09065 (SFD)Building
Addresst.,'
Owner
Earl Smil
Mailing
Address 1C
City
Cont
State Lic:
& Classif. .
Arch., Engr.,
Designer J
Address
78-105 CALLE
OX 504: n � I No. € 9065
345 ,Velasco LA QUINTA, CALIFORNIA 92253 °
BUILDING: •TYPE CONST. OCC. GRP.
95'' Skee A.P. Number 774-08-4-016
Zip Tel.
923361714/355-0S]L(S Legal Description
Project Description•.F'.i3.
1der
Zip Tel:
City
Lic. # Sq. Ft. No. No. Dw.
Size 7Q : Stories Units
ASS h Honf reda New ❑ Add ❑ Alter ❑ Repair. ❑ Demolition ❑
Tel.
6'731H�*.�.1•ooK K'Qnrana
- 1114 zs 0 i; - J 134 U
CityZip
State
Saxe b6r�dinl
3233rd
Lic. #
o
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
Estimated Valuation,
I hereby affirm that I am exempt from the Contractor's License Caw for the following
q 'Code:
�yt�
'
reason: (Sec.- 7031.5,Business and Professions Any city or county which requires a
.;•;permit to construct, alter improve, demolish, or repair any structure, prior to its issuance also
iiiilf96,612.40
-
; 5 ;.requires the applicant forsuch permit to file a signed statement that he is licensed pursuant to
. PERMIT
AMOUNT y
the provisions of the Contractor's License Law, Chapter 9 (commencing with: Section 7000) of
-
.e -'Division 3 or the Business and Professions Code, or thathe is exempt therefrom, and the basis-
'exemption.
• for the alleged Any violation of Section 703115 by 'any applicant for a permit
Plan Chk. Dep.
250.00
•subjects the applicant to a'givil penalty of nobmore than five hundred dollars ($500).
Plan Chk. Bal.
owner of the property, or my employees with wages as their sole compensation, will
MCas
he work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Of1St.
-
Pro essions Code: The Contractor's License Law does not apply to an owner of property who
4 � '
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
111
or improvement is sold within one year or completion, the owner -builder will have the burden
Electrical
•''
. of proving that he did not build or improve for the purpose of sale.)
O I, as owner of.the property, am exclusively contracting with licensed contractors to con-
Plumbing
1 n
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.
A '
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)'
Grading
-
O 1 am exempt under Sec. B. & P.C. for this reason
A,
20 -no
' „ A
Driveway Enc.
213 kl-
Date Owner
Infrastructure'
n va rr�
WORKERS' COMPENSATION DECLARATION
i, y 44".
I hereby affirm''that I have a certificate of consent to self•insure,'or a certificate of
t .
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800,'Labor Code.)
'
Policy No7 Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
3581.43 1 .3333.43
CERTIFICATE'OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
-
certify that in the performance of thg work for which this permit is issued, I shall not-
"i .,
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
3�1V a. i77ekd�l�Ffi.:`3 #41e y;
� a?A?Owner-
X&.te_I_..:
TICE TO APPLICANT: If,"after making thisCerfdicatef'ol.*Exemption you should become
'ZONE:BY:
Lbf I to the Workers' Compensation provisions of the Labor Code, you must forthwith
cor�r ply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances: -
Front Setback from Center Line
Rear Setback from Rear. Prop. Line '
' CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
Ihereby 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 Property,Llne -
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
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.
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 property for inspection purposes.
Validated by:
Signature of applicant Date
Mailing.Address
Validation:
City, State, Zip
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CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. S0. FT.
ROUGH PLU B.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
DUCTWORK
DRAINAGE PIPING
WALL S0. FT.
GAS (ROUGH)
DRINKING FOUNTAIN.
SO. FT. ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRYTRAY
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/. c
SEWAGE DISPOSAL
FIREPLACE
SO.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 �� 9�
OUND PLUMBIN /D 9/
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 7
ROUGH PLU B.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWERK
ROUGH WIRING
DUCTWORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. /z
FRAMING -8—
FINAL INSP.
ROOFING IOi,L Lf •�• 9�
/r1` � {/fir
iC/��/!��
/I�is_
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING -7—
MESH
INSULATION/SOUND -�j-7
FINISH GRADING '
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
Building
Address ✓✓✓
T4hf 4
ulcu
P.O. BOX 1504 APPLICATION ONLY
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owner
Mailin
EARL Snrl.z rf J
Address /6 0z 9'S B�9R BE'E
City Zip Tel. 7/`%
FonJTA(V A i s 331 355- 0-sr/6
Contractor r--
I — 1
State Lic.LITy
I
& Classif. Lic. #
Arch., Engr., 04
Designer H7� 705EOPH MONrlegi
E-MtoGK{O
. .v�)WA 1�t 587-. 370
CityZip ( State
S,q�l P, ,Ogovvo q 06 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,eusiiess 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 fife 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
Vsub)efjs the appica nt to a civilpenally of not more than five hundred dollars (E500).
'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. It, 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.)
O 1, 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.)
O 1 am exempt under Sec. B. & P.C. for this reason
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
O Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it 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 be a subject to the Workers' Compensation
Laws of California. C
Dater'_:A9–yo owner
NOTICE TO APPLICANT: If, alter makng 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 firs permit shaft 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 property 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 sof this city to enter the above-
mentioned property for inspection �JJ pu ses.
Signature of applicanDate/;-2-- �Q_ LP
Mailing Address
City, State, ZiPQ4r�[ZimL
FINANCE
LDING: TYPE CONST.
// ------GCC. GRP
Number
Description
t Description
Sq. Ft./ No. No. Dw.
Size / Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
frastructur
c�
TOTAL `�
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback fibm Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
FINAL DATE
Side Setback from Property Line
INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 12/20/90 1 Type of Permit I La Quinta
No. 10344 Permit #
Owner Name Earl Smith Log #
No. 53-345 street Velasco
city La Quinta zip 92253
Study Area
APN # 774-084-016 Tract # I J Lot # Square Footage 11710
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
This certifies that school facility fees imposed puzsu mt; to Government Code 53080
in the amount of 1.58 X 1710 or $ 2,701.80 have been paid to D.&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 Earl Smith Telephone (714)355-0516
Name on the check
By Richard M. Beck
)I; -i
Director, Facilities Planning & Development
Fee collected /exempted by Shelley D. Bennett_ y
Payment
Signature y; ChaWtio.343
�•- ,
r
Collector: Attach a copy of County or City plan check application form to Digin i&b &py.,-
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy -Accoun`
ng
to R€C,ORDING REQUESTED BY
[CCOROWG REQUESTED IM
ZK;pR TITLE IMURAN"
AND WHEN RECORDED MAIL TO
t!+ (-
Name MR. & MRS. EARL H. SMITH
Street 16295 Barbie
Address Fontana, CA 92336
City &
State L J
1 F_
Name
.Street -.
Address
City &
State L
MAIL TAX STATEMENTS TO
ABOVE ADDRESS
CAT. NO. NNO0582
TO 1923 CA (2-83)
7
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 $ 12.65
a a ( ) computed on full value of property conveyed, or
(xx ) computed on full value less value of liens and encumbrances remaining at time of sale.
( ) Unincorporated area: ( xx) City of La ouinta , and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby. acknowledged,
WILLIAM R. RILEY, an unmarried man
hereby GRANT(S) to
EARL H. SMITH AND PAMELA L. SMITH, husband and wife,
as Joint Tenants
the following described real property in tie City
Riverside I
County of ,State of California:
Lot 5, Block 226 of Santa Carmelita at Vale, La Quinta
Unit #21, as per map recorded in Book 20, Page 22 of
Maps,. -.-,Ln the office of the county.recorder of.said
county.
•
Dated: September 27, 1990
STATE OF CALIFORNIA
COUNTY OF Riverside }SS.
On J go before
me, the undersigned, a Notary Public in and for said State,
personally appeared William R. Riley
personally known to me or proved to me on the basis of sat-
isfactory evidence to be the person whose name is
subscribed to the within instrument and acknowledged
that Ivo executed the same.
WITNESS my hand and official seal./I.7
6
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r
WILLIAM R.' RILEY
OFFICIAL NOTARY SEAL
FRANCES BRIDGES
.v •' Notary Public — California
RIVERSIDE COUNTY
My Comm. Expires AUG 19.1994
(This area for official notarial seal)
Title Order No. Escrow or Loan No.
MAIL TAX STATEMENTS AS DIRECTED ABOVE
p
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1� M m
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GAG$
CC 0_j
z
O
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a�-g�r
p.
3'
V
Au
r
� -
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 $ 12.65
a a ( ) computed on full value of property conveyed, or
(xx ) computed on full value less value of liens and encumbrances remaining at time of sale.
( ) Unincorporated area: ( xx) City of La ouinta , and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby. acknowledged,
WILLIAM R. RILEY, an unmarried man
hereby GRANT(S) to
EARL H. SMITH AND PAMELA L. SMITH, husband and wife,
as Joint Tenants
the following described real property in tie City
Riverside I
County of ,State of California:
Lot 5, Block 226 of Santa Carmelita at Vale, La Quinta
Unit #21, as per map recorded in Book 20, Page 22 of
Maps,. -.-,Ln the office of the county.recorder of.said
county.
•
Dated: September 27, 1990
STATE OF CALIFORNIA
COUNTY OF Riverside }SS.
On J go before
me, the undersigned, a Notary Public in and for said State,
personally appeared William R. Riley
personally known to me or proved to me on the basis of sat-
isfactory evidence to be the person whose name is
subscribed to the within instrument and acknowledged
that Ivo executed the same.
WITNESS my hand and official seal./I.7
6
r
r
WILLIAM R.' RILEY
OFFICIAL NOTARY SEAL
FRANCES BRIDGES
.v •' Notary Public — California
RIVERSIDE COUNTY
My Comm. Expires AUG 19.1994
(This area for official notarial seal)
Title Order No. Escrow or Loan No.
MAIL TAX STATEMENTS AS DIRECTED ABOVE
RECOR IIN REQUESTED BY
WELLS FAR REALTY SERVICES, INC.
ANO WNEN RECORDED MA11 TO
Name La Quinta Estates, Ltd.
Street 8380 Melrose Ave. Suite 302
Address LosAngeles, Ca. 90069
City a
State I
Name
Street
Address
City 6
State I
MAIL TAX STATEMENTS TO
Above
o
-- o 41
uI 7� Io u
Q
O Cp
,.. - w W
1D
tl� U1 7 ,y
I G l
oWC m8
SPACE ABOVE THIS LINE FPP, RECORDER'S USE
Documentary transfer tax 8..... 0 ...............................
® Computed on full value of property conveyed, or
❑ Computed on full value less liens.& encumbrances
e aining thereo at time of sale.
yin `ells ergo Realty Set � s, lac.
Si ature of declarant r agent determining ax • firm name
Unincorporated area City of ..................................
Corporation Grant Deed
THIS FORM FURNISHED BY GRAYCO LAND ESCROW LTD.
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, WELLS FARGO REALTY
SERVICES, INC., a California Corporation, as Trustee, who acquired title as
GRAYCO LAND ESCROW, LTD., a CALIFORNIA CORPORATION, AS.TRUSTEE.
a corporation organized under the laws of the state of California
hereby GRANTS to
Charles L. Richards and Ann M. Richards, husband and wife, as joint tenants
the followi tr tlescribt�d real property in the unincorporated area-,,qf the
County of �3iverslde , State of California:
-)I Lot 5, Block 226, Unit 21, Santa Carmelita at Vale La Quinta, as shown by map on
I file in. Book 20, Page 22 of Maps, Riverside County Rem rds.
SUBJECT TO: (1.) Taxes for the fiscal year 1971 19 72 and subsequent.
.-(2.)•-Covenants,-conditions, reservations, -easements, restrictions, rights, rights of way, and all matters
appearing of record.
In Witness Whereof, said corporation has caused its corporate name and seal to be affixed hereto and this instru.
ment to be executed by its Vice President and Assistant Secretary
thereunto duly authorized. Wells Fargo Realty Services, c.,
Dated: December 6, 1976 a California Coroor tee_ .ry
STATE OF CALIFORNIA By
i.RC SS.
COUNTb LOS pNOF
On before me, the under- By
sig d, a NNotary 1li� 1Sc in a d for said State. personally appeared
" orfP J. Howeff known
to me to be the Vice President, and
Betty M. Georgino _ known to me to be
Assistant " ' Secretary of the Corporation that executed the
within Instrument, known, to me to be the persons who executed the
within Instrument on behalf of the .Corporation therein named, and
acknowledged to me that such Corporation executed the within Instru
ment pursuant to its by-laws or a resolution of its board of directors.
WITNESS ��l nd official seal.
Signature
Name (Typed or Printed)
Vice ` President
S1sLanr j Secretary
r
amzunttu;;;uu,ln+:^uu, a!:innuni;,.;,mann,.�wCfin:•.n�::^:fn'±tr.�n,nmunnmmn
i.
NO"iARY
COUNly
(VIY t_:,1 ;-; sit;:l c;; ;sus Aug.;, 97i3
yyyy,Wu11:::1.:1 W.bn1a14,nllaa:Htlrn,nln,ayn�pai,,,,,,...p1110N:It31,Ylnla,nlnl,nl
(This arra for official nuturial Nall
TRUST NO. Tl ()l ACCOUNT N0.
MAIL TAX STATEMENTS AS DIRECTED ABOVE
3--l'
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