11423 (SFD)Building 52r-455 Vallejo
Owner
' eaford
4
P.O. BOX 1504 �'X' N o .
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address 65118 San Jacinto Lane 420
City Zip Tel.
DHS 92240 567--3845
Contractor
Tpafo ,&Construction Bay Sands
Address
City Zip Tel.:
329-7226
State Lic.ll�! r1� City
&Classif. hh�na7 7 - / Lic.#
s
Arch., Engr.,
Designer Terry Roach
AddressTel.
6558 Arapahoe
4 360-1114
City Zip State
I.W. 92210, Lic.# 477924—B
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 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).
roas owner of the property, or my employees with wages as their sole compensation, will
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. If, however, the building
or Improvement is sold within one year of completion, the owner-bullder will have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ I, asowner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractors License L'aw
does not apply to an owner of property who builds or improves lhereon�, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec.sa' B B -PC for this rreatosA
Date
WORKERS' COMPENSATIONJDECLARATION
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.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (810) valuation
or less.)
I certify that in the performance of the work for,whicthis permit is issued,jl shall not
employ any person in any manner so as'to,become=subje tto the Workers' Compensation
Laws of California. J /I
Dale Owner ., - „�+ -��
NOTICE TO APPLICANT:/(11;!_dlfer�makih'g this ,CeFtiflcete of ExemptZit you should become
subject to the Workers'Compensa(flon provisions of the /Labor Code, you,_must forthwith
comply with such provisions or this permit shall be deemed revoked.
F
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
11423
BUILDING: TYPE CONST. \ OCC: GRP.
A.PrNumber, 773`262`"022
Legal' Description Lot 11 Block 82
'
Description SFD 7
Sq. Ft.1700 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit does not include block walls
or
Estimated Valuation
100' 967.30
PERMIT
AMOUNT
Plan Chk. Dep.
258.00
Plan Chk. Bal.
6-43.00
Const.
292.20
Mech.
55.50
Electrical
133.30
Plumbing
143.00
S.M.I.
18.10
Grading
20.00
Driveway Enc.
.00
Infrastructure
2181.93
Arts in Public
25.00
TOTAL
, 3 5 8 2. 0 3
---
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. SO. FT. ® $
UNITS
COLL. AREA
2ND FL SQ. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
FOR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. ®
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
GAS (ROUGH)
DRINKING FOUNTAIN.
SQ 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.COOL 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.
SQ. 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 ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE JELECT.FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. ,'A SOLAR'
SETBACK
GROUND PLUMBIN(f
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMSjq
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
10,10 l;P
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING ( d�L�
FINAL INSP.
ROOFING /LO
^' / `J1yJ/
/'/�lAf r l • l ���
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
HING lad 3Q Ace
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL 71
Owner
Mailin
Address
City ,.___-•_.. Zipc el. -
_Contractwa
Address
_ y
J4_
State L-ic.
& Classif: -2
• F
UILDING: TYPE CONST.
Q-OCC:•G7RP.---�-/— -
.P. Number>�./o l //
9gal Description�_�. ��"?
ro'ject Description4��A�'"
• Arcn.,xngr __
Designee{ -.A, f"�-� . New
AddressL40_ . 411 S(vo
.�C.ity zi.pState
Lic. #
• LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
e
'I )ffect. of Division 3 of the Business and Professions Code, and my license is in full force and
�..
• SIGNATitRE DATE
OWNER -BUILDER DECLARATION _
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,13usiness and Professions Code: Any city or county which requires a ---
.permit
`-
,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
the provWws 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 fire hundred dollars ($500).
0 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, Bulsness and
Professions Code: The Contractor's License Lew 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. g, however, the building
or improvement Is sold within one year of completion, the owner -builder will have the burden
of proving that he dM 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 of 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
Date Owner
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
❑ Copy Is filed with the city. D 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 thQ work for which this permit is issued, 1 shall not
employ any parson in any manner so as to become subject to the Workers' Compensation
laws of California.
Date Owner
NOTICE TO APPLICANT: ff. alter 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 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 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 of this city to enter the above.
mentioned property for Inspection purposes.
Signature of applicant -Date
-
-Mailing Address
City, State, Zip
FINANCE
-Storles-N�-- -Units
Add ❑ Alter ❑ Repair ❑ -Demolition ❑
� :r ;��•
y P.O. BOX15oa w` '
"
APPLICATION O��.LY
Suildirig
-- -' " _ 78-105 CALLE ESTADO
AMOUNT
Plan Chk. Dep.
Address
"'"' " ° ----LA QUINTA, CALIFORNIA 92253
� u
Owner
Mailin
Address
City ,.___-•_.. Zipc el. -
_Contractwa
Address
_ y
J4_
State L-ic.
& Classif: -2
• F
UILDING: TYPE CONST.
Q-OCC:•G7RP.---�-/— -
.P. Number>�./o l //
9gal Description�_�. ��"?
ro'ject Description4��A�'"
• Arcn.,xngr __
Designee{ -.A, f"�-� . New
AddressL40_ . 411 S(vo
.�C.ity zi.pState
Lic. #
• LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
e
'I )ffect. of Division 3 of the Business and Professions Code, and my license is in full force and
�..
• SIGNATitRE DATE
OWNER -BUILDER DECLARATION _
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,13usiness and Professions Code: Any city or county which requires a ---
.permit
`-
,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
the provWws 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 fire hundred dollars ($500).
0 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, Bulsness and
Professions Code: The Contractor's License Lew 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. g, however, the building
or improvement Is sold within one year of completion, the owner -builder will have the burden
of proving that he dM 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 of 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
Date Owner
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
❑ Copy Is filed with the city. D 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 thQ work for which this permit is issued, 1 shall not
employ any parson in any manner so as to become subject to the Workers' Compensation
laws of California.
Date Owner
NOTICE TO APPLICANT: ff. alter 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 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 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 of this city to enter the above.
mentioned property for Inspection purposes.
Signature of applicant -Date
-
-Mailing Address
City, State, Zip
FINANCE
-Storles-N�-- -Units
Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Estimated Valuatio
gZ_-_•----_ _ _____. _._..._ .._ .
PERMIT
AMOUNT
Plan Chk. Dep.
. S
Plan Chk.. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
-
Infrastructure
TOTAL
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:
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
Date 10/6/92 Type of Permit I La Quinta
No. 111762 Permit #
Log #
Owner Name Bob Teaford
No. 52465 street Vallejo
city La Quinta zip 92253 Study Area 111
APN # I Tract # I Lot ,# Square Footage 11700
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 1700 or $ 2,686.00 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 Bob Teaford • Telephone 329-7226
Name on the check !
By James E. Lively
Assistant Superintendent, Business Services
Fee collected /exempted by(�Vickie
, J. Durrett
('
Signature `� -J �d , o �� "'_t
' � .'�;- cep• o , .
e.: moi;
tom'.
Payment'-ReceiiFed
f% I t Check-- No. 1175
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
SID" TITLE •w ithk4t:'E
AND WHEN RECORDED MAIL THIS DEED AND. UNLESS OTHER-
WISE SH:.NN BELOW. MAIL TAX STATEMENTS TO:,
NAME Robert Teaford
Aooeess 1900 E. McCallum Way, Ste B-4
CITY a Palm Springs, Ca. 92262
STATE
ZIP lI )
Title Order No. Escrow No. 10-13590
GRANT DEED
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ED
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tx
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SPACE ABOVE THIS LINE FOR RE
GRANT DEED
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ED
The . undersigned declares that the documentary transfer tax -is 8....: • - r -•-•— .:............. .f.'.. y............--:...... and is
[j computed on the full value of the interest or property conveyed, or is
computed on the full value less the value of liens or encumbrances remaining thereon at the time of sale. The land,
tenements or realty is located in
unincorporated area city of .......... �, ................:.... and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
GERALD KATZMAN, an unmarried man, and SARA BRENNER, an unmarried woman
hereby GRANT(S) to
ROBERT TEAFORD, a married man'as his Sole and Separate property
the following described real property in the
county of Riverside , state of California:
Op Lots 9, 10 and 11 in Block 82 of Santa Carmelita at Vale La Quinta, Unit 10,
as per map recorded in Book 18, Pa.cie 70 of Maps, in the offi.c- of tlin County
NRecorder of said.County.
v
r
Dated November 27, 1990 / •%C -C- 1
Gerald Katzman
Sara Brenner
STATE OF CALIFORNIA
fJ„ S SS.
COUNTY OF l�•r
On this the day of �IJU --- 19-2p
before me the undersigned, a
Notary Public in and for said County and State, personally appeared
LR% S personally known
to me or proved to me on the basis of satisfactory evidence to be the
person whose name subscribed to the within instrument
and ack wI dged that. exec d the s e.
Signature o otary
FOR NOTARY SEAL OR STAMP
Assessor's Parcel No .............................................
MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABO\'E
Name
CAL-1/CT (Rev 2-88)
Street Address
City & State
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The . undersigned declares that the documentary transfer tax -is 8....: • - r -•-•— .:............. .f.'.. y............--:...... and is
[j computed on the full value of the interest or property conveyed, or is
computed on the full value less the value of liens or encumbrances remaining thereon at the time of sale. The land,
tenements or realty is located in
unincorporated area city of .......... �, ................:.... and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
GERALD KATZMAN, an unmarried man, and SARA BRENNER, an unmarried woman
hereby GRANT(S) to
ROBERT TEAFORD, a married man'as his Sole and Separate property
the following described real property in the
county of Riverside , state of California:
Op Lots 9, 10 and 11 in Block 82 of Santa Carmelita at Vale La Quinta, Unit 10,
as per map recorded in Book 18, Pa.cie 70 of Maps, in the offi.c- of tlin County
NRecorder of said.County.
v
r
Dated November 27, 1990 / •%C -C- 1
Gerald Katzman
Sara Brenner
STATE OF CALIFORNIA
fJ„ S SS.
COUNTY OF l�•r
On this the day of �IJU --- 19-2p
before me the undersigned, a
Notary Public in and for said County and State, personally appeared
LR% S personally known
to me or proved to me on the basis of satisfactory evidence to be the
person whose name subscribed to the within instrument
and ack wI dged that. exec d the s e.
Signature o otary
FOR NOTARY SEAL OR STAMP
Assessor's Parcel No .............................................
MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABO\'E
Name
CAL-1/CT (Rev 2-88)
Street Address
City & State
-`=4ue,.,� •i: a.�i;';, "�,ss:r }r-Ct:4k E'_ -?%:. s.i^ t�� •� �ro•,i '•�i-. ..'.rd-.G� z-�. �y�' ..-�� h,--:kr�«'a •�
a
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL _ ,
Received Fro `m: cr �G ne, r' c` '� �f� l ( `q- Date' q j'
(zjU
Address: l�� f f 8 SQ n a L t rn Lane f OPf'r- r 1 #z f SD r G
Account No.( CC) Lot(,) Tract -L
•r ;, Service Address' `"' a 1 l P : t 4 . G.A. Code
i. Qeervice(s)
. + ❑ Backflow(s) •I 's=• �: i ^a'•�v. '• ��s - ,•r N
❑ House Lateral(s)
❑ DetectorCheck(s)
❑ Meter Surcharge '
LI.-66n-itation Capacity Charge
❑ W.S.B.F.C.
❑ Temporary Construction Meter '
❑Tum on Charge)
�..,
❑ Uncollected Account - Name z
Tract -
D Inspection Fee -
Fee - I
❑ Plan Check Fees Water I Sewer - ` !. s `� s '
8 Tract - F
❑ Bond Payment - A.D. - Bond
Assmt. s
•t': ❑ Customer Deposit
i ❑ Other
TOTAL ` " . +a
Remarks: , . ! < ,f•' �( n F
i . +• • � yam
• ❑Copy to:
s . 'F Cash ' . ,' F� i a ��� SKl? ,Water Service
9'
Check h 3
MoneyCashier
.'. Order r ggr
_ .., _ _ t'_ - .,ry. « yR3F.s';7' o -i .. fix_ fW-.. � � rr' � t _ � f 3"M`_ � _. .;+. Y_.. �".•3 •y':•'!'r���, '��{'� '