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0108-126 (SFD)U) H -- N W Oath I-- dto ' W oZr-J (O O O JV� WW I— a rn Z M LO N ON U °) d Q Z Lo Q O 0 J J mQU d(H It Z_ co :5 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. c License # Lic. Clas ,,^ Exp-DWe , _ 11 L�Sxlis�+ ` moi= .,!�i.°•�r�3'JS:t Date * - `�` 4z—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&P.C. for this reason Date Signature of Owner - r s 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 Policy No. KATE COMP (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 syybject to the workers' compensation laws of. California, and 'agree that if I1,,sKould become subject to the workers' compensation provisions of Section„3700 of the Labor Code, I shall forthwith comply wt those provisions f” Date: r` t,.,�F` Applicant' e=—•� ;,-. Warning: Failure to secure Workers' Com nsation 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 ort 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 t — any permit issued as a result of this applicaton agrees to, & shall, indemni & hold harmless the City of La Quinta, its officers, agents and employee . 2. Any permit issued as a result of this application becomes null and void work is not commenced within 180 days from date of issuance of su permit, or cessation of work for 180 days will subject permit to cancellati - n. I certify that I have read this application and state that the above informatio is correct. I agree to comply with all City, and State laws relating to the build ng construction, and hereby authorize representativesof this City to enter upon the above-mentioned property for inspeciio`ri°purposes. ; .. Signature (Owner/Agent) �' �°� � — Date ��� ' keb BUILDING PERMIT - ,, PERMITk DATE// VALUATION LOT Q�"SRv�9 TRACT ti! / � ;a l o.olg M I rif AT.'K' 7 0 7 JOB SITE APN ADDRESS 54-4 i'Li :6 =f.gr"0'tsltl't:1Gt D.R.;t% i - p 74-221-4414 OWNER CONTRACTOR / DESIGNER / EN INFER '.F. Afi3%„�::EN 'EVASS � srXOR INC.' PAIRS)FN EVANS, DFMG.I N.C. 1 s0; f")X 621 Ro. BOX, 621 PUER .101? CA 92501 Ta::1Vi"'RISIDE C& 91,501 (760)399-1413 ' CBVI 6246 USE OF PERMIT kMRM'17K:kAJLY DWELTING fD - PF -WAIT .06,V3 'NOT iNdCLIWE Ii001P.3P,", DR. VMVl FWAY APPIwOd►CK SO LY COM13114WCION 4' 1IICTAI 9.4014° 0AR-:A WlsL L ftl% IY Y 0.fUMi24 'WA1,L,;C1'TY u+1 AVDA%O TPIAbpp"fyyn� 'f)C/r�1LLy��luudyy� 1d J.,p�ryryi 99Cl'14 c/c,�pbl yty� CtAl'fili.A,FICA15./S'a./RT 6 .l! f" WALL 515,1°0 LF 5 Trr. W.AJIL 50.00 LF Y-.F3E IA'I C0!; ' OF, +?"O,f EUR"UR.d.MI3 ,�i ����gqyy!!.�..y��yFy�e. j ��pp ��''''II }}������ RY PLAN C1.,W-K FEL301-113W-439-'.41818 1$2.116€ IrLt�e0.EIVII 101-000-4.39-318 4250.00 t,�k:C4UHX!ARpPEE )01-000-14711-000 %53150. 1t.LIM'Z''MCA1, Ff?.2 101.4 30-421,01µ00:1 PDA PIXI"ImDITa FEZ 1 ?1.0010-419-009 $123,75 :: R,!X3:15 MOTION M. • iLl€?!t} 101-000-241.000 $9.63 C.)1:,i4,DWO FEE 101-N0-4234)00 0.4234)00 V010 D1Y,V J,0> F,R IAYr-JS.CT ft% $1,907,00 PhICISE PLA14 101.000.441,345 1140.0 C0+14T€?.I.1{' iON M- 31: fi 101-000.418-004:t %iE [G'CALa t;oman.`: Tic i om Ji!'o 1'I, a i id''ire a o 1XV5 PRE-PAXO:�7KES 4350,00 SEP 2 4 2001 .OTAL i WH r DARUNOW 1 , CITY OF LA QUINTA FINANCE DEPT RECEIPT DATE ' y A, � BY I ALED pL INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs _e Underground Ducts Forms & Footings �� Ducts Slab Grade _ _A �d Return Air Steel Combustion Air Roof Deck. Q ( 1/ _ 5't Exhaust Fans 0. K. to Wrap Framing 0I v �` _� ( sf F.A.U. Compressor - Insulation �/r r ( f— 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 POOLS -'SPAS BLOCKWALL APPROVALS Steel Set Backs 9 .Z(p• ®( S,� . 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 �j� Heater Final Water Piping�7 8I / — Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans Sewer Lateral //� O.K. for Finish Plaster Pool Cover Sewer Connection Q ` ` Z�: - w Encapsulation Gas Piping Gas Test _ 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 112/d�( Utility Notice (Perm) 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 9/24/01 No. 22528 Owner NamePaulden Evans Design Inc. No. 54-070 street Eisenhower Drive City La Quinta APN # 774-221-004 Jurisdiction La Quinta Permit # Log # Zip 92253 Study Area Tract # Lot # Square Footage 1617 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 1,617 or $ 3,314.85 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 BC / El Paseo Bank - Paulden Evans Telei—bone Name on the check By Dr. Doris Wilson - Superintendent Fee colle4/exepted byAnnette Barlow Signatu Payment Received $3,314.85 Check No. 02461 NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) this will serve to notify you that the 90 -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 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 11 4"00. -:2 F,' 01(TUE) 09:39 FIDELITY NAT TITLE TEL:1-619-1179-0394 P.001 RFr'ORDING REQUESTED BY: R Ay National Title Company Eec►0W No. 43031 -CO Tills Order No. When Recorded Mail Document and Tax Statement To: Mr. Paulden Evans P.O Box 621 RivIrside, CA 92502 GRANT DEED E THIS The undersigned grentor(s) declere(s) Documentary transfer tax is $26.40 1 X ) computed on full value of property conveyed, or [ ) computed on full value less value of liens or encumbrances remaining at time of sale, [ ) Unincorporated Area City of Le Quinta FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged. William DeVane and Eugenia DeVane, Husband and Wife Community Property hereby GRANT(S) to Paulden Evans Design"Center, Inc., a California corporation the following described real property in the City of Le Quinta County of Riverside, State of California: Lot 21, Block 297 of Santa Carmelita at Vale La Quinta, Unit #27, as per map recorded in Book 19, Page 82 of Maps, in the Office of the County Recorder of said County. DATED; August 7, 2001 STATE OF CALIFORNIAA COUNTY OF S S _ ONn before me, personally appeared personally known to me ( 's of e) to be the personal whose name(&) is/awsubscribed to the within Instrument and acknowledged to me that M!'/shelOwy executed the same in bis/her/tbOr authorized capacity(Wil, and that by bis/her/tb@W signatureW on the instrument the personWt, or the entity upon behalf of which the personW acted, executed the instrument. Witness my hand qpj official se Signature ELIZABETH C. WYCKOFF Corrvnldon 0 1211414 We Ampift tin* �i1oo� MAIL TAX STATEMENTS AS DIRECTED ABOVE F0-213 (Flev 7196) GRANT DEED .y 0G.-28' 01(TUE) 09:40 FIDELITY NAT TITLE TEL:1-619-779-0394 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California ss. County of a E L F rj On rl D 0 Date personally appeared to UNDA SUE DIXON Commtsslan * 1�a W Notq^r ft bflr - ca"Wrlid tm Argelei! COtXwwww* NyComm, Jul3.20M Piece Notary Seat Above - rsonally known to me 0 proved to me on the basis of satisfactory evidence to be the personx*"Whose name(pKistvf subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/K/t4P ' authorized capacityw, and that by his/t 4!W signatureKon the instrument the personSp�, br the entity upon behalf of which the person acted, executed the instrument. my hand a94 official seal. Poolic OPTIONAL Though the information below is not required by few, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: — 2� Capacity(les) Claimed by Signer Signer's Name: / Individual 1u+r of tnumb Hera C Corporate Officer — Title(s): C Partner --- G Llmited O General UAttorney in Fact O Trustee O Guardian or Conservator C Other: Signer Is Representing: 0 1997 National Notary Astoclatlon • 2350 Do Soto Ave. P.O. Bort 2402 • ChatswoM, CA 91313-2402 Prod. No. 6807 Roordet: Cog Tc+bFrae 1.000.876.8627 P. 002 0 RC DISTRICT - PLANNING REVIEW FORM This form is to be used by CDD staff for review of single family dwellings in the RC (Cove Residential) District per Section 9.50.090 of the Zoning Code. Its purpose is to determine: 1) that the proposed house design, does not duplicate the same architectural style,of any house within 200 feet of the applicant, and/or 2) if there is a need for the applicant to file for Master Design Guidelines. If the applicant does need to file a Master Design Guideline, please transmitted this information to the Building and Safety Department as part of your correction list. Please attach additional explanations as necessary. APPLICANT PAULDEN EVANS SITE ADDRESS 54-070 Eisenhower Drive APN 774 - 221 -004 CASE NO.: 2001-5.34 LEGAL: LOT 21 BLOCK UNIT S.C.@V. L. Q. Wal'1 "Nesbit, DATE: CHECK AND APPROVED BY: �..... Y � 0 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 N COMMENT/CORRECTION Verify legal and APN information Wl�`7 Consistent with MDG on file (as applicable MDG filing required (5 filings since 9/3/98) Architectural variety within 200 feet of the surrounding area: Colors Materials Architectural design features s �d-4/wt Ot�moved b � mg oe��sPsston 0 pity Council Community Dev. Dept. Initials Case No. tee- 2co5:7: �3a' e -r Exhibit 1 Q With conditions 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: 54-070 EISENHOWER DRIVE Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0108-126 Occupancy Group: R-3,, U-1 Type of Construction: VN Land Use Zone: RC i. Owner of Building: PAULDEN EVANS DESIGN INC. Building Official Address: P.O. BOX 621 City: RIVERSIDE CA 92501 By: STEVE TRAXEL Date: DECEMBER 20, 2001 POST IN A CONSPICUOUS PLACE NOV-05-01 MON 02:54 PM WILKIKINSON- G EER I NG 909 682 20 14 P. 0 1 KEN WILKINSON ! STRUCTURAL ENGINEER 6956 INDIANA AVE. SU[.TE 49 RIVERSIDE, CA. 92506 VOICE (909) 682-2001 FAX (909) 682-2014 E-MAIL kenwilk(i�,airl.net November 5, 2001 CITY OF LA QUINTA BUILDING & SAFETY DEPARTMENT LA QUINTA, CALIF. Attention: BUILDING INSPECTIONS i Re: PAULDEN EVANS a 54-070 EISENHOWER DR. — LA QUINTA Subject: VISUAL S'T'RUCTURAL OBSERVATION REPORT FOR NEW REISDENCE To Whom It May Concern: The following is any report in regards to -the structural observation provided. by JCM inspections dated: 11/2/2001 at the subject property. The structural system as completed through the final framing stage is in general conformance to the approved plans and specifications. All observed framing members and connections have met or exceea.ed the design criteria: for this building. Thus all structural framing & connections have been approved by my office. a Wilkinson uctural Engineer Attachment: JC;M Inspection Repov No- 1944 Fxp, 9.30V;;_L,;- OF' NOV-05-01 MON 02:55 PM WILKIKINSON—ENGINEERI Elm Z� JCM.Inspe4ticns 39725`Gerand Lane Sulte F . Palm Desert; CA 92211 L N S P L C T i O N S Phone: 760-345.5554 Fax: 760.772.3895 INSPECTIONS INSPECTION REPORT Date: Project Name: Project No: Q. r. P • i Project Address: City: Title 24 AWS r-01-101 Other: - p O �►'t o ,1' File # DO 1.1 Client: Sub -Contractor: a App# Q D 1.4 ...r. Other General Contractor. Architect: �'`\. Structural Engineer: �, �v *r b- d+ -+IC b- v.` \ �\ Weather: S��n 61 Unresolved Items: None See Below Description of Work Inspected:A W 3 kg tl o « G•�� N .�.� a� G N „�,. ., 1' Z ` v Lo� sn CL 1 W \ Sal— W 1 O t r I hereby certify that I have inspected all of the above work, unless otherwise noted, a he st of my ability 1 have found this work to comply with the approved . plans, specifications .applicable building laws. Final report issued at proiect completion. Inspector: Jack C. Millin'*OV6yaatdt0 Contractots itepresentativ h.. -Le, za -1 1 - ,•.,�' .�.. ' c 1 Copy 1 Inspections Copy 2 Project Superintendent Copy 3 Governing Agency Page -A. M _ — 5 KEN WILKINSON STRUCTURAL ENGINEER 6956 INDIANA AVE. SUITE #9 RIVERSIDE, CA. 92506 VOICE (909) 682-2001 FAX (909) 682-2014 E-MAIL kenwilk@airl.net August 14, 2001 CITY -OF LA QUINTA BUILDING DEPARTMENT Attention: RESIDENTIAL PLAN CHECKING Re: PAULDEN EVANS - 54-070 EISENHOWER DR. - LA QUINTA Subject: DEFERRED SUBMITTALS FOR TRUSS CALCS PER CBC SECT. 106.3.4.2 To whom it may concern I have reviewed the submittal documents for the roof trusses and have found them to be in general conformance with the design of the building. Yoi►-&-truly, ixmson c� No. 1944 ral Engineer Ea, 8-30-