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9806-167 (SFD)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 _ v/Date ignature of Contractor OWNER -BUILDER I hereby affirm under penalty of perjylthaf 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 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). ( ) I am exempt under Section , B&P.C. for this reason Date 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) 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 7, y y La N1l j Policy No. S J A� 1 i:°. (This section need not be completed if the permit valuation is for $100.00 or less). ( ) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califor), and agree that if shout become subject to the workers' compensation7pr�visions of Spon • 00%f Labor Code, Is$alr,foj�w[t comply with thr, s • 'sions. t ate: JJ��JJUU �A,,pplicant f� Warning: Failure to secure Wo f Compensation cover a is unlawful and shall subject an employer to prim penalties and civil fines up to $100,000, in addition to the cosof comKp!ation, damages as provided for in Section 3706 t of the Labor Code, interesi.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 authorizVepresentatives of this�Ci to enter upon the above-mentioned property lforA spectioon,purposes. i "Signature (Owner/Agent) ,��"'""� Date BUILDINGPERMIT PERMIT# CONTROL# DATE VALUATION LOT TRACT % Q(� pI � zt r SS7,797.€ 0 ,70,-0; JOB SITE � APN ADDRESS J.3-3&5 AV 1N IDA RAA11RE %7� II-��31I OWNER CONTRACTOR/DESIGNER/ENGINEER 'WORLD i►ls'W1,01)MV.N , MCI, t4't )Ri.1� I?I SAI I,t�fthlf;�3'I', INC PO BOX 1287 110 Bo13287 PALM ITfiAWF 0A 9275`1 PALM 1?1151<'Wl' CA 42255 ' USE OF PERMIT i1'IA WAIJ.S t_'+;`at411*1'K(01.`1R( v [;3"5 4XI S1°' kit RC:ks P&J Fid l •i,1.00 iii, 0cl:RAQ',kU'CAaH.W 91aa` 406,00 SF Tal, 31, �'f>F:1} Z.'.I Si0 1? CIO N Si i.1Cr,iON' 87Y 1`97.019 it'.P; V%1tT V't4.:tis()I14l.13ARV t'fiilf�i`fi�{. ;I'tY'7?rf )10-, 1O1-t}t)1),= I Iii) S. n5" Of ANI CIfi1<t YtR 1"�..{i ifiluC�lf=1;��-�{� ;7++fS 6? kNU111ANWAL 1,LX l.tfi 1?13(1<<1 I.0 IN 55151) Iii f t kttit`Af, iAL r 1111.--(IW-420-WO S126.94t i�l,e k� JI`wt1 !' is IU1-tif}(,)41t)-( 1O 81127,9) F,1`R0 (t tLttl't' ON RIPIT-4110 10 i -fW ' 41 -f y f S14 ",;4 (,t2AOINO )TE 101'.000-421-000 11Vt`1�Fs>l. t�C�'i`U)ik;I^�:Iy .��vwUlii?- 4A-342 `et,8 41 PLAN tfi�dlfNlr�4�1-��d5 S,?�-tNl i ! f' nuvr wa F .(il9(F��J 't•• �t ? i,llf► a Pf d rla t'tTrAf f,`0N;t`i2.CIC.TION Au'v'0 PT,._AN"'IIFClt St,V?N 3n LUSS midi,•, ,UL)Fk 'S JUL 3 © 1998 TOT,, ki, PERMIT lea+V8 014,''NOW S3.078dfi 0 ISI 9y, 9 qy � p y L ®F LA QURN . mil 1 1 By A 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 Grad"Y-Tt- Return Air Steel 4s _ Combustion Air Roof DecK _ Exhaust Fans O.K to Wrap _� , F.A.U. Framing g/ Compressor Insulation _9 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 S 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 Linesd% �— Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Sewer Connection / 9d r 7 Pool Cover Encapsulation Gas Piping Gas Test if 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: d Twi�v at 4 Q" P.O. BOX 1504 APPLICATION ONLY Building 5'3- 3©s " AMS 78-495 CALLE TAMPICO Address � LA QUINTA, CALIFORNIA 92253 Own %v iLl f? nle �^��.-N, j� �r� �/ BUILDING: TYPE CONST.OCr. G/R�P/!, Mailing '" !/ C�.14ie� f" 7 c)a f��' loi �, 7 " G/ia� C �✓ 7 y Address A.P. Number City Zip Tel.L��S� 6,4 C�(Ur,�r1�4 , p...5,, I.,_'271 S'X71 Legal Description Contractor . 4 'We I Project Description ip I Tel.. State Lic.�"'City -74 8 Classif. 7 Lic. # Arch., Engr., Designer Address Tel. City( Zip ( State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I a licensed under Provlsilns.obGhapter 9 (commencing with Section 700 0 ) of Division 3 otrfh,¢eustness and /P_rofvs4sl�o�n�§;C�o e"and my license is In full force and effect. /19�� ��Ci�l'+" OWNER -BUILDER DECLARATION I hereby affif, that I am exempt from the Contractor's License Law for the following reason: (Sec. 1031.5.Busfness and Professions Code: Any city or county wAfch re0uires a permit torconsf�ucl;•. alter, improve, demolisA, or repair any structure, prior to'fts Issuance also requires jfh�applicent for such permR to lila a signed statement that he is licensed pursuant to the provlsionsof the Contractor's License Law, Chapter 9 (commencing wlfA Section 7000) o/ O,_ -On 3 of the Business and Professions Code, or that. he is exempt lherelrom, and the basis for the alleged exemption. Any viola' -n of Section 7031.5 Dy 'any applicant for a permit Subjects the applicant to a civil penalty of not more Phan live hundred dollars (5500). l: 1, as owner of the property, or my employees with wages as their sole compensation, will dihe work, and the structure fs not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Lew 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. 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.) (A 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 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.) 1-1 1 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. 3900, Labor Code.) Policy No. Company n 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 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. Date Owner NOTICE TO APPLICANT: It, after making this Certificate of Exemption you should become subject fo the Workers' Compensation provisions- of the Labor Code, you must forthwith comply with such provisions or this permit shelf be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby 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 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. Signature of aQplicant Date Mailing Address City, State, Zip+'_„ WHITE = FINANCE 10 if -3 ;?� Sq. Ft. / 7S No. Size / Sto f No. Dw. Units Add ❑ Alter ❑ . Repair ❑ Demolition ❑ Valuation PERMIT Plan Chk. Dep. i Plan Chk. Bal. l✓ Const..�y Mech. Electrical r, } Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS r A<C AMOUNT ZONE: BY: Minimum Setback Distances: Front Setback from renter Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Firoperty Line O FINAL D�7rd " i INSPECTOR Issulb a Ca, Date Permit �� %J Validated bye Validation:) yyy� cV YELLOW = APPLICANT 9 PINK = BUILDING DIVISION Desert Sands Unified School District j 47-950 Dune Palms Road r fir, Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 7/30/98 No. 17415 Jurisdiction Owner NameWorld Development, Inc. No. 53-305 Street Avenida Ramirez APN # t74=081-014 La Quinta Permit # City La Quinta zip 92253. Tract # Lot # Square Footage Type of Development Single Family Residence Comments' Lo;; # Study Area 1,375 Yo. 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 Am to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to . Government Code 53080 in tre amount of 1.93 X 1,375 or $ 2,653.75 the property listed above and ttat li Laing ` permits and/or Certificates of Occupancy for this square footage in this proposed project m.ay t>ow:be issued Fees Paid By CC/1st Community Bank/World Development, Inc. Telpphone r,771-5571 , rr' ` Name on the check'i..�„=4^�s By Dr. Doris Wilson ► '� "' Superintendent Fee collected /exempted by Juanita Green Payment Received $2,653.75 Check No. 081173 Signature (NOTICE: Pursuant of Assemblypill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest he fees or other payment identified above will begin to run from the ale 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 tolled 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 FROM PHONE NO. 7715070 Jun. 19 1998 10:56AM P1 j Fidelity National Title Company IRW 72925 Fred Warino 6rive Suite 204 • -Palm Dcsert. CA: 92260 ' (760) 3d1-4102 • FAX (760) 341.2076 SALE ESCROW INSTRUCTIONS' Lot 311�� Date: June 2, 1998 "TOK Block 223 U� COPI Escrow No.: 1590 -ST Escrow Officer; Shirley Thompson Buyer will execute and deliver a new Loan in the amount of ..::................ . 5 11,700.00 Prior to the close of. escrow, Buyer will hand you the balance of down payment plus closing costs, the sum of ........... . ................ . ...... S 800.00 TOTAL CONSIDERATION ............ , ..... ........ ...... . . S 12,500.00 AND, on or before , 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 procure/issue a coverage form Policy of Title insurance from Fidelity National Title with a liability of $12,500.00, covering the following described property located in the City of La Quinta, County of Riverside, State of California: Lot 3, in Block 2223 of Santa Carmelita at Vale La Quinta, Unit No. 21 as shown by Map on file in Book �e 22 of Maps, Records of Riverside County, California. SELLER/TRANSFEROR STATES THAT PROPERTY ADDRESS IS: Vacant Land/Ap'n 1/774-081-014, La Quinta, CA 92253 .S"3 �'� � �Mt � • Z SHOWING TITLE VESTED IN: World Development, Inc., a California Corporation FREE FROM ENCUMBRANCES EXCEPT: 1. Current general and special taxes for the fiscal year in which this escrow closes, 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 3.5 (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; 5. A First Deed of Trust; to record, securing a note in the amount of S 11,700.00 in favor of Robert C. and Marilyn J. -Hansen, Trustees of the Hansen Living Trust Dated June 19, 1989 as to an undived one half interest and Hubert W.Hansen and Anna Marie Hansen, Trustees. of the Hansen Living Trust Dated August 11, 1976, as to an undvidided one half interest as Tenants in Common PRORATIONS: Prorate as of Close. of Escrow, on the basis of a 30 day month: - Taxes CONSUMMATION of this escrow JSICONTINGENT UPON THE FOLLOWING; I. NEW LOAN: Buyer to execute a new First Trust Deed and Note, to record on your usual form, dated during escrow, in the amount of 511,700.00, in favor of Robert C. and Marilyn J: Hansen,Trustees and Hubert W. Hansen and Anna Marie Hansen, Trustees OR ORDER, payable at the place as designated by holder hereof, at the rate of no Interest Due , at which time the remaining unpaid principal balance will be all due and payable 2 years from the close of this escrow. Escrow Holder is authorized and instructed to insert the appropriate; i"at urity date on the face of the Note, over and above the signature of the Buyer, at close of escrow with out further approval from the parties herein. 2. 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, . enforceability, and/or collectability.of some. "The undersigned hereby acknowledge they havebeen advised by Escrow Holder to seek their own independent'counsel as to all matters concerning the