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05-2474 (SFD) + 00312749055 Avenida Anselmo 22 P.O. BO)e 1504 IE 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 J T4ht 4 XP Qum& Application Number: 0.5,00.0=02:74 Property Address: {49055 AVENIDA ANSELMO APN: 658-290-024- - - Application description: DEMO - SINGLE FAMILY Property Zoning:. LOW DENSITY RESIDENTIAL Application valuation: 0 Applicant: Architect or Engineer: ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 C ss: B License No.: 442116 Date: !.t/ Contractor.- OWNER -BUILDER DECLARATION hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she 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 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 and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the 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 or she did not build or improve for the purpose of sale.). (_) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractorls) licensed pursuant to the Contractors' State License Law.). 1 _ 1 I am exempt under Sec. , BAP.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: R LQPERMIT Owner: BRAD BUETTNER 49200 AVENIDA EL NIDO LA QUINTA, CA 92253 Contractor: , KENNEDY CONSTRUCTION CO, T.A. 48751 SAN PEDRO LA QUINTA, CA 92253 (760)564-4660 Lic. No.: 442118 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/20/05 ----------------------------------------------- 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 and policy number are: Carrier STATE FUND Policy Number 0024567-2005 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_Qde, I shall forthwith cgmply with those provisiggs. . WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this 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 application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 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 armee to comply with all city and county ordinances and state laws relating to building construction, ark hereby aut►yize representatives of this coupty to ent pon the above-mentioned property fpr inspection p oses. // Application Number . . . . . 05-00002474 Permit . . . DEMO PERMIT Additional desc . . Permit Fee . . . . 45.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/17/05 Qty Unit Charge. Per Extension BASE FEE : 45.00 --------------- Notes and Comments DEMO TO BARE GROUND OF SFD & ABANDONEMENT OF SEPTIC SYSTEM. PERMIT ISSUED TO GENERAL CONTRACTOR SUBCONTRACTING TO C-21 PER APPROVED SUB -LIST. Fee summary Charged Paid --------------------'------- Credited Due ---------- Permit Fee Total 45.00 ---------- .00 ---------- .00 45.00 Plan Check Total .00 .00 .00 .00 Grand Total 45.00 .00 .00 45.00 LQPERMTT CITY OF LA QUINTA SUB -CONTRACTOR LIST (0 IC (.Z0 JOB ADDRESS �f ��SSI'4Y� A�i/ji%C%moi PERMIT NUMBER © .S -Z OWNER 1�y'9-b N BUILDERT_ Cef�- This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all .information requested below must be completed by applicant. "On File" is not an acceptable response. Trade /Classification Contractor, :.;: ::::;>_:;;:....:;;:: ;: State::Contractor s License :-.;:....:: >. Workers Com ensationar su�ance:°`.;'' Company Name Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) EARTHWORK (C-12) CONCRETE (C-8) FRAMING '0;-W'-: STRUCT: STEEL (C-51) MASONRY (C-29) PLUMBING (C-36) LATH, PLASTER (C-35) DRYWALL (C-9).:. .: HVAC (C-20) ELECTRICAL. (C-10) :.. ROOFING iC=391.:`..:` SHEET METAL (C43) FLOORING (C.: 5): GLAZING (C-17)`. INSULATION .(C-2) SEWAGE DISP: (C-42) PAINTING (C-33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13) LANDSCAPING (C=27) POOL (C-53) � ,�� ���v� 12 �i� � C,-7( `� _32e 9 03. �� ���o I i � Ilan Jun 0-9,05 06:22p r Stan Miller Yachts ~Inc a 562 598 5349 ,6> p•2 Thursday, June 09, 2005 City of l.,,a'Quilitii Rc: Demolition Permit Requirements 49055 Ave. Anslemo . .. .. ... - To 11 , t..Niru:C:.r ncern:-.... ... _ _w ... :1.w. , ,..__ , ..- ... .., .: -., .. ., . - .. ,. ....-• -- Per your request, I. am including for you a copy of the Grant Deed for the above. captioned property. This letter will serve; as my official request authorizing the d the bear lot. emolition of said property to ,. Sincerely_ Brad .Buettner Jun 09 05 06:22p Stan Miller Yachts Inc 562 598 5349 p.3 TICOR TITLE ®®c to 20os-00selsla:3 SAN BENARC-INL) 01/23/2005 08:00A Fea:27.00 page I of 1 (Jot T Tax Paid R c0l"LtiGREQUESTEDBY Recorded in Official Records County of Riverside AND N'HE1 RECORDED;12,AiL'TO: Larry U. Ward A"essor, County Clerk d Recorder The Buettner Family Trust dated 12-13-94 4n Marina Drive IJI I( II I ��LIjIII>III�IIEI�III�;III�IIfII��III Long Beach, CA 90803 I U f;E I a:ce Ca PcOa, I I _J_ _. ------ A, ' A Q ! V CCFY LO•YG REFI NO roChC ti:Gt4 bl�� A• P•'�.: TRA #: f -y Order )\o.: 5259701-40 v. Escrow No.: 04 -7056 -ICES GRANT DEED 1'HE UNDERSIGNED GRANTOR(s) DECLARE(s) THAT DOCUMENTARY TRANSFER TAX IS: COuNTI 550.00 X ] computed on full value of property conveyed, or l J computed on full value less value of liens Or encumbrances remaining at time of sale, [ 1 unincorporated area; [ ] City of LLQ. nta , and FOR A VALUABLE CO 'SIDERATION, Receipt of w-bich is hereby acknow�ledeed, E1.1 Rome Yessayian, Trustee of The Yessarian Familh' Trust Dated. October 1, 19RS hereby GRAN'TYS) to Brad Buettner, Trustee of The Buettner Family Trust dated 12-13-94 the following described property in the City of La Quints, County of € verside State of California; Lot 133 of 'tract La Quints Golf Estates #1, as per snap recorded in Book 37, Page(s) 96, 97, and 98, of h4aps, in the Office of the -County Recorder.of said County. Roxie Yessayian,Trustee Docu;rient Date: December 2". 200; STATE OF CALIF,- R IA )SS COUNTY Ol' iv Com.=A7_._— o0 6 before. m_. personally appeared l �.L� r ,�� ����� ! -• _. personally known to me (or proved to me on the bests of saris! ctory rvidence) to be the persons) whose nar e(s) is/are subscribed to the within irstt inert and acknowledged to me t tat he!shu they eX-1-1(ed the Salle in Itis/her/their aLttu)rized capacit,(ies) and that by hi.sther/their sigmiwre(s) on the iostrununt the perso i(s) or the entip• upon behalf of which the persor(s) acted, ex cuted the instnlmert. WITNESS my hand a.nd official seal. This area for official notarial seal. - Pt9NERE tt. � C0MMb&tnV 147664 NOftY Ftlbt: - e ' Rh aft Casty W COMM- leo "Mar 16, 20M -Mai! "Pax Statements io: SAML AS ABOVE or Address Noted Below