08867 (SFD)P.O. BOX 1504 N o .
Building 78.105 CALLE ESTADO -
Address 7%k-729 irAl 1P > i t- . LA QUINTA, CALIFORNIA 92253
Owner _
Address . 74"'8.8 ®elie, Dr #10
City lZip ITel.
Contractor
ress
Zip
State Lic. City
& Classif.3.SAg.62 81
Lic. #
Arch., Engr.,
Designer
Address 7Tel.
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 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 or 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).
O 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 such work himself or through his own employees,
provided 'hat' 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
or 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. C. fo this reason
Date Owner .•.
WORKERS' COMPENSATION DECLARATION
1• 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 permitis for one hundred dollars ($100) valuation
or less.)
I certify that in the performance �thq�work for which this permit is issued, I shall not
employ any person in any mannso as torbecome�sybjec the-Worke'r9 Cofrip'erisation
Laws of California.
Date Owner.
NOTICE TO APPLICANT�f ,- after 1Ng this Certificate of Exemption you should become
subject to the Workers Comp�nsaiion provisions of the .Labor Code, you must forthwith
comply with such provisions or ttfjs permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097„Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number16i� T.3�fif
Legal Description Leat 125 Unit 5 Rook 21 Pa X1; 62
Project Description SFs[}
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL -DATE
INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
Sq. Ft. 23��
Size
No. No. Dw.
Stories - Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
134y902.70
PERMIT
AMOUNT
Plan Clik. Dep.
250.00
Plan Chk. Bal.
402.95
Const.
762.00
Mech.
76.50
Electrical
161.44
Plumbing
184E.50
S.M.I.
9..45
Grading
20.00
Driveway Enc.
28..80
Infrastructure
2838..4$
Arts inPibli
87.26
TOTAL(ii2
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. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT. ®
DUCT WORK
j DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN.
SQ FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WAIER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SQ.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
lip/GROUND
PLUMBING 7if id
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) L%Git 1,0
[[
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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. (� � fr
FRAMING % — —��
/
FINAL INSP. O q �l
((
ROOFING �[ �r
a
/ ��
/ % v f'l17S /2
IZe(G�..` f '�—�l r �✓�
F�
REMARKS:
i
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING )/(4//C1 ( 10
MESH
INSULATIONISOUN A
FINISH GRADING
FINAL INSPECTION 6 l) Gl
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 11/28/90 Type of Permit JLaQuinta
No. 10288 Permit #
Owner Name Michael Yeomans Log #
No. 78725 street Calle Tampico
city La Quinta zip 92253 Study Area 116
APN769-135-003 Tract # I Lot # 0 Square Footage 12377
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 pursuant to Government Code 53080
in the amount of 11.58 1 X 0 or $ 3,755.66 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 Yeomans and HIeine Home Builders Telephone 7734772
Name on the check
:Z
Richard M. Beck
Director, Facilities Planning & Development
Fee collected /exempted by Shelley D. Bennett
Signature
Payment Received
,
. rJ � r ,.f `y ■
Check, ho. 1012 ^ '.-
Collector: Attach a copy of County or City plan check application form to District copy.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
RECORDING REQUESTED BY
AND WHEN RECORDED MAIL To
deme Mr and Mrs: M. P. Yoemans
a►eet 42-110 Lima Hall Rd
►ddrefe Bermuda Dunes, Ca 92201
:Ity m
tete L_
MAIL TAX STATEMENTS TO
r
creme
SAME AS ABOVE
�treek ,
eddres -
Q
:uy a �.... _ -
aea L
SPACE ABOVE THIS LINE FOR'RECORDER'S USE
TO 1923 A (2-8 2 Individual Grant Deed
TO 1923 CA (2-83)
THIS FORM FURNISHED BY TICOR TITLE INSURERS
The undersigned grantor(s) declare(s):
_jz Documentary transfer tax is $ 33,00
J a ( ) computed on full value of property conveyed, or.
( ) computed on full value less value of liens and encumbrances retraining at time of sale.
( ) Unincorporated area: ( ) City of
,and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
EDWARD G. WILKINS AND MARY ANN WILKINS, husband and wife
hereby GRANT(S) to
MICHAEL P. YEOMANS and JUDITH YEOMANS, husband and wife as'Joint Tenants
the following described real property in the '
County'of RIVERSIDE ,State of California: f
Lot 125 of Desert Club Tract
4
'l Dated: August 11, 1989
i ;►."ARD G. WILKINS
STATE OF CALIFORNIA
F.- COUNTY OF _L,oS��C1— �SS.
111 tn. N.•.�
' On _ li(ZrUN'5.r IIff 'before—MARY -ik N—WfLKiN
me, the undersigned, a Notary Public in an -1 for said State,N
personal) appeared Eb (,t) (�.Cz
_L Y ANN I1. -KI E S .
personally known to me
Ii to be the person whose nam_
subsc i ed to the within instrument and acknowledged
}� that executed the same.
WITNESS y hand Wd official seal. OtFICIAI SE/tiL
i JULIA H SCHARNSERO
Note
-I Signature OOUNTYle
ti MYOOomm. Exv, ,an. t9, i9w
(This area 6r official notarial seal) '
Title Order, No. Escrow or Loan No.
MAIL TAX STATE.MFNTS AS DIRECTED ABOVE
i
I