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9901-010 (SFD)N Oi =�..M d LC) o Z Q. o CO LU W LU l� 1-a, Z —:4 LICENSED CONTRACTOR DECLARATION erebg affirm under penalty of perjury that I am licensed under provisions of tiapter 9 (e.3,mmencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date Date - Signature of Contractor OWNER -BUILDER DECLARATION Thereby 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), (V)- I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code).d' • () I am exempt under Section B&P.C. f r this reaso ate ? 7,141 qtr' Signature of Owner i D . WORKER'S COMPENSATION DECLARATION fI j 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 issued. My workers" compensation insurance carrier & policy no. are: Carrier Policy No. (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 Sec Ion 3700 of the Labor Code, I shall forthwith comply with th se'provisi�ons. t (pate: �fh` f Applicant— Warning: pplicant 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. 11 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 abo e -mentioned property for inspection purposets V ignature (Owner/Agent) .�'-�� 3" ,-�'�'r/a/• Date>-�? BUILDING PERMIT PERMIT# : DATE ?/26/99 VALUATION;1194,489 �� LOT 19 TRACT 11240) , Uf20 , ADDRESS 53-1.24 1SEM�OWER DRIVE JOB SITE APN 774-061-006 r OWNER CONTRACTOR / DESIGNER / ENGINEER TEU.'SA A 21C HrY OW NET;: BLU1: ER ; 1161 MCMULLEN AVE YUBA C'V Y CA 9599). 'V Malt � A USE OF PERMIT ONGNA i,raMILY DIWELL!. O-. SM - PM- MI `.D-OES NOT .rNOLLIDE BLOCK WALLS OR .rOOL. PAID MAR (jt V TRACT GC�NST RUCTION 446Z00 SF PORMPM'10- 12110.00 SF 3i ®'F LA QUID 0ARAGFJCAJit'0iV 420.W S 6 FT. WO ID VENCE f.50.1?O LF ,z 'E `W YdtAtx VYI 'D COST 'a,Y.Y!'l.,`s/J9n71MM:'B.�I10N VC, RMXV FE11; SUMMARY M, _ .1gS'i RU(7F10N F82 101-000.418-000 5S9+9.W PLAN 101-W-439-318 $$)7.74 1T- Z- DEP 0: 31 101-000439-313 4250.00 MWHANIC:AL fes: 101 -ON -421-00 U0.04) #'LHC3'"t` ICA' ,fl',E 101 -ON 420-OLVO $123.07 NIMIl M0I—" lj� 101-000-419-000 $134.75 `3TROIINGr MOT 10N FIRIE - RESM .101-000-241-000 $9,05 GRADING FEE 101-060.423-000 1'AFRASTRUC YREFEF :.25-000-443-3472 5.1,971.42 PREC 8T,;` I,A1! 101-OW44.1-345 g1(►fl.0 SUTI- rri'ALCOMM 3C,ITON ND,r•LANCHECM 1.3,5215.01 1. 'SS .PR -PAID FEES 4250.00 1i'D TA1..14 ERMU' 1+'.3'x..US DUE NOW S3,275.03 Mlihr j RECEIPT DATE BY% D F ALD INSPECTOR r/ / .a 1 INSPECTION RECORD OPERATION DATE INSPECTOR. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS set Backs Underground Ducts Forms & Footings Ducts Slab Grade VT Return Air Steel Combustion Air Roof Deck $ — Exhaust Fans O.K. to Wrap 4 - 3 — ,e F.A.U. Framing' —QI Compressor Insulation — y — 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 PPROVALS 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.Vottage Wiring Fbdu(es Main Service -Sub Panels +Exterior Receptacles `.G.F.I. ..Lf : Smoke Detectors +;Temp: Use of Power f Final Utility Notice (Perm) COMMENTS: Building Address Owner T4hf 0 4 Qu P.O. BOX 1504 78-495 CALLE TAMPICO S -n � b wee Dk QUINTA, CALIFORNIA 92253 Address / A, C City � Zip _ _ Tel. Contractor r Address J City/ Zip Tel � �.� � � � State Lic. �� M1 J ^P, City 8 Classif. �' Lic. # Arch., Engr., - Designer Li Address r 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,off.the Business)antl Pro ions Code, and my license is in full force and, effect. /�'i/ter,• � i..�A.� �! / " 7 SIGNATURE r DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,13usiness and Professions Code: Any city or county which requires a permit to construct, after, 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 (8500). l" 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. It, 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.) "1, 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 doesnot 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 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. 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) vatuation 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 aQplicant _ Date Mailing Address City, State, Zip moi -ot0 5 L APPLICATION ONLY BUILDING: TYPE'CONST. OCC. GRP. A.P. Number –174 " (-)(,P(-)(,P4 Uo(q- '✓/ Y4,5 Legal Description L,,r- 19 V Uo +'C -a r , Description a 1._ Sq. Ft. No. No. Dw. Size 14 V2- Stories Units New ,❑ Add D Alter D Repair O Demolition ❑ iAGT : 1:?oa 'Rt r_.i4Cq SCn- - 4q64 Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. t 2.56 + 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 FINAL DATE INSPECTOR Issued by:—Date—Permit L� Validated by: Pi in Validation: ,,n, .1i`lt'J U �i I:JJ'J Y `-o- WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISIONT'�` tv 10 7 C • Alo,91 e � 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 2/18/99 No. 18372 Jurisdiction Owner NameBob Richey No. 53-120 Street Eisenhower City La Quinta zip 92253 Tract # Lot # Type of Development Single Family Residence Comments APN # 774-061-006 La Quinta Permit # Log # Study Area Square Footage 1462 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 1.93 X 1,462 or $ 2,821.66 the property listed above and that building"- permits uild ng` -permits and/or Certificates of Occupancy for this square footage in this proposed project may now be -issued r Fees Paid By CC/Rob Richey Telefhone Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Ellen Patino Payment Received $2,821.66 Check No. 7377001093 Signature JOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identffied 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 ollecl 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 a RECORDING REQUESTED ording Requested CHICAGO TITLE C WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW, MAIL TAX STATEMENTS TO.. TERESA A. RICHEY N 1151 McMullen Avenue 9—f Yuba City, CA 95991 m � CMU. SPACE ABOVE THIS UNE FOR RECORDERS USE / Grant Deed A.P.N. 774-061-005 a 006 o1c or•t The undersiped grantors)tless k / Documentary transfer tax I5 1 (x ) computed on fun valperty conveyed or ( ) computed on full valalue of liens and encumbrances remaining at time of sale.Unbtcorporated arca ty of LA QUINTA and �. FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, THOMAS M. TOLES AND SUSAN TOLES, Husband and Wife as Community Property hereby GRANT(S) to TERESA A. RICHEY, an Unmarried Woman the real property in the City of LA QU I NTA County of RIVERSIDE , State of California, described as LOTS 19 6 20 of BLOCK 208 SANTA CARMELITA AT VALE LA QUINTA UNIT 20, AS PER MAP RECORDED IN BOOK 19, PAGE 38 OF MAPS IN THE OFFICE OF THE COUNTY RECORDER OF RIVERSIDE COUNTY, CALIFORNIA Dated JULY 8, 1994 Suite of California ) cow" of Riversl e ) S.S. On 7/26/94 before me BETTY L. COMAN Notary Public personally appeared THOMAS M. TOLES and SUSAN TOLES Signature of Grantor MAS M. TOLES SUSAN TOLES Personally known to me (or proved to me on the basis of satisfactory evi- dence) 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 OFFICIAL SEAL same In his / her / their authorized capacity(ies), and that by his / her / BETTY L. COMAN their signatures(s) on the instrument the person(s), or the entity upon be- OTARY PUBLIC CALIFORNIA half of which the person(s) acted, executed the instrument. AMRSOIN COUNTY 1fr Conn+ Eames Oa u. 1904 WITNESS my and official seal. Signature , ja�) (This area for official notarial sea)) MAIL TAX STATEMENTS TO. 1151 McMullen Ave., Yuba City, CA., 95991 Form 31954(Rev. 5-94) This Document provided by Commonwealth Land Tide Insurance Company This must be in red to be a "CERTIFIED COPY" Each document to which this certificate is attached is certified to be a full, true and correct copy of the original on file and of record in my office COUNTY RECORDER County of Riverside, State of California Dated: JAN 0 4 1399 Certification must be in red to be a "CERTIFIED COPY" ER, RI�F�s/ 2 C � � Z O cq� JFORN�P RC District - Planning ReviewForm 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: APN: " .LEGAL: CK'D BY; 53-120 Eisenhower 774-061-006 LOT: 19 ,.BLOCK 208 , UNIT 20 , S.C. @ V.L.Q. MMUEZIMA BIN NO: 5D CASE NO. 99-35 CHECK 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 I N I COMMENT/CORRECTION —11 Case logged and number assigned Verify legal and APN information Consistent with MDG on file las applicable) MDG filing required (5+ filings since 9/3/98) -C-onsistenc-y--with--street/surrounding area: Colors V SGI bM. DC'��-I �✓' Go Materials V Architecture �J OTHER REQUIREMENTS: The zoning code, architectural and landscaping manuals, and/or assigned inspector should be consulted where uncertainties arise. The completed checklist shall be maintained in the Building .& Safety address file. L I Certificate of Occupancy City of La Quin'ta Building and Safety Departmentent 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 ADDRESS: 53-120 EISENHOWER DRIVE Use Classification: SFD Bldg. Permit No.: 9901-010 Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC Owner of Building: TERESA A RICHEY _ res -x Building Official Address: 1161 McMULLEN AVE City: YUBA CITY, CA. 95991 By: STEVE TRAXEL Date: 09-01-00 POST IN A CONSPICUOUS PLACE USSWORKS t,I:a Quinta Building & Safety ,. Attn: Steve T x78495 Calle Tampico 'La Quinta, CA 92253 have reviewed the "B2" truss on Mr. Bob Richey's project located atS3"±1.20ti xEisenhowerAin La Quinta, California. -The problem is the non-structural soffet added to the truss (see enclosed soffet detail) is ,,against the center wall of the garage. "Because of the non-structural nature of that design of soffet the fix is quite simple and has ,.no engineering value, and therefore falls under conventional framing practices. 1. Cut effected soffet verticals and scab a board or put plywood on the remnants of the vertical after raising the lower level of the soffet. A single 16'd will suffice on each of the scab or plywood per vertical fixed. If there are further questions, please do not hesitate to call me at (760) 343-3461. RANDOLPH -al Manager i P.O. Box 626 27-995 Rio Del Sol Thousand Palms, CA 92276 Phone: 760-343-3461 Fax: 760-34-3491