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07-2272 (RPL)P.O. 'BOX 1504 78-495 CALLE TAMPICO LA" QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 07_0.000-2272� 52952 AVENIDA ORREGON 773-315-016-10 -000000- POOL - RESIDENTIAL COVE RESIDENTIAL 18000. Architect or Engineer: W4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: HOFFMAN WILLIAM B, 52952 AVENIDA OBREGON LA QUINTA, CA 92253 Contractor: NEUBURGER EQPMNT RN'I P.O. BOX 623 LA QUINTA, CA 92253 (760)275-5740 Lic. No.: 746662 VOICE (760) 77777012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/13/07 F ONSan, u B _ Ci -f .OF LA �FUIWA FINANCEE 07'72'- - AP - 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 fSec. 3097, Civ. C.). Lender's Name: P. Lender's Address: ' LQPERMIT F performed under or following issuance of thispermit. 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 thisapplication 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 oft cQounty-to enter upon the above-mentioned property for insoestion purpp Date: " IV '67Si re (Applicant or -Agent): d - LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION, I hereby affirm under penalty. of perjury that_I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section .7060) of Division 3 of the Business and Professionals Code, and my License is in full force and effect." _ I have and will maintain a certificate of consent to self-insuie for workers',compensation, as provided License3 .Class: C12 C5icense No.: .746662 for by Section"3700 of the Labor Code, for the performance of the work for which this permit is issued.. 7 ntractor: �� , 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 _ R -BUILDER DECLARATION Xmexemi:it insurance carrier and policy number are: I hereby'affirm under penalty of perjury t6t from the Contractor's State, License1aw for the Carrier STATE FUND'- Policy Number 1576693-200'6*. following reason (Sec,'7031'.5,'Business and' Professions Code: Any city or county that requires -a permit to- _ I certifythat, inahe performance of the work for which this permitis issued, I shall not employ any ° construct,. alter, improve, Ceinolish,.or repair any -structure, prior to its issuance, also requireff' the applicant for the person in any, manner so as to become, subject to the workers' compensation laws of.California, 'and permit to file a signed statement -that he or she is licensedd-pursuant to the provisions of Contractor,'s State agree that, if I should become subject to the workers' compensation provisions ofSection- License Law (Chapter 9:(commencing with Section 7000) of Division 31of the Business and Professions Code) or 700 of the Labor Code, I shall forthwithco. ply, with those provisions. that he or she is exempt therefromandthe basis for the alleged exemption. Any violation of Section 7031.5 by �7 a.Appli any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (Arm ( 1 1, 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 (Seca 7044, Business "and Professions Code: The WARNING: FAI E TO SECURE WORKERS' C; ENSATION COVERAGE IS UNLAWFUL, AND'SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, _ - SUBJECT AN EMPLOYER TO -CRIMINAL PEN IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within , SECTION 3706OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. . _ one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for-thepurpose of sale.).- APPLICANT ACKNOWLEDGEMENT,' -Application (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on.this application. - property who builds or improvesthereon, and who contracts for the projects with a contractor(s) licensed _ 1 . Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of'this application, (_I I am exempt under Sec. , B.&P.C. for this reason 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 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 fSec. 3097, Civ. C.). Lender's Name: P. Lender's Address: ' LQPERMIT F performed under or following issuance of thispermit. 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 thisapplication 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 oft cQounty-to enter upon the above-mentioned property for insoestion purpp Date: " IV '67Si re (Applicant or -Agent): d Application Number . . . . . 07-00002272 Permit . . . BLDG POOL PERMIT Additional desc . Permit Fee . . . . 189.00 Plan Check Fee 122.85 Issue Date . . . . Valuation . . . . 18000 Expiration Date 2/09/08 Qty Unit Charge Per Extension . BASE FEE 45.00 .16.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 144.00 Permit . . . MECH POOL Additional desc . Permit Fee . . 26.00 Plan Check Fee 6.50 Issue Date . . Valuation 0 Expiration Date.. 2/09/08 Qty. Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 ---------------------------------------------------------------------------- EA MECH FURNACE >100K 11.00 Permit . . . ELEC POOL PERMIT -RES Additional desc . Permit Fee 45.00 Plan Check Fee 11.25 Issue Date . . Valuation 0 Expiration Date 2/09/08 Qty Unit Charge. Per Extension BASE FEE 15.00 1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00 Permit . ... PLUMBING Additional desc . Permit Fee 33.00 Plan Check Fee 8.25 Issue.Date Valuation 0 Expiration Date .2/09/08 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB FIXTURE 12.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL/SPA ALARMS/ BARRIERS SHALL "BE.IN LQPERMIT Application Number . . . . . 07-00002272 Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION EQUIPMENT ENCLOSURE NOT INCLUDED (NO WALLS) Fee summary Charged Paid ------------------------------------- Credited -------------------- Due Permit Fee Total 293.00 .00 .00 293.00 Plan Check Total 148.85 .00 .00 148.85 Grand Total 441.85 .00 .00 441.85 LQPERMIT Bin # r' Cl / :of La uinta `'1 _ Q 'Building U Safety. Division. P.O. Box 1:504,:78=495 Calle:, Tampico. La Quinta, CA 92253 - (760) 777-7012 Building. Permit Application and Tracking Sheet Permit :# 61- ` Project Address: _ q�'� N Owner's Name: J� 'Address: A. P. Number: Legal Description: Contractor: "City;'ST, Zip: — -u T0e046ne:.7w = Address:' �� � x Project,Description: ' D c7 ( F - City, ST, Zip:/ -4 -us �. .. . Telephone: c . a2 State Li # : City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #:Project Name of Contact Person: LCotistruction Type: .. Occupancy: type{circle one) Ne Add'n Alter Repair Demo. Sq, pt ; . #Stories: #Units: Telephone # of Contact Person: _L d. of Estimated Value of Project. fid, APPLICANT:DO NO,T._WRITE BELOW THIS UNE # Submittal Req'd Reed T12ACKIIVG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reyiewed, ready'for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Energy'Calcs.. Plans picked up Construction Flood plain plan Plans resubmitted MechanicalI.. Gradiag.plan 2°"Review, ready for corrections/issue' Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S. M.L II.O.A. Approval Plans resubmitted. Grading IN HOUSE: 3'" Review, ready for correctionsrssue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. APpr Date of permit issue School Fees Total Permit Fees P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA,' CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Application Number:_ . 0s7 -'R000_21272 Property Address: -5.2'9'S2�k IDA OBREGON APN: 773-315-016-10 -000000= Application description: POOL - RESIDENTIAL Property Zoning: COVE RESIDENTIAL Application valuation: 18000 R D Applicant: Architect or Engineg� a .f .2009 € �� I PG L�_Q 7`ll; N_�rr3.iiNTA r, - Owner: LEO HUBBARD 52952 AVENIDA OBREGON LA QUINTA, CA 92253 Contractor: Owner Date: 7/28/09 --------------------------------------------------------------------------------'----------------— LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I.hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following,declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have andwillmaintain a certificate of consent to self -insure for workers' compensation, as provided License Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is _ issued. - Date: Contractor: _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor OWNER-Bul LDER .DECLARATION hereby affirm under penalty of perjury that 1 am exemptfrom the Contractor's State License Law for the following reason ISec: 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 (commencing with' Secbon 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 arly applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ( 1 1, as owner of the property, or my employees with wages as their sole compensation, wili'do the work, and the -structure isnot intended or offered for sale(Sec 7044, Business and Professions Code: -The Contractors' State License Lawdoes 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 y__ 1 I, as -owner. of the property;:am'exclusively coritracting :with licensed contractors t6 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 contractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason ate: NST4w—cTION 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 ISec. 3097, Civ. C.I. Lender's Name: Lender's Address: LQPERA11T Code, -for the performance of the work for which this permit is issued. My workers compensation insurance carrier and policy number are:. - Carrier Policy Number - I certify that, in the. performance of the work for which this permit is issued, I shall not employ any - person many manner so as to become'subject to theworkers'-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 to, with those provisions. _ vLi r . t .:1 pplicant: ' 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 ofBuilding and Safety for a permiisubject 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) 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 ofa`t(Applicant or Agent): this my to enter u n the above-mentioned property for inspection pur es. '7 n a. ` -” �'� nature Application Number . . . . . 07-00002272 Permit . . . . . . MECH POOL Additional desc . Permit Fee . . . . 26.00 Plan Check Fee 6.50 Issue Date . . . . 8/14/07 Valuation . . . . 0 Expiration Date 2/10/08 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 ------------------------------------- EA MECH FURNACE >100K --------------------------------------- 11.00 Permit . . . BLDG POOL PERMIT Additional desc-. Permit Fee . . . . 189.00 Plan Check Fee 122.85 Issue Date . . . . 8/14/07 Valuation . . . . 18000 Expiration Date . . 2/10/08 Qty Unit Charge Per Extension BASE FEE 45.00 16.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 144.00 Permit . . . IELEC POOL PERMIT -RES Additional desc . Permit Fee . . . . 45.00 Plan Check Fee 11.25 Issue�Date 8/14/07 Valuation 0 Expiration Date 2/10/08 Qty Unit Charge Per Extension BASE FEE 15.00 •1.00 30.0000 ---------------------------------------------------------------------------- EA ELEC PRIVATE SWIMMING POOL 30.00 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 33.00 Plan Check Fee 8.25 Issue Date . . . . 8/14/07 Valuation . . . . 0 Expiration Date 2/10/08 Qty Unit Charge Per Extension BASE FEE 15.00• 2.00 6.0000 EA. PLB FIXTURE 12.00 _ 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments POOL/SPA ALARMS/ BARRIERS SHALL BE IN LQPERMIT Application Number . . . . 0.7=00002272 Special Notes and Comments PLACE AT PRE -PLASTER INSPECTION EQUIPMENT ENCLOSURE NOT INCLUDED (NO WALLS) 7/28/09' CHANGE OF CONTRACTOR TO OWNER -BUILDER. FEE. COLLECTED, PERMIT REPRINTED. Other:Fees . . . . . CHANGE OF CONTRACTOR 4.50 Fee summary Charged Paid Credited Due t F "PP Tntal "' 29'i nn Ptrmi '991 nn nn nn LQPERMIT P. -O. -Box 1504 LA.QUINUA 'CALIF'ORNIA' 92247-1504'' BUILDING & SAFETY DEPARTMENT 78=495 .CA[ LE TAMP;ICO (760) 777-.70.12 LA Q.UINTA, CALIFORNIA 92253 FAX (750) 777-7011 PRO PERTY O WNER' S TA:CKAGE Disclosures .& Forms for:Owner=Builders°Applying for Construction Permits IMPORTANT! hIOTICE TO. PROPERT- TOW-NER .Dear Property Owner.... . An. applicatiott..for ..a, building permit has been submitted in your, nam listing ,yourself gas the builder of the :'property :improvements specified at � 2 ai)¢gN .OQE=Zaa ' We are.providing.you with.an Qwner=B;uilder'Acknowledgmentand Information Vecification:Form to make.you aware of your responsibilities and possible risk you'mayincur by having this permit-issued_in your uanie'as the Owner -Builder. We will not'issue` 4buiiding permiit,untillyowhave read; initials i your. understanding of each'provision, signed, and returned this form.to' us at our official-addrest7indicaied. An agent of,the owner. cannot'execute .this: notice unless you, the property ownerobtain the prior approval of the permittingauthority. 11.E 3i.i2�C'•Al 7I.AFl1<xlf�:E7:1L�fi,T.T]STT:+A:i►rr-Vr"VU.mr . :mr iir.�r•rrr+ r:w�: :�t.*.rni►r . DIREMONS: Read and in tial'eaeh. statement below"to signify you understand or verify tfi�d infoimation. 1. I understand a frequent practice of unlicensed persons is to have the propertyowner obtain an. "Owner -Builder" b Id% permit -that erroneouslymimplies that the property owner is providing his or. her -own labor and inater al personally. 1, as an Owner -Builder; maybe held liable andsubject to serious'financial'risk.for any injuries sustained by. an unlicensed person and his or her. employees while working on my property. My homeowner's insurance may..not ,providecoverage for those injuries. I am willfully acting as.an Owner -Builder and ani aware;of the -limits of my insurance coverage for injuries to workers on my property. I understand building permits are not required to be signed by property owners unless. they are responsible for the cc__9FI§t�ction and are not, hiring.a licensed Contractor..to assume this responsibility 3. I understand as an "Owner -Builder" I am the responsible party of record on the permit I understand that 1 may protect i"f from potential financial risk'by hirimg.a licensed Contractor and having the permitfiled.in tiis'or Iter name instead of my own. 4. I understand Contractors are required by law to be licensed and bonded in California and to list. their license numbers on e� t its and contracts. C5. I understand if I employ or otherwise engage; any persons,*other than California licensed Contractors, and the total value �f_ny construction is at least five hundred dollars ($500); including labor and materials, I. may be considered' an "employer" under state and federal law. 6. I understandif.I am considered.an"employer" under state and' federal-Iaw, I must register with the state and federal ove ent,�_ withhold. payroll taxes;; provcde workers' corupensation disability;;insurance, andcontribute to unemployment . c enation for each "employee:" I also imderstandiny failure to abide by.these laws may subject me to serious financial risk: 7. I understand under California' Contractors' State License Law, an Owner -Builder who builds single-family residential tris es cannot legally build :them'..,with the .intent to offer. them :for sale, unless all work is performed by licensed subcontractors and the number of structures does not exce,61 four within any calendar. year, or all of the work is performed under contract with a licensed general building Contractor. U8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any m ciai or personal. injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 69.. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Se 'ce, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. 10. I am aware of and consent to an. Owner -Builder building permit applied for in my name, and understand that I am the art legally and financially responsible . for proposed construction activity at the following address: 11.1a gree that, as the party legally and financially responsible for this proposed construction activity, .I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. t12. I agree to notify the issuer of this form immediately of any additions; deletions, or changes to any of the information I aveprovided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license,. the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in -civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, .you may be held liable for damages. If you obtain a permit asOwner-Builder and wish to. hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing; the permit. Note: A copy of the property owner's driver's.hcerrse form notarization; or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Signature of property owner Date: `�-C U ^l 01 Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to -apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding. the Notice to Property. Owner, .the execution of which: I understand is my personal responsibility, I hereby authorize ' the following person(s) to act as, my agents) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form- notarization, or other verification acceptable to the agency is requiredid be presented when the permit is issued to verify the property owner's signature.. Property Owner's Signature: _ Date: 07/28/2009 10:22 FAX REW DWG REQUEYM BY LISV AM WM RECORDED MAIL T0: LEO HUBBARD 32952 AVENIDA OBREGON LA QUINTA, CA 92253 C3 ti 5184 A.P.N.: 773-315416-7 TRA #: 0010 - N I FIDELITY PALK DESERT 4 PRONET 0002/003 DOC # 2009-0273115 05/29/2009 08:09A Fee:15.00 Page t of 3 Doc T Tax Paid Recorded In Official Records County of Riverside Larry U. Hard Assessor, County Clerk 8 Recorder I lillll IlIII� Illi Illll 1111 1111 IIIIIIII lid 11111 IIS IIII VmR I U PAGE Sim DA MISE LONG RFD COPY A l 46S 426 NCOR SMF NCMG lig T: ao CTY UNI Order No.: 090157841-1 Escrow No.: 57813 GRANT DEED THE UNDERSIGNED GRANTOR(s) DECLARE() THAT DOCUMENTARY TRANSFER TAX IS: COUNT? $106.1 s [a� computed on full value of pv ue y conveyed. or [[ 11 oomputod on full value less of diem or encumbrances mnaioing at time of sale, unincorporated area; [ j City of LA OUINTA . and FOR A VALUABLE CONSIDERATION. Receipt of wW Is hereby aclmowledged. AURORA LOAN SERVICEe, LLC hereby GRANT(S) to LEO HUBBARD A WIDOWER the following described property in the City of LA QUINTA. County of RIVERSIDE State of Californla. LOT 9, AND 10 IN BLOCK 173 OF SANTA CABMEI.ITA AT VALE LA QUlNTA UNIT NO. 17, IN TIHIE CITY OF LA QUINTA, COUNTY OF RIVERSIDE, STATE OF CALIFORNIA, AS SIIOVVN BY MAP ON FILE IN BOOK 19, PAGES 19 AND 20 OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA. AURORA LOAN SERVICES, LLC By: NOfnta J. DuclBeon • asomievhMar>� ieni S�olufiof>s. Docuumn Date: ! 28 eq"% STATE OF AS COUNTY OPk�C�PH�t�� �. oA &m iS!�j, agga bd.. we. Mat M L. -0—romp . e wtiryr poft to ted for aid term. personuly ancend who PmCd to me on dte bash of mtblh M midaze to be dee penW$) wboso =zWs) hlam =MdW to da wiftlo hnuumot ted aekeoa WSW to tee that hchttehheyy ea vow the ume W hmeMhetr mdunkod cap cky0ft). sed that by hWherPlmir ftaars(s) oo era beseuutert she panoa(s), or the mtdty upon behalf of ahkh the persons) new. omned the htsoomeet. 1 cur* udder PENALTY OF A$R)URY under the kda of dre state of Callfontta that the torewiap paragrapb h am and correct. MARIA L. OROZCO ) NOTARY PUBLIC STATE OF COLORADO A0 crontmlmcn 6� Mail Tax Smta cats to: SAME AS ABOVE or Addrm Noted Below II Change of "contractor of record" I, Leo Hubbard, am current owner of the property located at 52952 Avenida Obregon in la Quinta, California. Attached is a copy of my grant deed. As owner I declare that Neuburger Equipment and Rental is no longer to be considered "contractor of record" for any work related to this property. As owner of the property I assume responsibility to complete the work (undertaken but not completed) by Neuburger and work with the City of la Quinta to obtain necessary inspections and finalize the project. a bbard 08 OQ 0. Y � - t f la....Qu, in' P.0 -.Box 1504, 78-49�61krarnp'lco Permit # Project, Address: A. P. Number: Addre Legal Description: Na IL29 Arch., Engr., Designer:. Telephone: 1.'Constru Proi ect type (circle o. ne): New AWn Alter Repair Demo Name of Contact Person: Telephone # of Contact Person: -Estimated Value of Pr9ject: ANT: DO.NOT # Submittal Re Yd PERMTr FEES Plan Sets :Plan Check subutittid tRl, in Amount Structural Cafes. Revicwed,ready for corrections Plain Check Deposit Truss Cales. Plan Check Balance Title 24 Calcs. Tlans picked up Construction Tlood plain plan Plans resubmitted -Mechani I ca Grading plan 2' Review r eady for correctiousAssue Electrical Subcontactor List Called Contact, Person. Plumbing Grant Deed Plans Oickedup. H.O.A. Approval Pla.ns.resu.bmitted Grading PlanningApproval ..Called Contact Person A.I.P.P. Pub. Wks. Appr Date of pe�mft issue School. Fees Total.permit Fees OQ CITY OF LAQUINTA2SUBLCONTRACTOR Lis BUILDER JOB ADDRESS 59:�� 51- hiyV—_�l Dk 65QZ:�4a,41ERMIT NU_ M'_'BIER OWNER �F This form shall be posted on the job with the Building Inspection -Card at all times in a. conspicuous place. ce. Only persons appearing on this list or their employees are authorized to work on this job. Any ,changes to thisfist must be approved,by the Buildin"g Div isionprior to commencement of work. Failure to comply Will result in a stoppage of work and/or the voidance df'bdfldihgpermit. For each apolicable trade, all inf.6rm*dtion requested below'must-b6'- omplet6d by applicant.: "On File" is not an acceptable response. Trade i Ciass rocat�on Contractor State: Contractor's License nsAtidh J 0k CitiBUsip Company Name Classil'ication License Number Exp. Date, Carrier Name Policy Number Exp. Date License Number Exp, Date (e.g. A,,131_ C-8) (xxxxxx) (xxlxxlxx) (e.g. State Fund, CalComp) (Format Varies) (xx/xx/xx) (Xxx X) (xx/xx/xx): EARTHWORK (C712) CONCRETE ,F"MINGIIC5): zT*J&`."..`St91EL. (C 51) MASONRY -,(6,29) 1N. PLUMBING i4iH_ PLASTER735) DRYWALL HVAC(E-201 diz ELECTRICAL (CA'di),:.,..., NA R QFINGAC73_ .9) SHEET ET. Cw-4 Y FLOOiRING (C GLAZING (C.!1.7):.-'_. 0 .INSULATI0N,(C-2):: SEWAGE -DISP16-4 :PAINTING (C-.31) CERAMIC TILE*.(C-54) CABINETS (C-6) FENCING JC -13) LANDSCAPING (C=27) POOL (C-53)..