11587 (SFD)Building
Address 51 --
Owner
4
P.O. BOX 1504
78-105 CALLE ESTADO
1%z74il \ A 174 1 1 m LA QUINTA, CALIFORNIA 92253
mailing
Address 46745 Monroe St.
City Zip Tel..
India, CA 92201. 342-5029
Contractor
Corner S tone
Address
City Zip Tel.:
Bermuda da ounf?n 92201 345 -
State Lic. City
& Classif. ,»,, , _ Lic.'#
Arcn., Lngr.,
Designer
Address
City( Zip ( 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.Busi.ness•and Professions Code, and my license is in full force and
effect.✓,�r! i" %��l /�; r�
SIGNATURE s'•'/••�----'_"-" .I DATE
a
/
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).
❑ 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 projectswith-acontractor(s) 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.)
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 i1 the permit is for one hundred dollars ($100) 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 Ownei
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.
1 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
r. Mailing Address
City, State, Zip
BUILDING: TYPE CONST. • SFD
rho. 11587
OCC: GRP.:
A.P. Number 773-143-023
Legal Description List 11 black 112 MB 018/079
Project Description
Sq. Ft.
Size 1394
New ❑ Add ❑
Permit does
Estimated Valuation
PERMIT
Plan CW `Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
No. No. Dw.
Stories Units
Alter ❑ Repair ❑ -Demolition ❑
$83.325.0
11
AMOUNT
237.83
567.50
121-75
157.50
8.40
20.00
1,836.43
25;00
3,023.41
ZONE: - BY:
Minimum Setback Distances:
Front Setback frim Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
,FINAL DATE 'NSPECTOR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CARP. SO. FT.
WALL SO. FT. ®
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM. FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE p DRYER
GH WIRING.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FOUND. REINF.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
METER LOOP
KITCHEN SINK
ABSORPTION SYSTEM B.T.U..
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
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 ® 1 Vic
SEWAGE DISPOSAL
=$
SO.FT.GAR ® 3/ic
HOUSE SEWER
FINAL INSP.
FRAMING '3-23-53
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWEFI,- R SEPTIC TANK``.CY 1
��[[
Cl3
GH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING '3-23-53
FINAL INSP.
ROOFING -3 ` t / _G 3 ��
ux
�a 9
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A t
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REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
/�
THING .3 —2_-(m Lh
MESH
INSULATIONISOUND 3
31J
FI
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
• 82-879 Highway 111
NOTICE: K Indio, CA' 92201
Document Cannot Be Duplicated (619) 347-8631
Date 11/30/92 • -Type of Permit JLaQuinta
No. 11869! ' ` . Permit #
T 1'
Owner Name Evelyn V. Greybill. Log
No. 46745 -street, Monroe Street
City Indio Zip 92201.,' Study Area 115
APN # 773-143-023 Tract # I Lot # 11 Square Footage 11390
Type of Development Single Family Residence 'No. of units .0
Comments Lot 11 -block 112 MB 018/079 -
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 1:58 x 1390 or $ 2,196.20 have been pain 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 Cornerstone Telephone 619'.3,45 01+1:3'�ta
-Name on the •check�a
By . Tams F. Lively s
Assistant'Superinten' dent Business Services
Fee collected /exempted by Peggy Reyes,
- Payment Received �
• r
Signature -
` Clkeck No.3212
Collector: Attach a copy of county or city plan check application form to district copy or all waivers.
Embossed Original- Building Dept./Applicant Copy Applicant/Receipt. Copy - Accounting
,1 t.
RECORDING REQUESTED BY
GO
8
AND WHEN RECORDED MAIL THIS DEED AND, UNLESS
OTHERWISE SHOWN BELOW, MAIL TAX STATEMENTS TO:
NAME
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N
STREET Evelyn V. Graybill
T�
AOORESS 12705 Kalnor
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C,TI• Norwalk, CA., 90650
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Title Order No ...............:........... Escrow No .........................
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Grant . Deed,'
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This space for Recorder's.use �: .• A �!
THE UNDERSIGNED CRANTOR(s) DECLARE(s)
DOCUMENTARY TIiANSFER.TAX is $ ,
'-unincorporated area Q City of i ( a r „
Parcel No.
`computed on full value of property conveyed, or
❑ computed on full value less value of liens or encumbrances remaining at lino: of sale, and
FOR A VALUABLE, CONSIDERATION, receipt of which is hereby acknowledged,
ROSALIE L.'TORTILLO,
hereby GRANT(S) to
EVELYN V. GRAYBILL, a single woman
the following described real property in the CJ� �� ��� �� ` (yv •n �. c>,.
County of Riverside , State of California:
Lot 11 ,'Block 112, of Santa Carmelita at Vale La O,uinta,
Unit 12, as per. Map recorded in Book 18 Pages 79..to 8C
of Maps, in. the office of the •county recorder of said county'. - s
4,
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DateApril 19, 19ad
-
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STATE OF CALIFORNIA ) Rosalie L. Portillo
COUNTY OF Los Angeles } Ss.
On Apri 1 24, 1984 ))
)cfrmz! Inc; the under�
signed, a Notary Public in and for said County and State, personally
appears ,;--RosaI ie L. Porti I lo-,
-,
Proved to me on the bast of a I�
fnrtory evidence to be
Vi✓YWA(lhe
to be the person whose name 1 s subscribed to the within
instrument and acknowled ed that she executed the same.
G c,tL-
Name ( Typed or Printed) 1
Notary Public in and for said County and State
OFFICIAL SEAL
�YANDREW J. MICSKY
NOTARY PURL r; _
CALIFORNIA
PRINCIPAL„ OFFICE IN
LOS ANGELES COUNTY
YI Cmamission,Expires-!Nay 23;'1986
( Space above for official not -trial seal)
MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SO SHOWN, MAIL .AS DIRECTED ABOVE
2461 Name Street Address f City !r State
yr "
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This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building:,'
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Code certifying that at the time of issuance this structure was in' com liance with the various.'
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ordinances -of" the City regulating building, construction or use. For the, following:
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$ K
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BUILDING ADDRESS 51-725 Avenida Villa
'
use Classification - Single .Family' Dwelling`s Bldq. Permit Nti: ..11587.
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Group �R3 Type Construction' 'VN� Fre `Zone _ Use Zone, "SR'
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Evelyn AV,. Greybi'll 46745 • Monroe St.
Owner. of Building Address -
;
City Indio, CA L 92201 Mark Harold
j
Dote: August 3; 1993
I
Building' Official e ,; _- ;' �...` + r_ •; _
„ POST IN A CONSPICUOUS PLACE
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