9804-140 (SFD)P.O. BOX 1504 l TEL 760-777-7012
78-495 CALLE TAMPICO INSPECTION REQUESTS
LA QUINTA, CALIFORNIA 92253 760-777-7153
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INSPECTION RECORD
OPERATION I DATE INSPECTOR
BUILDING APPROVALS
OPERATION DATE I INSPECTOR
MECHANICAL APPROVALS
Set Backs
Forms &Footings
Slab Grade
Steel
Roof Deck
O.K. to Wrap
Framing
Insulation
Fireplace P.L.
i�
r (
Underground Ducts
Ducts
Return Air
Combustion Air
Exhaust Fans
F.A.U.
Compressor
Vents
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
Electric Bond
Footings
Main Drain
Bond Beam
I Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
I
Electric Final
Waste Lines
Healer Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K, for Finish Plaster
Sewer Lateral
Sewer Connection
/
Pool Cover
Encapsulation
COMMENTS:
Gas Piping
Gas Test
Appliances
i
Final
Utility Notice (Gas'.
r 4� -57
ELECTRICAL,. �.PPROVALS
T�nio. Power Pole
Underground Conduit
Rough Wiring
Low Voliage V'Pring
Fixtures
Mair, Service I
Panels
—
ISub
Exterior lie;,�ptack!
G.F.- ---
Smoke Det ctoif�,
-
Temp. Us: of Power
txi ,! tirx tpe;,pt
�f7'7 - 565
Building
Address
Owner
4 urn
Ch�l P.O. BOX 1504
78-495 CALLE TAMPICO
-- LA QUINTA, CALIFORNIA 92253
tit Q44a:,.,
Mailing h
Address 0• %�Q x / /,V C/
City IZIP
Contractor
Address
City Zip Tel.
State Lic. City
& Classif. t S 3 Lic. # 4 "83 q%
Arch., Engr.,
Designer
Address Tel.
City I I
Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commoncing with Section
7000y of Division 3 of the Business and Professions Code, and my license is in lull force and
ellecl.
GNA ❑ATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the foliowing
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requims a
permit to construct, after, improve, demolish, or repair any structure, pdor to Its Issuance also
requires the applicant for such permif 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 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).
[: I, as oner 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, Bussness 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,
providedthat 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 confrac(or(s) licensed pursuant to the Contractor's License Law.)
17 I 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
n Copy is filed with the city. ❑ Certllled copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuallon
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
Date Owner
NOTICE TO APPLICANT., ff, after making this CmffFeafe of Exemption you should become
subject to the Workers' Compensation pfowa+ons of the Labor Code; you must forthwith
comply with such provisions Or this 00"Al shah bd deemed revoked.
CONSTRUCTION LENDING AGENCY
I 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 parmil when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify Thai I have read Ihls appllcalion and state that the above informaliori is correct.
I agree to comply with all city and county ordinances and stale laws relaling to bullding
construction, and hereby authorlxe representalives -of this city to enter the above -
mentioned properly [or inspection purposes.
Signature of aoplicanl Date
Mailing Address.
City, State, Zip
gSO4 -14 0
APPLICATION ONLY
BUILDING: TYPE'CONST. n OCC. GRP.
A.P. Number 4 `rr `22 — oil
Legal Description I frz
Project Description
u
Sq. Ft. No.
Sizel� 3 3 Stories
No. Dw. t
Units !
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
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 Pipp. Line
Side Street Setbac fr C nter Line
Side Setback fr y Line
FINAL DATE T
SPECTM �
Issued by: Date� C;9, PO
Validated by:
Validation:
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
By
Date 7/27/98 APN #
No. 17393 Jurisdiction La Quinta
Owner NameHoward & Connie Johnson
No. 77-855
City La Quinta
Tract #
Street Calle Chillon
Lot #
Type of Development Single Family Residence
Comments
774-222-011
Permit #
Log #
Zip 92253 Study Area
Square Footage 1,633
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 1,633 or $ 3,151.69 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 CC/Palm Dsrt National Bank/Purrfect Pool & Cons. Telephone
Name on the check
Dr. Doris Wilson
Superintendent
Fee collected /exempted by Juanita Green
Signature
Payment Received $3,151.69
Check No. 80940
NOTICE: Pursuant otAss#nbly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90-day approval period In which you may protest the fees or other payment identified
above will begin to run from the date an which the building or installation permit for this project Is sssued or on which they are paid to the District(s) or to another public entity authorized to
collect them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
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HECENED FOR RECORD
AT 2-00 O'CLOCK
PAID
Doc. Thiinwor Tax DEC 199.1
Alir. Co. ReG�wder d+�n,r,,,,�
an _ Hla°F FIN
'T1& 0-20.01 r GRANT DEED SPACE A$p RECoRDER,a ui3
the undersigned grantorw deg48.
let--
❑Gctrmentary transfer tax 1s
[ X 1 Computed an full lue Gf: pr6�arty conveyed. or
COMP[ 1 Unincuted on full valireaue less value of liens or encurnbranGes remaining at time of sale,
f ] Unincarparatascl Area City Of Le Quanta
FOR A VALUABLE CONSIDERATION. receipt of Which le hereby acknowledged, James. O. Varble �a-�
Varble, Hu$band and Wife as Joint Tenants who '3uirc� tir1P ets Virc i H.
hereby OiiAN7IS} to Howard
nip ]{. V�rk�lp
nd Virginia oward A. JoliiYsnn and, Connie � We Johnson. or their xueceegor,t, as
Truei,eem of the .1Ohnsvlr Living Trust, u/A dater] November 5, 1996
the following described real Property In the City of La Quints
County of Rivarode, State of California:
Lots 1 and 2, 81ock 296 of Sant& Carmeiita at Vale La Quints, Unit #27, as per map recorded in Book i
Maps, In the Office of the County Recorder of sold County. 8, Page 82 of
7 74 - Z 2.Z. - b 1 Z - I -or A* $4 -03 S Av i MftQY.q
DATED. December 2, 1997
Ir-L-
OLD REPUBM' TITLE CO
RECORDING REQUESTED BY:
Fidelity National Title Company
escrow No, Gas-ce
Tilt* Order Nc,
When Racarded Mail Document
and Tax Statarnant To:
Mr. Howard A. Johnson
P.O, Box 1004
Rancho Mirage, CA 92270
STATE OF CA
COUNTY OF�
,ON
f
before me,
Personally appeared
personally known to me for proved to me on the basis
Of satisfactory evidence) to be the is
whose
ngrU1W Islare subsCribod to the Within instrument and
acknowlediBi 14 me that helsheithe executed the
seine in hislherIjb it autirorixp0 c }act{i$ a and that
by hia/herltheir si na u►e{s} nr► the Instrument tilt
parson{sl, or t�se entity upon behalf of which the
per-rnn{sl acted, MOUted the Inatrument.
WitnesA my handed official seal.
Signature --- `
BARBARA PE'ilft
Comm, t 112817t
x1 NOTARY PUBLIC-CALliORNIA
Son Luis Obispo ('mly «•
My Comm. f,piits IAutA 6.lOOI
4,/ �1L
FD-2 f ;t IAev 9/941
MAIL TAX STATEMENTS AS blREC
GRANT DE6b