Loading...
0001-154 (SFD)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 714188 10!31/ C Date9- /U Signature of Contrae( 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 / l 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 GOIZ ?N 1vAQLE IN -3. Policy No. NWC,' $44063.01 (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 37.00 of the Labor Code, )„shall forthwith comply wif t�hoo- provisions Date: /.. w-- OPApplica.lt�Y-'.... �: Warning: Failure to secure Workers' Compensation code age 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 to enter upon the above-mentioned prope y or'nspectio purp'ses. ....� _ Signature (Owner Agent) --+> '/ Date - Signature � ��v PERMIT # - BUILDING PERMIT 0001_153 DATE ^ ' � /hAVALUATION LOT TRACT J /C6ll _ &369i087.70 6 111 til t l t/ JOB SITE`'' . ADDRESSj 4 v� „ir ..�1Cff APN 775-�.�f,�i• 00611 OWNER CONTRACTOR / DESIGNER / EN (NEER C�"liTi if CROWFIL (rC)A MLrW iM-S CENTURY CRfJWELL COWAUNIr 1535 00, TV IL : ' ? U.'#2,00 1.535 30, TO 91MET, .SII°E. x`200 SAN "EnNARDOTO CA S,AW R `i43AFTlI1W0 CA. 92:409 (909)381-6007 C-AL0 2120 USE OF rEnMIT =ICL 3 FA2vMY 1)VffJ.;L:[f. G SF.D - PERMIT DOES NOT iNCLUDE'BLOCK WALLS OR POOL 1 3 ` 3 CUSTOM CONSTRUCTION 4.40 ,00 OF PORCH/PATIO 652.06 Sly OARACIFJCARPORT (3F) 1?;110, 0 ES .D COST OF CONSTi2WTTC+N 369,087.10 P1 wRLKIT .M` SUMiVi.ttiRY C(YNSTRUCTf N "- E 101-000-418-000 SOX." PLAN CHECK FEE - 101-000-439-318 $1,.290.22 1199, DEPOSIT 101-000-439-318 • 500.00 €d1ECF,ANICAL. pjreg 101-0008-421.000 $115.00 EL CT:RIC AL FEE 101.000-420-000 $246,71 PLLt3yif INO F'EE 101-000-419-000 00-419.000 $266650 STRONG MOTION F'EE- FtW1) 101-000-x41.000 S36191 n iNQ FEE 101000-423-000 $20.01 DUVELOPER IMPACT PEE " $1,907,00 ART 1N PUBLIC PLACES � Rr? r 701-000-255-000 $427.1? a ; 913B�"1V1 CCi? MITCrIlON' ANS ld C,111~C $5,8941.56 IX SS ]PRE -PAID FFZ9 _$500.00 RECEIPT DATE BYE E DATE FIN ALED INSPECTOR 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 Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace .L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath / Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS -SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I 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 b Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fddures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: r LICENSED CONTH `"y '- I hereby affirm under penalty' of p4dt H Chapter 9 (commencing with.Seatlor W ` -.Professionals Code, and my License p License +Y , -, - _ 3 ?14188 r ZDate �a `' Signature of cor tr r t QWNER BUILD JJ W ` ' thereby affirm unrfer penalty of perj' CL . Uce iiae Law for,ths following reason; Z (') + I,'•as owner•of. hi property, or 1533 �40,'iS":b' ycofnpensation,,will, do the work, and t �/�y��� �' `S".BMARDIl�TO.' A - 7(408, SiW(Sec 7044;Business & Professic `owner my employees whh`'wages as their sole As of •the'property,' e (909)381^600'1 CBLI►i 2120 contracture t000natrirCt the•project '•code) "' O �I�arri�exemptunder Section + `� '�'•DAtq' Signature.`o1 l- y I Z.'WORKER'S°CO.MPEN j .CC } i hereby affirm under -penalty ;of pe ... F-`C�i have and will .maintain a certifl( X-til}t_T . ' '•Comperi tion; as'piWded 'for , Sl O �J Q `'performance of the work for which this , ) ° C have and willrtisinta' Wworkers O,V ��Y SecUon 3700 of the Labor Code, fo'r tt CL perMtiis issued. workers' compen OOLDEN�I.R1N�' .•.�. =Z � Q , Carrier.• . g is's9cUon need not be Completed,if t , ( )J ertlf tha(in the performance ,o '�I shall not employ:`any person in:any, �, worker. 1-c pensation laws ofvf I - o Code,Ighall forthuuyylth compl Date • « t�', VfjAPpli. Warning-Tallure to secure Workers' i shall subJ'ect ah`employer to criminal p `addition to the cost of'compensatlon, c of the'Labor Code,,interest and attome ;,IMPORTANT Applicatlon is hereby me fork a permit subject to the conditit 'appiicatitin r. Each person upon whose behalf tl whose request and for, whose. benefi s' ,any permit Issued as a result.of this I { • & hold'harmlessahe' City of La'AUiI r , '`'2 Any permit issued as a result of t f • ''work, Is .not commenced within `18( ` +. permit : or cessation of work for'180 L •'P I',certity.that Iheva read his appiicatior • correct: I'*agree to comply With'all City 'iconstruction, -and hereby authorize rel the above•montioned pro or `spa N { Signature':(O{ Ayen t�. NV 1 VA YCVLARAI IVIY s •': t �'�. .•+ ry that°lam°licensed undeiprovlsionseof .R. -r ,• -PgRMrr# - ) "D�N U L G PERMIT' 7000) of Division 3 of.the Businbss and DATE v � r - W01,164 s In.fuil force and effect: t p69,ii18":?ii , 6 �' ' x t �. 4 Lic. CIeAe ` F.xp Dela r „ " :, = j • JOBS r ADDRESS. EMACH - q 7 3=1711 t106 -, - _ 3 t = tr r t OWNER' CTOR./.DEBrQNER/ INEEq ER DECLARATION r C 1%%6t1Y G"RC�WIi t: CM1iiTRii'CR©-WM, G�Qumum= y that I arm exempt from the Contractor's 1 25 goo To, MAW, . 41& 1533 �40,'iS":b' .. r. -. �/�y��� �' `S".BMARDIl�TO.' A - 7(408, �y��� R*A0A0,I�' O�'1i� B *6 CA:'OUo g ; my employees whh`'wages as their sole ! , ` (909)381^600'1 CBLI►i 2120 ie structure Is not Intended or offered for i nals Code): ,: =. t '`i . USE OF PERMIT y. m exclusively contracting ,With' licensed `. MTt3LE FAMMY D1kJMJJ 0 y I (Sec. X7044, Business �' Professionals . ` B&P,C, for this SFD ^ PERMIT DOES NOT INCLUDE BLOCK WAUZ OR POOL , Owner SATION DECLARATION^ ti , Jury one of tf a foIIowing_.declarationa ate of consentto•seH=Insure (or workers' CUSTOM CONSTRUCTION 407. 00 Sp ` Iction'3700 of'the t::abor Code; for the PORCIWAVO .. 632.00 Sl►*" permit is Issued _° 0ARAWCARPOR cSFr 17,i1gff0 compensation Insurance, as r"UI ed by - y 6 e performance. of the -work for which this. cation Insurance Canter- & poll;- no are: Policy No r.. Emu= OEM OF CON>gI'RUGTIO�i �9.087.7Q. p9low FSE g�Y:. � 5 ; ie permd vajuatlon Is for' $1000.0 or less). ' CON$TRUC7JON PER000418.400 the work.for which this permit is Issued;, P>" CH9iC P'K$ .1,01-000;439>318 � mariner so to the nia an as to become subject d ag that_(f.t should become t nit DEPOSIT •' .'1 Ol •OOCi-+ 28.318: .: � <ss00.00 a �. . provisions orae of of otthe'r `MECHANIt�Ail. ) till`-QDQ«421-000 S provision ; . E1.BCTRICAL PB$ ,: 101.004-+IZ4.000 1246.11 a PLU?AI§INO iii "1 b I.00"". .000 :om"perisal CO f e is unlawful and' gyp' , ti S RONO MOTION FSE-.RP.81L� 141.000.241=000 a 336.41 t rnalttes and civo ines up• to $100,000, jri1.0�-(100+113 000' f24 ' amages as provided for in Section 3706 DEVS1AOWIMPACT FU' ? 901:00' ' y's fees. M. JRIt'C IN PUBLICi, PLACID-'RIti51L:701 000.2511, 000 °�t72'T# t de to the'Director of BuildingandSafety,fu: " ' `� �' : �• Ins , and restrictions"'set forth on 'his .' lis application Is made 8`each`person at i1B•'rG)'T . Ct�N�tUCIION AN4 F%I�T CIS "� $5,890.56, ' work Is performed under or pursuant to .C1i , applicaton agrees to, &shall, Indemnify L1 S.9 �'RE"PAI:�)'I 69 4500:00 its, Its officers, agents and employees • ' " ' its application becomes null and void if 1i'MALper`Iq Mi' -No (/ <. >�+ tm,%. days from date of issuance of such. r' .' < :J s _ days will subject permit to cancellations , and -state that the above Information is And State laws relating to the building Iresentatives%.of this City to :enter upon Cti�}fl u see. RECEIPT I'l DATE BY DATE FINALED INSPECTOR Date Building 1!2 Address56 -3 P.O. BOX 1504 78-495 CALLE TAMPICO �G1a LA QUINTA, CALIFORNIA 92253 Mailing Address �rJ35 5. S �+` ZCo ,CityZip Tel. Q� 'A*) �T'.?OA2-0100 i 0401 36 { - (,C)0 Contractor SA R7- A-, Aeo,r Zip State Lic. City & Classif. -j I tl! 8� Lic. # Arch., Engr., Designer �Ehi Q G Jt I- A 9— 3 A,�,so Address Tel. Ivr3 W Gle my 6 _,� e. I 1 r lv- 7- ^ (0U1Pf2 nCity Zip State K 11iE%I D CQ Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 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 for 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 (S500). I-] 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, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is soldwithin 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) ' 1'1 1, 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.) 11 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 r7 Copy is filed with the city. ❑ Certified copy is hereby furnished. f' CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (8100) valuation or less.) I certify that in the performance of thg 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 1hereby 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 applicant Date Mailing Address City, State, Zip WHITE = FINANCE APPLICATION ONLY BUILDING: TYPE'CONST. " A.P. Number Z/ �� 170 T ^ Legal Description L.l�f 60 1 Project Description . O0C. GRP. 00!� �} iz.. J 3V Z Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Sq. Ft. No. Size Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Cn;,T� ' P_ !2 1�4.4j�t 'Tog 3 A t (ooJ Validation: Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. fje)Q r "' Plan Chk. Bal. Const. Mech. Electrical,,_ Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback frorr Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: YELLOW = APPLICANT PINK = BUILDING DIVISION 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 7/10/00 APN # 775-170-006 No. 20687 Jurisdiction La Quinta Owner NameCentury Crowell Communities Permit # No. 55-362 Street Pebble Beach Log # City La Quinta Zip 92253 Study Atea Tract # Lot # 6 Square Footage 4407 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 :'ollowing reason: EXEMPTION NOTAPPLICABLE iM' y a This certifies that school facility fees imposed pursuant to Government Code 53080 in the amouin.of {} 2.05 X 4,407 or $ 9,034.35 the property listed above and that btdiding �`k'Ff�;' permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued t +a,',* Fees Paid By cc Tokai Bank / Ed Knight Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Sheryl Simmons Payment Received Check No. Signatu Telephone 909-381-6007 $9,034.35 200078634 40TICE: 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 prates: 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 :oliect them on the Dlsbict('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 ,_=b RECORDING REQUESTED BY I JOSEPH P..000HIUTO, ESQ. AND WHEN RECORDED MAIL TO: ,,;,.' FLAW OFFICES OF' =JOSEPH P. OCCHIUTO d0°D6 P.O. BOY* 33140 o" LRIVHRSIDE CA 92519 J ,i ,a ' 1 GD 964 IG - TN15 FORM FURM514tU 9T TRU5TOF45 SEGUNIFT 5ENVIGE 191619' The undersigned Grantor(s) declare(s) under penalty of pedury that the following,is trua and correct: Documentary transfer tax is $ Not of Public Record ❑ Computed on full value of property conveyed, or ❑ Computed On full value less value of liens and encumbrances remaining at time. 'of sale. ❑ 'Unincorporated area: ❑ City of and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, SANTA ROSA DEVELOPERS, LTD., a California Limited'Partnership hereby GRANTS) to CENTURY CROWELL'SANTA ROSA, LLC•, a California Limited Liability.Compant- the following, described real property in the County of Riverside , State of California: As set forth on Exhibit "A", appended hereto. SANTA ROSA DEVELOPERS, LTD., Dated December 30;1999 a California Lim -ted Partnership By: Santa Kosa Deveiopers, inE. State of Califomia a California corporation County of Riverside 24 On December 30,1999. y: ro sn, before me. �,l:S. 73 its President t personally appeared Jeff Troesh 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 person(s) acted, executed the instrument. WITNESS my hand and official seal. Susari J. Howard Comm #1"147611. n^ NOTARY PUBLIC - CALIFORNIAu/ RIVERSIDE COUNTY ' 0 Signature Comm Exp. July 20.2001 Title Order No. Escrow, Loan or Attorney File No. MAIL I AJC STATEMENTS TO: Century Crowell Santa Rosa, LLC., 1535 South "D" Street, San Bernardino NAME ADDRESS Cn'Y,STATE. ZIP CA 92408 - YOUNG ENGINEERING SER VICES *Engineering •Architecture•Surveying••Building & Safety Services Letter ofJransm[ttal To: City of La Quinta Date: 5/26/00. y Project: Century Crowell PC0001=154 3` Check Attn: Greg Butler W. 0.: Tel No. Tract No.. We are forwarding: By Messenger By Mail Your Pickup No. of Copies" Description: 1 PLAN/CALLS. • z Comments: Structural plans are approvable. This Material Sent for: Your Files X Per Your Request. Your Review Approval ' Checking . At the request of. Other By; Phone # 342-9214 47-159 Youngs Lane • Indio, CA 92201 • (760) 342-9214 •Bron Young • t _.N Certificate. of Occ, T . . a� r ° ° Cit pf La. in Aff Building. and Safety Department F�oFti V 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 followhig: BUILDING ADDRESS: 55-362 PEBBLE BEACH Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0001=154 Occupancy Group: R=3 Type of Construction: VN Land Use Zone: RL Owner of Building: CENTURY CROWELL COMM = . Address: 1535S. D STREET STE 200 • City: SAN BERNARDINO, CA., 92408 By: RICHARD K. KIRKLAND Date: 7/9/01 Building Official - a • POST IN A CONSPICUOUS PLACE - _.N Certificate. of Occ, T . . a� r ° ° Cit pf La. in Aff Building. and Safety Department F�oFti V 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 followhig: BUILDING ADDRESS: 55-362 PEBBLE BEACH Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0001=154 Occupancy Group: R=3 Type of Construction: VN Land Use Zone: RL Owner of Building: CENTURY CROWELL COMM = . Address: 1535S. D STREET STE 200 • City: SAN BERNARDINO, CA., 92408 By: RICHARD K. KIRKLAND Date: 7/9/01 Building Official - a • POST IN A CONSPICUOUS PLACE -