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14189 (SFD)414 12 i P.O. BOX 1504 N o , 14189 Building 78-775 Irvin Circe 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner 00.0 tsz.lme5 Mailing Address City Zip Tel. Contractor Apollos Construction At'dre.s Box, 977 Ca Quinta, CA 112253 Tel. 772-4024 State Lic. B 619600 City 2231 & Classif. Lic. # Designer Add,rSeri ` r3bif17 Tel. City JZip State f,y Lic. # ` LICENSED CONTRACTOR'S DECLARATION s I herofy affirm that Item licensed underN.provisions+d of Chapter 9 (commencing with Section D00) fiDi2,0n 3 of�the Business andaProfesf1dns Code, and my license is in full force and 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) or 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 (8500). ❑ 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 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 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- 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 contractors) licensed pursuant to the Contractor's License Law.) - ❑ 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.) Polio N ,0 .Company [oozy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COM P ENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (8100) 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 become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, after 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 if work thereunder is suspended for 180 days. Pcertify 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 lto enter the above-. mentioned property for inspection purposes. r Signature of applicant Date Mailing Address City, State, Zip BUILDING: TYPE CONST. V OCC. GRP. R3 A.P. Number 604-232-024 ,Legal Description Lot 153 Tract 23268 Project Description SY Acacia,. Tract Sq. Ft. 1835 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ _ Demolition.❑ Po mit does not include block Malls or pool. Estimated Valuation .$108,,049.00 PERMIT AMOUNT Plan Chk. Dep. 250.00 1 Plan Chk. Bal. 319.97 Const. 671.00 Mech. 68.50 Electrical ,136.31 Plumbing 156.00 S.M.I. 10. 80 Grading 20.00 Y Driveway Enc. .00 Infrastructure 2o431.10 Arts 2n Public Places 20.12 TOTAL ,, ii d REMARKS UCT 14 19 Rv 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 SLAB GRADE ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL. SQ. FT. STORAGE TANK FORMS , W\E SEWER - d MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® - FOUND. REINF. V - GAS (ROUGH) GAR. SO. FT. ® POWER OUTLET ROOF DRAINS REINF. STEEL GAS (FINAL) DRAINAGE PIPING CAR P. SQ. FT. GROUT WALL SQ. FT. SERVICE DRINKING FOUNTAIN. SQ FT ® BOND BEAM URINAL ESTIMATED CONSTRUCTION VALUATION $ GRADING cu. yd. $ plus x$ WATER PIPING NOTE: Not to be used as property tali valuation FINAL INSP. ` FLOOR DRAIN MECHANICAL FEES ROOFING WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED VENTILATION LAUNDRYTRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING 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 ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER FINISH GRADING FINAL INSPECTION �V f J GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEECONST. FEE JELECT.FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING A ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBI UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS , W\E SEWER - d ROUGH WIRING DUCT WORK ROCK STORAGE - FOUND. REINF. V - GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATE SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. ` FRAMING FINAL INSP. ROOFING � %/ _ /_ L �,IA 7w - REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL ? [l LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION �V f J '• CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated 619-775-3500 Date 110/10/941 Type of Permit I La Quinta No. 113111 1 Permit # Owner Name Bob Grimes Log No. Street City Zip Study Area 124 APN # Tract # Lot # 0 Square Footage 11835 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 17657771 x 1835 or $ 3,027.75 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 Robert Grimes Name on the check Telephone _4 1 By Dolores A. Ballesteros Superintendent Q z+ v` Fee collected /exe ted by L ne Arthur Payment Received: Signature Check��N©: 1051�.; 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 AND WHEN RECORDED MAIL TO F BOB GRIMES NAM[ BE' rY A. GRIMES ADDRESS STATE L MAIL TAX 111TATEMENT9 TO NAME SAME AS ABOVE ADDRESS CITY d STATE M�3 Q s SPACE ABOVE THIS LINE FOR RECORDER'S USE Pursuant to Section 11934 R 6 Documentary transfer tax.$.... Gode••&••Seeti•on•••12 , Ord. No. ` ❑ Computed on full value of property conveyed, or ❑ Computed on full value less liens 8 encumbrances remaining thereon at time of sale. �r Signature of declarant or agent determining tax • firm name ❑ Unincorporated area City of .................................. I Grant Deed l This form furnished by Orange Coast Title Company F, W)� U ��(M�hDEHATb",j' � of wNhich is hereby acknowledged, PARCEL NO hereby GRANT(S) to BOB GRIMES and BETTY A. GRIMES, husband and wife as cotmtunity property the following described real property in the city of J�dq/7 Gulps county of Riverside , state of California: LOT 153 OF TRACT 23268, AS PER MAP ON FILE IN BOOK 213, PAGES 67 TO 73, OF MAPS RECORDS OF RIVERSIDE COUNTY, CALIFORNIA 0 July 16, 1992 STATE OF CALIFORNIA County of Riverside On ,November 24 1992 before me, the under- signed, ndersigned, a Notary Public in and for said State, personally appeared _.,m a Th ornhtir�h _ t -- personally known to me or proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the per- sons) acted, executed the instrument. WITNESS my handXpd-,6T56�'al seal. FOR NOTARY SEAL OR STAMP OFFICIAL SEAL Kelly Lee Collier ® ;; NOTARY PUBLIC - CALIFORNIA RIVERSIDE COUNTY n My Comm. Expires May 28, 1995 Title 0 er No. Escrow No. • 4735-K MAIL TAX STATEMENTS 'AS DIRECTED ABOVE O Y ui O ; o U p a m c�� Q Y� Q s SPACE ABOVE THIS LINE FOR RECORDER'S USE Pursuant to Section 11934 R 6 Documentary transfer tax.$.... Gode••&••Seeti•on•••12 , Ord. No. ` ❑ Computed on full value of property conveyed, or ❑ Computed on full value less liens 8 encumbrances remaining thereon at time of sale. �r Signature of declarant or agent determining tax • firm name ❑ Unincorporated area City of .................................. I Grant Deed l This form furnished by Orange Coast Title Company F, W)� U ��(M�hDEHATb",j' � of wNhich is hereby acknowledged, PARCEL NO hereby GRANT(S) to BOB GRIMES and BETTY A. GRIMES, husband and wife as cotmtunity property the following described real property in the city of J�dq/7 Gulps county of Riverside , state of California: LOT 153 OF TRACT 23268, AS PER MAP ON FILE IN BOOK 213, PAGES 67 TO 73, OF MAPS RECORDS OF RIVERSIDE COUNTY, CALIFORNIA 0 July 16, 1992 STATE OF CALIFORNIA County of Riverside On ,November 24 1992 before me, the under- signed, ndersigned, a Notary Public in and for said State, personally appeared _.,m a Th ornhtir�h _ t -- personally known to me or proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the per- sons) acted, executed the instrument. WITNESS my handXpd-,6T56�'al seal. FOR NOTARY SEAL OR STAMP OFFICIAL SEAL Kelly Lee Collier ® ;; NOTARY PUBLIC - CALIFORNIA RIVERSIDE COUNTY n My Comm. Expires May 28, 1995 Title 0 er No. Escrow No. • 4735-K MAIL TAX STATEMENTS 'AS DIRECTED ABOVE Document y9% DaLe STATEMENT OF TAX DUE AND REQUEST THAT STAMPS NOT BE MADE A PART OF THE PERMANENT RECORD IN THE OFFICE OF THE COUNTY RECORDER (Pursuant to Section 11934 R & T Code and Section 12 of Riverside County Ord. No. 516) TO: Riverside County Recorder Request is hereby made in accordance with the provisions of the Documentary Stamp Act that scamps be affixed to this form for later affixing to the accompanying document which names:. Thomas A. Thornburgh- Name of one grantor or lessor Bob Grimes and Betty A. Grimgs Name of vne grantee or lessee Property described in the accompanying document is located in the City of La Quinta Show name of.city or unincorporated) Documentary Transfer Tax $ 57.20 XX ____Computed on full value of property conveyed, or computed on full value less liens an5/'ecumbrances remaining at time Declarant determing tax COASTAL COUNTIES ESCROW Firm Name ,Agent of declarant determing tax On Behalf of: THOMAS A. THORNBURGH NOTE: After stamps have been affixed to the document, the clerk will sign here: 0 CALVIN C. KAMINSKAS a Assistant Commissioner c t 0. (714) 275.3000 OrTICE OF AGRICULTURAL COMMISSIONER JAMES O. WALLACE. Commissioner 83-612 Avenue 45 Suite 7 Indio, CA 92201 (619) 342-8291 DAN RILEY Seater, Weights & Measure (714) 275.3030 DATE / d / / �/ CASE WAC DEVELOPER'S NAME t &-i ma S ADDRESS 1 F O 13 oj/_ 9,- 1 7 7 L • Q , q?- z z� 3 TELEPIIONEs. Dear Developer:w After reviewing your landscaping plans, all plant mterial listed is not in violation of quarantine laws governing Lhe Coachella Valley. If subs.t"itutions do occur and they differ from plant material listed, this office.must be notified inrinedia tely . Thank.you for protecting and preserving the Coachella Valley's pest -free environmen Agr cul 1 Can ss oner's Office cc:'Indio and Riverside 4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 925011 — FAX (714) 275-3012