9607-113 (SFD)H
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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 Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
5W22 813 110 7
Date y'[/ /�Signature of Contractor -P ~
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of 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 fXRNfPT Policy No.
(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,*1allorthith comply with tho �ovisl • ns.
Date:/! ApplicantWarningFailure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civilfines 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
corr9,ct. 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 fo nspee?ction purposes.
Signature (Owner/Agent)"-.r''r'-- ""` Date'" !T qo
q
BUILDING PERMIT PERMI96017-113 CONTROLft
DATE 7tZW96 , VALUATION ' �. LOT TRACT 3876
JOB SITE
ADDRESS t'���iN10A I'3ERRLL� RA APN
ADDRESS
OWNER
.'FTS t Y A.. POW FRS, A[.tS•i' E 4
.73149 SKYXViVd) vVAY . -
VALM DESERT CA N260
USE OF PERMIT
S- INQL,6 IA9t1.ILY
I _
CONTRACTOR/DESIGNER/ENGINEER
;N10JA0'.E HU110FR;_N'
L .A QlANTA CA. 92253
504-0148
04.1 4GE cal OW1dO & CONTRACTOR. NO C"•HflROR t'FiZ,&UT, (,/14/96 O4Y(+t01-01A.V40.0
(_,X)N1'1? ,1.TARPIMM.1'2'0.)ITC-0FMNEWCO NTRAr,770%
j SI'MA'1EX)%'(KVF.,®F C;O NSTRU .I'iaMN
:X11-':iULA:L C.X)Ivrt" 1R.UCJ 1(3N ,SND 1 t4N CHLC:K
LESS Pr V1_P1k1 F . S
r."
DATE BY DATE FINALED JINSPECTOR
INSPECTION RECORD
.., f
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS .
POOLS - SPAS
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
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 G (v
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)
COMMENTS:
Certificate of. Occupancy
City of La Quinta
Building and Safety Department'l
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
ollowing:
BUILDING ADDRESS: 53-960 Avenida Herrera
Use Classification: Single Family Dwelling Bldg. Permit No.: 9607-113
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: SR
Owner of Building: Perry A, Powers, Trustee .
Building Official
Address:
73-149 Skyward Way
City:
Palm Desert, CA., 92260
By:
Daniel P. Crawford Jr.
Date:
November 18, 1996 _
POST IN A CONSPICUOUS PLACE
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
Date 3/27/95 Type of Permit La Quinta
No. 113379 Permit #
71
Owner Name Double D Construction Log
No. 51-960 Street Herrera
City La Quinta Zip 92253 Study Area 111
APN # Tract # Lot # 0 Square Footage 11420
Type of Development 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 1.72 x 1420 or $ 2,442.40 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 Double D Construction
Name on the check
By Dolores A. Ballesteros
Superintendent
1t.
Telephone
f K�.
4J
Fee collectedpted by Mitch Moldenhauer
Signature f{:r.
' �� Payment Received'"
Check No. 1657
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
C'FMCAGO TITLE COMPANY 243186WHEN ' RECQRDED, PLEASE htA1L THIS
INSTRUMENT TO RECEIVED FOR RECORD
AT 2:00 O'CLOCK
PERRY A. POWERS, TRUSTEE
73149 Skyward Way
Palm Desert, CA 92260
T. S. No...... F 1294 .......................................
JUN 2 81996
Pacwo a r 0609 Racaa.
of Rnaroftcou".caw"a
R
W___IFees $ $
.ter.... T
SPACE ABOVE FOR RECORDER'S USE ONLY 1
q (0a3 C)W Q 0- yq -
t� p N'7`71 - I bLi - o ka TRUSTEE'S DEED
TAA 010-015
Executed by MANHATTAN FINANCIAL CORPORATION, a California
PERRY A. POWERS AND ANN H. POWERS,.TRUSTEES OF THE POWERS
corporation, and herein called trustee, To _
FAMILY TRUST, DATED 3/27/89 :i
herein called
The deed of trust hereinafter referred to was executed by MICHAEL D. DIETRICK, a Single Man
and recorded on FEB 9, 1995 as Instrument No. 041047in Book . Page ,
Official Records of ' Riverside County, State of California. In this deed, this county and state will
be referred to as "said county and state." The deed of trust was made to secure obligations stated therein and the payment
of a note 'or notes for the total sum recited on the face of the deed of trust, with interest, and to secure any other money
or obligations, the repayment of which was secured by that deed of trust.
Default occurred as set forth in a notice of default and elction to sell under said deed of trust, which notice of: default
was recorded on JAN 10 1996. Instrument No. 10015 of Official Records of said county and. state.
Trustee has complied with all requirements of law regarding the giving of notices. After'three months elapsed from the
recording of said notice of default, trustee posted a written notice of the time and place of sale in a public place where said
property was to be sold; caused publication of said notice in the PALM DESERT POST
published at Palm Desert , California, a newspaper of general circulation printed. and published in
the city or judicial district in which said property or part thereof is situated; and by posting a copy of said notice of We
on the real property described in said deed of trust, as required by law. The posted notices and the published notice con•
tained the description of the property to be sold.
Said publication and posting continued for a period not less than 20 days prior to the date of sale contained in said
notice. Thereafter Trustee offered the property described in said deed of trust for sale at public auction on
June 27, 1996 at 2: 00 PM o'clock at the main entrance to the County
Courthouse, 4050 Main Street; Riverside, California , in said county and state.
Trustee sold said property hereinafter described to the grantee above named for $111,527.27
subject to all prior liens and encumbrances. Said grantee was the highest bidder. No person offered to take any part of
said property for the amount of principal, interest, advances, and costs.
Trustee does hereby grant, without warranty of title, to grantee, that property in said County and State, described
as follows: Lot 13 in Block 238 of Santa Carmelita at Vale La Quinta, Unit No. 22, as
shown by Map on file in Book 20, Page 24 of Maps in the office of the County Recorder -
of Riverside County, California.
without covenant or warranty, express or implied, regarding the title to said eMpflypr any encumbrance thereon.
MANNA AN CORPORATION
Dated .................. ..use..z2.,...lR9a...................................... a Califo co ration
ugias Gr f the President
EXHIBIT 'A'
The undersigned grantor declares:
243186
1) The grantee herein was the foreclosing beneficiary.
2) The amount of the unpaid debt -together with costs was •••••
3) The amount paid by the grantee at the trustee's sale was .
4) The documentary transfer tax is ......
5) Said property is in ( ) unincorporated area: (x ) City of
MANHATTAN FINANCIAL CORPORATION
Beverly B64n
SE
State of ra l i f nrn i A
County of RiupraiAa
On June 27, 1996 before me,
Beverly J. Brown
DATE
NAME. TITLE OF OFFICER - E *JANE DOE. NOTARY PUBLIC
personally appeared Douglas Griffiths
NAMES) OF SIMERM
❑ 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 ac-
knowledged to me that he/she/they executed
the same in his/her/their authorized
capacity(ies), and that by his/her/their
is No
signature(s) on the instrument the person(s),
BEVERLY J. BROWN
' 'oMM.
or the entityupon behalf of which the person(s)
/961169 •
`•^� �� -; Notary Public-Califomia
acted, executed the Instrument.
RIVERSIDE COUNTY
Witness my hand and official Seal.
My comm. expires JUL 31,1096
$111,527.27
tem
CAPACITY CLAIMED BY SIGNER
Q INDIVIDUAL(S)
Q CORPORATE
OFFICER(S)
TITLES)
Q PARTNER(S).
Q ATTORNEY-WACT
TRUSTEE(S)
l] SUBSCRIBING WITNESS
❑ GUARDIAWCONSERVATOR
Q OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSONS) OR ENTITY(MS)
IgTIJiIT:
OF NOTARY
ATTENTION NOTARY: AMouph IAC Wannadon requested below is OPTIONAL. It Could prevem Iraudulen! anadwism of Itch Certificate to unauMmUed doowmnL
THIS CERTIFICATE Title or Type of Document
MUST O THE EATTACHED DOCUMENT Number of Pages Date of Document
DESCRIBED AT RIGHT: Signer(s) Other Than Named Above
CCCCCCCCCcc
e 1991 NATIONAL NOTARY ASSOCIATION IS= RWMelAve. -P.O.Dox 7184-CanopPIW
6CE14SEIS CdNTRk6T6R 696CARAf ION7
I hereby affirm under penalty of periury'that I am. licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
LicenW,,), Lic. Class Exp. Date
X 11h17
.19
81 -
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
Lice * rise Law for the following reason:
( ) - 1, As owner of , the property, or my employees with wages as their sole
comp ensation, will do the work, and the structure is not intended or offered for
sale.�(§iic..704.4, Business & Professionals Code).
1, as'o'wner 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-ofAe Labor Code, for the performance of the work for which this
permit is'MsuelvJ. �y workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
(This section need not be completed if the permit valuation is for $1 00.00,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 1. should become
subject to the workers' compensation pro I ions o tSer, ion 3700 Qf,.the Labor
Code, I shall forthwith comply with th Fd,v
Date: — Applicant—
�W'arn'ing: Failure to secure Workers Compensation coverage is unlawful a'rid
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 oi 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 madeA 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
qorrect. I agree to comply with all City, and State laws relating to the building
gq . I
construction, and h r b 'th lllze representatives of this City to enter upon
e e 'y au I - - I -
the above-mentioned propert, Xfor inspe' lio "purposes.
Agnature (Owner/Agent) �purpo` Date
T#
BUILDINGPERMIT PERMI CONTROL#
3791
DATE 7129/96 VALUATION SM) LOT' TRACT
JOB SITE 53-%.0 AVENIDA fi9RRr%,RA
APN 774-164-012
ADDRESS
OWNER
CONTRACTOR DESIGNER ENGINEER
PERRYA. M, WERS,T.R , USIT,14"
R
731,19 SKYWARD WAY -
677750NUNAROM)
PALM DESERT CA 97200
CATHE-1.) RAL C rrY- CA. 922M
(619)322-3205 CLIU 4339
USE OF PERMIT
CHANGE,* OF CWN91t & COWRAG70,R NO (;14A1WRPP:VMrr
RNTILIVIAT LD COST Or, CON STR 4 f MUM
0.00
PERAIT'll, FEE SUMMARY
SILTIVRMAL CON,;�FRWCTION ANDPIAN CHECK
$0.00
LESS r"P1.17-PIUD Fr. E's
$0.00
1.70TALP.RRN11TFJK&% DUENOW.
$0.00..;
RECEIPT
DATE
-By..
DATE FINALED. _[i�tPECTOR
INSPECTION RECORD
OPERATION I
DATE
I INSPECTOR
OPERATION
I DATE
I - INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
ExhaustFans
O.K to Wrap
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
I
Final
Final
BLOCKWALL APPROVALS
POOLS -SPAS
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
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 C rinection
Encapsulation
Gas Piong
Gas Test
—7
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)
COMMENTS:*