9809-103 (SFD)I- hereby affirm underpiir� ' alty�_oi perjury that I am licensed under provisions if
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
4a .6 111144 ignatu"re of Contractor. Z4
OWNER -BUILDER DECLARATION
I hereby affirm
penalty of perjury that I am exempt from the Contractor's
'
License Law for the following
( ) |, as owner ofthe pmporty,u,myemployees with. wages as m�,00w
compensation,w0do���om.angmoo�uomm�nm
�intended�,____
oo|e(Goo�7o44.8uoin000aPmfeeomno|oCouo). . '.�.
� ( ) |, as ownor\� m�P�pe�y am oxd ng with |
�
contractors to oonotruu,mo project (Seo 7044 & Professionals
Code).
()|am'exompunder Section omPofor m��aoon_�______~
�
Date Signature of Ownern
WORKER'S COMPENSATION DECLARATION '
�~
| hereby a� -under p�alty`cx perjury one of the following declarations:
() | have and will maicertificate ovconsent mself-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.
I have and will maintain workers'- compensation insurance, ag,.required by
S 'Gon 3700 of the Labor Code, f6r the performance of the work'for. Which this
permit is issued. my workers' compensation inovmnoo oamo, & policy no. are:. �
Carrier - Policy No. `
'Ur,3CARE|1<3(%) 3{54- 1197-<4,179'
-
(This section need not 6e completed if the permit valuation is for $100.00 or less).
`( ) | certify that inthe, performance ofthe work for which this permit iaissued,
| shall not.,employ any person in any manner so as to become subjectmthe
workers!'Compensation laws'of California, and agref that if I should become
subje t to the workers' compensation proPions of ection 3700 of the Labor
.,Pate: —ILILA-1—PlApplicant
Warning- Fai, re to secure Workers' Compensation coverage is unlawful and
..7rt7re to
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition ~ the cost ~ compensation, damages �~provided for ^'~~~~~'~'`~-
ovthe Labor Code, interest and attorney's fees.
IMPORTANT Application isxo�mo�mmo msmmmg�d Safety
h`, a permit subject to mo *conditions and emhminno mm honx on his
application.
1.Each person upon whose behalf this application is made & each porknox
whose request and for whose benefit work ioperformed under orpursuant m
any permit issued uaaresult oxthis appnoamnagrees to, & shall, indemnify
& xo|U ha,m|oao the City of La Qumta, its officers, agents and employees.
o. Any permit ioovod as result of this appnoaxion b000moo null and void if
work ianot commenced Within 1enduys�from date hf.issuance ofsuch
permit, or cessation o,.wo,k/nr 1nodays ~m ou�uotpo�n.itmIoanoe||ohon.
| certify that | 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
constru'6tion,d hereby authorize representativesof this City menter unvn
m "uo 'monnnnoo property /
/signature(Owner/Agent)� �}�no�omV
BUILDINGPERMIT
9809403
DATE, VALIJATION $266,432,,74) LOT TRACTA 26152
JOB SITE
ADDRESS 477-550 VIA NOKYANA
APN
643-120-041
OWNER
CONTRACTOR DESIGNER ENGINEER
o7opRooymou'LowDIUVE, MTE 208.
1570 BROOKHOLLOW DRIVE, SUrIT 7.08
SANTA�ANA CA 9.270-5
SAUNTA AINA CA 9270-5
t-71.4)751-9151 CUM 4485
USE OF PERMIT
., if h4FLY DWELUNG
CONWCRUCT ION FVX 101-000-418-000
ELECIRI.C.Al, FtiE WI -000-420440 S204.95
2254)00-443.,342 S5.89i'18
LESS. PREflAID FEES
4250,00
NO
DATE
BY
IN SPECTOR
19RECEIPT4
JUT' bA15
'
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings _e
26
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
F.A.U.
Framing
_
Compressor
Insulation
_ Z —
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
— Z—
Drywall - Int. Lath
Q
Final
Final
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg.. 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
�y G
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
Final
Utility Notice (Perm) 4tisav
COMMENTS:
Desert Sands Unified School District
47-950 Dune Palms Road;
Notice: ' La Quinta, CA 92253,2
Document Cannot Be Duplicated 760-771-8515
CERTIFICATE OF COMPLIANCE
Date 11/10/98 APN # . 643-120-041
No. 17978 Jurisdiction ' La Quinta
Owner NameCanaday and Company Permit #
No, 47-580 Street Via Montana Log #
City La Quinta Zip 92253 Study Area
Tract # Lot # Square Footage 3,203`
Type of Development Single Family Residence No. of Units 1
Comments
At the present time, the Desert Sands Unified School District does not collect fee'son 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
1.93 X 3,203 or $ 6,181.79 the property listed above and that building•%/.:'
permits and/or Certificates of Occupancy for this square footage in this proposed project inay;now 65 issued
Fees Paid By CC/City National BarWSteve Sante Tclephone 7711=9636 n,:
Name on the check
f. 6 , i
By Dr. Doris Wilson .R
Superintendent
Fee collected /exempted by Juanita Green
Signature
Payment Received $6,181.79
Check No. 915541573
NOTICE: Pursuant of A40mbly 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
above will begin to run frbrn the date 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
collect them on the District('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
•,.Y®iC
4,4
:r714
0��
78-496 CALLE TAMPICO — LA GIUINTA,, CALIFORNIA 92253 –` (760) 777-7000
of FAX (760) 777=7101
. TDD (760). 777-1227 ,-
September 22, 1998
Mr. Steve Sante '.
Canaday, &• Co. i
"1570 Brookhollow -Drive., Suite 208.. .,
.Santa Ana, -Calif., 92706
SUBJECT: Approval of.Minor-.Use Permit 98-090 for Guest House
r Dear Mr. `Sante, r ti
Your request for Minor Use Permits 98-090 to allow a.guest house to*be constructed
at 47-580 Via Montana in Lake La Quinta has been'approved.'.You.will need to have
'
the, Covenant and Agreement recorded. by the County Recorder and deliver,a._copy of
- the recorded documents for' our 'files .'after' it. is ,recorded. Once recorded, our
department ' will give.. clearance to obtain a building+ permit for the affected. lot.
Enclosed is a letter to the County, Recorder indicating our, approval of the request.
,i Should -you"have any questions; please call me at (760) 777, 7064.
vvy
`• . Ver ,truf ours, • I � ~ • � r ?:.. t
JERRY`HERMAN
COMMUNITY DEVELOPMENT`• DIRECTOR t
.STAN B. SHWA'
Principal, Planner,.
sbs
enclosures r
C.. jGreg Butler, BulldingTar1 -Safety Department
all
c:\Itr appr mup 98-090
•, S v - e ' ` .• _.` , t♦ + if � •ZDV
MAILING ADDRESS �- P.O. BOX 1504 = LA QUINTA, CALIFORNIA 92253 '.
7J,La/�QJ•��' 1 7' 4 • »r+. at ff , 1 '• f
78-495`CALLE TAMPICO — LA CUINTA,,,CAL•IFORNIA 92253 - 1760) _7774000-
cF� of�wv FAX - (760) 777-7101, '
1 y TDD (760).777-!1227
September 22, 1998
County Recorder
County of Riverside
Post Office Box 1.51,,-',,{M '
Riverside, Calif. 9252 F '
.' SUBJECT: Recording of Covenant and agreement for Minor'Use Permit 98-090 '
Dear-Sirs: '
The City of La Quirita has approved thee, Covenant and agreement for Minor Use
Permit 98-090 regarding guest house restrictions. Please record the document;as
presented by Canady & .Company: ' r
Should you have •any questions, please call'. meat (760)'77.7-706.4.
Y Y Y •
Ver 'trul ours;' .. *
;'
JERRY HERMAN
COMMUNITY DEVELOPMENT DIRECTOR
SUN. B.
Princial Planner'
sb's
`enclosures r
c: Canady & Company,
• '7f .. t * � : -� l,' ..fit � ... , - '` �. '- r Y • ; ,
c:Utr co rec ro6p98-090
y ° MAILING ADDRESS' P.O:`BOX "1504—'ILA AQUINTA,4CALIFORNIA'92253 ��,
RECORDING REQUESTED BY:
Canady &. Company"
1570 Brookhollow Drive, # 208
Santa Ana, California 92705
' WHEN RECORDED PLEASE MAIL TO:. '
Canady &, Company
1570_Brookhollow.Drive, # 208
Santa ' Ana, California 92705 f
,.
*COVENANT A.ND'AGREEMENT RESTRICTING' THE USE, OFA DETACHED- GUEST.,
HOUSE AT 47-580VIA MONTANA, LA QUINTA, CALIFORNIA'
This`Covenarit and Agreement are made and executed on this the 18T" •day.of
September, 1998;. by Canaday & Company, jor property. described herein. The, City {
.of La Quinta, a Municipal Corporation, is hereby'made a party to this agreement for the
purposes set, forth below. a
The undersigned hereby certifies that he is the property. owner of the" following
described real property in the City. of La Quinta, County of Riverside, State of
California: w'
r Lot 269, Tract. 2615.2; as shown by Map of file in Book 227, Page 77-78, of.
Maps,,Records of Riverside County, California (APN: 643-120-041)
In consideration,of the City ,of, -La Quinta issuing a building permit for certain
•improvements which will be constructed on said property, the undersigned. does {
'
hereby covenant"a'nd agree to. and with.said City to'restrict the ^use of said property '
as follows:
1. The guest house may not be rented -or sold independent of the main
single family residence (Minor Use. Permit 98-090). ,
2. The detached guest house is intended for use by the property owner •and
does not have a kitchen. per the provisions .of the Zoning 'Code. 'The
guest house is for sleeping or recreation purposes of the on-site residents
and their non-paying guests or employees, pursuant to Section 9.60,100
of the Zoning Code. ,
This covenant and agreement shall run with the land and shall be binding upon
-future owners, their successors, heirs, or assigns, and".ourseIves, and shall continue
p:\stan\gh coven mup 98-090 Page 1 of 2 .
in effect while said second dwelling unit remains on the real, property or unless
otherwise released,by the authority of the City of La Quinta:. This agreement shall be.
entitled to the remedy of injunctive relief in addition of any remedy in law or equity.
This covenant and agreement and the provisions hereof are irrevocable and
nonmodifiable except by the written consent of all parties to .the'agreement, including
the City of La Quinta, a Municipal Corporation. The City shall have the right to enforce
each and every provision hereof and. the parties agree: that the agreement shall not be
rescinded, revoked, modified,. or otherwise amended or changed, without the
expressed written consent of the. City first being obtained. '
In the event that the owners, their heirs, assigns or successors in interest, shall
fail to :perform any obligation hereunder,-they hereby agree to pay all costs and
expenses incurred by the City of La Quinta in securing performance of such obligation,
including attorn6y's fees.
Dated: ` gg
By: Z�
By;
v•
Christine di. I�io, 'PI nning Manager.
City of L.a.Quinta
Note: All signatures are to be notarized.
p:\stan\gh coven mup 98-090' Page�2 of 2
State of California
County ofRiverside
On' to,lq $ before me, Phyllis Manley; Notary Public; personally, appeared
Stephen L. Sante ; proved tome on the basis. of satisfactory evidence.to be the person whose name
is•subscribed to -the within instrument and acknowledged to me that he executed the same in his
authorized capacity; and that'by his"signature. on the instrument the person or the entity. upon behalf ,
ofwhich the person acted, executed the instrument.
WITNESS my hand and official seal. (Seal)
Document Description: Covenant & Agreement restricting the use of a detached guest house at
47-580 Via Montana, La Ouinta- CA.
Number of Pages: -2
` " Date of Document: 9/18/98