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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 Exp., Date
333670 0&30' i
ate — �� Signature of Contractor �-
i9D,
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that l 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
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.
GOLDEN. 'ENGLE NkAIC. `22373-01
(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 Section 3700 of the Labor
Code, I shall forthwith comply with thos Zprovisions� f
date: a Applicant 1/41 Z_/ _/ .sv ;
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
construction, and hereby authorize representatives of this City tosenter upon
the,above-mentioned property for inspectionpurpose
Signature (Owner/Agent) �`/r j'�-�i'l�S Date
v
BUILDING PERMIT PERMITNti�-�,
DATE ()2/091.2()0 VALUATION $11)7t4116'J() LOT TRACT w
1
r
JOB SITE
ADDRESS 54-105 E I-SENNHO YE> -DIUVE
OWNER
CONTRACTOR / DESIGNER / ENGINEER
a.�,�v��rrtomt t
CLn.:neer, r�x+r,r��a n*rr��l
"
PALM. l)i'.SEX
C:A. 92211
(7fn)3454196
Cy;
Lpf 1011
USE OF PERMIT•
,�IN4.r!„lrs t'.t�ll'i,l1..1` L91Rf1sL!',�i�lL+
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11'i'�P*1X `,M C05T 0r �.�f�i6���,'�rL ��;i�t
107 "36,50
PERMIT FEE SUIW AR
CCPNS'f.KL:�CH0N FEE 101,000-41"00
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EC1114VIVIi .-�1�L P'12, l,�t'Fv'i 1'31)0 S60.0
CIL J� "I'RI.C..AL FEE S141U 0
r_,
PLU4IBINOl+'.FX 101-{S()C!-41W-(:00
f'r1rc� !r:NV4(- fr)WI:PF, ftt Gln Int -elft() -2l 1_M0 $1074
0411AI NC; p'IMM 101-0WO-423-000
I)tsVELO.PCRik1PAQTFEE
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f -.y�•�
$1,907.W
PRASE FLAN 101-000-441-345 g'lU!).Oti
i 1
ART rev ref 1BfAC PLAr`ES - fitE Krr, 7 01 - MY 0-7`5_00n
Ci' L"i13I?[iS'i jf)i-t10(14�'?i4 -$3"`1).4(1
( }�•
i�
S ftZ-1"C�iA. ,e.ONSTRUORON AND PT,R:NC3(ECK
LESS PR,"E- AID FRES
4257.00
0111, NOW.
$3,148.19
1 ` ��~
.� Y�JLt1 �
RECEIPT
DATE
BY ' �'
ATE A ED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
V
Ducts
Slab Grade
3�
Return Air
Steel
Combustion Air
Roof Deck
3— D
Exhaust Fans
O.K to Wrap
1 - od
F.A.U.
Framing
c`_ S _ OD-
Compressor
Insulation
y-// _ Oa w-
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
-17 -
Drywall - Int. Lath
- 1 - Oa %:tz-
Final
Final
0-4.
POOLS - SPAS
BLOCKWALL
AP ROVALS
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
Water Piping
_ _ _
6 S
Heater Final
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
6d S
Encapsulation
Gas Piping
Gas Test
W 1-0
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 (Perm)
ul�crcv ,
P.O. BOX 1504 APP IC 040 Y
Building 78-495 CALLE TAMPICO
Address 4.07- /v 31-Y< LA QUINTA, CALIFORNIA 92253
Owner BUILDING: TYPE'CONST.-OCC. GRP.
Mailing
Address A.P. Number
City Zip
Legal Description
ContractorProject Description
Address
72-9-r,0
city
P4 ph
State Lic. city
& Classif. 3 3 Sq. Ft. No. No. Dw.
Arch., Engr., 5- o o Lic. # Size V7 Stories Units
Designer New 0 Add 0 Alter 0 Repair 0 Demolition 0
Address Tel.
City Zip State
Lic. # r3, 3 (p
LICENSED CONTRACTOR'S DECLARATION
I he bgffirm that I am licensed under provisions of Chapter 9 (commencigg with Section
7/ r t�! ons Code, and my license is in full force and
7000)reof i,,, �fh B s'n d P 4f I ZZF
effect.
SIGNATUREd DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation
reason: (Sec. 7031.5.8usiness 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 PERMIT AMOUNT
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.heis exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
1-11 1 as ownf the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do iowner of
work and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions ode: Th. Contractor's License Law does not apply to an owner of property who Const.
builds or improves thereon and who does such work himself or through his own employees, Mech.
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 Electrical
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- Plumbing
struct the project, fSec. 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 S.M.I.
such projects with a contractors) licensed pursuant to the Contractor's License Law.) Grading
11 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date owner Infrastructure
WORKERS' COMPENSATION DECLARATION
Ihereby 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. 0 Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
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 thp 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
DateOwner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions Or this permit shall be deemed revoked. Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Lind
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, CIO Code.) Side Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct. Issued by: Date- Permit
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. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
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 2/9/00
No. 20015 Jurisdiction
Owner NameMark Tuvell
No. 54-105 Street Eisenhower Dr.
City La Quinta zip 92253
Tract #
e
Type of Development
Comments
Lot #
APN # 774-215-018
La Quinta
Permit #
Log #
Study Area
Square Footage 1787
Single Family Residence 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 1,787 or $ 3,448.91 the property listed above and that butilding
permits and/or Certificates of Occupancy for this square footage in this proposed project may nowt'l be issued
r_1• 1
Fees Paid By CC/1St Bank/Mark Tuvell Tele hmne
p `.
Name on the check -
By Dr. Doris Wilson �;� •�. '?,
Superintendent
Fee collected,%exempted,by Mary Ann L. Borja Payment Received $3,448.91
Check No. 53011
Signature
NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 915 -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
i
RECORDING REQUESTED BY:
AND WHEN RECORDED, MAIL TO:
Mark F. Tuvell
.S9 / Vs -
THIS SPACE FOR RECORDER'S USE ONLY
ASSESSOR'S PARCEL NO.: 774-215-018 The undersigned Grantor(s) declare that the DOCUMENT TRANSFER
TAX IS:
TITLE ORDER NO.: 124759-13 $ 14.30 County $ City
xx computed on the full value of the interest of property conveyed, or
ESCI OVV NO.: 5341 -DS _computed on the full value less the value of liens or encumbrances
remaining thereon at the time of. sale.
GRANT DEED OR transfer is EXEMPT from tax for the following reason:
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Edmund Vasiliauskas as Trustee under Edmund Valiliauskas Trust
hereby GRANT(S) to Mark F. Tuvell, a married man as his sole and separate property
all that real property situated in the City of La Quinta County of Riverside, State of California, described as:
Lots 6 in Block 298 of Unit #27, Santa Carmelita at Vale La Quinta,
as shown by map on file in Book 19, Page 82 of Maps, Records of Riverside
County, California..
Dated August 24, '1999
STATE Y -4i3
COUNTY OF � (r� �
ON , before me 0(-L1;1j, 0_WSSE,:T7—
Notary Public, personally appeared
tip Uastllei(J-SiLq S
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 signature(s) on the instrument
the person(s). or the entity upon behalf of which the pers ) acted, executed
the instrument.
WITNESS rrly and and official seal.
Signature _
MAIL TAX STATEMENTS TO:
Mark F. Tuvell - 72-850 Somera Rd., Palm Desert, CA 92260
Edmund Vasiliauskas, Trustee
"OFFICIAL SEAL"
Criselda C. Gossett
Notary public, State of Illinois
My Commission Expires 04.01-02
(This area for official notary seal,
-RC District - Planning Review Form
This form is to be used by CDD staff for review of single family dv,,, the RC (Cove
Residential) District, in order to determine the applicability of r ues or need
to require the filing of Master Design Guidelines by the apes" smitted to , N
Building & Safety as your correction: Iist..'Please attach r - icessary.�.
APPLICANT: SUNROSE CORP ' hh
V
PROJECT
ADDRESS: 54-105 Eisenhower Drive
APN: 774-215-018 b
LEGAL:LOT' . BLOCK , UNIT . S.C. @ V.L.Q.-
. �o
CK'D BY:
Greg Trousdell
BIN NO:.. CASE N0. 00-184 .CHECK -DATE:
Inform -the assibned Building plan checker .upori..y-our..assignment to this case. The CDD
Executive Secretary maintains a log book to track applications and. assign case numbers. '
7� REOUIRED ITEM Y.
N
COMMENTICORREC ON
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'..'. \+�iy� a ':� }��/�y; :. \hC.i..`1`tl�:<:h.\. ''Z�♦`�\t. 2}<}.�:'v.'' �+it�`t\', NOW+V.•\.\
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Case logged and number assignedb
verify legal and APN information
Consistent with MDG on file las applicable)
s:r...r..en��i.od 15+ filinnte since 9/3/9A1 n ��
/
rnh6 istO'nt with'streetfsursoundi�g
..�\� �£. � X117• ,.t.i .
Colors W�7 K
Materials
Architecture ._
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OTHER REQUIREMENTS:
v '
The. zoning code, architectural and landscaping manuals, .and/or assigned inspector should
be consulted where uncertainties arise. The completed checklist shall tbee e
maintained -in th
Building:& Safety address •file. • 6w,rJ> T 1��'L
irCertificate 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:
Use Classification:
Occupancy Group:
SFD
54-105 EISENHOWER DRIVE
R 3 Type of Construction: VN
Owner of Building: MARK TUVELL
Building Official
Bldg. Permit No.: 0001-160
Land Use Zone: RC
Address: 72-850 SOMERA RD
City: PALM DESERT, CA. 92260
By: STEVE TRAXEL
Date: 06-20-00
POST IN A CONSPICUOUS PLACE