07098 (SFD)J4 4 Q" .
P.O. BOX 1504 No. 07098
Building 78-105 CALLE ESTADO
Address 51-265 Paloma LA QUINTA, CALIFORNIA 92253 .
owner - I
Michael G. Mitchell
Address 8-6,50 Avenue 42 #1808
City Zip Tel.
Bermuda Dunes 92201 345-4678.
Contractor
Owner/Builder
State Lic. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I 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
.. , `' �tC ' G' r
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affimm that I am exempt from the Contractor's License Law for the following
,reason: (Sec. 7031.5,Busi7ess and Professions Code: Any city or county which requires a
permit to construct. atter, 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 the 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 rive hundred dollars (5500).
❑ 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. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
or 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 reason
11L'DING: TYPE CONST. OCC: GRP.;
P. Number 769-141-0417
Legal Description
Project Description
aYD
Sq. Ft. No. No. Dw.
Size 2564 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑
POOL NOT INCLUDED IN PNMT
Estimated Valuation $15de658
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Date owner I 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.
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 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
Laws of California
Date Owner
NOTICE TO APPLICANT: ff, 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.)
Lenders Name
Lenders 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
TOTAL
n(�
AMOUNT
a00
816.00
438.80
79.00
149.24
187.50
10,57
20.00
20.00
3,181.54
REMARKS ,� x r., ; . �;: s -s n _ R e ...daS , )
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 INSPECTOR
Issued by: Date 2/14/90 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL SO. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR SO FT ®
SEWER OR SEPTIC TAN ROUGH WIRING
DUCT WORK
POWER OUTLET
I ROOF DRAINS
GAR. SO. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAW
DRAINAGE PIPING
CAR P. SO. FT. ®
GAS (FINAL)
TEMP. POLE
DRINKING FOUNTAIN.
WALL SO. FT.
GROUT
WATER HEATER
SERVICE
URINAL
SO. Ff. @
BOND BEAM
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
GRADING
cu. yd.
-plus-x$_=$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
O
C
�v/� ✓�� r/
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GAR. FIREWALL
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING , j ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUM; - G
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TAN ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAW
OTHER APPJEOUIP.
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.
FRAMING x`v
FINAL INSP.
ROOFING 3/2�
VENTILATION
O
C
�v/� ✓�� r/
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING io
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
CERTIFICATION OF PAYMENT
OF fLDQ�
SCHOOL FACILITY FEES
T0: Cit of La, QtYint DATE: fIOD
City * ' CC.>�ti�:'q taro
Department �Qf Cbtp � y De�?l;oI A t
78-105 Calle Estado `'1lt®I � AiV 07.
La Quinta, CA 92253
whichThis is to certify that C�
rdeveloper of_ ....� .���
locatedat—VEWWM -�Zij within
this District, has paid school facility fees imposed pursuant to the
autr't g e at by Gover ent Code Se tion 530,8q in the a ount o
$
cove ing a total of square feet of (, ) residential orc „I
( ) industrial/commercial deve opment and that builds g permits for .
this footage in this development may now be issued by your jurisdiction.
(Jv-ft�- I' kj-&w n
aS for DESERT SAN •UNIFIED SCHOOL DISTRICT
White - Building Department • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
June 10, 2010
Subject: Address Correction — APN 770-174-007
To Whom It May Concern:
BUILDING & SAFETY DEPARTMENT
(760)777,-7012
FAX (760) 777-7011
The Building & Safety Department is. the issuer of official addresses within the
City of La Quinta. Recently, we were made aware.that a residential address
within the. city is incorrect. The address mutt be changed to facilitate proper and
timely response of emergency services, as.:well-as for routine :deliveries.
The current identifying information -.is:
APN: 770-174-007
Legal Description: Lot 189 MB 21%61=62. DesertClub Tract Unit No. 5
Address: 51265 Calle Paloma, La Quinta,' CA 92253,:
The APN and Legal Description_ noted above are correct. The address is
incorrect. Please-trevise your records, effective immediately, to show the
following; corrected physical address:
51295 Calle Paloma, La Quinta;.CA-92253
Please note the change on your records:as necessary. If you have questions
concern ing,thi's change; please :contact me directly.•for confirmation by telephone
at 760-777=7015, or by a -mail at gbutler' la=quinta.org_
Yours truly,
Greg Butler
Building & Safety Manager
Order No.
Escrow. No. '10-11186..
Loan N .
WHEN RECOD.MAIL TO
Mr. , and -Mrs. Stephen Mitchell,. et.;al
P. 0. Box 696
La Quinta,,CA., 92253
M
f -
c
Gated February 8, 1989
L
I„1.
L
W:.
SPACE ABOVE THIS LINE' FOR RECOER'S US
MAIL TAX STATEMENTS TO:.
DQCIJMENTARY TRANSFER TAX $..,31.:90.: ...............
XX.. '
Computed ,on the consideration or value of property conveyed; OR
SAME AS ABOVE
...... Computed on ,the consideration or value less liens or encumbrances
remaining at time of sale.
Signature -of Declarsio or Agent iletenniningtax _ Flrm Name
GRAN:::DE:E°D,
FOR. A VALUABLE CONSIDERATION,
receipt o,f,,which is hereby� acknowledged,. MITCHELL RABB and ELLEN L. RABB, '
'
Husband and Wife as JbiiA Tenants•as
to an undivided 1/2 .interest and; RAYMOND F.,MILLER and
'.TERRIE A. MILLER, Husband and
Wife as Joint; Tenants as.to- 'an undivided 1/2 interest, all
as Tenants in Common
hereby GRANT(S) to
..MICHAEL
MITCHELL, a Single
Man .as to an undivided'.1/2 interest and'STEPHEN MITCHELL and
KAREN MITCHELL, Husband and
Wife as to an .undivided 1/2 interest
r
the real property in the City of
La Qtiinta
County of Riverside
- State of California) described as
Lot 189, Unit 5,of The
Desert Club Tract, as'per map recorded in,;Book 21,
Pages 61 through 62 of
maps in the office of the County Recorder of Riverside
County, California.
c
Gated February 8, 1989
L
I„1.
L
(Individual)
STATE OF CALIFORNIA
SS.
COUNTY OF Riverside
Feb. 221, 19asI Betty L. Coman
On ore me a
Notary Public in and1or said State,
C, personally appeared MITCHELL
(known to me;
(or proved to me on the basis of satiafactory'evidenoe).to be the pe n whose nameLI —S- su'b' to the
within instrument and acknowledged. that HE 1:1 1:11:31G"—,
executed the same.. OFFICIAL
WITNESS my hand and official seal.
YL :OMAN
NOTARY PUBLIC CALIFORNIA
PRINCIPAL OFFIC&IIN
$
49-/RlVEOSIIJE:to
LINTY
"C
-
Form 3213 (CA 12-82) (7714 area /Of official notarial $"D
STA E OF CALIFORNIA )ss.
CO TYOFRivprqitlp
On March 7., 1989 before me, the undersigned, a Notary Public in and for
said State, personally appeared Ellen L. Rabb
persor
factory
scriber
he/shE
WITNE
Signet
...........
STATE OF CALIFORNIA
COU Y OF RIVERSIDE., SS.
On FEBRUARY 17, 1989,
M . before me, the, undersigned, a.Nptary Public in and for said
State, I-ersonally appeared TERRIE A. MILLER ,,
z . .
(D
E
0 to be the person - whose name IS
subscri
CD
31 to the within instrument and acknowledged, that %,: she'
0 executed the same.
WITNESS my hand a d official seal.
f
Signature of, otary
0
• kK �n-on to m
)any
SHEME-V-SROM
OMM;* -am II. low
(This area for official notarial seal)
4.
:� .
John H. Hacrker_& Associates
Civil Engineers
February 16, 1990
City Of La Quinta
78-105 Calle Estado
La Quinta, CA 92253
ATTN: Grading Section
RE: Lot -'189, Desert Club Tract Unit #5
Builder: Mike Mitchell
Gentlemen:
This letter will serve as a certification that the grading has
been done per the approved Grading Plan. A field inspection shows
that the pad elevation was 39.20 and the approved plan shows it
to be 39.20 , since this falls within the standard grading practice
tolerance.
Sincerely,
John H. Hacker, R.C.E. 14614
Exp. 3/31/93
JHH/jag
xc/file eV FESS/0;,,
NO. 14614
EXPIRES 3-31-93
sl\ '
OF C aye;
� AO _I���
4501 E. Sunny Dunes Road • Suite C 9 Palm Springs • California 92264 • (619) 327-4565
DAILY REPORT OF
GRADING CONTROL
eSOIL and TESTING
r> ENGINEERS INC.
JOB LOCATION
Qv ;% t4
CLIENT OR OWNER _
M i Kk
REPORT SEQUENCE NO.
GENERAL LOCATION OF FILL
t -x
PURPOSE OF FILL OR NATURE OF STRUCTURE TO BE SUPPORTED
DATE
3o-Qo
DAY OF WEEK
GENERAL CONTRACTOR
tL�^Pif�
GRADING OR EARTHWORK CONTRACTOR
V hl�v�o
JOB ENGINEER
t" S
HRS. CHARGED
2.s5,
CONTRACTOR'S SHIFT
0.Im.
CONTRACTOR'S SUPT. OR FORMAN
&I� Y4
ASSISTANTS
HRS. CHARGED
SOURCE @ DESCRIPTION OF FILL MATERIAL & MAXIMUM DENSITY 6 M/C
JO T.
WEATHER
SOo
' 117,0 !' Y
ZAPPROXIMATE
/� S,
YARDAGE
PLACED THIS SHIFT TOTAL TO•DATE
TEST
N0.
TEST LOCATION
ELEVATION
IN
FEET
COMP.
CURVE
NO.
TEST
MOISTURE
%
TEST
DRY
DENSITY
LBS./CU. FT.
RELATIVE
COMP.
%
RETEST
NO.
NOTES
17� D Lx�
LOT
�
o� c�sv- lecnp,
310,
Z
is, �
108�o
IcA,o
2
M►�-E,,�-sr secno►,
37.1
I3��o
//Silo
99rS
3
Som - CA -sr S-ec ter+
1-307
I
11-1
1114-3
97.7
Cev1
C3
36,1,v
Z
1313
104,4
74-7
SUPPLEMENTARY REPORT (DESCRIBE EQUIPMENT USED FOR HAULING, SPREADING, WATERING. CONDITIONING & COMPACTING; ALSO REPORTTHICKNESS OF LIFTS, AND
AND NUMBER OF ROLLER TRIPS.)
:jajTj
I? La
{.Q OIV1N a
60 1+eJ T1 a a -n.le .
r Q !//w
_77,
�- k-
" �o , � �H O h 490 T,
Z
'
/TL
JOB NO. 9b IOC 7 COPY SENT TO CLIENT
CONTINUED ON NEXT PAGE
PAGE OF