0104-286 (SFD)LICENSED CONTRACTOR DECLARATION
�• 14hereby affirm under penalty of perjury that' I am licensed under, provisions of
f4 . ,
;Chapter 9 (commencing with Section 7000) of Division 3 of the Business -and
"Profession"als Code, and my License is in full force and effect.
;r License # Lic. Class Exp. Date
ate �° "��" 1 Signature of Contractor."
{• -
ar.r d r �... ,
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 licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
O •J am exempt under Section B&P.C. for this reason
}. Date Signature of Owner
f, WORKER'S COMPENSATION DECLARATION
A: I hereby affirm under penalty of perjury one. of the following declarations:
Q) I have and will maintain a certificate of consent to self -insure for workers'
s compensation, as provided for by Sectiom'3700 of the Labor Code, for the -
performance of the work for which this permit is issued.
t fiOs I: have and will maintain workers' compensation insurance, as required by
ction 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.
.` c M'TAIL FiTA41) 1 T6 6 4f1
(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,
Lshall 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 37=,of'the4.abor
Code', I shall forthwith comply with'those provisions.
Date: /1 Applicng;
. 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 Gity to enter upon
the 'above-mentioned pro y.for'in`sp4 tion purpose
r
S'gnature (Owner/Agent)•f •'-r'`Date`
fes.,_.... � �,...✓':., °
• •BUILDING PERMIT.,. PERMIT# • �'-i` i ,'..
DATE` . VALUATION :.' COT._, 01.0444 TRACT
- . V&57600 4 7 X31 X 7.1 �.
JOB SITE
ADDRESS:, •''' "
,• 2.25. WMA. VEXASCO
APN "
OWNER
CONTRACTOR/DESIGNER/ENGINEER "
';_&131.- 1i'SI 1�1�..�1'3'ION •�fORICS R1'C
f; $1 bik ETS BY MECIi1iPW t�CYR��' WC
01 01JR010 BLVD, 111TUIT.B.D18
1Q1 DIDIOIBLWX : WI.T,DI!a
D10 �k . 92201
�.
; t ��rp
�,/�tcry3
�yi60)342-1133
I
ry y q p2fta
'�! 60) 742- t i o. 3 Yi�.1:..F o ;5392'
USE70F PERMIT "•"
S
3X.0r,)~t���AR27a9y1pTt)�7Oyy�SgNO�T INC:`-2lybfa 01,0CK V1AL}.Itj(3f?l.ei3P -DR,
3�JL-1'F0.FI'd.'d�."'•i'.Y !,i`.�S.,i �l dr' C`i,s'2Xr- `'',..+
TRACT -CONSTRUCTION 147000 OF
POR:;4 iMATIO 07.00 .5F
aw#3uC:Ai2,PO1` T (SP) 111,033.20
XN=4A, =1.) COST OF C01491RUalION
1<' 13 r na" SUMMARY
CONSTRUCTION "M 6636.00
3T1.1+wNof1',a M., $519.33
FEE i EP031T• 101-000-439-318 4=100
'M2R �pM.A+9, - A.L PEES 101-000,421-000 $60.00
1;1;WIR1CAL FFS 1 Q3-COn-410'"000 $113,69
PLUMB1N1: IVER 201 -00041"9.000 ' 1.13.35
STR.ONO mo -TION Fe AF, 11? 1.ol-00o4AI'v000 $9.66
EUTADITIJa FEE 101 _000_423-000 $20.00
OtAV.T;i OF'EP,.IMPACT .WE
1:REC313fP, PLAN 101-000-441•..345 �10d.i10
ANT) PIAN C1'MCK
$3,468.93
D" A LESS PRE -PAW 1 113
4250,00
'1 . R 1 DUE Now
APR 2 5 2001
Y
CITY OF LA OUINTAFINANCE QFPT i
,.
k .j:,sf jr
DATE 4NALEJ
INSPECTOR •� F tf
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Forms & Footings
_IleCa ►
s
Underground Ducts
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
9
Exhaust Fans
O.K. to Wrap
�_►�
j
F.A.U.
Framing
�T
Compressor
Insulation
y=gyp. p (
T
Vents
Fireplace P.L.
!
Grills
Fireplace T.O.
Fans & Controls
Party Wail Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
�Z 27 0
Final
POOLS -SPAS
BLOCKWALL APS' OVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
'I
I
Underground Pibg. Test
Final
I I
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
F/.:
S�
Heater Final
Water Piping
•O�
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Spower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
S. 3.0 !
_
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
D - O �.
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
W 10.1
'Utility Notice (Perm)
9—�ev
Building
Address
Owner
Mailing'
Address
Contractor
q� /o P.O. BOX 1504
j 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
ililxy Gel, //r�?r
/ .Q I )1r9r9n 1 I Zi 3/
AddressJag
State Lic. _ City
& Classif. -59 Lia N
Arch., Engr.,
Designer r ti
Address Tel'.
W
City State
Lic. N
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm,dhat'l am,licensed under ) ovisions`oPChapter 9 (commencing with Section
7000) of Division 3 of the Business and,P,rofession`s Code, and my license is in full force and
effect / J /✓` rl
SIGNATURE t _-•�'-" - 0"wr DATE
�1_,_ 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 jsuch 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 1 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 contractors) licensed pursuant to the Contractor's License Law.)
1-1 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1hereby 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
n 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 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: It, 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 i su d. (Sec. 3097, Civil Code.)
Lender's Name I
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 sof this city to enter the above-
mentioned property for inspection purposes.
Signature of a0plicant Date
Mailing Address
City, Slate, Zip
APPLICATION ONLY
BUILDING: TYPE'CONST. OCC. GRP.
A.P. Number l 05
1+ — 0 27
Legal Description I
Project Description
Sq. Ft. No. No. Dw.
Size S 7o Stories Units
Add ❑ Alter ❑ Repair ❑ 1 Demolition ❑
imated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
AMOUNT
-�)�
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 H INSPECTOR
• r }
Issued by: } Date R.r 1mit,
Validated by: .A&Q 0
Val
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Notice:
Document Cannot Be Duplicated,
Date 4/25/01
No. 21941
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253 '
760-771-8515
CERTIFICATE OF COMPLIANCE
Owner, NameKathryn Letellier
No. 53-225 Street Avenida Velasco
City La Quinta
Tract# BLK 217 Lot # 9&10
Type of Development Single Family Residence
Comments
APN # 774-054-027
Jurisdiction La Quinta 3
Permit #
zip 92253
Log #
Study Area
Square Footage 1,570
*Received a cashiers check in the amount of $6,027.00.
No. of Units 1
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
This certifies that school facility fees imposed pursuant to
Government Code 53080 in the amount of
2.05 X 1,570 or $ 3,218.50
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 CC/ 1St. Bank - Dan Dryden
Telepho6e-x:760 8-3-1-10198
Name on the check
, e
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Paula Ruiz
Payment Received $3,218.50
Check No. 58658
Signature
NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
above will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
collect them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
'Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting r
R _
QOrporatlOtt &rant �Bteb
THF DF:SEI;'1• CLUB, n corporation organized under the laws of the State of .CidiforniA
(hcrcieaftcr dcgignated either as "Grantor" or "Seller"), with its principal place of bugincsg at
Los nngeia. California, in consideration of., ...: ....
...
ea.r.u..e.aatt+nte.+++ TFN-B+ttit•+++.+tt.t.t.t.eDollara (810.QO........:.:.J, to it in hand paid,
receipt of -rich ig hereby acknowledged. does hereby
(brant to ir,j_-N C1.0..fi IIOPy.INS, a married woman.
the real pra;s�rty in the County of Itiverr.ide, State of California described as follows:
Iit>i -10, Block 217 of SANTA CARMELITA UNIT. No..21......... ns lier.Map thercuf
recorded is the Oitem of the Recorder of Itivergide County at page.22......:.o! book..20 -_-,of Mei, s '
SC?J?f? to coverimta, n.ndltiona, restrictions, wraesaments. rightsof•w,%y and comments of record, and
subject n na<merts for aanitary wwer and/or storm drain purposes;
MCF-rMNG AND RESERVING from saan
il property sit stdlae, '.- s, percolating or olt,er eaten in or
'under rid property, together with the right to remove same through underground channels by means of wells or
tur,neia an oo.l er property;. .
si-o ;.xcF. riNG*AND Rt:SF:RvING there from easements and rights-of-way in, on, over, slung, across.
and thrvie tuch portions of such property as In the opinion of the Seller may be necessary for the erection, tan-
' stnution. eairt�nance. installation, operation and repairing o! pole lines with the necessary cros►•arms and wires
f,.r ;tics:-%.:,ia,im, i•f electrical energy, and for telephone and telegraph linea and/or for laying and malntaining.
conduir w4l,,r pipe lines for said purposes and/or fur water; gas, sewer iWor•other purposes, together with the
right of irv"e and egress for the purprw of constructing, laying, maintaining, repairing and operating same; alrm
reneni:.g r.t right to convey or Iease the whale, or any portion of said easements and rights-of-way and rights of
. in;;res. Y! egrere.. - - -
T'bEe U,1 is caen.trd and arrr•pted up,o„ the f.rlluwing-clipnas rcnditicns.
pill: -1 Ut:U, h,.wevrr, that this convc)ance Is made and accepted, and said properly is hereby granted• upon
such of tri !olinwing eapreea conditions', provid(,ns, reatrictJons and covenants hereinafter referred to u "condi6oni'.
o rcaY by•:cir'terms be appliublethereto, which shall apply to and bind the partles hereto, their heirs, suceesson
and :uigm. aril are imposed pursuant W a general plan for the improvement of said tract above designated, end
ear -h awl fiery. lot In said. tract, and are designedfor the mutual benefit of the owners of the lots In said tract,
aril a ail _ ,n W and pans w:Lh each and every lot therein,
Saat eoerditinns aro impns d upon acid Kelly .sa an obligation or charge against the same, for the benefit of
each' aw'. e+rry Int in aid trset, and the owner or owners thereof, with the right of enforcement of each and all of
r id rnr.!t•�r,e :meted in the owner or owners oLany one or mon of the other Iota in said tract; and similar sun•
ditiora n'j..!r have been, or will be imposed upon each and every other lot therein. -
S..,.i ter.Ait)nns an An follows, to.wlt;
(a) —,,at all lots in said tract shall be used for residence purposes only; that no outbuildings or structures
o:.'✓r �.aa •..+ Bingle• one -fatuity reddenee, with the customary. oabuildicgs
t, including a private garage• in
.
l -.al.' �c:i°-•;r hal( lot o! said property'according W n
the plane "d specifleatiora referred W hereinafter m But..
pangzi= •r!) of thin paragraph. -
• i%) -77—at any residence buildmg.erec4d, pl"&I or maintained on said propertY shall cost and. be fairly worth.
Gat Mesa •r-^ $ 5.000 -CO..-.,.
(c) 'io tcmponry building, shack, trailer, or tent shall be erected or maintained on any lot In said tract; that
no old tisi:!ir,g %hall le moved Uwe— from elwwher►;'that any building or improvement erected• placed or -nuon-
Wns! r:n rad property. nhall be frurn, with and of new'rna4riaL
(•!) the !melt, line or any. residence erec'wd upon the property shall be at least twenty fed back from the
prr•pefr k+u of saw parcel. .
(e) That'all.balhroom-and W)let crmvenlencn shell I•. ..bin the wails of the house or building, and con•
rectnf w:.1i vaderg earirnA drainage, which stall consist of septic tank or tacks; prov!drd, however. that whenever a
sewer b:t_4 constructed to within a(,bty feel of any portion of the frost line of said property, add bath rewrm and
sz,vet circ, eeai,,c*s !haij be coanettad with saw saner line, if it L poadb)a W connect th2renth; further pro ._ a
that ri2tkng hereto contained &hall be constcumd as requiring Grantor to construct such or any sewer Ism.
ll). That ell b✓jild,r.v..s e,ectel in said tract shall have tiled rnufs and 1.r. of or In ron(ntmity with f1panh1i
style or type of architecture; that two complete seta of bailding plans for a structure of any kind to be erected,
placed or maintaiovi on sold prop- ty, accompanied by two arts of apeclAut!nna for the orectton of amid structure,
in comp�innce with all the conditions herein ret forth, shall be. submitted to Seller, and no Atruriurr `of any kind, the
plans, elevation and sp-cil ions of which have not received the %written approval of Seller or any ArchiVrtural and
Planning Commission approved by Seller, and which does not fully comply .with such ipprvvnl Plana and aperlAca-
tiocs and type of a:rhiu•rh,rr, shall -Ir erected, placed or mainlainel upon meld pinprrty. Wherever pn.etiralde, such
.pproval shall be a:dr.rsnl ul,on the plans and specifications- and such plans and apccfflcationr shall then be filed na
requirel by law. Ap;.rn,n] of much -plana ,wd apecif,"ti.ne shall be further ^vidmred by a prolwr written Interment
sicced and acknow!eerr•i by Seller, and such approval shall not be complete or valid until Amid Instrument has been
duly rhorded by Ruyrr of Crantre In the office of the County Recorder of Itiverside G,unly; approval by Seller as to
the construction of any Pitch building ,n accordance with the plans and speclAutions, sha11 •.dao Ix -evidenced by a
. proper written inr:rument tiKned and acknowledged by Seller, which Innlrurntnt shall ulau be ,duly izcorded by
Buyer or Grantee in the office of a -id County Recorder; the ]ant named Instrument may. Iw ea,Yuted al' any lime
,iftevthe comitrurtion of Auld building; provided, however,tlint if -Seller dull dlmepproveLof rurh construction, such
disapproval; evideraed by a 'prol..r writteninstrument tier.ed and ahnowl!drpil by. Seller, shall be duly recorded
within ninety days after rrennlat,on by Buyer or Grantee of "Nothe of Completion" of raid construction; failure
-•n tae par of Seller i, record much Notice or Disapproval within Bald'ninety-day period shall be deerntel to be a
waiver of any An•I all further )unsd!ction of !!.eller as is amid plans and'speclAcations, or either of them, and of raid
ronstruction of laid building. but nothing herein contained shall be construed na a waiver on-the.part of feller of
tae right to enforce compliance with any of the other condition► Imposed herein, Upon .recordation of any inmtru•
-
ment.in the office r,! the County Recorder of Riverside County, sa hrre{nmbive pmbidrd; the (ac's therein stated
snail conclusively 1/ dremrd t, be true as to all third parties subsequently acquir!nv Amid pmlrrty,ur of any interest
therein, or any dim or rnrumbrance thereon. Seller ahalt not he resprmslble for any structural drfre. in said plans
and .,r s1wrificatioo,, or n, N:,•v budding, or structure erected according to much plans end. anriArntl.,na. Rover or
!3rantee agrees to pay to Willer Z•S.IU for the examination, inspection and_spprovnl-of each art_ In dupliewe of the _
-plass and Feecifrationa submltte%! in accordance with the provisions of thin condition. '
lg) That rwhorerm, rattle, live stock, cr poultry may be kept or maintained In,.ou or about said property. '
(h) That no part, of any of said property ever, at any time, shall he add, conveyed, leaned or rrnted In any
person not of the white or Caucam;arn rue.
(it That eo part of amid p-perty.ehal] ever, At any time, be used or occupied, or le I,ernittrd to be used or
ncr_piei, icy any perw,a; ool of the ..hitt or Caucaminn rsc e, except such as ire in the employ of the resident ovenera,
or resident tenants of said properly.
(j) That -nn'uRnl,oarila of; any ,character; billboranb, or any. nuipanci, Abell IM rrrrtiJ, plxM., or permitted
.vr maintained. on ary part of the property herein described.
.. . (il That All water or sewer mains, conduitA and other utilities installed In or upon Add property by Seller,
=hall le, and remain the property of Seller.
PROVIDED that inch and all of the conditions contained in parcgraph■ (a) to (g) Inclusive, shall, in all
respects• terminate and rod, and tv of no further effect,eithrr legalpr rquitable, af'rr lso.o v I. I!n:,; and *that
the,conditions rontained in paragisphe (h) to (k) inelusive•ahall be perpetual and binding foreyer, upon all of said
],,:s. the part." }.e roto, their heirs, devisees; executors, administrators and aaalgns.. -
PROVIDED. ALSO, that a breach of any of the foregoing condilimIa shall Manan Bald really to revert to the
sai,! Grantor. or its vurcessors in interest, -who ■hill hive the right•of Immediate re-entry ul,on said realty in the
event of -tiny rurh 'armee,, ami am to the owner or owners of any other dol or Iota, or part or parta thereof, in mai
Trx:, the forrgorr.g conditions. shall operate as covenaots running with t}m land, And the breach of mry such rove•
can:, or the continnarae of any such breach may be enjoinel, abated or remedied by said .Grants r, cr AA successors
interest, or by.an'y' much wienrr or owner, but by no. other peewee. The tern "owner" shall inrlcdr the lana fir
r.-wner L" holder of in Agieemenl of. Sale executed by Grantor herein for any of the )r,ls in said hart.
_ rROVIDED', Al.!',(), Oat* b!rarh of any of the forrzoinK envmsnla, or conditions, or u,y rs-ert-ry cry moon of
such brrarh, shall not defeat Lr render invalid the lien of any Mortgage or Dred of 'frust mule in go,d faith aced
value, am to uv! really or any part thervo/,,but said covenmta or cowliUnns slid) Ie ldnding upon ami effective
against any suhunomt o,ner of said realty.
This co ... yar,ce is mule ami accepted under the further rondition and providon:' That rioth:i,► herein inn•
tained shall leen
crtrued to be a guaranty, warranty or rrpreaentatlon as to the present ser future existence, non-
.
- exii:once, scope, content, validity or effect of any conieg law- cr oU,er Isw,'urdln►nte or ngulatfmm of any goven•
mental or political urRuJuaun or authority coneere! • or limiting the type or charactar.of, or the right to creel.
buildings or structures on said realty, or the one .ti oblch the same may be•put, it�d this grant scud the conditions
,herein contsined'are erpresaly made subjeet_to the present or.futurt tarrc(se of any fewer of such organisation or
authority to imfaae and/or rnfores the same, other, farther or d!f!trcrt rgttrictlonr open AAIB Preys';.
ZIN
11•
TO HAVE AN.
TO IIOLD to said Grant��' °r heirs or ussiltna.
[\ «'IT?�ESS
WHEREOF. said 1'}IE DFSI•:RT CLUB Igm Cause&its cnrparnty name and �enl
to be.aYixed hereto and this instrument to be executed by residen.V an
it 1'e ec�relary thrrcunlu
1 duly author
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THE DESERT CLU
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STATE: OF CALiFORMA
COUtiTY OFF.Scere
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On this..7..-. ..day.. of ..:...........
' a'Notary Public in
and for said County, perso Y D ar 1....... It
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ment snd known W me to be the persons who executed the within instrument on behalf of the corgi
poretion therein .named, and. acknowledged to me that such corporation executed the same.
WITNFSS my hand and officia sent. ^'
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RC DISTRICT - PLANNING REVIEW FORM
This form is to be used by CDD staff for review of single family dwellings in the RC (Cove Residential)'
District; in order to'determine the applicability of compatibility issues or need to require the filing of Master
Design Guidelines by the applicant. It shall be transmitted to the Building and Safety Department as your
correction list. Please attach additional explanations as necessary.
APPLICANT Dan Dryden
SITE ADDRESS Lots, 9 & 10. Avenida Velasco
APN 774 - 054 - `027 'BIN NO.: CASE -NO.: '2001-420' r
LEGAL: LOT 9 & .10' BLOCK UNIT :S.C.@V.L.Q.
CHECKED BY: Fred Baker DATE:
Inform the assigned Building plan checker upon your assignment to this case. The CDD Executive
Secretary maintains a log book to track applications and assign case numbers.
REQUIRED ITEM
Y.
N
COMMENT/CORRECTION
Compatibility Review
Case logged and number assigned
Verify legal and APN information
Aj!R'0VED7TY
DT
EXHIBIT
COM UNITY DEVELOPMENT DEPT
Consistent with MDG on file (as.applicable
CSE
NO.
MDG filing required (5 filings siince.9/3/98.)
Consistency with street/surroundirig area:
Colors
.
Materials
Architecture
-
Other Requirements: