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0310-342 (SFD)U) H N (n W p =) M r, 0 L0 ' W o Z 0 P:� W W I— a In Z LO N ON _U °) �0_Z ,�O Q JJ mJ, CL rn Z_ �O J 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 Professionals Code, and my License is in full force and effect. License # Lic. Class ,------xp Date �'- IS4 Date 1 2 �/: Signature of Contractor OWNER -BUILDER DECLARATION I hereby 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). ( )` 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&RC. 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 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 STATE FUND Policy No. 1,733183-03 (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`tosbecome subject to the workers' compensation laws of California, and agree�thatfif-•I'should become subject to the workers' compensation provsons� ©,f:Se'ctPon_3700 of the Labor Code, I shall forthwith comply with those/r ulson�%�" Date: ��/`� Applicant r� Warning: Failure to secure VVork_ers"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 D whose request and for whose benefit work is performed under or pursuant t any permit issued as a result of this applicaton agrees to, &shall, indemin & 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 i 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 authorise representatives of this City to enter upon the above-mentioned property'ior inspeci'ion,purposes. Signature (Owner/Agents: !%" Date PIZ BUILDING PERMIT PERMIT# 0310442TRACT DATE VALUATION LOT JOB SITE / APN ADDRESS 3_8W ]QSKM10WEF.DI3. 7114-471--007 OWNER CONTRACTOR / DESIGNER / EN (NEER ;PC1WF,R TCB ASSOC DR.AUC'IOAANN 19C P,O. DOX 134 - PO BOX 317 1A QU'.ti* TA CA 92,253 LA QUINTA CA 92253 (760)409-5422 C'R110 2 587 USE OF PERMIT OLE PAMiLY T1W.'1 ING ' 1918 SP. 3F T) PE4tM1T I)O S NOT INCI,,CI02 81.O K WA.L1,110,71.AP.A. O.K L RTVKWAY APPROACH I e: TRACT CONSTRUCTION 11938.00 or PORCHI.PATIO 38,00 SP 0ARAGEICARPORT 480-00 SF E&"rAIATD C0937 OFC3NSWZUMTON 114,DW.80 P. 11TAX SUM&RY CONISTRUCTIOAT PER 101.000-418-000 $692.00 PLAN CHECK N'1rS 101-000-439-318 $51M.96 FEE DEPOSIT 101-€ 00-439.318 4211OA0 MPCHA141CAL 799, 101, _.0003-4.21-000 $65.50 ELECTRICAL FRE 101.000.420.000 $125.23 PlIUMBI G.NEE i091-000-419-000 $1142.00 STRONG MOT1014 FSE - RZOID 101-000.241.0300 $11,41 OiUADIWO TEs; 101-0300-423-000 D1s'11'ELOPER IMPACT FEE 52,408,00 PRECISE PLAN 101-000-441-345 $100.00 B B -T L CC3A1S RrX:TlON AND PLAN CHECK $4,134.10 3.�9 PRS-:E'A:f47l��"�� NOV 10 2003 -�25U.OU "['tA7: ��?:� :1':Xl�ll'2' . "P .S 1)X* .1�ToW $�, W4.'10 CITY OF LA QUINTA FINANCE DEPT. s RECEIPT DATE, � ju ✓� BYE DA F FI LE �( INSPE TO j - a INSPECTION RECORD OPERATION DATE INSPECTOR BUILDING APPROVALS Set Backs Forms & Footings Slab Grade Steel Roof Deck elL O.K to Wrap Framing Insulation Fireplace P.L. Fireplace T.O. Party Wall Insulation Party Wall Firewall Exterior Lath Drywall - Int. Lath OPERATION DATE INSPECTOR MECHANICAL APPROVALS Underground Ducts Ducts Return Air y Combustion Air Exhaust Fans F.A.U. Compressor Vents Grills Fans & Controls Condensate Lines POOLS - SPAS BLOCKWALL APPROVALS 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 . . e 3, Heater Final Water Piping ' Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Seaver Lateral Pool Cover Sewer Connection • O 3ZZ -'Encapsulation Gas Piping Gas Test G, 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 Utility Notice (Penn) orr Date 11/10/03 No. 25181 Owner Power Finance Assoc. Address P.O. Box 1234 City La Quinta Zip 92253 Tract # Type Single Family Residence =113011`1 I FCATE OF COMPLIANCE Fid C Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 APN # Jurisdiction Permit # Study Area No. of Units 0 Q BERMUDADUNES r RANCHO MIRAGE �f N�INDIAN WELLS PALM DESERT ,y LA QUINTA "IQIN0 y� O 774-171-007 La Quinta 0310342 i Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 53-880 Eisenhower Dr. 1918 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 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 (spaces that do not contain facilities for Irving, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that 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 Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14 X 1,918 S.F. or $4,104.52 have been paid 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 C/C-Valley Independent, Mike Brauckmann Check No. 297866 Name on the check Telephone Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Signature iaia Barbuzza Payment Recd $4,104.52 F$0--00oo Over/Under NOTICE: Pursuant to Government Code Section 66620(d)(1), this will serve to notify you that the 9D -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 issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting OCT. 9.2003 3'02PM RECORDING REOUSsm ey. First American T^Ne AND WHM RECt7B131311 MAIL TO, Pbwar Rninw Awadelos. Im a Cg%rels fttporwon Order Ne.: tusois Emmet Now grSftac ARK: 774-1714W-2 and 774171.W&S '3 -900 N0.856 THE UNDERSIGNED GRANTOR(S) bECLAM(S) DOCUMENTARY TRANSFER TAX IS $143.00 [ X ] computed on full value of property conveyed, or ] computed on full value 1868 value of liens or encumbrances rerrlaining at time of sale. I j untncorporeted area j x ] City of La Guinto FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Darrell Glenn Desgranges and, Doliglas Abbott Desgranges and Lucinda DeagrangM husband and wife and Todd Michael Desgratlges hereby GRANT(S) to Power Finance Associates, Inc. a California corporation the f011owing_desalbed real. property in the County of Riverside. State of California "r1At�17 anii o%61a- 2ifi of Santa Carmelite at Vats Lap Stat Unit No. in City of La Quint;, County of Riverside, State Of Callfoimta, as per map recorded in Book 2e Pa e( 25 of Mlsceiianeous Maps, in the offloe of the County Recorder of said County. a Page(s) Dated: October 9, 200.1 _ STATE OF CALIFORNIA COUNTY OF On � bd6m me e Willctory evidence) to be the peteon(s) whose netne(s) 4sdare subscribed to the within inapvrrtent and aolpwWedged to me that he *Wthey aXwuted the same In hiegwAheir awhorized capacily(les) and that by hlb WAheir slgnatttre(s) on the inebument the person(a), or the entity upon behaff of which the person(s), 4044 executed the instrument. WITNESS my hand and official se' Signature Si re of as, P.12 7-74 -17/ -.007 77q -1-11-005r I A M1'011 Nljjfl8 Nvilim Nvti:8 coot 'win Certificate of Occupancy Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the. time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 53-880 EISENHOWER Use classification: SFD Occupancy Group: R3 Owner of Building: POWER FINANCE ASSOC Building Permit No.: 0310-342 Type of Construction: VN Land Use Zone RC Address: P.O. BOX 517 City, ST, ZIP: LA QUINTA CA 92253 By: KIRK KIRKLAND Date: 5-24-04 POST IN A CONSPICUOUS P