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9905-370 (BLCK)N Vf? 4 04 W O d LO LLJ O Z I-- 0 O O (n �a Z co LO N ON 0 °) CLQ Lo acc 0 0 J J m< O cl:0� v Z_ co 5 r` d J LICENSED CONTRACTOR DECLARATION 1 -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 /460284 cIft.> 07 ina ,©ate ~' / zr Signature of Contractor d.% 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 licerised 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. (�y)" 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 Policy No. i�I'e11;iJ kiAC:LIs ";WC 4^A' 116%).01 (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 Code, I shall forthwith comply with those provisions. t iDate: f -S ) / '!'Applicant 's ' r 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 representatives/Of this City to enter upon theabove-mentionedproperty for inspection purposes. ;Signature (Owner/Agent) i l Date BUILDING PERMIT PERMIT 9905-370 DATE 0.4VZ 711" VALUATION U,346.45 LOT ';p TRACT 28470„1 JOB SITE ADDRESS U-100 (3TATION COUR APN 7409-162--001 OWNER CONTRACTOR/DESIGNER/ENGINEER RAYMOND ft & BARBARA LOST URN NY DOBBINS MASONRY 74353 MONTEGO BAY OR, X10-432 PERIWINKLE COURT URT 11E1t.Agt1DA DUNES CA. 92201 PALM DESERT CA, 922M {7601568-5R77 Ci fA 293 USE OF PERMIT GARDENWAUS- HOx6';5Yx5', 39'x4';WxT,CITY S'rAM )ARJj 0 FT. WALL 103.00 LF 5.FT. iFJ'.ALL 5.30) LF 4 V 1'. WALL 39.00 LFA A'.•.NTIA�.t'RT11s.�a/ COST O.6 ICU � T1`ii�~�. ON ft 15 CONSTRLIC710N EEC 104-0013-418-000 S'f2.lM) f, t:t�N�T{?iJ�,'T1l�N -,fAID �+?�1f? PTfll'1 �;lil:t, $7?00 XSS PRE -PAID FEES bA.J MAY 2 8 1999 Tal'A3, PIRRMIT li'EM 01)V NOW $72,00 iTY OF U+ Q.U1NTA. ra. RECEIPT DATE BY, J DATE FINALED INSPECTOR i3 J 7 " t INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs . Underground Ducts Forms &.Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam — fF 57 Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final G Gas Piping PLUMBING PP OVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing. Top Out Equipment Enclosure Shower. Pans O.IC for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL 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) Recording Requested By No 027430 First American Title Insurance Company RECEIVED FOR RECORD OrdcrNo,, 2084039 -EL AT 8.100AM Escrow Nu. -18.53—TC Loan�io. QAt0 JAN 2 7 1998 tar Tax C;Rjj,. , Trane WHEN RECORDED MAIL TO: �ooro� Mr. . & Mrs. Losi Co. Rewrder d jr,.r i0 79-353 Montego Bay Drive Bermuda, CA 92210 MAIL TAX STATEMENTS TO: Space above line for Recorder's Use DOCUMENTARY TRANSFER TAX S11AS 40 ,,,Computed on the consideration or value of property conveyed; OR SAME AS ABOVE Computed on the consideration or value less lions or crtcurnbrances remaining at time of sale lice Underelenod Ore -++tor Signature of Declarant or Agent determining tax -Firm Namo APN: 70-162-001 TRA: 020-015 GRANT DEED FOR A VALUABLE CONSIDERATION, reccipi of which is hereby acknowledged, TRADITION CLUB ASSOCIATES I.LC, a Delaware limited liability company hereby GRANT(S) to Raymond Ii. Losi and Barbara Losi, Husband and Wife as Community Property the real property in the City of Le Quinta County of Riverside State of California; described as Lot 3 9 'ftact 28470-1 (See Exhibit "A" Attacitcd hereto) Dated: December. 6, 1997 State of California ) -� ) ss. County of i Wef%' A -e. ) On before me, } r�c. personalty appeared personally known to me (or proved to me on the basis of satisfactory evidence) to be "son(s) Mose-name(§) is/are aWmcribed.to the witbin instrument and acknowledged to nie Qtat he/she/they executed the same in his/her/thole authorized capacity(ics), and that by his/her/their signature(s) on the instrument the persvn(s) or the entity upon behalf of which the person acted, executed tate instrument. WITNE S MY HAND NI) ICTAL SEAL By: pB ASS S LLC ini edliabi ' y pally Its: ��LyTl ✓lir �II Gf✓ APds! vfs�T Its: ERRIE MILLER ; Comm 01128652 n TARV PUouc CALIFORNIA RIVER910f COUNTY `J Comm Esp. March 6 ?001 •k ms (This area for official notarial stal) Lot 3y 01 lratit /.o`t/v-1, U* b11UWAi vy u141) wA a-,...,. Wav,. r••t,. .d. . of maps, rwords of Riverside County, Califoniia. THIS DEED IS MADE AND ACCEPTED SUBJECTTO THE FOLLOWING: 1) Non -delinquent real estate taxes assessments. 2) All matters of record, including without limitation, that certain Declaration of Covenants, Conditions, Restrictions and Reservation of Easements for the Tradition Community, recorded on July 25, 1997, as Instrument No. 2.62677 and rc-recorded August 15, 1997 as Instrument no. 292176 both of Official records of Riverside . County, California, which is incorporated by reference herein as if fully set forth at length (thc "Declaration"). The Declaration includes, among.other matters, certain architectural and development guidelines and restrictions which will apply to the construction of a residence on the above-described lot. 0 TRADITION GOLF CLUB October 7, 1998 1 760 564 2356 11/23/98 13:35 (9 :02/02 NO:424 .ra.ffo Via Pint Chm Mail mid faerimae Mr. and Mrs. Raymond Losi Post Office Box 2722 Blue Jay, CA 92317 Re, Lot 39, Tract 28470-1 52-100 Citation Court Construction Documents -- I' Submittal Dear Mr. and Mrs. Losi, The ARRC of Tradition Golf Club met today and a motion was made and accepted to approve your Construction Documents submittal subject to the following conditions: i. All conditions from Design Development were met except item 1. D. Please submit this information as requested. 1.D: Proposed cutting out of rear yard as shown on this submittal is too much. Redesign to move less of existing slope all in one grade change. :Provide more undulation in the design. 2. ' Please provide Landscape Plan for review and approval. The above conditions must be submitted for review and approval before the foundation inspection will be done. Also, at this time, please re -review the Construction Process portion of the Tradition Design Guidelines. If you have any questions or need additional information, please do not hesitate to call. Sincerely, Christina J. Dores for ADRC at Tradition Golf Club Aid Enclosure PC: Mr. Thomas H. Jakway `via jW 78105 O►.i) ANTNUE 52 -- L:� QuiN'ra - (YA `)2253-1111) - 131 -low 610/564-3315 -- FAX 6191564-2.356