0212-024 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing witK.Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Expi Date
'1102.30 B C 0'7/31 W
i
/Date ' A ® 1 Signature of Contractor` r�
/,--,
OWNER -BUILDER DECLARATION
I hereby affirm uhder 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 not intended'or offered for
sale (Sec. 7044, Business & Professionals Code).
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 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 U 11 FU14D Policy No. 1,7171,r,-03
(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,,Seelion 3700 of the Labor
Code, I shall forthwith comply with those p 0 10 S.
Date: j, 1,Z Pda Applicant
s - Ile �r
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, damages 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 represeniaiives of this City to enter upon
the above-mentioned property for in peon purposes.
Signature (Owner/Agent) / �� Date �i!%
f ,
' BUILDING PERMIT PI RMI
1
0:5
TRACT
DATE VALUATION LOT
r we,SASS .00 X9.4 21RVr3
JOB SITE
ADDRESS a f7$1 �iI_1.v
7tf=0'�t3}
OWNER
CONTRACTOR FER
.
MARX BONE ZI, IT-LX3R -
PO BOX :1714
PO BOX 1714
T iJCW CA 96160
;CRUC`JN, C,A 96160
(5:a 0)613-1173 CW 'i'1= D
USE OF PERMIT
ffl3l1�w�1Lf��3:iis�li Sa1t�1)
SP13.- PERMIT 1 0IMS NOT FNC:LUDE ;31 ocr, Atj 5, Pom,, SPA, ORI
DRIVEWAY WAY APPf2OAC 1.1.
"`t
i
CUSTOM C>ONSTRUCTIO14 �,604.00 F ,
FORCF•PAVITI49 A4 :l?f9 $1P
GARAMUCA1'..PO.WT 93 .00 $SS'
r
4
E5AAMM C06: OF CON91R CUON
: nt •.�
FAW1.HFRE SgMVqARY
00142TRUC £ION FRE 101 NQS/(?- 1 Sn(SfiC► 54,:� .SA
PLAN C'1:XC;K FEE 101-000-139-318
FU DZPOSIT 1.01.000-439-318 4750:00
MECHANICAL ftF 101-00� X121-000 $146. +t;
ELECTRICAL PEE 101.000-420.000 $20192
PLkt k413.040 IEEE 1014040-419-000 $183.2
STRONO MOTION FRE - R& SID 101.000-241.000 $".So
ORA1 INO ME 141-030-423-000 P5.00
DEVX.W�PER IMPACT FEE $2,405.00
ART 1114 PUBIC PLACES • RIM''1L 270-000-445-000 $263,53
SUP -TOTAL COk1gMt7+:Ti0N A1U`_) -PLA14 CHF-r—'K
vi20.€ 7
1: x.3 PR&PAI f k
7 SCI.Ct�
T , 110 DUE NOW
V1970.$7
JAN3 0 2003
QUINTAL
RECEIP FI�Nm DEPT.Y
,�,` �'
ATE F AL D '
INSPE
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
A
Combustion Air
Roof Deck
UExhaust
Fans
F.A.U.
naming
Compressor
Insulation
03
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
174 �1
Drywall - Int. Lath
ZZ
Final
Final O _
BLOCKWAL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
D
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Waste Lines /fj ��—
Water Piping c
Gas Test
Electric Final
Heater Final
Plumbing Final
Plumbing Top Out
_ _
Equipment Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection/`
3 �� Z
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit Qfj
Rough Wiring D3
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power �
Final
Utility Notice (Perm)
COMMENTS:
p- _-3
&AddzTW /DILW A'=7
EFUems(cl C.k-%rra P&)uoll a*g,§ 54_
qM4-rVZ4 ;r AL (24�. `{(7c/03► )
�^ 079
;� Building
• Address
Ow MAek— &Dy�n1 Z1
Mailing Q u
Address P4 . gck 17
City Zi
i1Zc7e ' - c,4
T4ht 4 4"'Quucvi
P.O. BOX 1504 APPLICATION ONLY
`n 78-495 CALLE TAMPICO
�S %z( LA=INTA, CALIFORNIA 92253 � vl%�
Contractor
Addres
Cit Zip Tel
State Lic.�^ 0 ,� City
&Classif.0—A 417ioz30 S Llc.a
-&/3ii73
Designer b65e2f_ CAA) QEF5A,&)
Address Tel
1359
UJODDItJ E, (70)
779-0336
ty Zip n� State
IQL/�) 0t? �e /2Z LIC. If
LICENSED CONT TOR'S DECLARATION
I hereby affirm that I am Ilcen r visions of Chapter 9 (commencing with Section
7000) of Division 3 nd fessions Code, and my license is in full force and
effect. _ :g g
SIGNATURE,DATE
OWNER -BUIL RRDECLARATION
I hereby affirm that 1 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 of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is *exempt therefrom, and the basis
for In
alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
I�: 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
Professions 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 that such improvements are not intended or offered for sale. It, 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.)
I'1 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 67 property who builds or improves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
11 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. 3800, Labor Code.)
Policy No. Company
Copy is filed with the city. A Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the K1.rIffic!e
hundred dollars (S100) valuation
or less.)
I certify that in the performance of thghis permit is issued, I shall not
employ any person in any manner to the Workers' Compensation
Laws o California.
Date "1 0'V Owner
NOTICE TO APPLICANT: Il, Ke mak ng 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. OCC. GRP.
A.P. Number 76Y-0.30 ®O -L
Legal Description �D �A� ®✓l -.LA Qy; AAA GA 9'>ZZ.��S3
Project Description silojofr irAn'rdy �ESiaPAil� G✓t�S9'rttv�C�
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.DAI
Issued by: -
Validated t
Validation:
'3
WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE
3�.s
3:3' orf
1
Sq. Ft3(y
Size /(moo 1 '
No.' No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
r AMOUNT
Plan,Chk. Dep.
Plan Chk. Bal. -
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL.
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.DAI
Issued by: -
Validated t
Validation:
'3
WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE
Coachella Valley Unified School District
P.O. Box 847, Thermal, CA 92274
(760) 398-5909 — Fax (760) 3984.224
Project Name:
Owner's Name:
Project Address:_
Project Description:
This Box For. District Use,Only `
DEVELOPER 217FFN PATT)
AREA:
AMOUNT
LEVEL ONE AMOUNT': ..
LEVEL,TWO AMOUNT:
MITIGATION AMOUNT:
COMM/IND. AMOUNT:
DATE:REC6IPT:
'
CF�CK #:
INITIALS:
CERTIFICATE•OF COMPLIANCE
(California Education Code 1'7620) '
APN: 794 , nin and ra . #ice �Qou
Type of Development: / Residential XX ) Commercial
Date: . NO : 7, 2003
Phone No., 760 200-0428
Lot #'s: < 24
Industrial
Total Square Feet of Building Area: 3604 `Sq:;Ft
Certification of Applicant/Owners: The person signing certifies that the -abovd:information is correct -and makes this statement
under penalty of perjury and further represents that he/she is authonzed'to sign o ehalf of ter/developer.
Dated-- (' % ' 0 �• Signature:
SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN
ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE)
Education Code Gov. Code Project
17620 65995 Approval
Number of Sq.Ft. 3604
Amount per Sq.Ft. $ 2.16
Amount Collected $ 7,784-64
Building Permit Application Completed: Yes/No
By: Carey M. Carlson
Asst. Supt., Business Serv.
AgreementExisting Not Subject to Fee
Prior to 1/1/87 Requirement
Note -
Certificate issued by: MarCela Valdez Signature:. ,! /
Facilities C er - =
NOTICE OF 90 DAY PERIOD FOR PROTEST OF.. FEES AN TATE1VIElVT OF FEES
Section 66020 of the Government C6&e asserted by Assembly Bill 3081, effective January 1,A 99,7,requires that thisDistrict provide (1)VisNo'tke'shall
e to
the project appellant, at the time of payment of.school fees, mitigation payment or other exactions'(" Fees" ); of the 90 -day period to pr test,tion of
these Fees and (2) the amount of the fees. Therefore, in accordance with section 66620�of the Government code and other applicable la
serve to advise you that the 90 -day protest period in regard to such'Fees or the validity.theeeof; commences with the payment of the fees or performance of
any other requirements as described in section 66020 of the Government code. Additionally, theimount of the fees imposed is as herein set forth, whether
payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy As',In--the latter, the 90 days•starts on the date hereof. This
Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School
District, and up to three (3) such extensions may be granted. At such time as this°Certificate expires,.if a building permit has not been issued for the project
that is the subject of this Certificate, the owner will'be reimbursed all fees that were paid to obtain this'Certificate of Compliance.
MV:c/mydocs/devfees/certificate of compliance 09/30/02
RECORDING REQUESTED BY:
Fidelity National Title, Company
Escrow No. 45171 -CB
Title Order No
When Recorded Mail Document
and Tax Statement To:
.Mr. & Mrs. Mark Bovenzi
P.O. Box 1714
Truckee, CA 96160
60C , jS, —7041.Z4
IW24/1 M_ 68: 000 Fee: 7 - ee
:pass . A of 1• 6!6c, T, Tax Paid
Rec_cr_d'*d.1n-.0,f1f_1cia1 R960rdls
Cot mt.y'10 Riverside
Gjr�y,L. O"o
'Lli%t'v, cierk &_ fteorder
12,7
A J. R, L c6p.y,
XPR: 764-UJU-UU4-U L_ ,LO�REFUND NCHG EXAM
DEED
GRANT.
The undersigned grantor(s) declare(s)
Documentary transfer tax lstils,.bo
X I computed on full value of property conveyed,, 6r,jQ
J computed on full value fess'value oi liens,or enwm , branceis.remaining at time�of sale,
I Unincorporated A
rea of La `Quints
FC VALUABLE CONSIDERATIONS r6ceipt'of which. Is �hereb WilliamE. Thomas and Dorothy
.. I y a
J. Thomas, Husband and Wife as -j6i;ni:Tenants
hereby GRANT(S) to. Mark Bovenzi. and Melanie Bov**e'nz'1,: Ti"iees of the'--B6venzils Cash
Plan Trust dated,,Narcfi, 1j"1994.'
d
the followingdescribed eal"propefty In the City of La.( uinta-,
County of Riverside, State -of Calif o''rnia',*
S 5 0�6'gei 76
Lot 24 of Tract No. 28983, a per,map recorded in Book 2.8 82 of Maps; ih'the Office of the County"
Recorder of said County.
DATED: September' 18,.2002
STATE OF CALIFORNIA
COUNTY OF MC0cL,Ac_,
0V -before me,'
\A
b , � kn;449 so pr6v'6d to rhe.oh'the,bas basis
of satisfactory evidence) to,.4e the Oetscirits whose
n.ameSjsjWar,e subscribed to the within. instrument and
acknowledged to me that hem/.they executed the
same in hia{ker/their authorizedca�pb''6'i'tybW','andI'that
by hisaw/their signature(s) on the . ihstrurrIp6t the
person(§j, or the entity upon,'be'half -of 'which the
person(s) acted, executed the instrument.
Witness my hand and official seal.
Signature
MAIL -TAX STA'
FD -213 (Rev 7/96)
TERLKELLY
NOTARY PUBLIC .'CAUPOWA
4EVADA;0UW`
> MY COMMISSION EXPIRM
0ECEMBER 37..2N3
—:.,r
S_
,PAqE.
SIZE DA.
PCO _ Ft
NOCO
6W.
I
12,7
A J. R, L c6p.y,
XPR: 764-UJU-UU4-U L_ ,LO�REFUND NCHG EXAM
DEED
GRANT.
The undersigned grantor(s) declare(s)
Documentary transfer tax lstils,.bo
X I computed on full value of property conveyed,, 6r,jQ
J computed on full value fess'value oi liens,or enwm , branceis.remaining at time�of sale,
I Unincorporated A
rea of La `Quints
FC VALUABLE CONSIDERATIONS r6ceipt'of which. Is �hereb WilliamE. Thomas and Dorothy
.. I y a
J. Thomas, Husband and Wife as -j6i;ni:Tenants
hereby GRANT(S) to. Mark Bovenzi. and Melanie Bov**e'nz'1,: Ti"iees of the'--B6venzils Cash
Plan Trust dated,,Narcfi, 1j"1994.'
d
the followingdescribed eal"propefty In the City of La.( uinta-,
County of Riverside, State -of Calif o''rnia',*
S 5 0�6'gei 76
Lot 24 of Tract No. 28983, a per,map recorded in Book 2.8 82 of Maps; ih'the Office of the County"
Recorder of said County.
DATED: September' 18,.2002
STATE OF CALIFORNIA
COUNTY OF MC0cL,Ac_,
0V -before me,'
\A
b , � kn;449 so pr6v'6d to rhe.oh'the,bas basis
of satisfactory evidence) to,.4e the Oetscirits whose
n.ameSjsjWar,e subscribed to the within. instrument and
acknowledged to me that hem/.they executed the
same in hia{ker/their authorizedca�pb''6'i'tybW','andI'that
by hisaw/their signature(s) on the . ihstrurrIp6t the
person(§j, or the entity upon,'be'half -of 'which the
person(s) acted, executed the instrument.
Witness my hand and official seal.
Signature
MAIL -TAX STA'
FD -213 (Rev 7/96)
TERLKELLY
NOTARY PUBLIC .'CAUPOWA
4EVADA;0UW`
> MY COMMISSION EXPIRM
0ECEMBER 37..2N3
RECORDING REQUESTED BY:
City of La Quinta
Community Development Department
La Quinta, CA 92253
WHEN RECORDED PLEASE MAIL TO:
City of La Quinta
Community Development Department
c/o Greg Trousdell
P.O. Box 1504
La Quinta, CA 92253
a -
2003-046066
0112212003; 00A' Fee :'19.00
�.+Page,.1fof 5'',
Reccrde&'iA' Official Records
"Oe .so
Clerk &.Recorder
' M '
�S U
PAGE `- SREt
DA
PCOR NOCOR
SMF MISC.
A,.
RT8
COPY
LONG REFUND
NCMG E%AM
COVENANT AND AGREEMENT RESTRICTING THE USE 'OF TIIE PROPOSED
RESIDENCE AT 56-078 PALMS DRIVE LA QUINTA,'CALIFURNIA RU
This covenant and agreement is made aria executed owthis-the..9`," day of -January, 2003; by
Bovenzi's Cash Plan for property described herein. The City ofLa Quinta, a Municipal Corporation,
is hereby made a party to this agreement for the purposes set forth below.
The undersigned hereby certifies that he is the property, owner ofthe following described real
property in the City of La Quinta, County of RiversideWSW
e of :California:
µj.
Lot 24 of Tract No.. 28983 (APN: 764-0301=004)+ in the,, City^of La 'Quinta, County of
Riverside. BOOK SBS, PA(e
In consideration of the City. of La Quinta issuing a building permit for,,certami improvements
which will be constructed on, said property, the. undersigned does h6reby covenant and agree to and
with said City to restrict the use of said property as follows:
1. The detached guesthouse may not be rented nor sold independent of the main single
family residence (Minor Use Permit -No. 2003-378);.. ,
2. No kitchen or cooking facilities shall be'coristructed,iii the"g fest house per the
provisions of Chapters 9.30.030 (RL.Zone District) and 9:60.100`(Guest Houses) of
the La Quinta Municipal Code; and,
3. All on-site facilities are intended for the sole occupancy of .the property owner,
nonpaying guests, and domestic employees.
COVEN378.WPD/g/greg Page 1 of 3
.` C4
This covenant and agreement shaltrun with-tlie. land an&shallbd binding upon future owners,
their successors, heirs, or assigns, and ourselves,4nd shall *continue in:effect.',while said accessory
building remains on the real property or unless otheiwis&if6leasedby, the authority of the City of La
p, y . shall t
Quinta. All leases of said dwelling and/or property - be o this restriction. This
agreement shall be entitled to the remedy of injunctive rel 16f,inaddition of any'rem6dy in law or
equity.
This covenant and agreement and the provisions 1fdreof ,are irrevocable and nonmodifiable
except* by the written consent of all parties toAhe. agreement-; , y Quinta, "includin'the,Cii 'of La Qnta, a
municipal corporation. The City-shalfhavethe right to enforce each-and&Very, provision hereof and
,erevoked;4�niodifie'd f otherwise amended
the parties agree that the agreement shall not bel�'T scii�aed .4' 6
'fY -' i
or changed, without the expressed written consent of the. City. i. st� be ng obtained'.
In the event that the owners, their heirs, assigns or sup ce-�s`orsin interest, shall fail to perform
X-9
any obligation hereunder, they hereby agree to pay all'. costs aria exp'ense_s incurred by the City of La
Quinta in securing performance of such obligation) inchidin's including attorney's y
Dated: -,2.0 0-3 14 Ai
50ve ra-21i s K
By:
M Bov'6zi, Trustee
7—CARRIE X COOK
Ic
Noy
Notary
COVEN378.WPD/g/greg
sudactlbtd to's cfO
0
7 -
Page 2 of 3
I
CALIFORNIA ALL-PURPOSE;..ACKNqWLE0Q, M ,T.
State of Califffia
ss.
County of rCiU
On ,4 before 'me,
Data Narne and Title of Officer (e.g.,'Jane Doe, Notary
personally appeared
CARRIE&A.,
C
onhrribon At
V4
N0tCffVJ
'MY.
0nnycoinm: 014rildl� C&J
. X 1 0.
Name(s) of Signer(s)
11 .:known tome oa��:J,
t6 e �n. e
- m; the basis' of satisfactory
owed
evidence"
t&" be the" -person(, lwhose naME(S)/iS/
i6 'i '•*
syb�cr§,�.d_, th6.. w 'it h n instrument Knd
acknowledged h
iik`I6dged*to-me t 'at, sj?4tho? executed
the -am'e.. Jn,'-,his/(/6r/Keir -authorized
capacity('`and, that, by hisxr/(r
'Sign`ati]ireo-iibn the instrument the perso9o), or
the",ehtity-,_upbn, 666ali'of which the personx
acted,
led, exec ed the, instrument'
W." 4NS,,. ftig' 4,
,)Iny hand and.o,
aI.A
Signatuir�6 NotarQPublic
OPTIONAL,
'piove,vZ6;
Though the information below. is not required by law,* it may to..persorts -relyfng on,th6 document and could prevent
fraudulent removal and reattachment of this form to another-doc6ment.
Description of Attached -Document"
V
Title or Type of Document:
Document Date: Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Clairr�id by Signer -
Signer's Name:
0 Individual,
Top of thumb here
0 Corporate Officer Title(s):
0 Partner — 0' Limited .[j General
0 Attornby'in- Fact
0 Trustee
0 Guardian or Conserva!!.
0 Other:
Signer Is Representing:
0 1999 National
7
Notary Association • 9350 De Soto Ave.. P.O. Box 2402 -,Chatsworth, CA 91313.2402 • MAW.naliqnalnotary.org Prod. No. 5907 Reorder: Call Tall -Free 1-800-876.6827
, 51:
COVEN378. WPD/g/greg
2-- . .
State of California
County of Riverside
On January 9'-2003 before me, Regenia-Hensley Notary Public, personally
appeared OSCAR ORCI , personally,known tome to be the person -whose name
is subscnbedlblhe;Within instrument;and acknowledgedto`me that he executed the same
in his authori2ed capacity . and tf at' by"'his. signature on .,,the m'strument the'
person or.the
entity upon behalf of which the person acted, -executed the.insttument..
WITNESS my hand and official seal. (Seal)
•,
REGENIA HENSLE
commission # 1274458 z
Notary, Pudic - Caiffomia y
�vetsideCounty
/ myCaTun_ E es Augl9.2OD4
Document Description: Minor Use Permit1003-378 - Restricted Use of Residence at
56-078 Palms Drive, 6 Quinta,California
Number of Pages:
Date of Document: JanuaW 9 2003
. 4
01/08/2003 11:25 7605680324 AVAIL PROP MGT PAGE 01
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ii e; t .e 2�al m
T rra assoc tIM
VI .;
ATYMR.,
PALMS•'
December 17, 2002
Mark $ovenzi
P.O. Hok 1714-
Truckee, CA 96160
RE: Lot 24 - Architectural :Review
Dear Mr. Bovenzi:
The Architectural.Committee revieved,,and.-approved your working•
construction plans for :Lot 24.
Please submit .your refundable; check,in .,the -amoun:t of $5,000 ,to
this office,' payable ,to The village?. "it "Thee Palms,, for the con-
struction deposit'.
. F
Thank you for your cooperation inn.this submittal process.
Good luck on your construction.
Sincerely,
Cam Anderson
Project Manager
Availprvye ty Mar ggemew
7-0. SOX 1032
PaCtn Desert, CA' 92z61-1032
(76% S69 -27A7. 568-0324 0)