The URL can be used to link to this page

9803-220 (SFD)D LICENSED CONTRACTOR DECLARATION 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 # Lic. Class Exp. Date ul B Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: . ( ) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is riot 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). () I am exempt under Section B&P.C. for this reason D tae z 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,vdamages 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 applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 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 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 purposes. �Slg ature (Owner/Agent) ; �_� 7 Date BUILDINGPERMIT PERMIT+ CONTROLN �xf1 S-xx0 DATE VALUATION SK194.00 94.00 LOT TRACT 8064 JOB SITE APN ADDRESS 552-800 AVE NIDA CARR:ANM 773-322-603 OWNER CONTRACTOR/DESIGNER/ENGINEER R100rRIT fi 1 411,10 S U"! '1141S /l t �ftF� ! F i 11F•> i?AJ BOX 2231) PAI,114 L)ESVI(T CA 102201 USE OF {PERMIT S 1.0 Y, t 5!'1? ilk -ami t ! maty Ni -it 1tv:;';.i, oh tf,i,.t_02K WAIA S (.lit x A. JUL 14 1998 '1,Zrk't' �-t ftp. 3"lti.� t'ftJi�! 1, ,t1tt.�) a1• fh *L'iV1Y,t kQ ":t .f F 1 d�--- ctfA.lirAt.fri:le'fAN.}'+_1t'i' itit.etti SF.., �: - h f%1' Wf-9 4's },•t..NC F ;!tkl.ilti 117 f�i+:to;lf+ai t�lr.i!, titif1�i11��'~�41 ti Ff�tS'fttttt"1'i) 1Af l 17 !Ui sitifk4l)C-i!t}+i fit,:t+F.r+► 1)1 SAN C11VVr,' 147-V illi •11t;t1.1 tf1.1lR 1517 87 Atl i'1f,'<tJft �Al. I'Ll; 101 ()(It) T -11 -Wo $1.000 Lf.s:a'i'1Z1t'lAi.f+J., iiJi.1!{it0A20-uW Fit 1i(Q 111.IthHON1'11-4-16. ftif 000 -IN -000 Z/ SO %'1't;()N(4 hl.tt ii'1r TN VV1- Itf•':fi t 11011 -0110•141 •M) 0R.1 ,., 1 t''' lir, O`(>if 1123.000 'y�str}ts fN!,RA.1 dHtJk "MRI-. ribs S) PRIl fItSH VI- A:v till (AX) -441-34% V"Stu► 0"I f II -Pi 1'111' K''[t) (lit SF 110't71'/A I, C'ON:�"i'f2t tf "110N AN1"i Nf.Ahl ("1041; S 41f i4lx 19 1.ESSS 1IRE •1'A11) F1iia fit S0110 MIA), Ai. PFktMIT VMS MfF' N ►ati' —"LEDRECEIPT DATE BY , ---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 I Equipment Location Underground Electric Underground Plbg. Test Final -Gas Piping PLUMBING APPROVAL Gas Test Electric Final Waste Lines 4 Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connectiono j .��- _ 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: Notice: Document Cannot Be Duplicated Date 7/14/98 No. 17326 Owner NameRobert M. Rollins Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE No. 52-800 Street Avenida Carranza City La Quinta Tract # Type of Development Comments Lot # APN # 773-322-003 Jurisdiction La Quinta Permit # Log # Zip 92253 Study Area Square Footage 1,500 Single Family Residence 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 1,500 or $ 2,895.00 the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may'now 6P. issued''f Fees Paid By Bank of America/Robert M. Rollins ,delephonv ' Name on the check By Dr. Doris Wilson ' `' ' `' Superintendent Fee collected /exempted by Juanita Green Signature Payment Received . $2,895.00 Check No. 2006098506 NOTICE: Pursuant of Assejfibly 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 frons{( the date on 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 COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL Received From: Cko ui Fly jjz N 61 1.3-7 IC y4S ' 4O�K�1CA1� �J'J /�/V 7Z�✓ ir%, j Address: Account No. t • ✓ /�T'�t� Lots _ Service Address "�' i✓�1V • C�� p Meter(s) / Service(s) r ❑ Backflow(s) ❑ House Lateral(s) ❑ DetectorCheck(s) ❑ Meter Surcharge 4 Sanitation Capacity Charge ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account - Name ❑ Inspection Fee -Tract - Fee - ❑ Plan Check Fees Water / Sewer - Tract - ❑ Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit ❑ Other Tract � � C,44'14C'�c-/ %A G.A. Code zso� TOTAL $ ✓, JJ Remarks: AQ C'e f ✓e� /)6copy to: J S ' `J l t Cash Water Service June 24, 1998 6' Post Office Box 2239 Palm Desert, California 92260 760-564-2457 Attention City of La Quinta. California Building Department, To Whom It May Concern, I, Bobby Rollins authorize Wally Miles as acting agents. He is assisting me in constructing a new home in La Quinta at 52-790 Avenue Carranza, La Quinta, California 92253. If I nyone has any concern with Mr. Miles as my acting agents please contact me directly at 760-564-2457. The house is not intended for sale. We intend to complete in one year with me Bobby Rollins acting as contractor with Wally Miles as my acting agents. Cordially, MAY.-26'98(TUE) 11:38 FIDELITY NAT TITLE TEL:1-619-119-0394 P.001 0 Fidelity National Title Company 72926 Fred WaAhg Drive 104 • Palm [Insert. CA 92260 (760) 776.6770 a FAX (7601779-0394 SALE ESCROW INSTRUCTIONS Date: March 17, 1998 Escrow No.: BSD -CB Escrow Officer: Cathy Boyd Buyerlsi have deposited with escrow, receipt of which is hereby acknowledged, an Initial deposit in the amount of... .... .... ......... 9 100.00 Buyer will execute and deliver a new First seller carryback Deed of Trust in the amount of ............................................. S 4,750.00 Prior to the close of escrow, Buyer will hand you the balance of down payment plus closing costs, the sum of .... $ 4,660.00 TOTAL CONSIDERATION ...... .............................. $ 91600.00 AND, on or before April 15, 1990, Escrow Holder will be handed additional funds and/or Instruments required to enable Escrow Holder to comply with these instructions, which Escrow Holder is Instructed .to use when in a position to procureirssue a CLTA Standard Policy - 1990 Form coverage form Policy of Title insurance from RdelHy National Title Insurance Company with a liability of $9,800.00, covering the following described property located In the City of Le Quina, County of Riverside, State of California: Lot 24 In Block 167 of Santa Carmelita at Vale La Quints, Unit 416, as per map recorded in Book 1 B. page 99 of Maps, in the Office of the County Recorder of said County. SELLERITRANSFEROR STATES THAT PROPERTY ADDRESS IS-.* APN 0773-322.003-7, La Quima, CA 82263 SHOWING TITLE VESTED IN: Wallace S. Miles (EXACT VESTING TO BE DETERMINED PRIOR TO THE CLOSE OF ESCROW) FREE FROM ENCUMBRANCES EXCEPT: 1. Current general and special taxes for the fiscal year in which this escrow cioses, and taxes for the ensuing year, if any, a lien not yet due and payable; 2. The lien of supplemental taxes, if any, assessed pursuant to the provisions of Chapter 3.8 (commencing with Section 75) of the Revenue and Taxation Code of the State of California; 3. Bonds and Assessments with no delinquent payments, if any; 4. Covenants, conditions restrictions, reservations, easements and rights of way now of record, if any; 0. A First Deed of Trust, to record, securing a note in the amount of 94,750.00 in favor of Kathy C. Berg, Successor Trustee of the King Family Trust established May 7, 1990, PRORATIONS: Prorate as of Close of Escrow, on the basis of a 30 day month: Taxes ` CONSUMMATION IS CONTINGENT UPON THE FOLLOWING: NEW LOAN: Buyer to execute a new First Trust Doed and Note, to record on your usual form, dated during escrow, in the amount of $4,750.00, In favor of Kathy C. Berg, Succetsor Trustee of the King Family Trust established May 7, 1990, to read as follows: DUE ON OR BEFORE 16 months after the close of escrow), for value received, I promise to pay to Kathy C. Berg, Successor Trustee of the King Family Trust established May 7, 1990, or order, at place designated by Beneficiary, the sum of $4,750.00, with interest, on the unpaid principal amount from (close of escrow), at the rate of 8% per annum, principal and interest payable at MATURITY. Escrow holder is authorized and Instructed to endorse said Note with the date interest is to accrue, insert the appropriate payment dates and the maturity data on the face of the Note, over and above the signatures of the Buyer, at close of escrow without further approval from the parties herein. Escrow Holder is relieved of any and all liability and/or responsibility with respect to the terms and conditions of said Note and Deed of Trust including, but not limited to, the validity, sufficiency, R Conhinued on loAowing page Initiatest t.i :-? /`i MAY. 26'98(TUE) 11:38 FIDELITY NAT TITLE TEL:1-619-119-0394 P.002 Date' March 17, 1998 page 2 Escrt, .. No: 880-c8 enforceahifity, and/or collectability of same. The undersigned hereby acknowledge they have been advised by Escrow Holder to seek their own independent counsel as to all matters concerning the recital(s), if any, contained therein. The parties hereto recognize and acknowledge that the comprehensive National Energy Policy Act of 1992, effective January 1, 1982, provides in part that in the event this transaction involves 6 seller -financed residential sale and if either Buyer or Seller, or both, claim a deduction for qualified residential interest, or if any person receives or accrues interest from seller -provided financing. such person (both payor and payee) shall Include on his or her tax return the name, address, and taxpayer Identification number of the person to whom (from whom) the Interest is paid for recelvedl. Exchange of tax Identification numbers between Buyer and Seller shall be made by the parties. Said Note andfor Trust Dead to contain the following recitals: LATE PAYMENTS: In the event that any payment, or any portion thereof, due hereunder is not recelved by the Payee within 10 days after the due date thereof, the undersigned agrees to pay to Payee, in addition to the regular payment, a late charge of 6.0000% DUE ON SALE: Anything herein to the contrary notwithstanding, in the event of a volimtery Sale, transfer or conveyance of all or any portion of the property described herein, any Indebtedness or obligation hereunder, shall at the option of the holder hereof, Immediately become due and payable. BALLOON NOTICE: This Note is subject to Section 2966 of the Civil Code, which provides that the holder of this note shall give written notice to the trustor, or his successor In interest, of prescribed Information at least 90 days and not more than 160 days before any balloon payment Is due. ADDITIONAL INSTRUCTIONS: 2. PRELIM APPROVAL: This escrow and buyer's and seller's obligations herein are contingent upon the buyer's approval of the items in the preliminary report to which buyers floe will be subject, within 6 calendar days of buyers receipt thereof, sent by certified mall, return receipt requested. In the event the preliminary report Is personally delivered, a return receipt shall be requested. If written disapproval of any matter is not delivered to escrow holder within the time specified above, then all such matters shall be deemed approved and this contingency satisfied. 3. SUBORDINATION: All parties herein are aware that buyer will be obtaining a new Coiistruction Loan through this purchase escrow, at no additional cost to seller herein. However, seller herein agrees to subordinate the above mentioned loan with the new Construction Deed of Trust. Buyer and Seller understand that buyer shall remain liable to seller in the event buyer defaults as to either Trust Deed, and seller, by subordinating for buyer, is not waiving any rights to recourse from the buyer. All costs in connection with said subordination are to be at the buyers expense. All parties herein are aware that the following documents will be recorded In the following order. First - Gran Deed from Kathy C. Berg to Wallace S. Mlles, Second - Trust Deed In the sum of $4,750.00 In favor of salter herein, Third - Subordination Agreement between buyer herein and construction lender and fourth - Construction Deed of Trust in favor of buyers construction lender. GENERAL INSTRUCTIONS: Seller Is aware that interest on the existing Ican(sl does not stop accruing at close of escrow, but continues until the actual day of receipt of the payoff by Lender. Seiler Is aware that interest will accrue through weekends or holidays. Seller is aware he/she/rhey are responsible for payment of all of such interest and will indemnify and hold Escrow Holder harmless in connection with the payment of such interest. 2. In accordance with Sections 18662 and 18668 of the Revenue and Taxation Code, a buyer may be required to withhold an amount equal to 3113 percent of the sales price In the case of a disposition of California real property interest by either: A seller who Is an individual with a last known address outside of California or when the disbursement instructions authorize the proceeds be sent to a financial intermediary of the seller. OR b. A corporate seller which has no permanent place of business in California. The buyer may become subject to penalty for failure to withhold an amount equal to the greater 1�rf Condnued an following page lnw �% - rA MAY. -26'98(TUE) 11:39 FIDELITY NAT TITLE TEL:1-619-779-0394 P.003 Date* March 17, 1998 Page 3 Escn... No: 880 -CB of 10% of the amount required to be withheld or five hundred dollars (0600). However, notwithstanding any other provision Included in the California statutes referenced above, no buyer will be required to withhold any amount or be subject to penalty for failure to withhold If c. The sales price of the California real property conveyed does not exceed one hundred thousand dollars ($100,0001; OR d. The seller executes a written certificate under the penalty of perjury, certifying that the sailer Is a resident of California, or if a corporation, has a permanent place of business In California; OR e. The seller, who is an Individual, executes a written certificate, under the penalty of perjury, that the California real property being conveyed Is the seller's principal residence (as defined in Section 1034 of the Internal Revenue code). The sailer Is subject to penalty for knowingly filing a fraudulent certificate for the purpose of avoiding the withholding requirement. The California statutes referenced above include provisions which authorize the Franchise Tax Board to grant reduced withholding and waivers from withholding on a case-by-case basis. THE PARTIES To THIS TRANSACTION SHOULD SEEK THE PROFESSIONAL ADVICE AND COUNSEL OF AN ATTORNEY, ACCOUNTANT OR OTHER TAX SPECIAUST'S OPINION CONCERNING THE EFFECT OF THIS LAW ON THIS TRANSACTION AND SHOULD NOT ACT ON ANY STATEMENTS MADE OR OMITTED BY THE EScROw OR CLOSING OFFICER. 3. Buyer acknowledges deposit of balance of funds to close escrow to be in the form of wire transfer, certified check, cashier's check or teller's check payable to Fidelity National Title Company pursuant to the "Deposit of Funds', Paragraph 1 contained In the General Provisions attached hereto and made a part hereof 4. The undersigned hereby authorize and instruct Escrow Holder to charge each party to the escrow for their respective Federal Express, special mail handPng/courler and/or incoming/outgoing wire transfer fees. Unless specified in writing by the undersigned, Escrow Holder is authorized to select special mail/delivery or courier service to be used. Wire services required by the portion herein or by their individual lenders will be charged at twenty dollars 4820.001 per wire. Incoming and 'outgoing. S. You are Instructed to debit Sellers account and pay Sellers usual costs and charges including but not limited to Sellers portion of the escrow fee, CLTA Policy of Title Insurance, document preparadonr documentary transfer tax, and recording of reconveyance (s), If any. In the event the Buyers new loan is a FHA or VA loan, charges shall be debited to the Seller in accordance with FHA and VA regulations, S. You are instructed to debit Buyers account and pay Buyers usual costs and charges Including but not limited to Buyers portion of the escrow fee, document preparation, recording of deedis) of trust, If any, ALTA Policy of Title Insurance, if any, and new loan charges as instructed by lender, If any, In the event the new loan is a FHA or VA loan, charges shall be debited to the Buyer In accordance with FHA and VA regulations. THE FOREGOING INSTRUCTIONS AND THOSE "GENERAL PROVISIONS' ATTACHED HERETO AND MADE A PART HEREOF ARE APPROVED AND ACCEPTED IN THEIR ENTIRETY AS FULLY SET OUT IN THIS PARAGRAPH. EACH OF THE UNDERSIGNED BUYERS) HEREBY AUTHORIZE ESCROW AGENT TO FURNISH COPIES OF CLOSING STATEMENTS TO LENDER ANWOR BROKER INVOLVED. BUYER'S SIGNATURE.• Wallace S. Miles G' MAILING ADDRESS) • 4' 5'- G' FORWARDING ADDRESS- Continued on following page , = r Iritiales .8 MAY. ;26'98(TUE) 11:40 FIDELITY NAT TITLE TEL:1-619-779-0394 P.004 Datr March 17, 1998 Page 4 Escr�a No: B80 -CB I/WE HAVE RECEIVED A COPY OF THESE INSTRUCTIONS. SELLER'S SIGNATURE.' Kathy C. Berg, Successor Trustee of the King Family Trust established May 7, 1990 ' By: Kathy C. Berg, Trustee MAILING ADDRESS: FORWARDING ADDRESS: END OF INSTRUCTIONS, A-011.1 Conrinued on /allowingpage Initlab. 1 S• n Certificate of Occupancy City of La Quinta Building and Safety Department This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS: Use Classification: SFD Occupancy Group: R 3 52-800 AVENIDA CARRANZA Type of Construction: Owner of Building: ROBERT M ROLLINS Building Official Bldg. Permit No.: 9803-220 Land Use Zone: RC Address: P.O. BOX 2239 City: PALM DESERT, By: STEVE TRAXEL Date: 6-15-99 POST IN A CONSPICUOUS PLACE CA 92261