9806-160 (SFD)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.Buslness and
Professionals Code, and my License is in full force and effect.
�.. License # . Lic. Class Exp. Date
Datertl, Signature of Contractor
OWNER=BUILDER BE�LARATION
I hereby affirm under penalty, perjury th t 1`I am'exempt from the Contractor's
License Law for the following reasory
( ) 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).
(, :) 1, -as owner,of'thepproperty, am exclusively,contracting with licensed
contractors to construct. the project (Sec. 7044, Business & Professionals
Code).
O 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:
Cartier Policy No.
TATE V12,11) ,44244
(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 Californi ,rand agree that if I -should become
..subject to the workers' compensation jprovisionsdof-Sectiooi 37.0• o the Labor
Cpde,.I- ti 1) fo h;w t comply with those r visions.
iDaie: d Applicant �i'� 7fines
"
Warning: Failure to secure Wof s' Compensatione is unlawful and
shall subject an employer to-cri . Inal penalties and cip to $100,000, in
addition to the cost of co4erfsati6n, 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.
1 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"�'p• ection parpos s: 4
Signature (Owner/Agent) lrt` Date
BUILDINGPERMIT PERM T# , CONTROL#
DATE VALUATION.. LOT TRACT
JOB SITE' _ _ ~�
r
]APIN
ADDRESS
7/73-2-73-01.7
OWNER
CONTRACTOR / DESIGNER / ENGINEER -
Cir S i.�. 1 \11� i/,) ;�.4"f�7�1•� ii'i �J
y
tS,..r,SI
CA 91n,55
.i'ALM.DESEXT A 9.2,1_5a
USE OF PERMIT
'�u'c;R f D nt�9`i,Eic._iIJ.[.�83 : �40I ..i li? X St:iRVID- t AL'75�4JKA3�i'
l,11EC .fi1VUC t'rt)N .f \PLAID, V45(ki1"C f,klElfs KiiT 3?gCLU0F1 POOL oft
PtIr Ir. WALLS
ads. � c<�.�;hjS'I'ftU�'a:IG2v' • ' i,;.373.E1t1:�i;` ' i .
,
'03.00 SF
Cs.f\�/•1C4}i�/�; f�f24�ia:Z�l' , at�6.tli `;A� �
.,•
S :h `1': W00..0 FENCE _ �fQ.Cf� :LF
C,M. "f 0 CON SI'1tV.f.`10-14'; �
.::,, _ 'up'.71)7:i0
7 ?� ss&x�c a 9TAna+Yd ala'S'13M.A711ED
-
C�ESS'1"1i>Llr °TUl '►?? k? 10.4-000-418-000
MAIN C:4 O >r'RE 114)
ft^uCf�"t1o�.t.�iG�L � •111t-€iCtti�iEl_p?�1 ..,. : �; $�'a,>�
.
(11 u tCtMAL 1 i G r -.:5a
n.;(i'loEf[2 o;x - 101-000-41940'. $1" 7.sc)
ISTI d.(YNG 4dso im x'6;;4?.,. iZ.M .• m 10! -000-241-000
-100
GitA1.7f1v°; � 1, �7' 1t?s 0t2f,)�=i?'?ti>� $'tt �:�
•
1N 1 �1�Si"Itis 't M.E. T2 000- 43�-34' `j,fst3:�.41
PRECISE'- PL;<1N 1:09-000-441.-3445
d ORF, D, `4'�0,81T t; {r0?-000434?;,:.1
} ,a
AND PLAN CH -D. -X.
, $2,956.54 '
• Lt SU ial�E:iy.C.r'id1� FEE
, . '•$no.00
JUL 3'10199&
VITAL PERMIT 34.VES DUE NOW
�S�9tf16.
FRECEIPT
DATE ,' BY `
DATE FINALED
INSPECTOR
INSPECTION RECORD
' OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Roof Deck
_ _
//�
Combustion Air
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
A
Compressor
Insulation
_
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall oe
Exterior Lath
_jV
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL
APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
_
Waste Lines /��9
Water Piping
Gas Test
Electric Final
Heater Final
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
Appliances
Final
COMMENTS: -
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)
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 7/30/98 APN # ' 773-273-017
No. 17413 Jurisdiction La Quinta
Owner NameWorld Development, Inc. - Permit #
No. 52-405 Street Avenida Villa - Log #
r
City La Quinta zip 92253 Study Area
Tract # Lot # Square Footage 1,375
Type of Development Single Family Residence No. of Units 1
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered s
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 ,:n tii'Kamount'of
1.93 X 1,375 or $ 2,653.75 the property listed above ani. thitliuilding.0.
permits and/or Certificates of Occupancy for this square footage in this proposed projPct may new be 4ysued,
Fees Paid By CC/1st Community Bank/World Development, Inc. T lephorey 7715571
Name on the check
ByDr. Doris Wilson nor ` '1'�`'s:
Superintendent
Fee collected /exempted by Juanita Green Payment Received X2,653.75
Check No. 081179
Signature
' (NOTICE: Pursuant of A6sembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may pretest the fees or other payment identified
above will begin to rur{/rom 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. f
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 1.
_ T
Z
FROM PHONE N0. 7715070 JL-n. 18 1998 04:08PM P3
Fidelity National Title Company
72925.Fred Wining Driva Sui(p 204 . Palm'Desort, CA 32260 -.
(rGo) 341.A102..FA,' (750) 341.2076
SALE ESCROW INSTRUCTIONS
Date: June 2, 1998
..lot 7 " :
YOUR COPY TO KEEP
Block 101
Escrow. No.: 1592-ST
Escrow Officer: Shirley Thompson
_Buyer will execute and deliver new Loan
in the amount of ..... , .. .........:........... .... S 12,200.00
Prior to the close of escrow,.Buyer will hand you the balance of down payment
plus closing costs, the sum of.................. : .............. . S 800.00
TOTAL CONSIDERATION .... _ . . . .. . ....... . ............... S" 13,000-00
AND, on or before May 27, 1998, Escrow Holder will be handed additional funds and/or instruments
required to enable Escrow Holder to comply with these instructions, which Escrow Holder is instructed
to use when in a position to procure/issue a Joint Protection Policy coverage form Policy of Title'
)nsurance from Fidi;W.Nationol Title with a liability of 813,000.00, covering the following described
property located in the City of Le Omnia,. County of Riverside, State of California:
Lot 7, in Block 101, of Santa Carmelita at Vele La Quinta, Unit 11 as per map recorded in Book 18.
Page 75 of Maps, in the Office of the County Recorder of said County, California.
SELLERrTRANSFEROR STATES THAT PROPERTY. ADDRESS IS:
Vacant Land/APN #773.273-017, La Ouints, CA, 92253 .
SHOWING TITLE VESTED IN:
World Development. Inc., a California Corporation
FREE FROM ENCUMBRANCES.EXCEPT
1. Current general and special taxes for the fiscal year in which this escrow closes, and taxes for the
ensuing year; if any, a lien not yet due and payable; ,
2. The lien of supplemental taxes,, any, -as essed':pursvent to the provisions of Chapter 3.5,
(commencing with Section 75) of the Revenue and Taxation Code of'the State of California;
3. Bonds and Assessments with no delinquent payments, if any;
a. Covenants, conditions restrictions, reservations, easements and rights of way now of record, if
any:
S. A First Decd'of Trust. to'record, securing a note in the amount of $12,200.00 in favor of Hubert
Walter Hansen and Anna Marie Hansen, Co Trustees under the b0claration of Trust Dated 8/1 1x76'•
PRORATIONS:
Prorate as of Gose of EsetOw, on: the basis of a,30 day month:
Taxes
CONSUMMATION of this escrow is- CONTINGENT UPON THE FOLLOWING:
1, NEW LOAN: Buyer to execute a new First Trust Deed and "Note, to`re0ord on your usual form
dated during escrow, in She amount of 512,200.00, in favor of'Hubert Walter Hansen and Anna
(Aerie Hansen, Co"Trustees under the Delclaration •of Trust Dated 8/11 r76, OR -ORDER, payable
at the place as designated by holder hereof, atthe rate of no interest due at which time the entire
unpaid principal balance will be all due and payable 2 years from the close of this escrow.
Escrow holder is authorized and instructed to insert,the appropriate maturity date on the face of
the Note, over and above the signatures of the Buyer, at close of escrow without further approval .
from the parties herein.
• I ,
Escrow Holder is relieved of any and all liability.and/or responsibility with respect to the terms and
conditions of said Note and Deed of Trust including," but not limited to, the validity, sufficiency.
enforceability, and/or collectability of some. The undersigned hereby acknowledge they haveb,een
advised by Escrow Holder to seek their-own independent counsel as to all matters concerning the
recital(s), if any, contained therein.
The parties hereto recognise and acknowlodge that the comprehensive National Energy Policy Act
of ,1992, affective January 1, 1992, provides in part that In the event this transaction involves a