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0110-272 (SFD)W H N U) W p ch d o Z r - CSD 0. C J D F - Z C'o LO N ON CL Q T cc Q O xw— J. Q Q. U O U, Il MH rZ_ Co 5 r- Q Q J 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 Busir?ese"ani" Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date Date © Signature of Contractor'_ OWNER -BUILDER DECLARATION I hereby affirm under penaltyof perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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, 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 under Section B&P.C. for this reason Date 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. ( ) 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 is issued. My workers' compensation insurance carrier& policy no. are: Carrier Policy No. EXEMPT (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 of the Labor Code, I shall forthwith comply with those Provsions. Date: ")� I Hd Applicant" 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 ins action purposes. Signature (Owner/Agent) u-' ^~"' Date'jep & 4 BUILDING PERMIT PERMIT# DATE VALUATION LOT 1_'yy3"rZ TRACT RIX 49 TT4 JOB SITE ADDRESS " APN 1-299 AYF.N A DI".77�-i1�'�4i2t OWNER CONTRACTOR /DESIGNER / EN (NEER SAI+1T.tb ROSA 171 VEMOPMW 11C MOJAVE TA L DW P,O.BOX.113x5 31.898MOB WAY 11 t PALMDESE d1; CA. 92255 LAQTWrA, CA 92253 (760)341-3949 C3 UF' 4360 USE OOFPERR\MIIT44 Q lya gyDWRI{ W/ SFV - PERMIT 00.0 NOS` ►NCI:UD1, SLCICK tri►,AUi,, .F004 SPA OR DRIVta'WAYd's.PI+ROA,CR 82JE Sil.iFs-j tRT, CTSTOM C-043TROCTION 40crZOD 3 PCJ12f fYWATIO 30.000 SF Cl;t'tl2AMMA..ItPORT 4�)XO 8F mugWrAID COST €, F f:.'67�1K, ., �WC`-M0H }}��yy;;YY }},, ��y-yam .i."dSnMITY 9 i316P-A'�'4r�'J14+1,J.C..Y CONG"MUCTION FRE 101-000-438-000 S PL.AX CH V1Lluu'' 101-000-4.29-3118 $735.19 FEE DEPOSIT 101-000-439-318 47%00 11X'tWH AXIC.AL FEE 101-000-421-000 $66.50 EUCTIUC:AI, ice!? 101 -000-420-000 x1273 K.UMBINO 1TZ 101 -000-419-000 $113 �5 5TI 140 MOTION PEP,-RESID 101.300,241-000 S+I6151 OFL%DINQ PZZ 101,000-423-000 $20.00 NV);";1ot.7PE'R IMPACT IT, $1,907,00 PRIKIC11HP PLAN 1.01 -000.141 -US $180.00- . yRUS:''014 WD PLl-`S CHMi:IC. U 711.103 PRU-.P a"�.S 4VAO�f)c MAR 0 i 2n92 I ` AIL rim' 'M I n8 Dr7p, NOW �PYY®FLAQUIR TA FINAKFOEPT V3,7700. 3 RECEIPT DATE BY: DATE FINALED INSP Ojj INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms& Footings 7f,#4,. Ducts Slab Grade Return Air Steel _ Combustion Air Roof Deck -O Exhaust Fans O.K. to Wrap - io—p y 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 $et Backs Electric Bond ootings Main Drain 3ond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines - - p G,/� Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Stiower Pans O.K. for Finish Plaster Sewer Lateral Sewer Connection Gas Piping`/ / ZS <, .� Z Pool Cover Encapsulation Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp.rPower 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 p Utility Notice (Perm) -dam ,� COMMENTS: ' 9 Vim, CITY OF LA QUINTA SUB -CONTRACTOR LIST ,�Af r JOB ADDRESS �� a 9 ���Z PERMIT NUMBER OWNER -5�'� Go rr BUILDERS This form shall be posted on the job with the Building Inspection Card at all times in a consp cuous place. Only persons appearing on this list or their employees are authorized to K on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the void ce of building permit. For each applicable trade, all information requested below must be completedby applicant. "On File" is not an acceptable response. Trade / Classification Contractor ' - :: .•.'::: State.Contractor's License >:. : •:•. Workers Compensationansiirance .;. City Business`License Company Name Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/)!x/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-1 2) c�gj� l0 2-2 -� 9- X2V✓1 �� oq 3lot� �� g�03 CONCRETE (C 8) LA t/1 /� Q �ro`f`hcuS C -'g 7 GO 7 q � 3 3eti O r T �� r.�—, D =Y �(5� __ _loott000 4 y9^ / -1 -03- . O p 632 FRAMING;(C-'5)..:.:;.:.`:,,:.;::. 6xVVJ8VA w� Q SD 9' 30D AlO AS S-e'7vfc�� iiUGl/ gsl,3(P/ STRUCT. STEEL (C=51) N MASONRY (C 29) .' j PLUMBING (C 3til ,> �(� (%!1 DI -t {e L� iP i't �L %1;03 I <�f( .:f d(zA ���7 �� I / ®� (per% q % LATH; PLASTER:..(0:'351.: ��vn 01a0in Co //6//23 ,, -7 �l�b�� r,�I)103 '7f 31103 VT`zV� f q -4a 15-7(v7 j �` 4� 03 d11' DRYWALL (C-9) 5 V4 (I r 1�cwi /1 CO lo%�(o% �i (I I J 6`7 1 T—O ( i D Z Oo . .� �$ f0 1` HVAC IC 201 PCI G C2o /G �$ �% 01 S2 _ I.� 1 a,!'rM c%tp✓► O I !< (2 002 SS$ -t Ilip 2 OI Ol4 03 - ELECTRICAL (C7.:10) : Lei��l �O �ct -30-03 5+4 122Q OZOOfy.3,ge' 111103 0/9$1+ 2,5/c,2- ov- ROOFING (C-39) �� /r �/e) �I�jOlO'L! o���"D ��pZgj X11 n3 p2 in" SHEET METAL (C 43) FLOORING (C 15) I�UAh, i. \Q C•5 (P9 0 M31102- S'T-`l �t.4V�'�A''1't f l'T2�3 gq!.'t�% /!// D O� ��3 D GLAZING (C 17 ) t lldov W O� t' s pe lv` L �7 " CS) X378 •9 7 3� �_ 3 a ,�rir, cs,� °-"Nwc 12� z 300 �// oa- 0-3. 0 3S I2/ "� 2 INSULATION(C21 PlGVatgV1 .��o3i' � 1� �tS ,- c2,�J^u� 122E.ID2S � q3 0329/ 2y/02 p1L SEWAGE DtSP (C-42► ��-- � �� PAINTING (C,-33) -' Q� l!� kJ �t 1 CX �•�S J 7 00 D 4 3 6o L CERAMIC TILE (C 54) I�Gf(/!')/L2 G S� %�{?'Zr�J�;'' -alp 3j 0 r fI S-l�'�C �tt.nc4� ��i2 3q$�- 0 I s �(f/ f/02 �� l3 oZ �L CABINETS (C 61 FENCINGIC3) (i?'►oly&t4�f� 2Z- ?;,� eXr�nPT :, . ' 74vh 4c. � 01 7? 03 ��e 1D 11�-7� LANpSCAPING (C 27) -.:. Q a v.e. �� `�l,��c� CC5 � �BSi���Z � u4 BOO r � v tL J.'A it 15rv`«cc .wr�sKgrr, w� ""t Of aw %l/ 4W101f I Al� P.O. BOX 1504 APPLICATION ONLY �Plg�� Building; f _ a L/ G1 �1 V� 1 �y 78-495 CALLE TAMPICO Address � / � 4 LA QUINTA, CALIFORNIA 92253 U` I )1O - 2r7 Owner _� Owner , Ro}c, Mailing 6rl J2S Address , / .J City ,f'-- 1 o-) OC6-Ari 2 of 1 D I) " vt'i L- r L • C, 22 SS t,onuactor, �41r�ruT_I3�-,f1���s Address. Pitt, 1 13 BUILDING: TYPE'CONST. OCC. GRP. A.P. Number /-73 - 043— O2 1 :I. y�(og ` S2J Lo r 7 a4r Uy0Legal Description { (j. 408-7,57 �p.'j "7� Project Description 1, "? - E r i f I , . OO / .l V Cir/t�1► orse f ZI� 2 S S Te 7 S- 76S7 State Cla sif. S �J't B 6 2 2 LicCity B # rarcn., cnyr., Designer Address CityI Zip I State I 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 ellecl. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,9usiness 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). l_1 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.) I 1 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.) 1-1 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 n 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 (5100) valuation or less.) I certify that in the performance of lhg 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, 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 Ihereby 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 Sq. Ft./ No. No. Dw. Size Stories Units Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT 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: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 2/25/02 APN # 773-043-021 No. 22984 Jurisdiction La Quinta owner NameSanta Rosa Development No. 51299 Street Avenida Diaz City La Quinta Tract # Lot # Type of Development Single Family Residence Comments Zip 9225.3 ew Single Family Residence - 2007 sq. ft. Permit # Log # Study Area Square Footage 2007 No. of Units 1 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 2.14 X 2,007 or $ 4,294.98 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 1st Bank - Vince D'Ambra Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Crystal Scott Signature 6 Telephone Payment Received Check No. 61380 $4,294.98 40TICE: Pursuant to 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 rbove will begin to run from 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 pllect 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 0-HABLES ®. GARLAND """ Architecture, Interiors, Space and Land Planning Structural Calculations 20 April 2002 The City of La Quinta Department of Building and Safety 78-495 Calle Tampico La Quinta, CA 92253 Project: A Single Family Residence for: Santa Rosa Development 51-299 Avenida Diaz La Quinta, California Regarding: Project Structural Observation To Whom it May Concern, I have been asked by the developer to certify and observe the structural components and system For the project noted above. To this end I visited the job site and walked the project on or about 5 April 2002. At that time I found all of the structural system to be in substantial compliance with the structural design intent of the structural design documents generated by my firm for the project. Minor blocking and strapping issues were noted and addressed during that visit. All other aspects of the project's structural system have been observed by me to be in substantial conformance with the structural design intent of the construction documents. If you have any questions or comments regarding these issues or any other issue please do not hesitate in contacting my firm. 74.854 Velie Way, Suite 5 ❑ Palm Desert, CA 92260 ❑ Phone: (760) 340-3528 o Facsimile: (760) 340.3728 RECORDING REQUESTED BY Old Republic Title Con>pany ORDERa 521249 /Esc4604596-LCE APN 773-043-021-1/TRA:020-017 WHEN RECORDED MAIL TO r SANTA• RDSA DEVELOPMENT Name LLC C Street Address 40847 Sandpiper Court City Palm Desert, CA 92260 State ZIP L _J DOC N 2001-477724 10/02/2001 08:60A Fee:8.00 Pape 1 of 1 Doe T Tax Paid Recorded in Official Records County of Riverside Gary L. Orso Assessor, County Clerk 8 Recorder 11111111111111111111111111111111111111111111111111111 M S U PAGE SIZE DA POOR NOCOR SMF misc. A R L COPY LONG REFUND NCHG E4 Grant Deed The undersigned grantor(s) declare(s): Documentary transfer tax is S 81.40 ( X) computed on full value of property conveyed, or ( ) computed on full value less value of liens and encumbrances remaining at time of sale. ( ) Unincorporated area: (X ) City of La Quinta ( ) Realty not sold. FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Michael J. Beaumont, as Trustee of the MICHAEL BEAUMODTT, M.D., INC. CCMBINATICN RETIRDMENT TRUST,U/ A, dated 05/07/86 hereby GRANT(S) to SANTA ROSA DEVELOPMENT, LLC that property in the City of La Quinta, Riverside County, State of California, described as: Lot 7 in Block 49 of Santa Carmelita At Vale La Quinta, Unit No. 4, in the City of La Quinta, as shown by trap on file in Book 18, Page 62 of Maps, Records of Riverside County, California. Mail Tax Statements to Grantee at address above Date August 6, 2001 STATE OF CALIFORNIA COUNTY OFf.'�i� I�(I,�_�� r On l C-5L1S� 1 4 7 ��f before me, the undersigned, a Notary Public ini aDid for said State, personally appeared (or proved to me on the basis of satisfactory evidence) to be the personN whose name is At subscribed to the within instrument and acknowledged to me that hbyt executed the same in lfthbir authorized capacity(TeK), and that by(fi§t cl*heir signature(t) on —TSe instrument the persons , or the entity upon beftalf of which the person acted, executed the instrument. WITNESS my hand a of' 'a cal. Signature AA // Name C�f���s,� AA (typed or printed) FrGIS-1140 &94 Mlc 1Fae`1- J`.� Beaumont; Trustee CRM M!11J32 Comrn:S5:_MG1 p 1281377 Z Z Notcy NubAc_ -- CoDfomfo San Diego County Comm. Nov 18. 2lItY4 MAIL TAX STATEMENTS AS DIRECTED ABOVE (This area for official notarial seal) Order: AUTO -KC -00007844 Description: 2001.477724 Page 1 of 1 Comment: U OLD REPUBLIC TITLE January 03, 2002 12:28:27 pm PST Report Origination ID: 15-R12-3000 RIVERSIDE COUNTY 2001-02 TAX ROLL Customer Service Request APN 773-043-021-1 PAYMENTS AS OF 12/14/2001 TRA 020-017 - CITY OF LA QUINTA Legal LOT 7 BLK 49 MB 018/062 SANTA CARMELITA VALE LA QUINTA UNIT 4 Mail 17776 BELLECHASE CIR SAN DIEGO CA 92128 Acq. Date: Doc No. 10/1993 : 0399520 Assessed Owner BEAUMONT MICHAEL J Assessed Land I Net Fund Type 68-2382 1915 BOND 68-2373 LNDSCP/LTG 68-4882 MISC ASSMT TAX CODE USE CODE 000 YY • BILL: 000405216 Values Taxes 64,856 Status Payment Date Total Tax Tax Install Penalty Balance Due 64,856 Total Taxes Due Special Assessments Included In Tax Amounts Description LA QUINTA AD 92-1 LA QUINTA LDSCP & LTG CVWD STANDBY CHARGES Total Of Special Assessments Additional Property Information VESTING PUI CODE NO R07 , Reference Notices End Of Report 1st Half 2nd Half DELINQUENT OPEN 1,128.60 564.30 564.30 56.43 66.43 620.73 564.30 1,185.03 STAMP AMOUNT 63.25 F Amount 381.58 11.74 10.00 403.32 Old Republic Title Company Palm Desert Page 1 of B1Thursday, January 03, 2002 ". 0 lIKrO II OIKIO (611 (Gold ^ON (�� 'I!lo)'RIun00apislania l�`� MIR SR � � � � tt °� W 'Od M 'NA A S-SOSS3SSVPD1 M J3 M �tssa tl�ra rc t 'ON V1NIf10 V1 31VA IV V1113H8V3 VINYS B/811 '8'161 • • SC 9 9rro ron / ��_ J, �y [6�..[6 s i1 ra fuG L661 8 0334 .� o �J• J.J 9I 111 / i e l It N a l 9Z . 1 1 t l— '.O it G -10 1 V's re eel eel 9m Q r! 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X3 Vl ' ' 11 ZI II 01 6 6 x3 x3 .4 I x3 `'JFr6'9 a3 es x3 x3 x3 as3 I el•Ir Gs as [s as Wes S31INNICHO 3115 5NI01109 80 11145-101 1YO01 HIM Aim 1011 AV" L — 860-OZO 133 1j s.aoss3ssr HSOHS vivo 3x1 to unvaly 3N1 ao3 a3nssv sl L L tt0-OZo 'V'a'1 vigin0 Vl 30 Am 40 A1111Bp11 ON '4100 MOM 1H3PSS.My MI ON0'd3Nd SVA M SIH! 39 A 59 1 l MAN 1.. i s s v e HONI NV 40 OL/L N131vos C„W, 12 December 2001 The City of La Quinta Department of Building and Safety 78-495 Calle Tampico La Quita, CA 92253 Project: A Single Family Residence for: Santa Rosa Development 51-299 Avenida Diaz La Quintal California Regarding: Review of Truss Calculations To Whom it May Concern, CHARLES D. GARLAND Archifecfiu; Interidrs, Space and Land Planning Structural Calculations I have been provided a copy of the manufactured truss calculations prepared for the noted project by Spates Fabri- cators of Thermal, California. I have reviewed the layout and profiles and have found them to be in substantial con- formance with the structural design intent of the structural calculations and design of the project. If you have any questions or comments regarding this issue or any other issue please do not hesitate in contacting my firm. Charles D. Garland Architect 74.854 Velie Way, Suite 5 o Palm Desert, CA 02260 o Phone: (760) 340-3528/Facsimile (760) 340-3728 Certificate of Occupancy City of ..La Quinta Building and Safety Department This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS: Use Classification: SINGLE FAMILY DWELLING 51-299 AVENIDA DIAZ Bldg. Permit No.: 0110-272 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RD Owner of Building: SANTA ROSA DEVELOPMENT, Address: P.O. BOX 11335 LLC City: PALM DESERT, CA 92255 By: KIRK KIRKLAND Date: JANUARY 31, 2003 i Building Official