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9907-059 (SFD)LICENSED CONTRACTOR DECLARATION !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 Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date /2;726." l3C CIO C39 .-� 03131M, ate 'YX�<�Rignature of Contractor i OWNER -BUILDER DECLARATION I hereby affirm, under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: 4 ( ) 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 8 Professionals Code). ( s) 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 Date Signature of Owner WORKER'S COMPENSATION DECLARATION I 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 3.700 'of 'the Labor Code, for the performance of the work for which this permit is issued. (fi 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.' STA`,i'.UfN3.) A +Nic�il?-9.G (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 no employ any person in any manner so as to become subject to the worke s compensation laws of California, and. agree that if I should become sub' ct to the workers' compensation provisionp of Section 3700 of the Labor Cdde, I sh II forthwith comply with those proves b'ns� tate: < - U /tea 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 con truction, and hereby authorize representatives of this City to enter upon th above-mentioned property for insp�epGon purposes. .- a 7 Signature (Owner/Agent] �'""---" """"�.- _ Date BUILDING PERMIT PERMITk " 11,7469 DATEVALUATION .sa�i�`f�.�.s5 LOT TRACT 7iii3 JOB SITEF ADDRESS. :7�?+FD �?,��� i�rrd:. APN OWNER CONTRACTOR /DESIGNER IENGINEER . & UUIO //I V14"yCCCO 11 .1 .1:RON C" MORRIS ISO 80y, 1928 78505 V1 r`1 A OEL SOL i,AQUINT-A CA 92253 I.rdMkN WELLS C A. M2 ..10 (760)34541120.9 49 C13T.10 - USE OF PERMIT WNW], N`!'�t���.I+.pL�..�A���g(�E. ��77�FI�LLiy�,`4/-0 y} y ' oy T) q* [ T x� p � SFD OYL � - Pi.i6.1[YU .lJOES 1�:3.>r! ]6:1, .3r�.rSliA. i`dtJt.�...i � OtrALL, i,-b—NO3 01 . 't' ACT GO1+3y,TRtlCTION {,42I.0-) SF �*w3i Cvli/t�Ftairu 3 :s3i3 SF 514.00 1V CI 'M'�.*Y,�� 6�A.1. �4..�:VS d R C CT11 N � 971713.50 C`%�N:3:'IaISC."t`�Citai �' 1i11�U'C)- IiS-4lf}(9S55550 NMC'FiJ1:fdICAL F' .ltd; (iC4T= 23-40 J 1. f:;ii`t 013,E i IC}:I�t 1i£-�1 4Ti-I�i3ai S12.i,S2 �. . Pj.URVIJ NCk F Eii ►'til-()e'1t? I `3-t3Q}() $1.3.50 STIR0040&!(Yf(!0NFEE -RESUD Sii?;,4'k!9-,:21!-f)t',Y8 Z",94 1014,M -4234M Nl RA.STR4,f'C'Ti:3 O M 225-000-443-34.2 PLAN 4-345 ��� S"i�I..13ts'€�+tiff#P`1' fi.6x�f0[ita-k3Q-Yi8-g2.aQf.�) .. AND P!AN EC K $4,�3S.�1� 1.,Ess PTUE 41\1f) FEES 41250,00 . H•.,.�g.ci�d A-.ipYJ..'1;A:i� �' �(1 �.l:sY Y.t'Y7 AC.'i ,tVVYY •11.Y�.L�e7.�''& iI DATE BY _RECEIPT D FINA job INSPECTOR is ~ s INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Z . Exhaust Fans O.K. to Wrap _pQ F.A.U. Framing - 6cJ S Compressor Insulation - _ �� s Z Vents Fireplace P.L. _ Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath �2,i/_ cgv S% 7_ Amo Final Final y mss' - oa BLOCKWALL APPROVALS POOLS - SPAS steel Set Hacks 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 46-y- ¢' ! Encapsulation Gas Piping I Gas Test _ s' Appliances _ Final `tip M Final - - =� Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole O Zo Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: �i'>i!'ri"+rwroa..'""�'°'!�. .. .'��-1f"'"'�1��,+�'�'�"'gid''.T��� x.J(art'*�''.':"ar'N-.4'.,,, <•...,:` .. ..., tr:,i�ro.r- �.+Ar-sll pl-85-q C- 61.1 qmw- D , P.O. BOX 1504 l Buildings 78-495 CALLE TAMPICO APPLICA 10 O L E°1 Address % / / f- . 4eJ,11 4, k1 � LA QUINTA, CALIFORNIA 92253 Owner ti. C 10 I Ib BUILDING: TYPE'CONST. CC. GRP. Mailfribly- Addresst." G �' A.P.Number44, 131 C 6 D City lZillf- —]Tel.aiJ1 1 C ./ �. � 7 . � Legal Description 1_01 - T . �� � F.. 2 41q �✓��i � 24-77 � 0-on't'f otbP v' aw Project Description Address ✓ / -�"�� City Zip Tel. State Lic. City 8 Classif. Lic. q Sq. Ft. 1L 2 No. -� No. Dw. - Arch., Engr., Size Stories Units Designer New pJ/' Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. sco : 524,3 City Zip State Lic. k 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 !or thealleged 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). iJ 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, Suisness 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. 11, however, the building orimprovement 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.) FI 1, asowner 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.) 1-1 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. ❑ 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: 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 allplican Mailing Address_ City, State, Zip_ mated PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT 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:J) 1 l WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION 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 8/4/99 APN # 774-131-007 No. 19143 Jurisdiction La Quinta Owner NameRaul & Rocio Velasco Permit # No. 53-640 Street Eisenhower Drive Log # City La Quinta Zip 92253 Study Area Tract # BLK244U23 Lot # 18 Square Footage 1,421 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 1,421 or $ 2,742.53 the property listed above and that builhfj%i,�Vt'- permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued - Fees Paid By Cash Teleptiore ; = Name on the -check N. By Dr. Doris Wilson - Superintendent Fee collected /exempted by Juanita Green Payment Received $2,742.53 Check No. Cash Signature NOTICE: Pursuant of Asse frlbly 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 cr other payment identified above will begin to run fronUhe 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 ►� 1 N ;\1D I �1 RECORDING REQUESTED BY Reconfling Requested By First American Title Insurance Company AND WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW, MAIL TAX STATEMENT TO: Name RAUL VELASCO Street ROCIO VELASCO Address P.O. BOX 153 city& LA QUINTA, CA. 92253 State Zip Title Order No. 2031866 Escrow No. 15499 CTC 1-101 (8-93) PAID Doc. Transfer Tax FRANK K. JOHNSON Riv. Co. Recorder 13950'7 RECEIVED FOR RECORD AT 8:00 O'CLOCK MAY 31995 aoome.e In omd.i ti. Oft of R Mam coatrl, C'aftr" `%!� R900fd@f FABS; SPACE ABOVE THIS LINE FOR RECORDER'S USE Grant Deed THE UNDERSIGNED GRANTOR(s) DECLARE(s) DOCUMENTARY TRANSFER TAX IS $ MM /. ❑ unincorporated area ® City of T.A_ QHTNTA Parcel No. 774-131-007-8 70 Code: 02'0-015 © computed on full value of interest or property conveyed, or ❑ computed on full value less value of liens or encumbrances remaining at time of sale, and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, THOMAS M. MANDIC AND MYRLEEN C. MANDIC, HUSBAND AND WIFE AS JOINT TENANTS hereby GRANT(S) to RAUL VELASCO- AND ROCIO VELASCO husband and wife as joint tenants the following described real property in the CITY OF LA QUNITA county of RIVERSIDE , state of California: LOT 18, BLOCK 244, OF SANTA CARMELITA UNIT #23 IN THE COUNTY OR RIVERSIDE STATE OF CALIFORNIA AS SHOWN BY MAP ON FILE IN BOOK 20, PAGE 25, OF MAPS RECORDS OF RIVERSIDE -COUNTY, CALIFORNIA Dated APRIL 21, 1995 STATE OF CALIFORfyIA COUNTY OF Kiverside } S.S. On April 26, 1995 before me, Constance Gorsuch a Notary Public in and for said County and State, personally appeared Thomas M_ Mandic and Myrieen C. MandiG 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. cknowledged to me that he/she/they executed the same in his/her/thei authorized capacity(ies), and that by his/her/their signature(s) on thein; rument theerson(s), or the entity upon behalf of which the persoq 8) acted, exejuted the instrument. / WITNESS Signature s THOMASA ND• CONSTANCE GORSUCH COMM. M 1027617 O Notary f ublic-Califomia RIVERSIDE COUNTY CD My Commission Expires May 25.1998 (This area for official notorial seal) MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SHOWN, MAIL AS DIRECTED ABOVE Name Street Address City & State Co Tb : 6eS. RC District -P/annino Review For�xi 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 applicabitity 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: MR. & MRS. PAUL VELASCO PROJECT ADDRESS: 53-6.40,;Ei-senhower APN: 774-131-007 LEGAL: LOT- 18 , BLOCK 24.4 ,UNIT . 23 , S.C. @ V.L.Q. CK'D BY: Greg Trousdell BIN NO:. 2 4 CASE NO. 99-80 ..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 ITEMI Y N I COMMENT/CORRECTION 'Y:•'•i'•i:4:{:+ii.!{^.'{\:•it4{{{??�i:,•i<'•4??G5:}}+}'\+.,kn{\4N?i�.ti:F,......4?•:•:2:i}�ti;'iy'•:{•::: :ti(:;?:$•'•?''.fCrn •:.?y: •�\' \: :\\ Y+:?•v.. \ \ )"n ."{'`.•{'';'•S::i\•i1'???:�< •.\'•.a Q,\}.1 ?a'\t: \'�\\:\ 4 ±,\al;:•\'}$ti:r.}\4.::�v ••{c>•;`.;Sn?:;>,.N:::.: •:" ••+t•:•+::.,•�\, . \.•{.;:;::, s, ..\ A\> .c•• ,:'@, ,gip .•, •: ' : •\�.?,\'?}:\•� v••'4;7.iii:{?•\.ti,•,•:•i\ti?+'.yJi'\4��••vY•n•:r;.;•\',•'yi~$:•f::}••+V•�i,•\'�'+••)'•.�v�4�; C'311AP1?i13ET:EIYe�?:.:a?>;<:>>:?>:.... \ x,. #:+.:.:::....w•....::...`.:..•v..•:.\\?n.k:•..:.••b.•:r �::.: 4. �stti'>j:':i2ti?:•j•v,$:?i:':iv'.T•.,:•::ti.•....\.. 'C,:w�{•{hv:i(Q:4,��3•'S\ �'4 • h k y� i'�,'h•� \.>:>:>.:«...... •x,.>,>::k :,� ... .w .. .. •.. ... 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) x Con"sistericy -with-street/surrounding area:• Colors Materials Architecture 7761 Gov G.7l3ir+E k 0 �.,,-��r r,✓(,ovz- �, ea 3Q�Z/�ff OTHER REQUIREMENTS: The zoning code, architectural and landscaping manuals, and/or assigned inspector should be consulted where uncertainties. arise. The completed checklist shall be main. ine 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 ADDRESS: 53-640 EISEHOWER DRIVE Use Classification: SFD Bldg. Permit No.: 9907-059 Occupancy Group: R 3 Type of Construction: V Land. Use Zone: RC Owner.of Building:. RAUL & ROCIO VELASCO Address: P.O. BOX 1928 ..1101 Building Official City: LA QUITA, CA 92253 By: STEVE TRAXEL Date: 04-25-00 POST IN A CONSPICUOUS PLACE �(7r,.-�..�sr-' IT,`�'.�"'\��"R'.�� . n^"�'Yt-TTTTI. •1i1'T^`+� 1`',F-Y.u�^'�Y.�1Y�.s`v'^•'.'ll'•r'Y�. '�,``r.'*-'c'JA'11ai+n{4-r'f-"44 �'t' '"�.�..,.. .�r.1 tit-.r•l�,,r� •''•ti•},.r� '+"` 'c"7' _.+�*._ ...` 4 Sladden Engineering 6782 Stanton Ave., Suite E, Buena Park, CA 90621 (562) 864-4121 (714) 523-0952 Fax (714) 523-1369 39-725 Garand Ln., Suite G, Palm Desert, CA 92211 (760) 772-3893 Fax (760) 772-3895 Date 9- /y- 99 Job No. -'5Z -- 7/.55/ FIELD MEMO Project Name 5 3'-6y® �., D"V ,._ Client: Site Address Zwl rA Job Phone Work Done cf+w+ �Gq f iV .v ori �I.J'' y Test Summary / Footings Inspected Test No. Comments Location Elev. Dry Density Moist % % Relative Compaction Ref. Max pcf Moist % T, 7 95 2. 112-- Comments � a ` Super. or Agent U Field Tech. p g 24 hour notice requested to schedule Field Technician. Thank you for the opportunity to be of service. I.