9805-067 (SFD)LICENSED CONTRACTOR DECLARATION
in I :hereby affirm under penalty of perjury that I am licensed under provisions of
I-� -Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
j' Professionals Code, and my License is in full force and effect.
O M License # Lic. Class Exp. Date
W LO' 'lvil di
Z Date ' L1 -2 Signature of Contractor"/
CO 0
JI.—
C:) OWNER -BUILDER DECLARATION
LL! W r— I hereby affirm under penalty of perjury that I am exempt from the Contractor's
~ a License Law for the following reason:
Z_ ( ) 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).
ce) () I am exempt under Section B&P.C. for this reason
L
N Date Signature of Owner
Q WORKER'S COMPENSATION DECLARATION
4.
QI hereby affirm • under penalty of perjury one, of the following declarations:
r H O O 1.1 ` Ve and:will.maintain a Certificate of consent to self-insure:for workers'
X w compensation, as proJided for by Section 3700 of the Labor Code, for the
m
,Q performance of•the work for which this permit is issued.
QCJ �( I have and will maintain workers' compensation insurance, as required by
O Q Section 3700 of the Labor Code, for the performance of the work for which this
a:0)H permit is issued. My workers' compensation insurance carrier & policy no. are:
'IT Z Carrier Policy No.
pD 7 fw nt �y » i.rtarr� 112,2 y � ^�I
r- ry llt�JG=P�s�lE-q3.�i,.�C.l e� °W
Q (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\l should become
3 subject to the workers' compensation provisions of Section o3Z00 of the Labor
Code, I shall forthwith comply with those provisions.
Date?S2 11 • S °fi Applicant -'', /' i .ate.-�= ln.--" o..
v=
Warning: Failure to secure Workers' Compensation coverage,is unlawful and
shall subject an employer to criminal penalties and civil fine's-up;L $100,000, in
addition to the cost of compensation, damages as provided foriin;Section 3706
of the Labor Code, interest and attorney's fees. �r
IMPORTANT Application is hereby made to the Director of Bwlding._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 Quints,' 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 above-mentioned property fob ,inspection purposes.
S gnature (Owner/Agent)--►-n Z Date-'
BUILDING PERMIT
PERMIT#
DATE h VALUATION 71�p �•Al LOT
-i C/farl
�, TRACT
JOB SIfE
ADDRESS',__ �" 7"V �� , )t�
OWNER
CONTRACTOR / DESIGNER / ENGINEER
Io
21.08? %tARi/•EI;.,;Lik '
"�,8N fit'NNI RRA RV.
1
US OF PERMIT
;511Vt,1L,f .1'r9 L1l. ,i DW.(<1.L1[dti
:%WRA-IT iUt.tj;,ey WYk dicl'tiOL YAL(k9. Ork PUOL
t'"T iriuio1 a'1" 1
.:J
s q q+ere 9° -y y d' r 1N iNITN't 1%,
COST ��' 1 �RP.� x:Y tl. �I'�i.
g) `;
8°i+ itIVA i'r � it c sIjiC `vi Aa�
0f)NS'[i2U0_At N VEP',',
5 f.Sfo oto
w AN(yfTov, T;rR 161-0ftft-AW- !)<
s 11f;Z z11
itissi��MRIiNC; 11.1.11.1.1fl'l4)0r1_1.iq._(rol
�i��x+y,.11 S11
MOTION � y MID
AICI N [01Jf4I C PLA4•`.E.S -
;i Iri=!'CJ`fr1E ; e "i ;I tx`` N ANOpy >'t,r t�; ('14)1C'k
RECEIPT
RECEIPT
DATE
BY ��(
DATE FINALED
INSPECTOR
r�T
�j
Qg-?'fo JcA L,00A
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
121.0
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
CI— I_S 7159
Exhaust Fans
O.K. to Wrap 6
S,
F.A.U.
Framing
Compressor
Insulation
O
Vents
Grills
Fireplace P.L. C, •10 -Gz
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final D
BLOCKWALL AP kOVALS
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
COMMENTS:
. Q��rJ�`7 6►Y���� d��- 'moi-�-�
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)
4,�f 1
r. I
0
Building
Address
Owner
Ifs i / h
}.. r.�s::^^ -.k �, ....yr'�.�' in.�4;•1N+tYr*t ,.�,�l,n'� I f. �� � �I',.l r�.�. . ,
Tit9p
Cv
P.O. BOX 1504
U r 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Address Z-5O,s�;Z AMMA
City lZip ITel.
Contractor
ress
ty lZip `9'Tel..
State Lic. I City
& Classif. Lic. N
Arch., Engr., �G
Designer JG�P
Address rTO.'
CityZip State
G Q 2 Lic. N
LICENSED CONTRACTOR'S DECLARATION
I here affirm that I am licensd under provisions of Chapter 9 (commencing with Section
7000 :vision 3 of the Businessa and Professions Code, and my license is in full force *and
,elect.,
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 thathe 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 ($500).
FJ 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,
,,.video 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
of proving that he did not build or improve for the purpose of sale.)
I I I, 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
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
17 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.)t
Policy No. Company
r7 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 it the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thF 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
1 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 Aino. expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information i coI agree to comply with all city and county ordinances and state laws relatingto bui
construction, and hereby authorize representatives sof this city to enter the above-
mentioned property for inspection purposes. MAY 13
Signature of a0plicant Date
Mailing Address validation:
City, State, Zip
'9 OUINTA
4 `_-00_7
APPLICATION ONLY
BUILDING: TYPE'CONST._OCC. GRP.
A.P. Number
Legal Description OZ—
Project Description N"
ZONE:
Ci
/. UiGCa
Distances: "
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Sq. Ft.
Size JTiS
No. No.
Stories
No. Dw.
Units
AMOUNT
NeWA Add O
Alter ❑
Repair ❑w,
Demolition ❑
Const.
Mech.
ZONE:
BY:
Minimum Setback
Distances: "
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Estimated Valuation
Side Street Setbact from Center Line
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Date Permit
Const.
Mech.
Electrical
Plumbing
}. S.M.I. ,r r
Grading
Driveway Enc.
Infrastructure
TOTAL
4G
REMARKS
ZONE:
BY:
Minimum Setback
Distances: "
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setbact from Center Line
Side Setback from property Line
FINAL DATE
INSPECTOR
ssued by:
Date Permit
�Qt dated by:
WHITE = FINANCE YELLOW = APPLICANT , PINK= BUILDING DIV131ON
Y
Notice:
Document Cannot Be Duplicated
Desert Sands Unified School District
47-950 'Dune Palms. Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Date 9/28/99 APN # 6131-810-024
No. 19385 Jurisdiction La Quinta
Owner NameDon Redfren Permit #
No. 48790 Street Via Linda Lo #
City La Quinta . zip 92253 Study Area
Tract # Lot # Square Footage 4385
Type of Development ' Single Family Residence No. of Units l
Comments_.
At the present time, the Desert Sands Unified School District does not collect fees on gara„es/carports, covered
patios/walkways, residential additions under 500 square feet, detached accessory structures or repla•:ement 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 fie amount of
1.93 X 1 4,385 or $ 8,463.05 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may no%- be issued
Fees Paid By CC/ B of A/ Jenny McIntire Telephone 345-7186 ;
Name on the check
By Dr. Doris Wilson t
Superintendent 4,
Fee collected/exempted by Sylvia Carrasco Payment Received $8,463 05�%
Check No. 2014914171
Signature
OTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
bove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to :mother public entity authorized to
,,,act them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original -.Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
r
0
'✓ ,a _ °mss
MRY 12 '99 09:02RM INSLI_ECTRO 7144540070 P.1
tit{COM MU RBouggrl:n W
Ant? WItBN t 4M)tDW3 MMLT(k
Donald M. Redfern and Sutata C. Redfern
0082 hjuravina Lang
COW 00 Cats, California 02679
A.P.N.: 63110.024.7 TRA #; 0Wo-.;101411-3
20 Order � ��� Escrow Nu�
-5371-DJM
GRANT DEED
IYX UNilrlRt4ANfirlGliAATt+Ox;)X)rBAtiWgjjLWrl)0CUMM.1�►rAKYTAANSlr..RTAXM-C0UmrY
] computed on fltll va ur f pro fly conveyed, or
computed on fun valu �e va�us of liens or encymbrunceS rcmalnin8 at time txf sale,
unincorporated area; f X 7 City of „W-QWUg _ and
FOR A VALUABLE CONSMERATION, Receipt of which 10 hereby acknowledged,
DONALD M. RiEDFERN AND SUSAN C. REDMAN. TRURTEZS OF THS REDFERN FAMILY
TRUST,
hereby GRANT(S) to DONALD M. REDF$RN AND SUSAN C. RRDFERN, CO-TRUNTIERS OF THE
REDFFRN 1982 FAMILY TRUXT, UNDER OXCLARATION .OF TRUST DATED JUNE 1, 1982.
the fiRowing described property is 160 City -of Le Q81igta. County of RtveWde State of Califurnia;
AN PER LEGAL DESCRIPTION MARKED EXHIBIT 'A' ATTACHED HERETO AND BY THIS
REFERENCE MADE A FART HEREOF.
By;
Document Date., 6
SM17 tiff t".AIXFORNIA
CoUNr.ty r)P
L�
J
prraonalty spfAawd
1*Pf-&m11u hn— in
IfMIM pant and t tbtowledged to etc Thal ) tv W th& person(e) whm nalae(s) WIM Viditf bad b the Wilkin
.,o The lnetn,ment the �/�'/t yexecatT 0 the afine 10 h➢tdlter� Wraulbotbsd npaeityrree) and that by tie jWAheir ai�Tlilure(e)
wrrNass PQ+s�(6) or the egnty npOn behalf Of WCL the peaoe(s) Rood, emoted the InstTvmmt.
� d and odhtal tom{.
til�+atale �
Mail Ta: StalelneflIs 10: SAME AS ABOVE
dt 96ed - :8888689eve
1AMl1
w��• � 17t.1e0i •
r Address NOW Below
:v.l;aaZnsul :�9
PUBLIC WORKS CLEARANCE LETTER
FOR
CUSTOM HOME LOTS }
Dear Builder:
Prior to issuance of a building permit, you will be required to obtain clearance from the
Public Works Department for one, or more, of the following!' - -r
1. - Verification that rough grading. is complete, and the .pad elevation certifications us
prepared-fby a licensed surveyor; or'engineer, are on file' in the Public Works;
Department.
r w
2'. Verificationthat infrastructure improvements and other required tract -improvements
are complete, or sufficiently advanced to warrant build* errriit issuance Tis
P Y 9P"'
3. Prepare an engineered grading plan that provides for on -lot storm water retention;,
and have it checked and approved by the Public Works'Department;: -j
• Tract 26524 (Estancias) Y P"
• Tract 26769 (Mountain View Estates),'
4. Prepare an engineered grading plan that provides for building pad grading in �`
accordance with the existing soils report and tract grading. plan, and . have 'it"-,'{ r}R1
33
checked and approved by the Public Works _Department. z
t
a
• Tract 28034 (South Valley Estates)
y is
iFOR MTERNAL USE BY PUBLIC WORKS DEPARTMENT
.A a
COMMENTS:"
TRACT: x.523
I HORIZATION DATE.
F:IPWDEPrOOCS%FORMS%PW CLEARANCE LE TER.ss
3 ;
10:22A FROM:
OCT.00 10:00 7148581513
"-27-EM 05:50A FROM:
} COMPUTERIZED CONSTRUCTION SERVICES
••J�.•Y• •'rte - —
T0: 176077770 A.1 P:2 3t
HIS,
rra� bl i
TO;171gM1.60 P: 2.12
;i
F.,
t
Friday. oca�ba 27. 2W S
r'..
f.
C+1Y of 1a Qalrtta 1t`s
Community Uavelopmml F' '
78493 Calle Tampico i �)
P.0. Box 1504
LA Qdmw CA 971.3E
LZC 1702
Re: Id4paicr� i+e*J�`1
Job AddvW. 4!790 Vis 1A^ la Quints, CA
OW suns
Per SWlon 1702 Offt Ctlif0mi& BuiWng Code, 01'3 letW e6ai1 serve as my dcsl"*t m of:
John H, faael�er P6 � � r
68487 Hiompy It, Suits 44
Cabe" City, CA 97.234 r
to pa" flim mored n of the .hove prupo
Jf y= have vy q>t, P Feel fka to call aro
slimmly,
Cwnp r,a�ctio� Ssrrlow v fl d
1
. "&I rww rMoM *mor MMr. CA MX
a
- , F.
PAGE:1
OCT -27-2000 FRI 10o05AM ID: l'x
SPECIAL INSPECTION SERVICE
REGISTERED INSPECTOR'S WEEKLY REPORT
JON TANDY
3763.0 Medjool Ave.
Palm Desert, CA 92211
Office (760) 772-7192
Fax (760) 772-7193
Pager 4760) 776-3338
TYPE OF
INSPECTION
PERFORMED
O REINFORCED CONCRETE
O POST TENSIONED CONCRETE
❑ REINFORCED MASONRY
O STRUCT. STEEL ASSEMBLY
O ASPHALT
O FIRE PROOFING
- �6jY
7 OTH R
JOB LOCATION
�$ -770
P' _�i�
/9 T
REPORT SEQUENCE NO.
TYPE F STRU LUREPERMIT
NO.
LATE
DAY OF WEEK
MAT IAL DESCRIPTION
ARCHITECT
I
HRS. CHARGED
Jv
EN
ER
ASSISTANTS
HRS. CHARGED
INSPECTION
DATE
GENERAL
CONTRACTOR 2 t _
SUB
CONTRACTOR
l'016 GG
l _
—
Jr
:57-
e
/e
/,o —7Ac
/
6
O
-42
COPY SENT TO CLIENT O
CONTINUED ON NEXT PAGE O
PAGE
OF
CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY
KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE
NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED
'PLANS. SPECIFICATIONS. AND APPLICABLE SECTIONS OF THE
OVERNING BUILDING LAWS.
IGNATURE OF REGISTERED INSPECTOR
1S6374930��T
ATE OF REPORT REGISTER NUMBER
"I A
4
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: 48-790 VIA LINDA
Use Classification: SINGLE FAMILY DEWELLING Bldg. Permit No.: 9805-067
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL
Owner of Building: DON REDFREN
Building Official
Address: 23-082 MARVILLA
City: COTO DE CAZA,CA.92679
By: STEVE TRAXEL
Date: 5-23-01
POST IN A CONSPICUOUS PLACE