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0011-181 (SFD)LICENSED CONTRACTOR DECLARATION ' I hereby affirm under penalty of perjury that I am licensed under provisions of ,Chapt& 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 r ' Date "aT• , +� Signature of Contractor L OWNER -BUILDER DECLARATION I hereby affirm under 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). ( ) 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 affign 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. -k/) I have and will maintain workers' compensation insurance, as required by Sbbtion 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 Policy No. STATE la'%TD (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 Section 3700 of the Labor C de, I shall forthwith comply with`those provisions. ,) Applicant I Warning: Failure to secure Workers' Cornpensation coverage is unlawful and shall subject aniemployer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. d 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. • .Signature (Owner/Agent) r_ f - Date :2 % i• -� BUILDING PERMIT PERM T# - DATE .°i ) VALUATION LOT TRACT r JOB SITE APN ADDRESS OWNER CONTRACTOR / DESIGNER / ENGINEER 1�.!V33..�:it'fSV1. L SIMMEIS ` 45-675 GURIARY DR1M? 45675 G'URIZY DRIVE Ill'. AN WELLS CA 822.10 INDIAN N WEIV,S CA 92210 (76(1)5611.2020 C3:IA. 3907 USE PERMIT ��Otty�F��P,q Q 9 Y ys t �� y q to tt7 V DWELLING 04GLY, dTd`�aviDc ]✓ 9�lFy��i LING 3RD - ulE.itMIT DOM''S NOT INC:I.t3D9 d31..x:X= DRA EWAY TRAM 3 COrNO Ri IC Y ON 2110.00 sp ' P011C PATIO 2_70.00 SIS CIARAG AMRT (SS) 12,70.80 g P"1. 'P,toon FNCIt Bltft.09 LF byF¢[.MA�i'E S Fay/ t. OSI G OF�'@6i'l.Y�AIRPTW��d.�.+dZ 147,49 7.3,9 ��yy�•.Q� '�q$�1'y ��yyyy��y CMISTRUCTIONFEE+ 103.00OA-18.000 $207.50 f='t t -X CHECK FFR 10 1 .10("39-'a ). a $674.610 FRIr DEPOSIT 101 -000-439-318 •�d�f1,GA MECHA141CAL YEZ 101 •.000421 d€3t?f= 6.t3v &ECTR.ICAI. FU 101.000..4.2014WX S144M W.Y1LgBiR a M. 101-000-419-000 $148.90 O'j"R(?WO MOTION ION PE - IMAM 101-000-241-000 £.94, M URADINO F:EWE 101-000-4,23-000 1r►EVEYOPER IMPACT FEE $1,007m PRECISI PIS 03 4Y00-441-345 IOit.Oil n q . 6 SUB-WIAL CONSM CMON AND PY.AW f":I�t ICK $3,912.7 IE -33 PRE, -PPM 4250,00 TOTAL T -K- 5fi.1.'+ ff F;S DTM NOW �3,b�►2.71✓ ' FEB 27 2001 17 Y U_ , RECEIPT DATE �?� BYq I DFjT F NAL , INSPECTOR t INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR c BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings Slab Grade I_Underground j 4�G p ( 'S-! G 5� Ducts Ducts Return Air Steel Combustion Air Roof Deck 6-m nj-7 Exhaust Fans O.K. to Wrap �_( CJ_� t 1% "'r F.A.U. Framing Insulation Fireplace P.L. =� C, .� /_ _ a-(� p( C� g -T Compressor Vents Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath _ Drywall - Int. Lath -p C S� Final Final 1 /o/vz POOLS - SPAS BLOCKWALL APPROVALS 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 Lines Water Piping / / (�-�(//�—( c5 7 Heater Final Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection end ( `jam Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICA L. 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) 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 336192 B-1 Date Signature of Contractor OWNER -BUILDER DECLARATION 09/30/2( I hereby affirm under 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). . . . . _ .r . -code)*. I am exempt under'Section B&P.C..for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION. y - I hereby affirm under penalty of perjury one of the following declarations: O I have.and'will maintain a certificate ofconsent 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 Section3700_of:the' Labor Code,. for the .performance of ,the Work. for which this permit is:assued My workerscompensation insurance carrier & policy no. are: Carrier,"".. Policy_No. STkTE-FUND (This section needriot be completed If the.'permit valuation is foi.$100:00 or.less). i (,) I,certlfythat n the performance.of the work'for which this permif is'issued, I shall not°employ any. person in•any manner so as -to become subject to the Workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section, 3100 of the Labor Code; I shall forthwith comply with those provisions. Date: Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up t6 -$l 00,000, 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 Quihta, 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 representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) Date BUILDING PERMIT PERMIT # VT' -E DATE VALUATION LOT 001.1-L81 TRACT $147,497.30 JOB SITE ADDRESS APN 51-420 CALLE PALOA,1A 770-173-005 OWNER CONTRACTOR / DESIGNER / EN (NEER 1v11I,LI1qNIZJ1v1 DEVELOPMENT WILLIAM L. SHIELDS 45-675 CKTF EY DRIVE 45675 13YURLEY DRIVE INDIAN WELLS CA 92210. 11,TDIAW WELLS CA 92210 ' (760)568-2020 CBL4f 3907 USE OF PERMIT SaIGLE FAIVDLY DWELLING PERMIT. DOES NOT IN BLOCK WALLS/POOLfSPAf APPROACH Dk VEWAY t - TRACT'CONSTRUCTION 2,385;60 SF PORCI'JPAT10 '" 270.00 SF . GARAGE/�'ARPORT (M12,100,30 . 5 FT. WOOD, FENCE 200.90 LF FS -T= QOST OF COMST UCTION 147,497;30 0 PE12141T PE'E SUMM& Y CONSTRUCTION FEE 101-000-4' 8000 PLANS &HECK' FEE 1 u'I -UQC-439-3 I $ $874.50 FEE DEPOSIT 101_000-439-3.18 •$250,00. M ECHAN ICAL, FEE i 0 i =000-421-000 $48.00 ELECTRICAL FEE ` 101=000-420 000 g 144,94 PLUMBING FEE'" 10L-000-,415-000 $I4Q:00 -STk014 0 M0TI0_1s1eFEE-- RE,SID 101-000=241.000 $14,75 GRADING FEE 101-000-423-000':= $ZU.09 DEVELOPER IMPACT FEE $1,907,00 PRECISE PLAN 10.1-000-4.41-345 $10000 SI; N -TOTAL CONSTRIJC 1Ol I AKDE PLAN CHECK $3,912:59 LESS PRE -PAID FEES -$250.00 TOTAi. PE--Wj rr FEES nUT_+' NOW $3;662:79 RECEIPT DATE BY DATE FINALED INSPECTOR �O Building < I >✓) J Address ) 1 Owner P.O. BOX 1504 APPLICATION ONLY 78-495 CALLE TAMPICO LLQ `71_,lDt j_ LA QUINTA, CALIFORNIA 92253 Address /, C -I, ) J Tel. City Zip State C1 11(-V1 L Z, 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 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 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 thealleged 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). C-1 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 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 of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) i 7 1 am exempt under Sec. B. & P.C. for this reason Date Owner I hr r 1 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 n Copy is filed with the city. O 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 (E100) valuation or less.) I certify that in the performance of thK 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: 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 a0plicant Dale Mailing Address City, State, Zip BUILDING: TYPE'CONST. Ni►OCC. GRP. A.P. Number —% Mailing �- ( Legal Description L )T 1,21- 1r t��aLE C ✓�5 i iLh`1 UP Project Description '71t -CUR \��,i��t�L \L —, t r Address raj Wil. V 1 ` 'y City '; Zip Tel. Contractor _ ppnn15��`t�5 y'1 Address t^ L REMARKS Cit, Zip -.� to Tel. -) fib, • �6� ry State Lic. � & Classif. r� { c"1 Estimated Valuation City Lic. # Arch., Engr., L ° ' t . Designer 1�)�-i! C { - v1�• J"n Address /, C -I, ) J Tel. City Zip State C1 11(-V1 L Z, 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 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 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 thealleged 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). C-1 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 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 of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) i 7 1 am exempt under Sec. B. & P.C. for this reason Date Owner I hr r 1 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 n Copy is filed with the city. O 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 (E100) valuation or less.) I certify that in the performance of thK 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: 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 a0plicant Dale Mailing Address City, State, Zip BUILDING: TYPE'CONST. Ni►OCC. GRP. A.P. Number —% Mailing �- ( Legal Description L )T 1,21- 1r t��aLE C ✓�5 i iLh`1 UP Project Description '71t -CUR \��,i��t�L \L —, t Infrastructure Sq. Ft.No. Size -� ' Stories No. Dw. 11 Units New l Add ❑ Alter ❑ Repair ❑ Demolition ❑ r_T� ��Lp F►IC4 TOTAL REMARKS S-, Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS S-, 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 Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 Date 2/22/01 No. 21691 CERTIFICATE OF COMPLIANCE APN # Jurisdiction La Quinta Owner NameMillinnium Development No. 51-420 Street Calle Paloma City La Quinta zip 92253 Tract # Lot # 770-173-005 Permit # Log # Study Area Square Footage 2385 Type of Development Single Family Residence No. of Units 1 Comments 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 due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 2.05 X 2,385 or $ 4,889.25 the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued Fees Paid By CC/Palm Desert National Bank - Bill Shields Telephone 360-6020 Name on the check By Dr. Doris Wilson Superintendent ` Fee collected /exempted by Ellen Patino Payment Received $4;97.5.00. Check No. 81795 Signature NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) this will serve to notity you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is sssued or on which theyare paid to the District(s) or to another public entity authorized to collect 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 1 FLOOD'PLAIN DEVELOPMENT PER .MIT BUILDING SITE LOCATION FLOOD ZONE "AO" —DEPTH 1 COMMUNITY -:PANEL NUMBER 0709 0005; B '8%19/199 ap Revised -.: APPLICANT INFORMATION SECTION APPLICANT NAME APPLICANT. ADDRESS (MAILING ADDRESS N07'THE BUILDING SITE) f % /�� DAYTIME ,TEL.EPHONE NO'. Skj� L ee/G INSTRUCTIONS ' °t 1. A Flood+P.lain Develo;pinent:Permit:is required by LQMC Section 8.11:040pA). The Applicant should complete the Applicant Information' portion of',thls .appllcation::andisubmit it to `the Englnee�ing Departmenfalong with the required documentation. noted,hereon at the sameAime the Precise :Gfadirig Plan>is submitted'to the Building and Safety Department for plan checking. 2. Documentation required for STEP 1 OF 2- APPROVAL prior to receiving clearance for Building Permit issuance • Copy of the proposed Precise Grading Plan for review and approval containing all information required by..♦ the checklist shown on the back of this application.' 3. Documentation required for STEP 2 OF 2 APPROVAL prior to receiving Flood°Plain -Development Permit approval. Note, this approval occurs after forms for the lowest habitable; floor are set and before the Building & Safety Department authorizes foundation construction. • Submit a completed FEMA "Elevation Certificate" form to the Engineering Department. • Submit 95% relative density soilscompaction certification to the Engineering Department. STEP 1 OF 2 APPROVAL STEP'2OF 2-AP_PROVAL The Precise Grading Plan submitted for this application has been All; requirements have been, satisfied. This Flood Plain reviewed and found to contain all data°required to satisfy the Development Permit is approved. requirements of LQMC 8.11 The proposed'dwelling is eligible to receive a building permit upon.satisfyind'all other `Building & Safety Department requirements. c12 /Z rte%/ [;AUTAHOR1ZED.SI(WA'rLfREDATE/ La Quinta Engine ring Dei merit AUTHORIZED SIGNATURE DATE. , La.Quinta Engineering Department FILE: Upon Ste 2 a ` p p approval, original goes in "Flood Plain be file; copy gDes.to Applicant F090 REV -2 7/00 i CHECKLIST FOR PRECISE GRADING PLANS IN "AO" FLOOD ZONE 1. Prepare Precise Grading Plan in accordance with Checklist for Precise Plans and the following additional items. 2. All elevations shall employ the NGVD-29 convention. 3. Show and label elevation of "Highest Adjacent Grade" next to the building footprint. This refers to the highest existing natural grade next to.the proposed building prior to constructing the elevated the building pad. 4. Show and label the "Highest Existing Elevation on Lot" 5. Show and label the "Lowest Habitable Finished Floor Elevation". Note, this elevation shall be at least ONE FOOT higher than the "Highest Adjacent Grade" elevation. 6. The following grading note shall appear on the plan: All fill material placed under the structure shall be compacted to ninety-five percent (95%) relative density. t F090A 10/99 / 7 FEB -22-2001 THU 03:02 PM PALM DES"NAT'IONAL BANK.. FAX NO. . 7603415589 A 1 De -eft R'a'tional hank J-765 1:1 Pasco CA Pat or R61een ORANGE' ; COMPANY COAST' -UTLE -Riverside 1060 East �Washington. Street Qolt&-�) 41'ff6i@492324 _5' (90) 82-8800 P. 02 I-esponse to the above referenced applicationfbr_a pbli-6yJof title insurance, Orairigc Coast Title Company hereb) reports that it is prepared to issue, or cause to be issued, as' of . .of We'da-te h6rieof,'a policy or p6tide i s:of title insurance describing flu land and the estate or interest therei rt'h 6re'fn after set forth, iiisunng'-against loss:which may be �Susiained by reason of any defect, c lien or encumbrance not shown or referred to as an ti6epiio�Wpw or'not-exclild' �-fro 0 m coverage pursuant to the printed schedules, conditions and'stipulaltions of said policy f6rin's. The printed exceptions and exclusions.from the coverage4j d .ofs -policy ofpolici6s.are`sqt forth inExhibitA attached. Copies of the policy fon-ns should -be read. They are available fiom the office, whiW'issuidAis report Please read the exceptions shown or referred to be'low'6nd We exceptions, and exclusions�ict foirth in Exhibit A of thisl report carefully. The exceptionsand exclusions are tneant to provide you -with notice of matters; which. are not covered z-,,nder the terms of the title insurancepolicy . an d should lie - c`;i're` f a"') I Y, id"it's i d e' r e d, is important to note that -this Preliminary report is not written representation as to the condition of title and may not list all liens, defeets, and,enizurn6rances arfectihg title-to.the land, This report (and any supplements,,or atbendments.hcret6) is issued -solely for the:purpose.of facilitating the issuance of a policy of title insurance and no liability. is_assumed .hLiteby. if itis d'e'sked,tha . t'liability be-assurried pfi6r'to,'the issuance of a policy of. title ::_IIUTance, a bindert sh Id b"requested. or commitmen ou e Dated as of November 28, 2000 at 7:30 A.M. nhthia,K'5c.k Tide Qfficel,. Fax: (609)'370-3332 The form of Policy of Title Insurarice contemplated by this ,reo.ort is: A.I...T.A. Loan Policy (10-17-92) with A.LT.A. Endorsement:- Form.1- Coverage The prem iurn for a Policy of Title Insurance, if issued•will be based on., rate. =�0-%2-200'1 THU 03;03 'PM PALM DES NATIONAL BANK FAX .% 76'03415589 P. 04 y Order No. R-193132-1 SCHEDIJLIC "B" At the date hereof exception to coverage`.in addition .to .the printed exceptions and exclusion contained in said policy form would be as follows: 1) GCncrdl and Special taxes fotthe fiscal year 2000-2'00 VJncluding any assessmenfscollected with taxes. Total amount $173.06 1st installment $86:33 delinquent . Penalty $865:(after 12=10) 2nd instaliment $86:53.open ?'Analry $T8,65 (after4=10) Code are?. 020016 Parcel No. 7_7.0-173-0058 F,.-\emption none 2) 1'he lien of supplemental taxes, if any, assessed pursuanttothe provisions of section 75,.et seq. of the revenue and taxation code of the State of California. 3) An easement for public utilities as, shown on the ma'p of said tract affects: East5 feet of said land. 4) Covenants, conditions and restrictions: in an? instrument tecvrded December •3,,1947 as instrument no. 808, Official Records,,which provide that a violation thereof 'shallnot, d'efeat;or render invalid the lien of any mortgage or Deed of Trust made to good faith and for'value- but omitting 'any coven' 11s'or restrictions, if any, based upon race; color, religion, sex; handicap; famili5l !sfatus, of national origin unless:and only to the extent that said covenant (a) is; exempt under chapter 42, s coon 3607 of the- United State's code or (b) relates to handicap but does not discriminate against handicapped -persons. "NOTE: section 12956.1 bf.the gaveinment code provide=the folIowirig;. if this document contains any restriction based on race, color, religion, .sex, familial status, marital -.;status, disability, national origin, or ancestry, that restriction violates; state and federal fair houstng laws; and, is void, and maybe removedpursuant to Section 1295G.1 of the gove`mment,code. Lawful restriction understate and federal law on the -age of occupants in senior housing for older persons shall not be con'sfnied as restriction biised oii:familial'status." 5) An easement,for purposes herein stated; and rightsancidental:thcreto as- .set fortl:in an instrument Recorded: March 19; 1948 as,instrument no: 2977, Official'Records, For: pole lines and' incidental purposes A teas: the locitibriL of said easement•:cannot bq detetinined from the public records. 6) An easement for purposes herein stated, and rights incidenttil thereto as provided in an instrument Recorded: May j 0', 19G8 as instrument no. 43936, Official Records For. utilities and tne�dental purposes In favor of:General`Telephone'Company of California Affects: Sout}ierly 2'feet of.tha Easterly'20'feet'ofsaid land. A Deed of Trust to. secure an indebtedness of Amount: $3'6;500.00 Trustor; Divis Kharia, a single woman and' balip S. Tibb, a single mai! Trustee: Commonwealth Land Title Company; a. California Corpora ion B ne icia,y: Charles Sodikeffarid Rebecca Sbdikoff; Trustees of the Svdikoff Family Trust dated �� t ( July. I2;'1920 Dated: Aprit6, 2006 Recorded: June 2l, 2000 as Instrument No: 2000-238543, Official Records. Eiid`of Schedule B ifiato of Occu anc Ce tc - 'City of La Quinta Building and Safety Department 0F This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS: 51-420 CALLE PALOMA Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 0011-181 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL Owner of Building: MILLENNIUM DEVELOPMENT Address: 45-675 GURLEY DRIVE City: INDIAN WELLS, CA 92210 By: KIRK KIRKLAND Date: JANUARY 10, 2002 Building Official POST IN A CONSPICUOUS PLACE CITY OF LA 01ANTA JAMES G ORL 4ND, CIVIL• ENGINEER IOII MANHATTAN -BEACH BOULEVARD JUN 21 RECD MANHATTAN BEACH, CA 90266.'" (310) 54578808 FAX (310) 545-_'8035 BUILDING AND SAFETY June 18, 2001 City of La Quinta Department of Building- and Safety 78495 Calle Tampico _.__La�Quinta, CA•92253 -- Subject: Structural Observation Project: New Single. Family Residence, 51-420Ca_TT- Paloma, ;La Quin�ta Gentlemen: Bob- Randolph;Working:under my direct supervision performed a Structural Observation on Saturday, June 9, 2001 at the project Attache d•is a copy, of the field notes. All noted deficiencies are,minor. 'he structure as built'coin lies with ;my structural;;design requirements. Please feel free to call if you have any questions'. Sincerely yours; G� G�% James C. Orland - Civil Engineer FESS/pN9 acv@Q,o� 5 C OR Q No. 022024 c :rn Exp. Sept. 30, 2001 Zo rF OF CAS -SFO JAMES --iC--.r VRLAN-D —'cIVIL -ENGINEER ' - . ' . ' i_-' ' 1011-MAMUTE N'�Bi BOULEVARD MNIL A-90266. AT-tA 'C '(310)545-8808.FAX .(3,10)'.545=8035 June 11, 2001 City of La Quinta Department of -Building and Safety 78495 Calle Tam Pic*6 o CA .92253 Subject:. Structural Observation Project: New -Single Family Resi'deALqe, 51'„420 Ca11Paloma,-el Gentlemen: Bob Randolph working 11fid'ermy-oirect sup6r,'v6sion, perform"bda §tructu'ral Observation �on Saturday, June 5,2001 at the-projecf. Attached is a -copy ,of the tes. All noted deficiencies are minor. Please feel free, -to call ifyou"have any questions-. O�A,pFcMC) I "V .Sincere�.]_ our-,. S N C22024 rn Ejp'.' 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S AND G PUMPING SERVICE 73-680 Hwy 111, Suite 123 • Palm Desert, CA 92260 INVOICE # 2 6 3 2 Cell (760) 766-5074 • (760) 404-6325 Date: _ , — , Bill To: Ph#: Address: eCAIV A 1nMIMIC— Mechanic: /MI C. city: City: 1 Helper: Job Name and Location: Descript' n of Work: r '—j Price r' LW rQuantity AVT ry Pump & Dump Fee per 1000 gal (Septic Tank) r Amt. Pumped .5 Gal KSeptic Tank PSeepage Pit ❑ Cesspool ❑ Grease Trap ❑ Other ❑ System is Failing ❑ System Passed Inspection ❑ Excessive Sludge ❑ Roots raid t.5y: u t necKB u CIII ID: Signature Date Next Service Due Description of Work or Material Used Price Amount rQuantity Pump & Dump Fee per 1000 gal (Grease Trap) Pump & Dump Fee per 1000 gal (Septic Tank) Locating & Opening Fee (per hour) High Pressure Water Jet (First Hour) High Pressure Water Jet (Addtional Hour) Labor per hour Rooter Mainline Rooter Lateral Rooter On -premise ❑ After Hours ❑ Sat. Charge ❑ Sun. Charge Fuel Surcharge ThankYou Total raid t.5y: u t necKB u CIII ID: Signature Date Next Service Due