08208 (SFD)• �l i��l'I�I fiV
P.O. BOX 1504 _
Building
78-105 CALLE ESTADO
Address 53.135 Rmimz LA QUINTA, CALIFORNIA 92253 P%1 S
Owner �✓
Mailing
Address
City Ip Tel.
t� 4trta 92253 554-1899
Contractor
ress
IZip I Tel.
State Lie. City
& Classif. 45 792 Lie. #
Arch., Engr.,.
Designee
Address Tel.
City I Zip I State
#
LICENSED CONTRACTOR'S DECLARATION.
I hereby affirm that -1 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 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.ol the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 or ;theBusiness and Professions Code, or thathe 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 ofnotmore than five hundred dollars ($500).
❑ I, asowner 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
Prolessions-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'thel such improvements are not intended or offered for sale. If,however, the building
or improvement'ls 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.)
❑ 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.)
❑ 1 am exempt under Sec. B. & P.C. for this reas n
Date _Gown e✓� i t" /E..t
WORKERSCOMPENSATION 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'COMPENSATIONINSURANCE
(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, 1 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: 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.
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.
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 applicant Date
Mailing.Address
City,' State, Zip
BUILDING: TYPE CONST
No.
OCC: GRP.
Number 774'121-026
Z - O
Legal Description
Project Description �i��C�i.rGi1T�
Sq. Ft. No. No. Dw.
Size 1783 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Brack wall included in perch.
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
250.00 "
Plan Chk. Bal.
Mal
Const.
539.5€
Mech.
75.00
Electrical
131..3
Plumbing
151.50
S.M.I.
7.00
Grading
2;.00'
Driveway Enc.
20.00
Infrastructure
2129..38
TOTAL
.3720.92 3470.92
REMARKS
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
Issued by:
Validated by:
Validation:
INSPECTOR
Date -7/2/90 Permit
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE ��
_A
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCKSTORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT. @
GAS (FINAL)
TEMP. POLE
WALL SQ. FT.
DRINKING FOUNTAIN.
SQ FT ®
WATER HEATER
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
��
_ ��/j,
0Aw��!
�/Y
ax ��ii A0
! Yv
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
LATHING
SQ.FT.GAR ® -/ac
HOUSE SEWER
MESH
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 f% /
GROUND PLUMBIN(9
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE ��
_A
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
FOUND. REINF. '� [jn
s
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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. 17 %
FRAMING Qty
FINAL INSP.
ROOFING!r „J° ��
��
_ ��/j,
0Aw��!
�/Y
ax ��ii A0
! Yv
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION 7
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
.w z x"82 879 `Highway 111`
NOTICE.Indio, CAa92201
Document C9nnot,B6 Duplicated . .x(619) 347=8631
Date 7/16/90 ' Type of'Permit 1 L4 uiiit;
No. 141M,7 I f Permit #
r Log #
Owner -Name J:W'. Smith r
No. ° .street See BeloW``
City La Oiinta :Zip 92253:x• Study Area 111
"N # .Tract # Lot # Square -Footage i
�..
Type of°DevelopmentSingle ;Family Residence` . , t No. of units
Comments
.53 725 •Ramirp7 and 5�-735:R.amirP� - � . k
At the present time, the -,Desert Sands`Urnfled Scl ool1Disthet does not collect fees on
garages/carports, covered patios%Walkways;residential;�iiztions under 500' square'feet,
detached accessory structures,or:.replacemeni-,n'Aileliomes., ;It has -:been determined
the above-named owner is exempt from paying school:,fees 'at' th's,time due to the
following reason:' ,
EXEMPTION-NOT—APP ICABLE
1
This• certifies that school facility `fees unposed pursuant to Government Code 53080
Mthe amount:of 1.58 v X 433.`:` or $ 5,424.14 been paidao D.SU S.D. for
f • bsted above and.that buil " " ` "`' k t
the property .' r + duig.permits and/or Certificates of -Occupancy for
this square footage in this;pr9posed proqect',may:now b63ssueds:i �..
,
Fees Paid By J.W.-Smith: and-- Assoc. Inc. r, ^ Telephone 564-1899
Name on,tlie clieck
By John. D,:, Brooks 4 ,,
Associate Superintendent; Business Services ,
Fee collected /exempted by Shelley D. Bennett
Signature _ •Cti
-. 005
. .. __ , eck No.
Collector: Attach.a copy of County or City plan, check application for�n�to fJz`�tr c{ copy.
Embossed Original -Building b pt /Applicant t" Copy Apphcant�Receip�t;? 'Copy -Accounting
i
i. ,
Zip
ReC'Ord,ing,"requested -by---
QNl6k'LN'NQ TITW60 PANY
MAIL TAX STATkMtNT TO
JAM E.S -W. SMITH Av
80733 C H E R R:Y; H I L L -
,LA QU I NTA, -,..CA "§2253
WHEN RECORDED MALT
77,
�j
yy
ORDER NO. 20 4 1 U12
ESCROW No. 4403 -JC
CORPORATIONr
GRANT .,D-EED.
.e.
C:)
Cr
%n
USE ONLY
OAX
OF
Ll j 'PROPERTY CONVEYED,, OR
E,
W I ..,WIN. VU"U VML-UV- L -r-00 LIENS &ENCUMBRANCES
REMAINING THEREOWAT TIME OF SALE.
Signature"6f declprpnt orad6nt determining tax Firm Name
j -.t - W�. I
Unincor6or6ted�-Ar6a City of
Code Parcel INo*.
JOYCECO SERVICES, I NCA` CAL IIFORN I A'.'CORPORAT1ON
a corporation
FOR A VALUABLE CONSIDERATI.QN-DO,ES-HER.EBY GRANT TO
,s,KN D,-.- W I,F,�. -A:S J 01M.T. TENANTS
a
the real property in the County of R, I V FRS : T -D F. Sta ie'of.0 lifornia, described as:
LOTS 11 AND :.12* IN B,L O,Ck 232 'OF-%k,NiA,"'t,AR-M:ELIT--A •AT.VALE LA 'QUINTA, UNIT
NO. 22, AS. P-ERMAP -R Ct`b,R:D t`b I,N - BOOK K'. 2' I P :2 4 OF KAP S � !RECORDS OF
RIVERSIDE COUNTY., CALIFORNIA. A PN`#` 1`7*14 J;,21 .'023, r� 774 12102 4)
"NO TAX DUE. THIS COKSUMMATES A TAX DEFERRED EXCHANGE. TRANSFER* TAX DUE
IN CONNECTION WITH THIS' fRA.�NSACTI , 0 k., bdi Lftl E D A"; N'D PAJ,DF ON FIRST TRANSFER, .
NAMELY GRANT . DEED FROM -C.O.RN;J RIG: TO , JOYC-,E-C'0 �S*ERVI.C'ES I NIC RECORDED
.CONCURRENT` HEREWITH:.,
Dared:. JUNE 5., 090
40kt,'C!0 SERVICFS, TN(' A CAI TFORNIA
0 k'Pb k -f ION
(SEAL)"PA 0
By o
President
• Corporation Acknowledgment
F CALIFORNIASTATE 0 V
SS. Secretary
COUNTY OF
On JUKE 5
19 90. beforeme, the unders gned, e Notary Public In and for said County
cn a0f R '-brionally kho wiri�to me (or proved. to me
and-Stite" jpbiso`hally.� appeared I H lik.&�,-
p
on the basis of satisfactory evJ.deqce') to be the .
CO�O
1 R- President, and
J 0 H,E 'A. R,
Secretary of the corporation that
.,.known to to,bb the
-ththl'n"IrIstrument. and kn'"n to m"e t" o' -.be' t'h'�e*pers'6'-h's.�,�vh'o'bx-ec bted the within Instrument on behalf of
ewl
the corporation therein named' and ackn'owlig
ed-edtomat such'corporati6n executed the within Instrument pur-
'e
4
suant to'lti By'rl-dw's or,6 R6sbl6ti6h* cd its, -'Board of Dir"
WITN
,PS5,Ty hand. a
Notary Public In afid.for
and Staff.
Y
EAL
9FFICIAL
IRENEfRING
;<1 x 'ftOTARY .
CALIFCRNA
PRINCIPAL OFFICE IN
RIVERSIDE COUNTY
Ali Comm.ssion
Exp.- Sept 1/, 1990
MAIL TAX STATEMENT :'AS 'AS DIRECTED ABOVE
?f yis{a i y1n`,it�:�'•1 ��'�'' E.�ti;: f�i� s,'•at'vE';6 d." ^r-St2>aMfs y'` , .
Y d +
•Q I+..K
ri
N Yx +
'�"` •' COACHELLA VALLEY WATER DISTRICT
dk a act, CASH RECEIPT DETAIL
+; �
°
� .YJ.' ,i •a � ` r 1�d,Y�•.f Il�„��54'4L.`�'=� .
:Received From: i % % ' i '�' (°'' s Date:
Address:,^ �. �; �• ._` +
'Account No����iL�'fL�cln' �h 'Lot(s)
Service Address �� �� f - y ; G.A. Code
Metes($)
Service(s)�—,
j0- Backflow(s)
`❑ House Lateral (a)
:❑ ;DetectorCheck(s)14T .
�❑ Meter Surcharge'.*
t+?J
{Sanitation Capacity Charge ✓ l q ' `� 'i Vii(
W.S.B F.C. :. S' w �' 'L• " ,.� . �'�• 1
❑i,;Temporary Construction Meter
❑ Turn onxCharge Y e< a r^ a
❑ Uncollected Account -Name
❑, Inspection Fee - Tract -
t •' asF ` `• +;4+'y' + t r t �r r s
' Fees, Z :i f
�, T ";+) � ?*d� R. -y�-+. a "` i.' r� •!. ' s, r,il',, e°;g�.r_y�. -' :�
%❑JPIan Check Fees Water (Sewer - * ¢ ,^�.,�
+ � �w 1 • Tract - - ".i.:�� : 5 .?' f� •:.,,.x � �, � �;`�±�:r• ...mss. • � , ?4 �`
`❑ Bond PaymentAD Bond ,t , '• y
rt S
p❑,Customer Deposit a �• a` :)
J❑'Other y. . y �A�r C•. — t-i,,i - TT
s.x'..F y TOTAL $�
+ Remarks sj���E e 6L -ems
Y-kn } f, . +� ✓✓ SAN '.,y :,'-f. + / Y"' /gyp �t''.'ia r• .y. _ F :r
:❑Copy to
� y
o -t... . �r ,. at ..'. rv, ;rpt„ -+,4' "!'F _? *o,.t `s. ?+. w, r?',�`.:.�. ... .,r- It t'3.t `•�` nti
., Water SerVlce - -
Cashier `l
A
r CVWD 438(11/89) s
i .!•Si t 1
r