9982 (SFD)Building
Address 53-640 �ilarez
Owner
Bar Cori Develop
Mailing
as ohn
Address 41--625 Eclectic Hi
City Zip
Palm Desertl 92260
Contractor
Sane as above
Address
rC( 'A
P.O. BOX 1504 !�N,'' l� No. 9982
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Cl` a'ski BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 774--111-007
773-9024 Legal Description Lot 18 Block 132 Unit 19
Project Description SFD
City Zip Tel.:
State Lic. City
& Classif. B1 564202 iLic.# .
Arch., Engr.,
Designer
Address Tel.
City Zip' State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
tt)DO) ofivigo—n 3,of a Business and Professions Code and �Y license is injfull fade and
Y ect. S,.?i/, \\i! jrL!i
S GNATUR DATE
g 01WNER-BUILDER b&LARATION
I hereby affirm that I am exempt from the Contrdctofs License Law for the following
reason: (Sec., 7031.5,Business and Professions Code. Any city or,coumty w/dch requires a
permit to construct, atter, Improve, demolish, or repair arty structure, prior to as issuance afro
requires the applicant for such. permit .to file.a signed statement that he is rce sed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (co mtencig with Section 7000) of.
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the Gaffs
for the alleged exemption. Any violation of Section 7031.5 by any appftW for a permit
subjects the applicant to a civil penalty of not more than foe hurdled dollars (S500)-
❑ 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 art owner of pn%u" -who
builds or improves thereon and who does such work hinsef or through his own enpbyees,.
provided that such Improvements are not intended or offered for safe. 0, however, the building
or improvement is sold within one year of co plelbn, the owner bidder wi have the burden
of proving that he did not build or improve for the purpose of safe.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to cow
struct the project. (Sec. 7044; Business and Professions Code., The Contractors Licese,Law.
does not apply to an owner of property who bunds or iriprDves thereon, and who contacts for
such projects with a contractor(s) licensed pursuant to the Contractors License Law.) . . '
❑ 1 am exempt under Sec. B. & P.C. for this reason
Sq. Ft. No. No. Dw.
Size 178E Stories Units
r
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit does not include block walls or
)poal
Estimated Valuation
102, 9994.00
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, ora certified copy thereof. (Sec. 3800, LaborCode.)
Policy No. Company '
Copy is filed with the city. . ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed If the permit is for one Modred dollars (1100) vadetion a
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.
Date Owner
NOTICE TO APPLICANT. 11, alter making this Certificate of Exemption you should became
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= 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
PERMIT
.'-', _
AMOUNT
Plan Chk. Dep.
00
Plan Chk. Bal.
299.15
Const.
650.00
Mech.
62.00
Electrical
134.60
Plumbing
141.00
S.M.I.
10.30
Grading
20.00
Driveway Enc.
20.00
Infrastructure
r
2243.75
25.00.
TOTAL
M, 3r *.80
3605.80
REMARKS
&M mow 9
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
1
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES"
1ST FL. SQ. FT. ® $
2ND FL SQ. FT. ®
FOR. SQ. FT. ®
GAR. SQ, FT. ®
CARP. SQ. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
/
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Vi c
SEWAGE. DISPOSAL
SQ.FT.GAR ® V4c
HOUSE SEWER
VENTILATION
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 ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK �%
ND PLUMBING / [
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
/
GROUT
WATER HEATER
SERVICE
FINAL INSP.
,BOND BEAM
WATER SYSTEM
FINAL INSP. 3
GRADING
�cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING� 0 �/
1
FINAL INSP.
ROOFING�p1 / / 9/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING`f OJVIV �b
MESH
INSULATION/SOUND / �3
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
�YA'6F .MZ !n,4
Building
Address
Owner
Mailing
Address LA
City Zip
Contractor
Address__.
City -
State Lic.
& Classif.g,
Arch, Engr.,
Designer .
Address
. p
Zip
P.O. BOX 1504 `OAPPLICATION ONLY
78-105 CALLE ESTADO
J u ALe Z LA QUINTA, CALIFORNIA 92253
kINJIC III-Ak, BUILDING:- TYPE CONST-%' fA' OCC: GRP.
* t L A.P. Number
acs1Tel.
-7-13-90LA Legal Description �4 I Ps LiC. I 2
- �s� �•ti. G�(ZM�t_i A A� AL2
r v Project Description
Z I Lic. #
Tel.
ityZip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commenci(g with ec
000) okDiviLsion 3 of th,kBusiness and PAfessions Code, andjpy lice))ge is in full force
OWNER -BUILDER DECLIRATION
I' hereby affirm that I am exempt from the Contr lor'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) or
Division 3 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis
for the alleged exemption. Any violation or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
0 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, 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
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 Cede.)
Policy No. Company
O 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 ($10C) 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: If, after making this Certificate of Exemption you shouki become
subject to the Workers' Compensation provisions or the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I��ereby 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 DIVISION
Sq. Ft.
Size.-. -I" l Q
No. 11 No. Dw.
Stories ` Units -
New>4 Add ❑
Alter ❑. Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
�Q o
Const.
Mech.
Electrical
Plumbing
'
S.M.I.
Grading
`
Driveway Enc.
Infras ructure
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 DATE INSPECTOR
Issued by: Date Permit .,
Validated by: -
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT.
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CARP. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTENot to be used as property tax valuation
J
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE I
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347,8631
Date 9/23/91
No. 110883
Owner Name Bar Con Development/John Clapinski
No. street see below
city La Qunita
Type of Permit
La Quinta
Permit #
Log #
Zip 92253 Study Area 111
APN # Tract # Lot # Square Footage .1 3560
Type of Development Single Family Residence No. of units 0
Comments 52-640 .hiaraz 1780 sq- ft_ 54-620 Disz 1760 sq- ft
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
11is certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.58 X ® or$ 5,624.80 have been paid to D.&U.S.D. for
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 Bar Con Dev/Irwin Golds
Name on the check
g� James E. Lively
Assistant Superintendent, Business Services
Fee collected /exempted by Diana M. Allard
Signature
Telephone 619 773.9024
11 • •
Payment Receiv'gd. ,
664"W"146.41-59/4155
Collector. Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building DeptJApplicant Copy - Applicant/Receipt Copy - Accounting
®® VqMM-M r'"M ffMn f.IrJ9.71 La" V=R!MM rvm mm s r"!^n P--"r" .n EMM
0!*Y 1� !�"1s71 d'lCt�
State of On this the -i day of ��� " before me,
SS. �
County of tt �'I_ ''f S
the undersigned Notary Public, personally appeared9tt ,
z�
' OFFICIAL SEAL '
M.E. TORRES
ersonally known to me
' NOTARY PUBLIC—CALIFORNIA 17 proved to me on the bdsls of satisfactory evidence
:4 cam' ihM�T� �M = PRINCIPAL OFFICE IN to be the person(s) whose name(s) �� subscribed tc the
Rll'F�.'IOE COUNTY within Instrument, and acknowledged that '
My Ccmmi;; ien J--5 Dec 17, 1993 9 executed It.
WITNESS my hTnd and official seal.
2q'lz"e/
Notary's Signature 1
RECORDING REQUESTED B,
AND WHEN RECORDED MAIL THIS DEED AND, UNLESS
M, OTHERWISE SHOWN BELOW, MAIL TAX STATEMENTS TO:
r -I
NAME Barcon Development
STREET
ADDREss41-625 Eclectic Street, Suite H-1
CITY,
STATE
ZIP Palm Desert, CA 92260
L J
Title Order No. Escrow No.
QUITCLAIM DEED
C(OPY
ABOVE THIS LINE FOR RECORDER'S USE
DOCUMENTARY TRANSFER TAX $
D computed on full value of property conveyed, or
O computed on full value less value of lions and
encumbrances remaining at the time of sale.
Signature of Declarant or Agent Determining Tax. Firm Name
John J. Clapinski and Nancy E. Clapinski
(print or type name of grantorts)l
the undersigned grantor(s), for a valuable consideration, receipt of which is hereby acknowledged, do hereby remise,
release and forever quitclaim to Barcon Development, a California Limited Partnership
the following described real property In the City of La Quinta
County of Riverside , State of California:
Lot 18, Block 192, Unit #191 Santa Carmelita at Vale La Quinta, as per map
recorded in Book :19, page 34 of maps in the office of the County Recorder
of said county.
Assessor's parcel No. 774-111-007
Executed on / ' -� , 19 at
ICr y and Slatel
#1h n4J-la inski
°L 1
Nancy Ei lapinski.
STATE OF CALIFORNIA
COUNTY OF SS
On this day of --5.1L4 _I- In the year 191_L,before me,
i.
the undersigned, a Notary Public In.and for said State, personally appeared
( personally known to me (or proved to
me on the basis of satisfactory evidence) to be the person_ whose name_
' subscribed to the within Instrument, and acknowledged to me that
! -She_ executed It.
s OFFICIAL SEAL
WITNESS my hand and o I seal. -iy�� ; R H JONES
n NOTARY PUBLIC -CALIFORNIA
RIVERSIDE COUNTY
My comm. expires JUN 29, 1993
Notary P Ic In and for said State.
MAIL TAX (This area for official notarial seal)
STATEMENTS TO
Irk NAME ADDRESS ZIP
WOLCOTTS FORM 790. Rev. e•e4 This standard form Is Intended for the Iypleal situations encountered In The field Indicated. However, before you sign,
a QUITCLAIM DEED (price class J) read It. fill In all blanks, and make whatever changes are appropriate and necessary To your particular transaction.
Consult a lawyer If you doubt the form's fitness for your purpose and use.
,e 1984 WnICnTTS INC
-7
71
a.
COACHELU
"CAS
Received .P-bm--
Address: Ol
CALVIN C. KAMINSKAS
Assistant Commissioner
(714) 275.3000
DAN RILEY
Sealer, Weights & Measures
(714) 275-3030 .
OFFICE OF
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE, Commissioner
83-612 Avenue 45 Suite 7
Indio, CA 92201
(619) 342-8291
DATE g- l3 9 CASE NO.
DEVELOPER'S NAME:
ADDRESS: 3-7 - (O L -os Cc, �_c s lir E,
�G a irc�cA- Z -7r,
TELEPHONE:
L t9
Q►x /o/2 -
Dear Developer:
"7 -7 3 - ?oma V'
o v Lk -.0110 C Z 0. 0 w; w4q
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ from plant material listed, this office must be not
immediately.
"Thank you for protecting and preserving the Coachella Valley's pest -free environment.
Agric t al omnissioner's Office
cc: Indio and Riverside
4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 - FAX (714) 275-3012
EARTH SYSTEMS CONSULTANTS S.C.
BUENA ENGINEERS DIV.
79-811 B Country Club Drive
Bermuda Dunes, CA 92201 • (619) 345-1588
Client Name
Client
Client Phone
DATE
TEST LOCATION
� o -km Ifs
JOB NO.
PROJECT
LOCATION
CONTRACTOR
MOISTURE
CONTENT
%
OWNER
WEATHER
MAXIMUM
DRY
DENSITY
Ibs./cu. ft.
TEMP. o at AM
at PM
PRESENT AT SITE
OAP4S.
2
//2 • S
TEST
NUMBER
TEST LOCATION
� o -km Ifs
LOT
NO.
ELEVATION
FIELD TESTING
REFERENCE CURVE
MOISTURE
CONTENT
%
DRYMAXIMUM
DENSITY
lbs./Cu.ft.
DRY
DENSITY
%
MAXIMUM
DRY
DENSITY
Ibs./cu. ft.
OPTIMUM
MOISTURE
CONTENT
%
OAP4S.
2
//2 • S
2%
9.3
/13.1
,S4 -62o JN4Z
A
� �
`h
Z
REMARKS:,Qe�
.LIENT REPRESENT TIVE SIGNATURE
FIEID REPORT
t
TECHNICIANS SIGNATURE 3