STEPHEN CANNON, BY FINAL DECREE OF DISTRIBUTION RECORDED JULY 25, 1989 AS INSTRUMENT NO. 246406, OFFICIAL RECORDS, AS TO THE REMAINDER hereby GRANT(S) to WILLIAM J. COX, A MARRIED MAN, AS HIS SOLE AND SEPARATE PROPERTY the following described real property in the City of La Quinta County of RIVERSIDE , State of Cali fornia: LEGAL DESCRIPTION ATTACHED HERETO AND MADE A PART HEREOF BY REFERENCE Dated March 17, 1995 STATE OF Q44MOOM UTAH COUNTYOFSAm JTTaNT ) SS. On ypy 1 S , 1 995 before me, RAYMA PERCELL a Notary Public in and for said County and State, personally appeared qrPPT4PM rAmmnm ____1 e,�� — STE HEN CANNON AMERICAN RESEARCH BUREAU, INC., 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 BY: MARY -.E,.- SCHWARTZ-, PRE3,jDENT. signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. BY: DAVID A. TZ. WITNESS my hand and official seal. U .Sig ,nature of Nota rARv slay lid• earls MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING, LINE: IF NO PAA LAS DIRECTED ABOVE SAME AS ABOVE xaraz�•�'::==-• 1 ... Name Street Address City, State & Zip GOI-08/07/84bk Page 1 -• ._ Escrow No. 85400 -23 LEGAL DESCRIPTION EXHIBIT X22, BLOCK 144, SANTA CARMELITA AT VALE LA QUINTA, UNIT NO. 15, IN THE CITY OF LA QUINTA, AS SHOWN BY MAP ON FILE IN BOOK 18, PAGE 92 OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA. APN: 773-301-002-1 a;. :r :v.4. n' v I DEEDLEGL-08/09/94bk moi% Environmental Geotechnical ~ Construction Consulting • Engineering • Testing REPORT OF FIELD COMPACTION TESTS TESTED FOR: WILLIAM J. COX AND SONS, INC PROJECT: 52530 EISENHOWER DRIVE 66-900 DILLON ROAD LA QUINTA, CA DESERT HOT SPRI, CA 92240 DATE: September 29, 1995 OUR REPORT NO.: 073-50161-00002 TEST DATA: (00001) Silty Sand OPT. MOIST. = 11.2% TEST LOCATION: Building Pad I North east of pad -� TEST TEST 3 SOIL ID MAXIMUM LAB DRY * WATER WET DRY PERCENT COMMENTS' Spec. 90% Min j NO. DEPTH NUMBER OENS17Y CONTENT DENSITY DENSITY COMPACTION 1 - 611 -ELEVATION F.G. * 1 119.0 10.2 123.9 112.4 94.5 - --I 1 - A -density ,.density obtained on sample indicated by .,,; 'VSOIL^CEMENT ' ' D. MOISTURE IN EXCESS OF SPECIFICATIONS ID number. ;- i1'r.OTHER- . E. MOISTURE BELOW SPECIFICATIONS * (00001) ASTM D-1557, Procedure A `^ �` TAIZ TESTINSTRUMENT: Campbell, MC -1 STANDARD. COUNT M: D: REMARKS: PSI DID NOT MONITOR THE FILL PLACEMENT. ADJUSTMENTDATA M: 00' �. D.: -00 **F.G. = Finsh grade** 2 6" i F.G. * 1 119.0 9.8 125.7 114.5 96.2 1 - A - --3 6" F.G. * - 1 119.0 8.7 123.9 114.0 95.8 .I 1 _ A - -` 4 6" I F.G. * 1 119.0 9.5 121.7 111.1 93.4 1 - A 5 6" F.G * 1 119.0 11.2 1 123.7 111.2 3.4 1 - A - TEST LOCATION: Building Pad 1 North east of pad 2 South east of pad South west of pad -North -pad ----- - 3 ---- ------- -- 4 west of A-__ ,_... 5 Center of pad NOTES: TESTS PERFORMED PER ASTM D2922-91 & ASTM D3017-88(93) •COMMENTS:1.'F:ILL IAT•.ERIAL A. TEST RESULTS COMPLY WITH SPECIFICATIONS DENSITIES SHOWN: Lbs. per cubic fool 2:�BAc4iCC' B. PERCENT COMPACTION DOES NOT COMPLY WATER CONTENT: Percent of dry weight, ,.. "3.''tBA'E'000RSE PERCENT COMPACTION: Based on maximum dry 4.ISUBBASE'' WITH SPECIFICATIONS C. RETEST OF PREVIOUS TEST -density ,.density obtained on sample indicated by .,,; 'VSOIL^CEMENT ' ' D. MOISTURE IN EXCESS OF SPECIFICATIONS ID number. ;- i1'r.OTHER- . E. MOISTURE BELOW SPECIFICATIONS * (00001) ASTM D-1557, Procedure A `^ �` TAIZ TESTINSTRUMENT: Campbell, MC -1 STANDARD. COUNT M: D: REMARKS: PSI DID NOT MONITOR THE FILL PLACEMENT. ADJUSTMENTDATA M: 00' �. D.: -00 **F.G. = Finsh grade** -4•a T T TECHNICIAN: Marshal Hislop _ %'E.- prof ss ional Service Industries, Inc. T> =SE TEST RESULTS RELATE ONLY TO THE SPECIFIC TEST -LOCATIONS NOTED. PSI IS NOT RESPONSIBLE FOR ANY OTHER LOCATION OR ELEVATION. R'--CRTS MAY NOT BE REPRODUCED. EXCEPT IN FULL: WITHOUT WRITTEN PERMISSION BY PROFESSIONAL SERVICE INDUSTRIES. INC. , - - SI A-100.2 (J)F PSI •42-240 Green Way, Suite C • Palm Desert, CA 92211 • Phone 619/341-5790 • Fax 619/341-5794 ----