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003347 (SFD)at P.O. BOX 1504 No. 003347 Buildingr, 78-105 CALLE ESTADO Address 53-905 Ramirez LA QUINTA,.CALIFORNIA 92253 Owner mauing Address City Contractor Address H.P.S. Associated Builders Inc. Zip IT BUILDING: TYPE CONST. OCC: GRP. A.P. Number 774-151,022-4. Legal Description Project Description Sinnla FAmila nwplIinn State Lic. City & Classif. .4512227 C. # SM $ Sq. Ft. j� No. No. Dw. w Size -Stories Units " Arch., Engr.; Designer New CX Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # .,LICENSED CONTRACTOR'S DECLARATION I hereby affirm thatl 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 " 4 OWNER -BUILDER DECLARATION Estimated Valuation I hereby'affirm that I am exempt from the Contractors 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 7o PERMIT _ - AMOUNT .the provisions or the Contractor's License Law,tChapter 9 (commencing with Section 7000) of Division 3 of the'Business and Professions Code; or thathe is exempt therefrom, and the basis basis." Any Section 7031.5 any for Plan Chk. Dep. - 00 for the alleged exemption. violation of by applicant a permit subjects the applicant to a civil penalty of not more'than rive hundred dollars ($500). - Plan Chk. Bal.. Sq, yp er 28.28 GJ ❑ I, as owner of the property, or my employees with wages as their sole compensation, will �1 2y8. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Suisness and . C6ns't.. 3°' 6.0 Professions Code: The Contractor's License Law does not apply. to an owrier of,property who builds or improves thereon and who does such work himself orthrough his own employees,. Mech. . 310 . provided that'such improvements are not intended or offered for sale. If, however, the .building or improvement is sold within one year or completion, the -owner -builder will have the burden Electrical 72.. 65 of proving that he did not buildor improve for the purpose of sale.) ❑ I, as owner of the property, am exclusively contractingwith licensed contractors to con- Plumbing _ 105.00 struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law �I does not apply to an owner of property who builds or Improves thereon, and who contracts for S;M.I. - r}.g� such projects with a contrector(s) licensed pursuant to the Contractor's License Law.) Grading 20.00 ❑.I. am exempt under Sec. B. & P.C. for this reason Driveway Enc. 20.00 Date owner Infrastructure 1,034.12 WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consenttoself-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. TOTALs3.Bai�?.i� _ CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (5100) 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 y ra Laws of California. 162'q �r,Q Date ' " Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you* should become ZONE: BY: ' subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Setback Distances:" comply with such provisions or this permit shall be deemed revoked. - Minimum - ' 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 PropertyLine Lender's. Name Lender's Address FINAL DATE!I�NSPECTTO R 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. Issued by: Ci®�Qf9 Permit Date ' 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. Validated by: Signature of applicant Date Mailing Address -Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ 2ND FL. SD. FT. POR. SO. FT. ® GAR. SQ. FT. ® CAR P. Q. FT. WALL SQ. FT. 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 STORAGE TANK FLOOR DRAIN MECHANICAL FEES DUCT WORK WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER REINF. STEEL GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM FINAL INSP. 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 VENTILATION SO. FT. ®c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ, FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER 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 17r� rl��SLAB (GROUND PLUMBINUNDERGROUND A.C. UNIT COLL. AREA GRADE J 2/- —� jG[C�(F ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK yy /( ORMS �-i -� 4 -�� SEWER OR S PTIC TA ROUGH WIRING DUCT WORK ROCKSTORAGE FOUND. REINF. OUGH) �Z/J METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) %% t 97 OLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ = $ LUMBER GR. ` FINAL INSP. rL ay FRAMING FINAL INSP. //// �GlG�R00F,(NG�G % 1- L�._� r) C `f n - q x ,/ ® n`� �� `� ��- !-/- Y 1 �G4.1 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL ktLATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Desert Sands Unified School District CERTIFICATION OF PAYMENT OF �oe3 SCHOOL FACILITY FEES t(p TO': City of La Quinta DATE: Department of Community Development 78-105 Calle Estado NOTICE: THIS DOCUMENT CANNOT' La Quinta, CA 92253 BE DUPLICATED. This is to certify that �a�ZE'eoh. developer of which is located at 5 — - within this District, has paid school f ility fees imposed pursuan to the authority enerated b Government Code Se tion 53080 in the mount covering a total of square feet o ( residential For ( ) industrial/commerci 1 development and that building permits for, this footage in this development may now be issued by your jurisdiction. for DESERT SANDS•UNI IED SCHOOL DISTRICT White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer (10)-37. , O RECORDING REQUESTEDBY • 0 AND WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW, MAIL TAX STATEMENTSTO: DAVID S. PETERSON 630 Grenfall #12 Palm Springs, Ca. 92262 ESCROW NO. ` 2232 TITLE ORDER NO. O e =SPACE•ABOVE.ITHIS LINE FOR RECORDER'S USE GRANT DEED. ,' •q V ~0 . i Q w Q ou� �. . Y :i0 :.5 F CV c n w ems„U m p .. N O 1f� e o _�:F- Qb F' E .. Q . q It U rc LL =SPACE•ABOVE.ITHIS LINE FOR RECORDER'S USE GRANT DEED. The undersigned grantof(s) declare(s): Documentary transfer tax is $;a2 A..P.N. ( ) computed on :.,full value of pro pci=ty conveyed', or . ( ) computed on full value less value of liens and• encumbrances-remai.ning at time of sale. ( ) Unincorporated area: (.X ) City of'.G-9 and By this instrument dated March 30, 1987 , for a valuable consideration CHARLES.H. STRANGE, JR., AN UNMARRIED MAN hereby GRANTS to DAVID S. PETERSON & AUDREY J. PETERSON HUSBAND AND WIFE AS JOINT TENANTS the following described real property in the County of Riverside ,State of..,. California Lot 10 of Block 235 of SantaCarmelita:at'Val..e La Quinta Unit No.. 22 as per map recorded.in Book 20 page.24 of maps in -..the office of the County Recorder of ,said county. STATE OF CALIFORNIA- ; COUNTY OF C'� S ` �• (]Il .'/��/� !/ %Cd / .VCrorl,; n1C11 !�- G;.+� the personally appeared a Notary Public, m and for said County and State,. (ss s! �.,: ?- personally appeared JJJ CHARLES H. STRANGE, JR. known to me to be the perso l�.4 whose name i is/�e subscribed to the within instrument, and acknowledged to me that i,c%c`.aliey executed the same. ' WITNESS pand d off' ' I scat OFFICIAL SEAL s r' CHARLES F. NIELSEN - a NOTARY PUBLIC - CALIFORNIA -.. LOS ANGELES COUNTY .My Comm. Expires Oct. 26, 1989 MAIL TAX STATEMENTS. TO. -PART Y SHOWN ON FOLLOWING LING .IF:NO PARTY IS SHOWN, MAIL AS DIRECTED ABOVE Name Strcct.Address.. City & State 1.9050 -TW - 7/81 AP0730 f F' The undersigned grantof(s) declare(s): Documentary transfer tax is $;a2 A..P.N. ( ) computed on :.,full value of pro pci=ty conveyed', or . ( ) computed on full value less value of liens and• encumbrances-remai.ning at time of sale. ( ) Unincorporated area: (.X ) City of'.G-9 and By this instrument dated March 30, 1987 , for a valuable consideration CHARLES.H. STRANGE, JR., AN UNMARRIED MAN hereby GRANTS to DAVID S. PETERSON & AUDREY J. PETERSON HUSBAND AND WIFE AS JOINT TENANTS the following described real property in the County of Riverside ,State of..,. California Lot 10 of Block 235 of SantaCarmelita:at'Val..e La Quinta Unit No.. 22 as per map recorded.in Book 20 page.24 of maps in -..the office of the County Recorder of ,said county. STATE OF CALIFORNIA- ; COUNTY OF C'� S ` �• (]Il .'/��/� !/ %Cd / .VCrorl,; n1C11 !�- G;.+� the personally appeared a Notary Public, m and for said County and State,. (ss s! �.,: ?- personally appeared JJJ CHARLES H. STRANGE, JR. known to me to be the perso l�.4 whose name i is/�e subscribed to the within instrument, and acknowledged to me that i,c%c`.aliey executed the same. ' WITNESS pand d off' ' I scat OFFICIAL SEAL s r' CHARLES F. NIELSEN - a NOTARY PUBLIC - CALIFORNIA -.. LOS ANGELES COUNTY .My Comm. Expires Oct. 26, 1989 MAIL TAX STATEMENTS. TO. -PART Y SHOWN ON FOLLOWING LING .IF:NO PARTY IS SHOWN, MAIL AS DIRECTED ABOVE Name Strcct.Address.. City & State 1.9050 -TW - 7/81 AP0730