14251 (BLCK)P.O. BOX 1504
Building 53--260 Ave,. Velasco 78-495 CALLE TAMPICO
Address LA OUINTA, CALIFORNIA 92253
Owner
Double D Construction
Mailing
Address 51--960 Ave. Herrera
City Zip Tel.
La Quints, CA 92253 1 771-1561
Contractor
Same
Address
No. 1 429
BUILDING:.TYPE CGNST. VN OCC. GRP. R3
A.P. Number 774"085-025
Legal Description Lot .1 2 Block 227
Project Pesch
ption
City
Zip
Tela
State Lic.
& Classif. B 651012
City
Lic. # 323
Sq. Ft.No.
0 0
No. Dw.
Size
Stories Units
Arch., Engr.,—
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition
Address
Tel.
Permit includes all block walls. Pool
City
Zip
State
permit to
be obtained separately.
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 and my license is in full force and
..��: /`� •:�V,� )Y� ' lr-��
_.��
ISIaNATURE DATE
OWNER -BUILDER DECLARATION
• I hereby affirm that I am exempt from the Contractors License Law for the following
Estimated Valuation
1 nA
$111 ! 960 . 00
reason: (Sec. 7031.5.Business and Professions Code: Any city or county which requires a
permit to construct, after, 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 the basis
- for the Any Section 7031.5 for
Plan Chk. Dep.
u • V
alleged exemption. violation of by any applicant a permit •
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
..
Plan Chk. Bal: _ .
_+ 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
- V
Const. ---
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,
Mech.
.
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
Electrical
proving that he did nor build or improve for the purpose of sale.)
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
• 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
S•M.1•
• ` such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑•I am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date owner
Infrastructure
•
_ y • u
AX tri tl
29.90
WORKERS' COMPENSATION DECLARATION
Precise Plan Z-1:1. ou
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.
—A.
TOTAL
i,GGi.97A.14
4
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
•i
- or less.)
I certify that in the performance of thg work for which this permit is issued, 1 shall not
employ any person in any manner so asr!to become<subjeat to the Workers' Compensation
Laws of California.
$) V V
Date_ F. 41.1 %4Owner t
&TICE TO A`PPOCANT: If, after making this Certificate of Exemption you should become
ZONE:
subject to the Workers' .Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this. permit shall be deemed revoked.
Minimum.S ack
es -,
ron etbac fro
,
nter Line
= ` •
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL. AND
,
tbMg f
r Prop. Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
Io
Id re ba
r m Center Line
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
1
Side Setback from
r erty Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,' AND
I
ATTORNEY'S FEES.
This is a building permit when properly filled out, signed and validated, and is subject to
FINAL DATE�y
----- TOR
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.
Issued by:
Date Permit
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 properly for inspection purposes. • .
Validated by:
- -
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
�..- .. �.. . -... _ ...-.....y .sari �.. Mq.
CONSTRUCTION ESTIMATE
NO. ` �' ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. $
2ND FL. S0. FT.
POR. SO. FT. @
GAR. SO. FT. ®
CAR P. SO. FT. ®
WALL SO. FT. ®
SO. FT. a
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
(ROUGH
y�
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP.IEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
FINAL INSP. 97
SO. FT. Q, c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
`/ //
SO.FT.GAR ® i/.c
HOUSE SEWER
FIRE ZONE ROOFING
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 8 AIR COND. SOLAR
SETBACK
GROUND PLUMBING ��—�y
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. tg 4a
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. -� ()t7 j!"GAS
(ROUGH
y�
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)/�
/
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus xS =$
LUMBER GR.
FINAL INSP. 97
FRAMING */ J6/10 -1 -7/ -/FINAL
INSP. 5/
J
ROOFING 2 ?�
!Zy—q(tw
-3 T GD
q`"v /f/%✓
`/ //
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC. 9�
FENCE FINAL
INSPECTOR'S SIGNATURESlIRITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
F 82-879 Highway 111
NOTICE: .Indio, CA :92201
Document Cannot Be Duplicated 619-775=3500
Date 10/25/94
No. 113149
Owner Name
Type of Permit ILA Quinta
Permit , #
Log
Double D Construction
No. 53260 Street Avenida Velasco
City La Quinta Zip 92253
Study Area 112
APN # Tract # Lot # 0 Square Footage 11818
Type of Development I Single Family Residence No. of units 0
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
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.72 X 1818 or $ 3,126.96 have been paid to D.S.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 Double D Construction
Name on the check
By
Dolores A. Ballesteros
Telephone 771-1561
Superintendent �.
Fee collected /exempted by Vickie J. Durrett
Payment Received `
Signature �� Check No. .
i
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
1
-Order No. 248758 I 7_
V
Escrow No. 10-31154
Loan No,
WHEN RECORDED MAIL TO: `L
co
Michael D. Dietrick ti 1' Y. .-4
51960 Avenida Herrera i Z •Z O ll -
cc
r4La Quints, CA 92253 ; o
U.
MAIL TAX STATEMENTS TO: SPACr_ AnOVE TI Ors LINr FOR I+f.CORDF:R S USE
DOCUMENTARY TRANSFER TAX S ...31.00 .....................
ABOVE Computed on the consideration or value of property conveyed, OR
.... Computed on the consideration or value less lions or
encumbrances remaining at time of sale
GENERAL ESCROW COMPANY
Signature of Declarant or Agent determining tax• 'Irm Name
APN: 776-085-025 G"
TRA: SANTA CARMELITA G"NT DEED
AT VALE LA QUINTA
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
ROY MARTINEZ AND CONNIE J. MARTINEZ, Husband and Wife
4; hereby GRANT(S) to
MICHAEL D. DIETRICK, a Sinale Man
the real property in the City of La Quinta
County of Riverside State of California, described as
Lots 1 and 2 in Block 227.of Santa Carmelita at Vale La Quinta, Unit No. 21, as per
map recorded in Book 20, Page 22 of maps in the Office of the County Recorder of Riverside.
` p County, California.
Dated October 6. 1994
STATE OF CALIFORNIA ) ss
COUNTY OF %��7n LJ�QC
On_("nToriC!.I_/`�Ci%____�_ before me,
�i�r:Y� =T �•Jt__(dcj �. CSN _:
personally nppeared &Qy _1)jL T rN Z n N l:!)
personally known to me (or proved to me on the basis of salisfactory
evidence) to be the person(s) whose names) Isere subscribed to the
within Instrument and acknowledged to me Inat I elshe/Ihey executed the
scone In his/herltheir nulhorized capacity(les) and Ihnl by hiornsr/lheir
slgnnture(s) on the Instrument the person(s) or the entity upon behalf of
which Ilre persnn acted, ereruled the instrument
RECORDING AEOUESTED BY
AND WHEN REC010E0 MAIL THIS DEED AND "LESS OTHERWISE SHORN
BELOW MAIL TAX STATEMENT TO:
Nem. r `
CITY OF LA QUINTA
Street
.0. BOX 150404
city a L ,,QUINTA, CA - 92253State _
L (NO FEE,, GOVERNMENT CODE.6103)-J Cz�
• MAII TAX STATEMENTS TO
Name r LEWIS HOLDINGS CORPORATION L J V f
Street
%ddrese P.O. BOX 1464' t
City LA QUINTA,-CA 92253
Stet.
TITLE ORDER NO.—ESCROW 10. SPACE ABOVE THIS LINE FOR RECORDER'S USE . •
v GRANT DEED
THE UNDERSIGNED RANTOR '
G (S) DECLARE(S)
DOCUMENTARY TRANSFER TAX is $ -0-
p computed on full value of property conveyed, or
p computed on full value less value of liens or encumbrances remaining at time of sale.
p unincorporated area ® City of _ LA. QUINTA , AND
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
LEWIS HOLDINGS CORPORATION
hereby GRANT(s) to
LEWIS HOLDINGS CORPORATION
the following.described real property in the City of,' La Quinta
County of RIVERSIDE State of California:
LOTS 1 ,AND ..2, BLOCK 227; SANTA CARMELITAr_ AT VALE. .1A -QUINT -A_,_ .•,,x
UNIT, 21 AS PER MAP RECORDED IN BOOK 20, PAGE 22 OF .MAPS, IN
THE OFFICE OF THE COUNTY RECORDER OF SAID RIVERSIDE COUNTY.
THIS DEED REFLECTS PARCEL MERGER NO. 89-178 (OR)
LOT LINE ADJUSTMENT NO.
AS APPROVED BY THE CITY OF'LA QUINTA
t
Dated JUNE 28, 1989 J ff4, J
STATE -OF CALIFORNIA SS.
COUNTYOF RTV.FRRTTIF
On this ' 27TH day of JUNE , in the year 1989 ,
before me, the undersigned, a Notary Public in ar)o for s`ld State, personally
appeared _ H LAUREN LEWIS
lZ personally known to me
p proved to me on the basis of satisfactory evidence ,
to be the person whose name is subscribed to this instrument, and acknowl-
edged to me that he (she or they) executed it.-------------
OFFIMAL SEAL
DIANA KING
NOTARY K0.IC—M:F"1RMA
"PAID=AL OFFICE Pi . .
• - ri . RIYCRSiDC CL'ti1•'Y
. 14 Co4m4L0W E.pvu Jrw t 1991
Signature l
NOTARY PUBLIC IN AND FOR SAI ATE (This area for official notarial seal) I
` - r
Reoo � "` By.. '
When Recorded, Return To:
La Quinta Planning and r
Development. Department
P.O. Box 1504 r
La Quinta, CA 92253
No. ,Fee, 6103 Goveniment 'Code.
Benefit ofLa Quinta' Carm�unity
Development Department ,
XHIRI
TA
.0 E RTI.FI . .» -
CITE
OF PAR
CE
LM.ERG
N0.
Record Owners Existing Parcels
;Assessor Parcel Numbers
LEWIS HOLDINGS CORPORATION 774-..085-001
771A-nRS-nn?
Recording Re seed
City of La Vuinta
When Recorded, Return 7b:
La puinta Planning and
Develbpbent Tepartment `
P.O. Box 1504
La Quintan CA 92253
No Fee, 6103 Government Code
Benefit of La Quinta C nTmity ,
Development Department
CE'RTIFIC,
257988',
EXHIBIT -B.
ITE OFTARCEL MERGER ''NO. E9„t
j
MONTEREY
h
0
N
i
0
e 24 O
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'
e
3o
a
Jo
30
Q
23 O�4
2
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22 0®
3
W
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4
I
4
DEPARTMENT USE ONLY
Record Owner This Certfflcate of Parcel Merger No.
Address • Ox Ici hereby approved
Map Prepared By 1-1-a By
Address CA— c Title
Area/District . Date APPRfWrn BY 01 NNtA1G nVjjSj0N
(`
J U N 0.8 -.9 5 THU 08:2.4 RM
P.0
L "AD LANE
WvodSt&k:Truss C
Cadeni
Hat Springs, CA 92240
4:
t4jupports (a) 53260 Ave. Valasco, La QtlinEa
'D roof Uwm On tW3 Project srenOt designed to cany the air condition w It.sri j
C 21 0 vy
h thatynuwme11sthere
nrit f c
Wguing Walls Wow.
'WC W
cight c8n be tramfmed to the bearing walls by either firw6agg up
a/c Platfonn Of, usillg cOtveiatiolig frami ng iq tecluii ues, add m iroific
to the bearing wails -below.
If You, nocd,im additional u'lfomlatiotx do not Hesitate t c ct
!�t?WO!kWRC4 PE, MMA
k
4,4
V
5"!
12102 SEVERN WAY, RIVERSIDE, CA 92603
i n
MON AAn-,)r r;AY fOOCYN
V