003408 (SFD)Building
Address
Owner
Mailing
Address
City
Address
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 003403
Coachella Valley Land Cu.. BUILDING: TYPE CONST. OCC: GRP.
.247 iNg. crnitv., Feta 42 A.P. Number 77A-11: -C120
Zip ' - Tel. �' �^ `
Legal Description
Project Description 04 "rvl ft rzm 4 l ea r*40%1 # Y .s..
stairr Coll st�ructi n
satte .
State Lic.
City
8 Classif. 74�k
Lic. #�
Sq. Ft.
1.410
No. No. Dw.
Arch:, Engr.,.
Size
Stories Units
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
- -
Lic: #
LICENSED.CONTRACTOR'SDECLARATION, ,_..
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section •f
7000) of Division 3 of the Business and Professions Code, and'my license is in full force and'
effect. . r JJ i
SIGNATURE DATE
/Y OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
Estimated Valuation
ryc
44.I*
$76441
reason: (Sec. 7031.5,Business and Professions Code: Any city or, county which requires a
V t l
permit to construct, after, 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
• PERMIT
' AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/
• Division 3 of the Business and Professions Code, of that. he is exempt therefrom, and the basis
for .the alleged exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit.
. Plan Chk. Dep. -
.
Ai cf n na .
• subjects the applicant to a civil penakyof not more than live hundred dollars (5500). '
Plan .Chk. Bal.
Q 1 A
❑ 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
COnSt.
Professions Code: The Contractor's License Law does not •apply to, an owner of property who
AA
SLC yE
builds or improves thereon and who does such work himself or through his own employees,
Mech.,
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 '
Electrical
' 11
o/ proving that he did not build or improve for the purpose of sale.)
7A _
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con•
Plumbing
struet the project. (Sec. 7044, Business and -Professions Code: The Contractor's -License Law
..
does 'not apply to an owner o/ property who builds orimproves thereon, and who contracts for
S.M.I..
-such projects with a contractors) licensed pursuant to the Contractor's License Law.) -
❑ I am exempt under Sec. B: & P.C. for this reason
Grading
9rk An
Driveway Enc.
7
Date Owner
Infrastructure
-
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.
TOTAL
CERTIFICATE OF EXEMPTION FROM
REMARKS
r r
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i/ the permit is for one hundred dollars (3100) valuation
or less.)
I certify that .in the performance of thg work for which this permit is issued, I shall not
-
.. F "itu:�li fir' f a :' frt' 1 i fV .. ►
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: 1l, after making this Certificate of Exemption you should become
' ZONE:
BY:
subject to the Workers' Compensation provisions of the 'Labor- Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances: "
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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
Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE
I
INSPECTOR
This is a building permit when properly filled out, signed and validated, an -d is subject to
expiration if work thereunder is suspended for 180 days.
/ e
I certify that I have read this application and state that the above information is correct..
Issued by:
Date 9 //2 9) 47 lPermlt
I'agree to comply with all city and county ordinances and state`laws relating to building
construction, and hereby authorize representatives sof this city to enter the above- .
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEF
IST FL. SQ. FT. ® $
2ND FL. SQ. FT. ®
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. Q. FT.
WALL SO. FT. ®
SO, 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
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
ROUGH WIRING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROCK STORAGE
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.
SO. FT. ®c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
WATER SYSTEM
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GRADING
cu. yd.
plus x$
=$
GAS PIPING
PERMIT FEE
PERMIT FEE
EIPERMIT 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
BACK
GROUND PLUMBIN /'J
UNDERGROUND
A.C. UNIT
COLL. AREA
' S B GRADE �G7
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
/L
SEWER OR SEP T
%
ROUGH WIRING
DUCT WORK
ROCK STORAGE
LIND. REINF. / / �O O
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. 2�
$
GRADING
cu. yd.
plus x$
=$
LUMBER GR.
FRAMING
FINAL INSP.
/yam
ROOFING fy/'/
v
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND fiIL
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL
__,.. " .
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.CV BY ::CEROX r TELECOP I ER 7OT0 9—GJ-87 � ' 7 : 489M� .�
SE, 14-BY:A ; 9-23-87 8:42AH ; 16195585479" l 20153;#"2'
■AII,TAII 1T51E1i TPS TO K0 M=1114 8111111MU WWI kLOW � '
N.,COACHELLA VALLEY LAND CO.
'street -TTN ; TOM STAR ,
'Address732 WILLIAMS ROAD
I' cliv &PALM `', SPRINGS
s1'ICA. •92262
MAIL TALI STATEMENTS TO a 1 t
AAEree'SAME AS ABOVE
TITLE"Oil ra ucoawu207753PB I _ �l -
SPACE -T-HIS TwIB 6IPlE"FaFitRECOPiDER'S USE e
GRANT DEED
THE UNDERSIGNED GRANTOR(S) DECLARE(S)
' 1
DOCUMENTARY TRANS FEF---,. AX is
X[3 computed on full value of property conveyed, or
C] computed on full value less value of liens or encumbrances remaining at time of sale.
' ) X❑ unincorporated area
O city of AND N
I • 1' 1
•- FOR A VALUABLE CONSIDERATION, receipt of which is hereby, acknowledged,
ROBERT B. ROSENTHAL AND JEAN ROSENTHAL; HUSBAND AND WIFE AS JOINT
TENANTS I
hereby GRANT(s) to
OACHELLA VALLEY LAND COMPANY, A CALIFORNIA LIMITED PARTNERSHIP i!
(
he following described real property in the -
County of RIVERSIDE State of California: "HCl I"I I
OT 9, BLOCK 191, UNIT 19 OF SANTA CAR14ELITA AT VALE LA QUINTA, AS PER►6.j ,
P'RECORDED IN BOOK 19, PAGE 33 OF MAPS, RECORDS OF RIVERSIDE COUNTY, 3%
ALIF0' RNIA: ! '1 I ;
t �
�1 d•_AY
� mow. -. - - - e1tIF.. ., .�. _,. : yw.?•-..« - . ,.=a «t-�'?t:., �,,c• „''"t ,k`4 � ?^i+-�»1,., ; T;• ?T ? ,..� ; - .i7 .+?.t �.•,�'i, r
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•yam
Dated July'17 1987 l� C�M�CL"+
OBERT'B. R ENTHAL• t
STATE OF CALIFORNIA
"COUNTY -OF San�D acjo sS EAN ROSE AL
20th July In !ne_ - --
on this_ day of year 19.67...,
before me, the undersigned, a Notary Public In and for said State,
personalty appeared w*Robert
i
Jea,,_►i Roseni hal ***
,
personally known to rile
.(or proved tip me on the basis of satisfactory evidence) to be the
persons Vho'se name 5 siM_ subscribed to the within
�1 i)r"FI%I. 1L C F. 1
instrument and acknowied ed to me that-tNhe-y- executed It. (; /•''
WITNESS 11w hander official heal,
Signature,,:
NOTA" PUBLIC 1N AND FOR SAID STATE ♦. tTnn ata lee ofl,elal Aou,ul §6611
Co-ett te:asl.. MAIL PAX $7AT9N i!WTS A$ DIRECTED ASOVE.