PLBG (9708-108)53541 Avenida Martinez
9708-108
003407
LICENSED CONTRACTOR DECLARATION
.,I hereby affirm under penalty of perjury that I am licensed under provisions of
H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
to W Professionals Code, and my License is in full force and effect.
O M License #Fw , Lic.,Class Exp. Date
U.) 12sU +1i 1 l - iL lUl.511•l J
' W
Z r-- Date ! Signature of Contractor f+/»
'
r c6o OWNER -BUILDER DECL RATION
C)
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following reason:
Z ( ) 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).
co () I am exempt under Section , B&P.C. for this reason
LO
N Date Signature of Owner
O N
Cn
Q WORKER'S COMPENSATION DECLARATION
C) 2 Z I hereby affirm under penalty of perjury one of the following declarations:
U-) < cc
O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W = compensation, as provided for by Section 3700 of the Labor Code, for the
O J Q performance of the work for which this permit is issued.
m Q CJ ( ) I have and will maintain workers' compensation insurance, as required by
O •U Q Section 3700 of the Labor Code, for the performance of the work for which this
2 LO F< permit is issued. My workers' compensation insurance carrier & policy no. are:
,It Z Carrier Policy No.
Cb aS` i' VUX-ilt l.Y;; tQ )fi
r` d
J (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
3 subject to the workers' compensation provision s?of Section 3700 of the Labor
Code, (.shall forthwith comply with those -provisions.
Date: 1 Applicant ,
Warning: Failure to secure WorkersCompensation 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. A
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 t0
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employes.
2. Any permit issued as a result of this application becomes null and void
work
work is not commenced within 180 days from date of issuance of suG
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 property for inspection pu oses.
Signature (Owner/Agent) -Z"' Date,a
-
BUILDING PERMIT
PERMIT,#dos-u}x
}7
CONTRO#
DATE 14n' " VALUATION "-4("")o LOT
TRACT
5778
JOB SITE 5 -3911 AV3stVtllfAtvti\le;f,A{tMEZ
APN 44-i4t.toi*
ADDRESS
OWNER
CONTRACTOR/DESIGNER/ENGINEER
ItS f:t l.i+lLLt: itli'1:ti'Ll.l3
yn+
F.'.i}, ,tiV:1 1`JL
LA QLIM't CA 41283
RAt,?V11 1 SI-R,'I` CA
922161
USE OF PERMIT
PLUMB
MB
LOW Niub al -viii CONNECT
CONR7UAK3`1 AINIVUiv'.t
I,0100 Lam:
C(Wr
OF CONVI'VIRIUCIx:3";
ilEE,RMIT FEE;M)(l1MriRY
PLUMFtIN0.FEN ;EVER l(fl-40()-419-000 $:tte1"t
t
ilr4»'P(yl'A(s(jj+3;:1`I ,UM'E(1NANDpi,AtiC'If}'.t"'{:,
S'3fiW
U,SS t'RtiT.` ID Pk:.ES
W f 1)
'f't a'IFA4,IT
Y(. F -S 011 It, NOW
SMI.W
i
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 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
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
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:
r
ECONO SEWER SERVICE INC. 760 347 4978 P.02
F
SIV.JF LA OUINTA
• AFETY DEPARTMENT
777-7012
AUG 2 Z I ECTION REQUEST LINE .
777-7153
nerFINANULDboPMENT AGENCY,
Ow
Contractor
ONO SEWER SERVICE
08
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS tTINEZ
SEWER HOOK. UP AND ABANDON
EXISTING FACILITIES
TYPE OF INSPECTION DATE INSP.
FOUNDATION S SETBACK —
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED.
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH GAS & GAS TE
HEATING & VENT - AIC
SOND BEAM
O.K. TO WRAP
GROUT p 4' O W
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
PLUMBING
FINAL GAS TES1
HEATING - AIC
HOUSE NUMBE
TEMP
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
wt 4 wQ rw
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 63-543 Avenida martinet LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address IAA k+ak+ .ti•ti Ks
City _ V Zip" Tel.
...Palm Springs . 92202 .3222--1020 lLegal Descrip
Contractor
starr Construction
No. 0034 1
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 774-3.31-014
Address
City lZip I Tel.
State Lic. I City
& Classif. 387934 Lic. # 895
-Arch.,-Engr.,
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION,
I hereby affirm that I 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 r - - 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 the alleged exemption. Any violation or 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner or 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 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.) _
❑ 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 or property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ .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
. ❑ Copy is filed with the city. ❑ Certified 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) 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 `" Owher
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 shaft be 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 permit'when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
1 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
HARD COPY
Project Description'
zllnr3c> L's>wrx+i r e► t xsrr
Sq. Ft. 1.410
Size.
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Estimated Valuation
$76,441
PERMIT
AMOUNT
Plan Chk. Dep.
5250. 00
Plan Chk. Bal.
S
39.14
Const.
364„08
Mech.
33.00
Electrical
74„11
Plumbing
103. 00
S.M.I.
5.36
Grading
20.00
Driveway Enc.
20.00
Infrastructure
1,121.12
TOTAL' Q
-
REMARKS
'
?, e t /'PA 'f.%j -., a 4" jtn
fi`. 1 fq
i a,i j'.A.,. l# x ` 1111 F't: t -
I r r'r .
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date. 4%2c)%R.Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. I SQ. Ff.
WALL SQ. Ff.
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
'
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/aC
HOUSE SEWER
FRAMING vv 3 Q Q
FI INSP.
O
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
6-Ir/tit'SETBACK /d' •a 4
GROUNb UM ING
UNDERGROUND
A.C. UNIT
COLL, AREA
I%LeSLAB GRADE/,O—d ' 71 a
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
/(//FORMS
10 _a S
SEW'ERV SE ICT
Kv/J
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
Cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP. Z
FRAMING vv 3 Q Q
FI INSP.
O
ROOFING
/ 5
J/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING47' %9/
MESH
INSULATIONISOUND aj Zc ✓
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIIAITIALS,
GARDEN WALL FINAL
-
4 4 Qum& ,lt v
P.O. BOX 1504 APPLICATION ONLY
Building/ / ` M 7&105 CALLE ESTADO
Address .613 60 1 AZ77A/A-Z LA QUINTA, CALIFORNIA 92253
Owner
A „ L- P& `JI ''
Mailing
BUILDING: TYPE CONST. OCC. GRP.
Address '261-7
A.P. Number %7d— /q/ % Z
Legal Description ler—, 2 R/,! f! '2A" .41A!/T 23
Project Description Vii'%,A, 0 ;A.
City
QW 5 _
Zip
Tel.
Contractor
-5 a
Address
7 'Z VA
C y
ZLIA < a
Zip
' 22.102
Tel.
3.22/oZU
State Lic. n'
& Classif. _ 3W 793
4
City
Lic. # '9
Sq. Ft. No. No. Dw.
Size /y/D Stories % Units /
Arch., Engr.,
Designer
Neng', Add ❑ Alter ❑ Repair ❑ 'Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm,,that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business a d Professions Code, and my license is in full force and
effect.a— % :,
r
+►TF DATE
S GNATU
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Buslness and Professions Code: Any city or county which requires a
permit to construct, atter, improve, demolish, or repair any structure, prior to its Issuance also
requires the applicant for such permit to 81e a signed statement that he is licensed pursuant to
Me 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).
011 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
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. I/, 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.)
Estimated Valuation r / 4r
( O
PERMIT. '
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical / 7
Plumbing 600
❑ 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 contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. B. & P.C. for this reason
S.M.I.
Grading
Driveway Enc.
Date owner
Infrastructure
l./%,a -,
WORKERS' COMPENSATION DECLARATION
f
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
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(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 the work for which this permit is issued, I shall not
employ any parson in any manner so as to become subject to the Workers' Compensation
Laws of California.
AAr
{ 4 7 /, 4 A5t2_'1 A O 7 T
0,4 4 '
- CASH i AL c75.
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.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
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.)
Side Street Setback from Center Line
Side Setback from Property Line
Lender's 'Name
FINAL DATE INSPECTOR
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration It 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.
Issued by: Date Permit
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
BUILDING DIVISION
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
GAS (ROUGH) .
DRAINAGE PIPING
WALL SQ. Ff.
OTHER APP./EQUIP.
DRINKING FOUNTAIN
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/a c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) .
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
-
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS,
GARDEN WALL FINAL
VALLEW LAND Wo
;NT G. . SUR
a 42
..,.., _;=217290 DOMIS D81VE. sunv tiog-
ARNEL, CA 93923
a
caps
trr
WAta>•et
V-
96
GRANT DEED' icy• i 3i -BA -4.
THE CONED 01MATOR(S) DECLARE(S)
DOCUMENTARY TRANSFER TAX A S 18.15
or
Zo ecoataw an Cur.vow of piowtv coow"ed.
0 cow*wW an fuN W" Im v&A of I** or qr4unftwwn tons" at time of isft.
20
0 c, of AND
FOR A VALUABLE CATION. DERATXW P -';- of which is imeby ackrAwledPd.
• LM V* AM Can= rl v =88M AND WIJP2 ANOINT TZRAM
he obw ORMT(s) I*
vwim LAW coonme a CIL 1A LIMITW PART= ry
the -
LzwwCo" of SaVERSIM sum Of Camornis:
Ts LC= 244 OPSAM CUMNLITA AT VALE LA QUXIM# UVIT 23*
ea pi m3L 2L=WIN WM 20, PA02 25 OF WMv MICM8 (W RMWIDS
0="r, cmaranza.
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P06071:
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DaftdJaly 17, 1987
STXTI Or OwAvam"
COUNTY01F Riverside
23rd
ontnis - dwol– July antryw 87
11810M ffW nw undws4pied, a XotWV Public in wid for sand SIOL
Christopher Lee Frahm and
pwomatlyamps md
Carole Frahm
personaft known to Me
for proved to nw on the bow of satisfactory evidmW to be the
pW*W_3 Whole nuns s are subscribed to the wq!P
histrunwa. and wknnoeMeAlp to WIN 11181— he— executed it.
wffmm my ftwid and othew no.
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P06071:
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