003561 (SFD)OvV,
P.O. BOX 1504 No. .003561
Buildingr + r 78-105 CALLE ESTADO
53„,
Address 955 11avarrid LA,QUINTA, CALIFORNIA. 92253
Owner +.
Richard W. Gric3er
MailingBUILDING: TYPE CONST.- OCC: GRP.-
. � ”
Address 10751 Laconia Drive A.P..Number 774 -174 -022 -
City Zip Tel.
vi31a Park— -92667 71.4-639-8576 Legal Description
Contractor Project Description'tx F'a;�itT• �krs�.i.rltx
Rlchakd V. Crider
Address. .
Ste
. City . Zip Tel:.
State Lic. City
& Classif: Lic. # Sq. Ft: No. No. Dw.
Arch.; Engr.,. .
Size * ' - Stories.. '41, Units
•- Designer. New ❑ Add ❑ Alter ❑. Repair ❑ Demolition ❑ .
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION a
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- BuaDER'DECLARATION Estimated Valuation
1 hereby affirm that I am exempt from the Contractor's License Law for the following - •-
reason: (Sec. 703 1.5, Business and Professions Code: Any,city or county which requires a � R,7
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'. PERMIT 'AMOUNT
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'thebasis - ... ^0
for the alleged exemption. Any violation of Section 7031:5 by 'any applicant for a permit Plan Chk':,Dep.. -$250 .00
subjects the applicant to a civil penalty of not more than five hundred dollars ($500): Plan Chk- Bal.
❑ 1, as owner of the properly, or my employees with wages as their sole compensation, will 64.76 Y
do the work, and the structure isnot intended or offered for sale.,(Sec. 7044, Buisness andConst... V
Professions Code: The Contractor's License Law does not apply, to an owner of property who
builds or improve thereon and who does such work himself or through his own employees, - ���Pl.A *-
provided that such improvements_are..not intended or offered for sale. If, however; the.building Mech. J 37!!AR
or improvement is sold within one year of completion,. the -owner-builder will have the burden Electrical -
of.proving that he did not build Sol or improve for the purpose or sale.) - s y�. 0
O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 105 00
struct the projeot. (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 ' S.M.I. 6.20
-such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
Grading 20.00
f7 I.am exempt under Sec. B: & P.C. for this reason.
Driveway Enc. 20.00
Date owner Infrastructure 1.y 961 .22
WORKERS' COMPENSATION DECLARATION
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 '
E). Copy,is filed with the city. , ❑ Certified copy is hereby furnished..
TOTAL .�, s 9 41.105.4
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (8100) valuation
or less.) -
... ..
I certify that in the performance of thg work for which this permit is issued, I shall not„f�±
• employ any person in any manner so as to become subject to the Workers' Compensation ,cr
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become -ONE: - BY:
'subject to' the Workers' Compensation provisions of the Labor Code, you must forthwith ZONE:—
Setback Distances:
comply with such provisions or this'permit shall be deemed revoked. `
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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.) Side Setback from.?roperty Line
Lender's Name
lender's Address
' This is a building permit when properly filled out; signed •and validated; and is subject to FINAL DATE INSPECTOR.'
expiration if work thereunder is suspended for 180 days:
I certify that I have read rthis application and state that the above information incorrect. Issued byi. DatePermit
I'agree; to comply 'with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of thiscity. to' -enter the above..
mentioned property for inspection purposes. Validated by:
Signature.of applicant Date
Mailing Address Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
1
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
"a SLAB GRADE /
2ND FL. SQ. FT. ®
BONDING
YARDS KLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ, FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. ®
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT. ®
OTHER APP.IEQUIP.
DRINKING FOUNTAIN
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER HEATER
SERVICE
A/I
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
FLOOR DRAIN
MECHANICAL FEES
//
I'Z(6OOFIyG`ce 2j�
VENTILATION C
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
of
LATHING
MESH
INSULATION/SOUND4ZZ,7
FINISH GRADING
'W1 -FINAL INSPECTIONZ r2yr�/�
/
V4<
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
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.
SQ. FT. ®c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
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 PLUMBING3
UNDERGROUND
A.C. UNIT
COLL. AREA
"a SLAB GRADE /
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
?. FORMS
SEWER OR SEPTIC TANK
ROU I G
DUCT WORK
ROCK STORAGE
FOUND. REINF. % Q
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
A/I
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR. A42��]
FRAMING '3 �jQ IN/L- '1dS.
//
I'Z(6OOFIyG`ce 2j�
VENTILATION C
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
of
LATHING
MESH
INSULATION/SOUND4ZZ,7
FINISH GRADING
'W1 -FINAL INSPECTIONZ r2yr�/�
/
V4<
REMARKS:
OCC.
FENCE FINAL
SIGNA
GARDEN WALL FINAL
/ \1
Desert Sands Unified School District
CERTIFICATION OF PAYMENT,
OF
SCHOOL FACILITY FEES RJA�
TO: City of La Quinta • DATE:
Department of Community Development
78-105 Calle Estado
La Quinta, CA 92253 NOTICE: THIS DOCUMENT
CANNOT
BE'DUPLICATED.-
This is to ce r_t.if th t ,
developer of , which is
located ,et within
this District, has paid school facility fees imposed puruant to the'
auth rity �eneratd by Government C de Se tion. S 080 in, t amount of
s ( ) w --)
covering a total of square feet of ( re idential or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
for ERT SANDS-UNIFt6D SCHOOL DISTRICT
White Building Department • Yellow - Facilities Planning • Pink - Accounting Oi Gold - Developer
!, K . (10) 37
N
FIDELITY NAHUNAL 1-I I Lt t -N5. W.
Recording Requested By
AND WHEN RECORDED MAIL THIS.DEED AND TAY(
STATEMENT TO: (®
F.
Richard N. Grider 0
Nancy E. Grider
10751 Laconia Driva
Villa Park, California.92267
J
ASSESSOR'S PARCEL NO.
ESCROW NO. 2540
TITLE ORDER NO. 82832
SPACE ABOVE THIS LINE FOR RECORIDER'S USE
GRANT DEED
„ The undersigned grantor(s). declare(s):
Documentary transfer- tax .is $ ff, $o
computed on full value of property conveyed, or
( ) computed on full value less value of liens and encumbrances remaining at timeof sale.
( ) Unincorporated area: (., X ) City of ( A Q LA );N at✓ _- and
By this instrument dated November 10, 1987 , for a valuable consideration,
EDMUND C.,DILLON AND. FRANCES M. DILLON, TRUSTEES OF DILLON FAMILY TRUST DATED
4/3/1985
hereby GRANTS to
RICHARD N. GRIDER AND NANCY E. GRIDER, HUSBAND AND WIFE AS JOINT.TENkNTS
the following described real property in the State of California, County of Riverside
Lot 10 of Block 250 of Santa Carmelita at Vale La Quinta Unit No. 23 as per map
r.e.cor.ded in- Book .20 page 2.5 of •maps. in 'th-e—off„i_re-- of the Crnlnty Reno- -ler, .of Sairl
County.
STATE OF CALIFORNIA ) SS.
CCNU NTY OF 0 r a n q e' . a.
On 'Nov. 17 . 19 8.7 before me, the Edmond C . Dillon Trus��te//E++,�`
undersigned, a Notary Public in and for said County and State,
personally appeared
Edmund C.' Dillon Fr nces'M: Millon Trustee
Frances M. Dillon
personally known to me (or proved to me on the basis of satisfactory + (Wvt0'J%1. 8F.AI.
are • •
evidence) to be the person(s) whose name(s) subscribed • SCOTT A. CHRISTIAN
to the within instrument and acknowled ed that t `•i e y s NOTARY PUBLIC—CALIFORNIA
9 ORANGE COUNTY #
executed the same. # My Comm. 6p. April 19, 1"1 �
Signature
21.9050 8/83
O
_
a
�E
L:
plr
{J
W
Q
x y
LC.
Y
�•u
>' w'-4.
C
U.
_5
Cr
f
08 V
:al,:
Wo�_�
4�
W
U.�\
m
S `J
ASSESSOR'S PARCEL NO.
ESCROW NO. 2540
TITLE ORDER NO. 82832
SPACE ABOVE THIS LINE FOR RECORIDER'S USE
GRANT DEED
„ The undersigned grantor(s). declare(s):
Documentary transfer- tax .is $ ff, $o
computed on full value of property conveyed, or
( ) computed on full value less value of liens and encumbrances remaining at timeof sale.
( ) Unincorporated area: (., X ) City of ( A Q LA );N at✓ _- and
By this instrument dated November 10, 1987 , for a valuable consideration,
EDMUND C.,DILLON AND. FRANCES M. DILLON, TRUSTEES OF DILLON FAMILY TRUST DATED
4/3/1985
hereby GRANTS to
RICHARD N. GRIDER AND NANCY E. GRIDER, HUSBAND AND WIFE AS JOINT.TENkNTS
the following described real property in the State of California, County of Riverside
Lot 10 of Block 250 of Santa Carmelita at Vale La Quinta Unit No. 23 as per map
r.e.cor.ded in- Book .20 page 2.5 of •maps. in 'th-e—off„i_re-- of the Crnlnty Reno- -ler, .of Sairl
County.
STATE OF CALIFORNIA ) SS.
CCNU NTY OF 0 r a n q e' . a.
On 'Nov. 17 . 19 8.7 before me, the Edmond C . Dillon Trus��te//E++,�`
undersigned, a Notary Public in and for said County and State,
personally appeared
Edmund C.' Dillon Fr nces'M: Millon Trustee
Frances M. Dillon
personally known to me (or proved to me on the basis of satisfactory + (Wvt0'J%1. 8F.AI.
are • •
evidence) to be the person(s) whose name(s) subscribed • SCOTT A. CHRISTIAN
to the within instrument and acknowled ed that t `•i e y s NOTARY PUBLIC—CALIFORNIA
9 ORANGE COUNTY #
executed the same. # My Comm. 6p. April 19, 1"1 �
Signature
21.9050 8/83
Building '? r- /
Address � 3 / 0
Owner
%1t S 7-A A <
Mailing
Address �O
City Zip
/A --/'D U r ec 1(
11 ++ t. 0-
7 ?(Q
-7?(Q
Al 1► Pim Y2�, I
State Lic.
& Classif.
Arch., Engr.,
Designer
P.O. BOX 1504 APPM�ATION ONLY -
07&105 CALLE-ESTADO
LA QUINTA, CALIFORNIA 92253 F
J 7Il 0
Tel.
o� S
Tel.
City
Lic. #
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm U1at I am licensed under provisions of Chapter 9 (commencing with Section
70D0) of Divisio 3 of the Business and(Professions Code, and my license 's, sop -full force and
effect. Q �1 � y?
SIGNATtl��'� /�/` "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 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 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. If, however, the building
orimprovement 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.I 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.)
I'] 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I h Aeby affirm that I have a certificate of consent to self -insure, or a certificate of
Workis , ompensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Polic No Company
o 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: 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 applicant Date
Mailing Address
City, State, Zip
BUILDING DIVISION
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description
Project Description
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
;timated Valuation
PERMIT AMOUNT
, t
Plan Chk. Dep.
Plan Chk. Bal
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL d
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 fron Property Line
FINAL DATE
ItiSPECTOR
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. @ $
2ND FL. SO. FT. @
POR SO FT @
GAR. SO. FT. @
CAR P. SO. FT. @
WALL SO. FT. @
SO. 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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM 3 /
II
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1'A c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR @ 3/.c
HOUSE SEWER
FRAMING
FINAL INSP.
GAS PIPING
PERMIT FEE
PERMIT FEE
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
1-'y
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. REI -11
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM 3 /
II
L�
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 �G1
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL