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07411 (SFD)Building $2-'770 Ave. Cortez Address Owner Bruce Shit ' u P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address 78-725 LA Fonda #1 CityZip Tel. Ls ouinta 9Z2b3 1 Contractor Address ` City Zip Tela rl1 State Lia 6 Lilo # �� & Classif. rJ{3s$12 _ 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 70 OO) of Division 3 of Business and Proons Code, and my license is in full force and efffegai ect. /Y. 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 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 live 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 or property who i 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 j 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 ❑ Copy 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 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 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 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 No. 07411 BUILDING: TYPE CONST. to OCC: GRP. A.P. Number 773-153-001 Legal Description Project Description Single Fwdl-y DwZl#iii • wd Sq. Ft. 1627 Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ imictaff % s umn And yad fent►. Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. M.06 Const. 612;50 Mech. 63.60 Electrical 113,N 'Plumbing 257•510 S.M.I. 6.68 Grading 20.00 Driveway Enc. 20.00 Infrastructure 072.03 TOTAL REMARKS b Nva' i10W-'f" Ite. #41 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 INSPECTORS Issued by: —Date_Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE tJO ,j 4v ROUGH PL B. BONDING YARD SPKLR SYSTEM 2ND FL. S0. FT. FORMS SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE- y a DRAINAGE PIPING CAR P. SO. FT. ® GROUT WATER HEATER SERVICE WALL SO. FT. ® FINAL INSP. DRINKING FOUNTAIN SO FT ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FRAMING a� FLOOR DRAIN MECHANICAL FEES �/l�/��� _ _// /Sv9, �/!� �f7Q�/� y f r WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER SPARK ARRESTOR GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED MESH LAUNDRY TRAY AIR HANDLING UNIT CFM FINAL INSPECTION 3 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SO.FT.GAR ® V4c 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 f /0 AgmBING/4�/J UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE tJO ,j 4v ROUGH PL B. BONDING HEATING (ROUGH) STORAGE TANK + FORMS SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. 7� GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPIEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE- y a GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING cu. yd. -plus-x$-=$ LUMBER GR. FINAL INSP. / 3 FRAMING a� FINAL INSP Gam/ /G1 ROOFING&4f Wme �/l�/��� _ _// /Sv9, �/!� �f7Q�/� y f r EMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING ��— ?0 MESH INSULATION/SOUND T 2I LLL FINISH GRADING FINAL INSPECTION 3 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL h �6d3C-7 RECORDING REQUESTED BY UNION LAND. JITLE COMPANY, ` + AND WHEN RECORDED MAIL TO r -t Name Bruce K. Swan Street 78-725 La Fonda #1 Address City a La Quinta, CA 92253 state L J MAIL TAX STATEMENTS TO F- 7 Name Street SAME AS ABOVE Address City a sat J state L CAT. NO. NNO0582 TO 1923 CA (2-83) SPACE ABOVE THIS LINE FOR RECORDER'S USE Individual Grant Deed THIS FORM FURNISHED BY TICOR TITLE INSURERS The undersigned grantor(s) declare(s): J z Documentary transfer tax is $ A - Qn a a (XX ) computed on full value of property conveyed, or ( ) computed on full value less value of liens and encumbrances remaining at time of sale. S ) Unincorporated area: ( XX) City of r.a Q,, in f -a , and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, DUSTA-LYN WEAVER JORDAN, a married woman as her sole and separate property, (who acquired title as DUSTA-LYN WEAVER, a widow) hereby GRANT(S) to BRUCE K. SWAN the following described real property in the City of La Quinta County of - Riverside , State of California. Lot 24 in Block 30, Unit No. 2 of Santa Carmelita at Vale La Quinta, as per Map recorded in Book 18, Pages 55 and 56 of Maps, records of said county; Dated: NAVPmhoar 7AF 7QRR STATE OF CALIF NIA _ �Ss. COUNTY OF 1 aOitdl�GCi On before me, the undersigned, Notary2Pun an for said State, rsonallDre c i= - rsonally known to me or proved to me on the basis of sat- sfactory evidence to be the person_whose.name �CdJ subscribe to the within instrument and acknowledged that executed.the same. WITNESS d and official seal. Signatur Title Order No. Dusta—Lyn Wea er Jordan OFFICIAL SM JUDITH J. M10111011 1 NOTARY PUBLIC- CALIFORINA RNERSIDE COINITY MY COMMISSION EXP. DEC. 9.1991 (This area for official notarial seal) Escrow or Loan No. MAIL TAX STATEMENTS AS DIRECTED ABOVE ►:� W J9C Z C O`v0 C _ x w O CV L A > Zlox p`gy— r 3 c ro u SPACE ABOVE THIS LINE FOR RECORDER'S USE Individual Grant Deed THIS FORM FURNISHED BY TICOR TITLE INSURERS The undersigned grantor(s) declare(s): J z Documentary transfer tax is $ A - Qn a a (XX ) computed on full value of property conveyed, or ( ) computed on full value less value of liens and encumbrances remaining at time of sale. S ) Unincorporated area: ( XX) City of r.a Q,, in f -a , and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, DUSTA-LYN WEAVER JORDAN, a married woman as her sole and separate property, (who acquired title as DUSTA-LYN WEAVER, a widow) hereby GRANT(S) to BRUCE K. SWAN the following described real property in the City of La Quinta County of - Riverside , State of California. Lot 24 in Block 30, Unit No. 2 of Santa Carmelita at Vale La Quinta, as per Map recorded in Book 18, Pages 55 and 56 of Maps, records of said county; Dated: NAVPmhoar 7AF 7QRR STATE OF CALIF NIA _ �Ss. COUNTY OF 1 aOitdl�GCi On before me, the undersigned, Notary2Pun an for said State, rsonallDre c i= - rsonally known to me or proved to me on the basis of sat- sfactory evidence to be the person_whose.name �CdJ subscribe to the within instrument and acknowledged that executed.the same. WITNESS d and official seal. Signatur Title Order No. Dusta—Lyn Wea er Jordan OFFICIAL SM JUDITH J. M10111011 1 NOTARY PUBLIC- CALIFORINA RNERSIDE COINITY MY COMMISSION EXP. DEC. 9.1991 (This area for official notarial seal) Escrow or Loan No. MAIL TAX STATEMENTS AS DIRECTED ABOVE DAILY WORK SHEET LJOBBN-AME JOB N0. DATE CLIENT COMMENTS TE TEST ELEVATION DENS Y PERCENT I MOISTURE DENSITY C RELATIVE )CATION OR l SOIL TESTING, INC. Phone (619) 340-9492