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9701-046 (SFD)LICENSED CONTRACTOR DECLARATION ' I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date �t Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's Lic - nse Law for the following reason: I, as owner of the property, or my employees with wages as their sole co . pensation, 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). () I am exempt und_errSection , B&P.C. for this reason 1 VDate f Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ( ) I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Y 1 I have and will- maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit isissued. My workers' compensation insurance carrier & policy no. are: Carrier Ow Fm'D Policy No. / 000"0q �gS�Dt�t-�i`Y �.l nl (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, I shall 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, 3700 - f t e Labor ,Code, I shall forthwifth comply with those pr Asions. Date: A "//> ` ?Applicant _ Fle .• ° 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 City to. enter upon the above-mentioned property for inspection ppurpose§.,e Signature (Owner/Agent)• —� � ' - ^ — Date/ O 'yY. PERMIT# CONTROL# BUILDING PERMIT 9741171-046 4579 'O G_7 VALUATION Si7(►,676.gtl LOT' TRACT DATE I/10/q_7 JOB SITE ADDRESS '7-9-12.3.5- T01% 0A; 10 V ANIC Io OW11< APN 761-iRyZ--{j�IR OWNER CONTRACTOR / DESIGNER / ENGINEER 7ANWS & DOWRES Bb:1t.,E1'.ADL OWNER ! y'WILI)1;R P.O. 60X 520 WNDHANI NJ 07945 i%r;BL m USE OF PERMIT ",K) , SPP - i ERM(T DOES NOT iNCIATUi:. KCtCK kiVt\L1..S OR [K)OL.PLAN' (:t1%:t K NI'J:11PI"1,):+:: fS AN Af')L)111ONAL. Sd_i8.00 F - OX IiE V 131 C) N.14 Nfiv)E Afri'HiR FlitST 12RNIFW. t f ST41'1M COIN r FR KI 1110N 10.1851.00 M t'OR IVIIA'(`IO 399AA) SIS f:7rjFtAtilS/(.�.�1t.lr(;i1<`1' I, t77,uf9 ;3iF� 01TWIXT01) CaNT Or, CON U" 10N STR CT 876,676.1' PERNUT FUC SUMN A Y r :aPfSi'Ki'[ F'It �N I -N 1().1-000-4.18AM 33. (711.9) P1,A140Ir. t•'t;l; 101.000.439.318 Ably A14 CIMCK Pl%i>t)WT X1110 IANICAi. 14188. 161-115Q-421-000 7:1,5v WAY -7 RIC'AL 4r {:HS I01.000 -Q0-000 P1,11%,0AP4 1+1�1'i 40I,•0s^e{)•41 - (1(I R!ils7,7s m'FLCw t -&&fico (I2es) 101.0()111-24l4OQ() $fii.�fi CIRAi)I&G 101.00.4234M $20.0f) iNF `�..A.SITUC31 4W 225-11100-44.11-342. SA, 011 YWt AIT tN i UR1,1r Pt. k(..,FS (RES)N011-1000-2.+5. fiUO +1,9�1 169 i 14 J '1'i AL 4v'C)?+1S .A.lv'1: PLAN CEC K - • � � 515,937.76 1 p '997 LESS PRE -PAID F IS 41.000. AN • ,1,11-11 %�' S,I#7.7t�RTklV.<N9 ~;-",,, Qvr G t. fi RECEIPT DATE Bl DATE FINALED INSPECTOR Yp, INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power r Final Utility Notice (Perm) COMMENTS: FROM : PAINTED COVE e TEL: 619 564 5530 APR.29.1998 1:27 PM P 3 OF LA QUINTA eu a 7S7Y@�4fAft TA 012 INSPECTION RE }$T�LUV9l 777.71 g,�H I� U Owner JAMES & DOLOIAh§oqMpT Contractor OWNER / BUjjrDER Permit Numlmr 9701-046 POST ON JOB INCONSPICUOUS PLA INSPECTOR MUST SIGN ALL APPLICABLE. SPACES JOB ADDRESS 79-235 TOM FAZIO LANE N. SFD - PERMIT DOES NOT INCLUDE BLOCK WALLS OR POOL TYPE OF INSPECTION DATE _ INSP. FOUNDATION A SETBACK } MAIN GROUND SYSTEM GROUND PLUMBING AIr P PRE-GUNITE DO NOT POUR CONCRETE UNTIL AkI, AB OVA HAS BEEN SIGNED CONCRETE SLAB JOISTS 6 GIRDERS ELECTRICAL GROUNDWORK f '_y_ 1 Aen—, /_== DO NOT POUR CONCRE E UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH PLUMBING ROUGH GAS A GAS TEST _ HEATING 6 VENT - AJC FIREPLACE ROOF _ - - BOND BEAM O.K. TO WRAP GROUT 0 a' 0 S' FRAMING / INSULATION PRE -ROOF 1l� l' / .( COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED DRYWALL INTERIOR 'y EXTERIOR LATH. POOL PRE PLASTER POOL FENCE A GATE SEWER SEPTIC TANK —' FINALS ELECTRICAL — �— PLUMBING FINAL GAS TEST HEATING - A!C HOUSE NUMBERS JOB COMPLETED TEMP POWER ABOVE APPROVALS DO NOT INCLUDE RIGHT TO 7/96 TURN ON UTILITIES OR OCCUPY BUILDING Notice: Document Cannot Be Duplicated Date 1/10/97 No. 15169 t , Desert Sands Unified School District 82-879 Highway 111 Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE APN # 761-522-007 Jurisdiction La Quinta. Owner Name Mr. & Mrs. Jim Beightol N0.79235 Street Tom Fazio North City La Quinta Zip 92253 Permit # —� Log # Study Area 109 Tract # Lot # Square Footage 10,857 Type of Development Single Family Residence ` No. of Units 1 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 1.84 X 10,857 or $ 19,976.88 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/Wells Fargo Bank y, ' Telephone 564=1849 Name on the check By Dr. Carol McGrew Administrator in Charge , _ .i :• :c 'c �`y •. ..... :SSS �j,l } ,�,� �t:. Fee collected /exempted by Pauline Pearson 'Payment Received $19,976.88 "Check No Signature J pAAAJb 'Do i A A 81Vt­ 0689018235 IOTICE: 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 ibove will begin to run from the dale 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 ollect them on the Districl('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 RECORDING REQUESTED BY AND WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW, MAIL TAX STATEMENT TO: 'I. 3eiz:11tol , NAME color:;^ n. mei,-:hr,o.l 00ET Post Officfe „ox ;1, CITY. STATE 6 ZIP CODE 1'in lii cL'ii, 1':J 07945 TITLE ORDER NO. ESCROW NO. GRANT DEED SPACE DOCUMENTARY TRANSFER TAX $ 0 ❑ computed. on full value of property conveyed, or ❑ computed on full value less liens and . encumbrances remaining at time of sale. Signature of Declarant or Agent Determining Tax Firm Name FOR VALUABLE CONSIDERATION, receipt of which is acknowledged, I (We), Jamieg 'i. ;e i rh t of :,oloreS y. ei:Thtol, husband :lif= as tenant' i INAOQE�E CaRlWZL1R.511 grant to y"-i:'es rl•`:ei,�ntol ;,olores A. 3eightol, husband? ;t:ife as all that real ('ro `rt ` '' Y (NAA5?F T E, p p� q situate in the Cit of u� � �a (or in an unincorporated area of) :i 1-.T e r s 1 r1.e County, Calif. described as follows (insert legal description): 4NAME OF COUNTY) (STATE) Lots 55 : 56 o*L' Tract 2?728 as recorc?e(i in gook 24) of r.;aps at pa ;;es 1 throw .-h 13, aecord s of 3iversid.e County, California. This deed reflects Lot Line Ad justment :do. 96-236 as approved. by the City of La juinta. Assessor's parcel No. 741-522-00? an,' 761-522-003 Executed on December 13 . , 1996 , at La Quinta, California (CRY AND STATE) STATE OF l2&11�p()'1)Q� COUNTY OF Imo- \Vern ed e— On << before me, � INAMEnIT ! JAr DOE. NO AR PUBLIC-) personally appeared eS a- 0 7,Ore 1 !; �- I personally known tome (or proved to me on the basis ot satisfactory tory evidence Ito e t Pers s w hose is/are subscribed to the within instrument and acknowledged to me that P69sb4/they executed the same in Dglh r/their authorized capacity(ies), and that by �A/Wtheir signaturels) on the instrument the person(s), or the entity upon behalf of which the personls) acted, executed the instrument. WITNESS my hand and official seal. a �d 010s4m (SIGNATURE OF NOTARY) 1 1� MAIL TAX STATEMENTS TO: Before you use this form, fill in all blanks, and make whatever changes are appropriate and necessary to your particular transaction. Consult a lawyer if you doubt the form's fitness for your purpose. and use. O= makes no representation or warranty, express or implied, with respect to the merchantability or fitness of this form for an intended use or purpose. WOLCOTTS FORM 778 - Rev. 3-94b (price class 3A) GRANT DEED ©1994 WOLCOTTS FORMS, INC. IIIIIIII) )III )III II III 7 67775 39778 9 CAPACITY CLAIMED BY SIGNER(S) 5QNDIVIDUAL(S) OCORPORATE OFFICER(S) (TITLESI OPARTNER(S) O LIMITED O GENERAL ❑ATTORNEY IN FACT OTRUSTEE(S) ❑GUARDIAN/CONSERVATOR ❑OTHER: SIGNER IS REPRESENTING: (Name of Personis) or Entity(res) EXHIBIT "B" LOT LINE ADJUSTMENT 96-236. LOTS 55 AND 56 OF TRACT NO. 27728 AS RECORDED IN BOOK 249 OF NAPS AT PAGES i THROUGH 18. RECORDS OF RIVERSIDE COUNTY. CALIFORNIA. TOM FAZIO .LANE NORTH L-115.70 T-57.67 L�•� T-40.31 N 68 36 32 — — — aj0L__ 4G33o�i— -AM-94 ��i�1�� 11_13 U; a o I CD LOT 56 cn � I LOT 55 o X IW W pl?0 57 oIN w . s N O a w a I O O I Z b CY.•D LOT LINE PAR01EL A 40568 S.F: /°fig./ �- - - - - - GOLF EXHIBIT m 4 _CASE N0.5;e-2-34 Na 26662 Sn ik X31'2 CIVIL SO 0FCX -Ao�PA ■ M a I U.5 ■ 6 M r.. — am u Sark QNOW n cru Ae w "Pon rye w aw-rna State of California County of Riverside On 1A —/(C, — 9,6o before me, Phyllis Manley, Notary Public, personally appeared Christine di Iorio, personally known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her authorized capacity, and that by her signature on the instrument the person or the entity upon behalf of which the person acted, executed the instrument. WITNESS my hand and official seal. (S WYLLS MANLEY -- � COMM. f 1042709'Q Notary PLbuc — CGd1b,do RIVERSIDE COUNTY Comm. Expires OCT 16.1998 Document Description: Certificate of Compliance Lot Line Adjustment 96-236 Number of Pages: 4 Date of Document: 12/13/96 APPLICANT: JAMES AND DOLORES BEIGHTOL PO BOX 519 MENDHAM, N.J. 07945 RECORDING REQUESTED BY: CITY OF LA QUINTA CONM,�TITY DEVELOPMENT DEPT. P.O. BOX 1504 LA QUINTA, CA 92253 CERTIFICATE OF COMPLIANCE (Title 13 of the Subdivision Ordinance) This certificate relates only to issues of compliance and noncompliance with the Subdivision Map Act and legal ordinances enacted pursuant thereto. The parcels described herein may be sold, leased, or financed without further compliance with the Subdivision Map Act or any local ordinances enacted pursuant thereto. Development of the parcels may require issuance of a permit or permits, or other grant or grants of approval. I certify that I have reviewed the following described real property and have determined that the lot line adjustment substantially conforms with all requirements of City of La Quinta; and that no conditions are imposed other than the recordation of these documents to complete the terms of Lot Line Adjustment 96-236. The real property is located in the City of La Quinta, County of Riverside, State of California, described as follows: Exhibits "A" and "B" OWNERS OF --RECORD: JAMES R. BEIGHTOL AND DOLORES A. BEIGHTOL Executed on December 13, 1996, at the La Quinta City Hall, 78-495 Calle Tampico, La Quinta, California 92253. &�L e5K' CHRIS i"'_NE DI IOkIO Planning Aanager City of La Quinta cert13-3 T4ht 4 4a " - 78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA December 13, 1996 County Recorder's Office County of Riverside PO Box 751 Riverside, CA 92502-0751 SUBJECT: LOT LINE ADJUSTMENT 96-236 (BEIGHTOL) Dear Colleague: 92253 - (619) .777-7000 FAX (619) 777-7101 CITY OI= LA QUINTA DEC 17 RECD BUILDING AND SAFE7Y Enclosed are the final documents necessary to adjust the property boundaries of Lots 55 and 56 of Tract Map 27728 (The Quarry) into one lot. The lot line adjustment request is consistent with the provisions of the City Subdivision Ordinance (Title 13) and State Subdivision Map statutes because no additional parcels were created greater than originally existed. Once recorded, please return the final paperwork to our Department. A self-addressed envelope is enclosed for your convenience. If you have any questions, please contact me at (619) 777-7067. Sincerely, GT. Enclosures DIRECTOR c: Mr. and Mrs. James R. Beightol Watson &=Christiansen Engineering Building and Safety Department rl Marcus Fuller; Assistant`Engineer I MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253407 LLA236-5