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9691 (SFD)1. T4tyl 4 �wa�rw Building Address 53-825 Navarro Owner William Baker Mailing Address r,1-610 Rubio City Zip La Quints I 92253 Contractor P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Tel. 564-2787 State Lic.I City & Classif. Lic. # .., Designer_..� Address Tel. City I 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 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 to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile 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 Cade, 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 sub ects the applicant to a civil penalty of not more than rive hundred dollars.($500). as owner of the property, or my employees with wages as their sole compensation, will o 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 foi 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 tb self -insure or a certificate. of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800Labor Code.) P011010 - --company - , s c `-f 1, . .T c n �__ ACopy 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) vatuatlon 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., 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 it 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 Malling Address City, State, Zip C/C No. 9691 BUILDING: TYPE CONST. OCC: GRP. A.P. Number^��{+ Legal Description Project Description SFS? Sq. Ft. No. No. Dw. Size 1714 Stories Units New ❑ Add ❑ Alter'P,43!Repalr ® Demolition,, ❑t' Persist does not include block wall or pool stimated Valuation 100, 0188 . 70 PERMIT AMOUNT Plan CKO Dep. " 250A0 Plan Chk. Bal. 2 4 3_ A R Const. 64-3.00 Mech. 92-00 Electrical t _ Q14 Plumbing 1.41-00 S.M.I. (). 10 Grading 0 10 Driveway Enc. 20.00 Infrastructure . 2159.44 ri- A in rsiihl ' 2 'i ii fit TOTAL 3755.93 3505«93 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. PjLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SO. FT. ® FOR. SO. FT. ® GAR. SO. FT. ® CAR P. S0. 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 7 ilfk FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER ROUGH WIRING. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ROCK STORAGE LAUNDRYTRAY AIR HANDLING UNIT CFM GAS (ROUGH) 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 WATER HEATER SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1V4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER $1 GRADING cu. yd. plus -x$_=$ 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 11 / GROUND PLUMBING -7 5 / UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 4 7 ilfk ROUGH PLUMB. BONDING I HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. I DUCT WORK ROCK STORAGE FOUND. REINF. ` GAS (ROUGH) METER LOOP I HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE t#j GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $1 GRADING cu. yd. plus -x$_=$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING /l�/ZQ/ !O/�/�/� A5 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND 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 6/13/91 1, Type of Permit La Quinta No. 10661 Permit # Log # Owner Name William Baker No. 53-825 street Navarro city La Quinta ' zip 92253 study Area 111 APN # Tract # Lot # Square Footage. 1714 Type of Development Single Family Residence No.'of units 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 t This certifies that school facility fees -imposed pursuant to Government Code 53080 in the amount of 1.58 X 1714 or $ 2,708.12 have been -paid to D.S.0 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 William Baker Telephone 5642787 Name on the check By Richard M. Beck Director, Facilities Planning &Development Af �' Fee collected /exempted by Shelley D. Bennett t Payment ReceivEAc . t��;'� Signature v Cieck tjo -254 F •�i �.'-'.. � C Collector: Attach a copy of county or city plan check application form to district c py,.foi ali waivers.. Embossed Original- Building Dept./Applicant Copy 7 Applicant/Receipt Copy - Accountink" (� ro'.;i X-11ti,'5GAN TITLE INSURANCE COMPANY d AND WHEN RECORDED MAIL TO Q F Name _•� Wi11iaM R. Baker cmN Street 52-448 Ave. Navarro , ; _; „ Address JLL La Quinta, CA 92253 a ..� <�� = O, City a LL o CY State L at p..- .. MAIL TAX STATEMENTS TO Name Street SANTE AS ABOVE Address City & .' State L J J SPACE ABOVE THIS LINE FO3 RECORDER'S USE CAT. NO. Individual Grant Deed TO 1923 CAA (2— (2-13 83)) THIS FORM FURNISHED BY'TICOR TITLE INSURERS - FFOR he undersigned grantor(s) declare(s): 7%t{--/ 791- ocumentary transfer tax is $ 23.10 O tycomputed on full value of properconveyed; or computed on full value less value of liens and encumbrances remaining at time -of sale. Unincorporated area: (XX ) City of La Ouintaand A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, /I JACK A, FRANKLIN, A UNMARRIED MAN AS HIS SOLE PROPERTY �1 hereby GRANT(S) to WILLIAM R: BAKER , A MARRIED MAN AS HIS SOLE AND SEPARATE PROPERTY nn� the following described real property in the city of LA QUINTA `"�' County of RIVERSIDE , State of California: LOT 4 BLOCK 250, SAN-.eA CARMELlTA Rf VALE; LA QUINTA, UNIT NO. 23, AS SHOWN BY MAY OF FILE.IN BOOK 20 PAGE 25 OF MAP, RECORDS OF RIVERSIDE COUNTY, STATE OF CALIFORNIA Dated: 8 — 17 - 90 • STATE OF CALIFORNI7 A4 CK A. FRANKLIN COUNTY OSOt.YI `ti Die 1 S DO S. — On U '% / g 2 Q before me, the unders' ed, a (�otar Public in and for s d State, personally appeared J .0, 0 . Q �r� ��t: h `-pe7rsonally known tome or proved to me on the basis of sat isfactory evidence to be the person_ whose name t 5 1 sub scribed, to the within instrument and acknowledged MELA91E L. SCHNEIDER that -0 eexecuted the same. NOTAR' PUBLIC WITNESS my hand and official seal., , SAN LUIS OBISPO COUNTY CALIFORNIA My Commission Expires on DECEMBER 10, 1993 Signature/•,vt/ (This area for official notarial seal) Title Order No. Escrow or Loan No. - MAIL TAX STATEMENTS AS DIRECTED ABOVE