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9511-040 (DSF)I LICENSED CONTRACTOR DECLARATION I hereby affirm 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 Date Signatureof Contractor OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 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 sate (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 rB&P ,G fof this reason �f 4 �z... mate Signature of Owner 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 Policy No. (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 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant Warning: Failure to secure Workers' Compensation coverage 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 application agrees to, & shall, indemnify- -& hold harmless the City of Indian Wells, its officers, agents and employees, 2. Any permit issued as a result of this application becomes null and void I 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 -representajives of this City to enter upon the above-mentioned property for iKspection purwoses/ Signature (Owner/Agent) Date , 1 ALCM [BUILDIPERMIT PERMITM DATE �� � � VALUATION J',@D"tLONG T 11 e� iO TRACT ¢j JOB SITE ADDRESS t t) APN 774-134 039 OWNER CONTRACTOR f)W100'.IMI!, i 1.1 ."R 'jODI)MaRILAC.I.S. EIDEEN `64-45 AVisNWA i)I3Iti=60N L A Ql.z U>, TA (7A 9�2s__i (111 ,4 DESIGNERIENGINEER USE OFPERMIi���g���� I P :'NI al,f'1`A )N (W 1-114k, l aANIA( f' FEE DESCRIPTION FEES ,3 T yIMA71 '',1) *anis 01*' C GIN STR*t b(`i'?tC1N 0.Et��1 tt �� r3i���t�I,t'I:f�w_tom: 1QI(2 t 4 3 d(tU S45 00 TMAT, DUE NOW 5 j o RECEIPT DATE BY DATE FINALED 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 P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wali 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 Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans OX for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final 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) COMMENTS: NOV 07 '95 03:23PM CHICAGO TITLE RIVERSIDE 6193437380 FF 1' PtOV-0:5-19y5 1 d �i0 • IRDING REQUESTED BY nGi:�st1':�Clt ttE'CC:iC1Gd Qn ;...3 X26.... AND W14EN REW11=0 MALL THIS DEED AND, UNLUS OTHERWISE `i ?, i^' � ei l i:•'tl? e L t?; t tic fe)moi /� � ` ' y SHOWN BELOW. MAIL. TAX STAYSANT TO: e ;`. N ►^ - �}}( // r no— ODb [-ilCi9JM SWEnE .dV S,t!;'\C .. t ,�\i:7"...Iitl sn.e, 30-810 CALLE JESSICA {>r�;_;Z:y C o.Y,le ,q,! A�trpSi THOUSANp PAU4S, CA • 92276 ;'I'VE 181Ur•_ 010UN-o Yr d �Mi-c.iRt � r �' ­41 crty a statezip V& (htlrr r4.56733$-_14._ F j3A1 SPACE ABOVE THIS LINE FOR RECORDEFUS USE Y 355 Log.V (244) Grant Deed THE UNDERSIGNED GRANTOR(Q DECLAREW 4T IDOCUML•NTARY TAANSFE.R TAX 7S,%_.$Q) 1. I UnincO owlet! ams city/of I OZO /1f C Parect No. 774-154-1)3�-� � �� 29 computed on full value of interest or property ciinveyed, sir ❑ computal on full value less value of liens or encunibrvnces rtmwining at uric of arlc, and FOR A --VALUABLE CONSiDF,RATION• - receipt of which is hereby acknowledged, MARK P. VAN DE i7MMM, AS TRUSTS AND A 'SUBSBD[MV TRVS"1'F,'E OF THE MM P. VAN PVAItiTI�tII�IDIVIDUAI.TRUST DATED APRIL 27, 1993. eLbby GRANTCS),tu 'TODD MIGIAEL SWEDEE Nj, A MA ZUED' MAN AS ` SEPARATE ' PROPERTX-------------- -_--, the following described real pFq¢erty in the City 'OfZ Quints, eaunty of 'RiV� ltd , state of Ceiife+rnia: , I1075 9 AND A , BWCK 202, UNIT NO. 19, SAWTA CARMELITA AT VALE LA, W_ TNTA IF iTJ THE • CITY OF LA,WMA, AS PER MAP REOORDED IN BOOK 19, PAIGES 33 AND 34, OF.MAPS IN THEOFFICE OF MINTY RECORDER OF SAID c-DIJtVY. ERER -OF ENCUMBWCES EXCEPT: 1. 'ALL G'F3EM ARID SPECIAL TAXES FOR THE -FISCAL YEAR 1995-96. 2. CIC IDI*I'ION5r RES'I'Rit-TI.CM, RESERVATIONS ;DONENAA DS, WE14DU'S, RIGHTS AND RIGHTS OF WAY OF RECORD, IF ANY. MARK P. !VAN DIE VAIVIRR, AS TRUSTEE AND A Dazed Nonrenber 1. 199 _ 999MUR[N TRUSS OF THE MARK P VAN PE _VANTER INDIVIDUAL TRUST DATED APRIL 271' , STATE OF CALIFORNIA 1993 i COUNTY OF RTVFi2.SIDF.� S.S. �/f �Q / l % .On 3 1925 Wore me, ! f� z /l.! /i� [.� B. A. QffitY - Mark P. iVan De Vanter, as stee i e No Public in and tar said Coun _ ete. personally appeared �73AT ` ng-...---- --- i personally known to me (or proved to me on the basis of satisfactory eviderim);to be the persons) whose name(s) islare subscribed to the ,��, B: n. CU: Er within instrument and acft wModged to me chat holske/they executed 016 same in hWheritheir authoozed caipacity(un), and tha by hwherrthatr r = -r:' I ' : I'• :.:r . r,; rniu 4 signature(§r on the instrument the penort(s), or the entiry upon behalf '4_ C., ( JUN Ot which the personts) acted. executed the instrument - +:• AN Comm. t,tp4a'I AUi996 WfTNES% my ham d i ' 1 68a1 ITh1, area 1o/ ortiCid1 nOi811d1 8001) MAM I' ' >STATEMEVTs TO PARTY SHOWN ON FOLLOWING LINE; IN NO P Ir�_M SHOWN. MAIL AS DMECTED ABOVE -� +! r a November 7, 1995 I, Todd Swedeen, together with Don Rhodes have aquired ownership of the property located at 53-945 Avenida Obregon, La Quinta as of this date, Nov. 7, 1995, as recorded by the county of Riverside. We plan to begin immediately cleaning up and repairing said property to comply with the requirements given to us by the City of La Quinta. We appreciate any and all assistance you may give us concerning this matter. Sincerely, I �Gdd. Todd Swedeen Don Rhodes A I_ RECORDING REQUESTED BY AND WHEN RECORDED MAIL THIS DEED AND. UNLESS OTHERWISE SHOWN BELOW. MAIL TAX STATEMENT TO: Name Street / O Address Z yC 0 I—C 1.+•v� o..�vp (,J;r,.y,, City &'-- ^ Slate r 1CCLSca n J 12-1.3 G Zip C% Z z %% -4 3 & Tide Order No. Escrow No. CTC 1-103 (8.93) SPACE ABOVE THIS LINE FOR RECORDER'S USE Quitclaim Deed THE UNDERSIGNED GRANTOR(s) DECLARE(s) DOCUMENTARY TRANSFER TAX IS $ ❑ unincorporated area © City of f�cClut.r�cr Parcel No. ❑ computed on full value of property conveyed, or ❑ computed on full value less value of liens or encumbrances remaining at time of sale, and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, hereby REMISE, RELEASE AND FOREVER QUITCLAIM to 4.l'J %1 tl �C� fJ. 1 � t1 eL.IQs Ce.nt� J Y1 t' ✓' �r � �• 1-( (1.�F �' yt� �• IJc .�C.�r [C n � �/ � C� (a�n �l O..l i r Qr7U the following described real property in the county of f� r d z r 5 t cue A,- c' , state of California: / e /.-euk' .2 C 2 ei-+ Vaj- ee. Q<Z"� I -7e rrnCLT c,.,,- _.. <�K �;�,rP� n3l3 Y .�t,L�,, K: %�•._ Dated STATE OF CALIFORNIA i COUNTY F L ' IiQ/•L�� } S.S. before me, On a Notary *bic and for SCc my and State, personall r appeared I All) Al personallto me ( r 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 ��offi//ci/alseal Signature ayn T. ktnS f e rn in -y n I< s --- JANA LEE CORBEIL COMM. 0 1041240 y Z - -a; ; Notary Public, -- California Z RIVERSIDE COUNTY My Comm. Expires AUG 5. 1998 r r MAIL T4N STATEMENTS TO PARTY SHOWN ON FnI.I.nW1Nc It rnrr. (This area roc official notorial seal) __ .._. ,.�,..,., —Ml- Aa UlKCLIGU ABOVE Name Street Address City Re State WeCOR �equesay CHICAGO TITLE COMPANY AND WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW, MAIL TAX STATEMENT TO: Name DONALD D. RHODES, ET. AL. street 72-400 LA CANADA Address THOUSAND PALMS, CA 92276 City s State Zip Title Order No. 6724731 T 355 Legal (2-94) Escrow No. 1647 4.. PAID Doc. Transfer Tax FRANK K JOHNSON Riv. Co. Recorder 212833 RECEIVED FOR RECORD AT 8:00 O'CLOCK JUN 101996 Recorded in Official Records of R'rvwside County. California Y�l Recorder l n Fres S _�IIXI/ SPACE ABOVE THIS LINE FOR RECORDER'S USE -Grant Deed - - THE UNDERSIGNED GRANTOR(s) DECLAREW DOCUMENTARY TRANSFER TAX IS $ 13.20 ❑ unincorporated area RR City of LA QUINTA Parcel No. 774-154-030-9 D-20 ®' S' ❑ computed on full value of interest or property conveyed, or RXcomputed on full value less value of liens or encumbrances remaining at time of sale, and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, TODD MICHAEL SWEDEEN, A MARRIED MAN AS SEPARATE PROPERTY hereby GRANT(S) to DONALD D. RHODES AND SHERYL D. RHODES, HUSBAND AND WIFE AS JOINT TENANTS, ASTO AN UNDIVIDED ONE—HALF INTEREST AND WAYNE T. JENKINS AND TAMMY M. JENKINS HUSBAND AND WIFE AS JOINT TENANTS, AS TO AN UNDIVIDED ONE—HALF INTTE'REST.------------- the following described real property in the City of La Quinta county of Riverside , state of California: LOTS 9 AND 10, BLOCK 202, UNIT NO. 19, SANTA CARMELITA AT VALE LA QUINTA, IN THE CITY OF LA QUINTA, COUNTY OF RIVERSIDE,.STATE OF CALIFORNIA, AS SHOWN BY MAP ON FILE IN BOOK 19, PAGES 33 AND 34 OF MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY. FREE OF ENCUMBRANCES EXCEPT: 1. ALL GENERAL AND SPECIAL TAXES FOR THE FISCAL YEAR 1996-1997 2. CONDITIONS, RESTRICTIONS, RESERVATIONS, COVENANTS, EASEMENTS, RIGHTS AND RIGHTS OF WAY OF RECORD; IF ANY. _ 3. FIRST TRUST DEED OF RECORD, PER ITS TERMS. Dated MAY 8, 1996 STATE OF CALIFORNIA COUNTY OF __RIVERSIDE } S.S. On May 13, 1996 -------------- before me, B. A. McCleery ------------------------- a Notary Public in and for said County and State, personally appeared TODD MTC'HAM, SWEDEEN------------------- personally known to me (or proved to me on the basis of satisfactory evidence) to be the personWwhose nameA is/are subscribed to the within instrument and acknowledged to me that he/shefthey executed the same in his/hekbek authorized capacity(ies), and that by his/her their signature,W on the instrument the person(6), or the entity upon behalf of which the person(o acted, executed the instrument. WITNESS my hand•ficial seal Signature d Michael Swedeen B. A. MC CLEERY a COMM -0 969400 Z Z T'+a' Notary Public — California Z Y' RIVERSIDE COUNTY Comm. Expires AUG 14, 1996 (This area for official notarial seal) MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SHOWN, MAIL AS DIRECTED ABOVE Name Street Address City & State t� September 5, 1995 Field Incident Report Approx 9.:30am September 5, while inspecting 53-900 Aveinda Alvardo pool final, a heavy fire. smell and then smoke was noticed in the back portion of the residence. at 53-945 Avenida Obregon. I responded to the 53-945 Avenida Obregon and notified the R/P there was a fire in the back of his residence. The R/P did not respond to my request for entry to assist, he re-entered his residence with his dog. I notified Building Department, Bruce to call in the fire for response from the Fire Department. I notified the South neighbor of the fire. The R/P re -appeared and stated that a BBQ was -the cause of the smoke and to not call the fire department. I requested LA315 to respond to the seen, because there was still smoke coming from the structure and the, ' R/P was acting funny. I did not call of the fire department. When the fire department arrived the R/P was not allowing entry. LA315 arrived on site and entry was made and I cleared the seen . with LA315. I went back to the 53-900 Avenida Alvardo for the pool inspection. Helped the neighbor with a hose on there back yard fence and structure until the fire departments hoses were out and in service. Approx 10:00am, 'Sam 2 and Sam 6 requested me to inspect and post the residence for No Entry,'Unsafe to Occupy: Pictures were taken for the record and'follow*g discrepancies were noted: 1. No water to the residence, R/P stated that it was disconnected Thursday, August 31, 1995. 2. Bootlegged electrical, and many extension cords ran to areas'of the house for power supply. .3. Bootlegged, hidden kiln room with three kilns and appears to be the source of the fire. The room was burnt and all electrical was melted .IID responded to secure power for the fire department, at that time .IID removed the meter -for life safety corrections and existing conditions. 10:30am 53-945 Avenida Obregon was posted Unsafe to Occupy. This concludes my report this incident. Respect y Submitted, elP. Cra ord Jr. Building Inspector I I �► Q JJJ � 1 T • f