04720 (SFD)--
P.O. BOX 1504
Building 49-08-0 Eisenhower
senh0wer 7&105 CALLE ESTADO
Address - LA QUINTA, CALIFORNIA 92253
aames Laiarr Trust
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address A.P:,Number- 631-341—OJS
City JzIp Tel.
. Legal Description
ContractorProtect Description # • D
Some
Address
City Zip Tel.
Arch., Engr.,
Designer
#
State
Lic. #
I hereby affirm that l am licensed under provisions of Chapter (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License law for the following
reason: (Sec.. 7031.5,8usiness and Professions Code: Any city or county which requires a.
permit to constnrct, alter; Improve, ' denglhh, or repair any structure, prior to its hstrerrce aim
requires the eppNcant for such permit to file a signed statement that heis licensed pursuant -to
the provisions of the Contractor's, License Law, Chapter 8 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he Is exempt therefmm, and the bash
for the alleged exemption. Any, Molatlon of Sectlon 7031.5 by ."any app8eanf for a pemYt
subjects the applicant to a e1v11 penalty of normore than lire hundred dollara,(1500):
O 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. 70.44, Bulmwss and
Professions Code: The Contractors 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 'Hnprovements are not intended or offered for sale. 9, however, fie WiAltp
or improvement Is soh/ within one .year o1 completion, -the owner=bugder wig have the burden
of pro'ving that he did not build or improve for the purpose of solo.)
El 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 Lew
does not apply to an owner of property who builds or improves thereon„ and who contracts for
such projscte7 with'a cornractor(s)'ecensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. a; & P.C: forthis reason
Date
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a'certificate of consent to self -Insure; or a certificate of
Workers Compensation,lnsuranc% or a certified copy thereof. (Sec: 3800; Labor Code)
Policy, No Company
❑ Copy Is flled'with the city. ❑ Certified copy Is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This.sectkm need. not be completed If the permit is for one hurdred dollars ($100) va4ra8on
or less.)
I certify that in the performance'oUthg work for which this permit Is Issued, I shall not
employ any pperson'�
;In any mann rlops to become sublect to the Workers'' Compensation
Laws Of Californla,
Date Owner,"
NOTICE TO APPLICANT: It, after making this Certificate of Exemption you should become
subject to the, Workers' Compensation provisions of the Labor Code: you must lorthwfth
comply with such provisions:or this Permit shall bedeemed re?okad..
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. (Seca 3087, Clve'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 hive read the application and state that the above Information Is correct.
I agree to, comply with all city and county ordinances and elate 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
WRITE - FINANCE, PINK = APPLICANT,GREEN -- BUILI
Sq. Ft. -3S29 No. No. Dw.
Size Stories Units
New ❑ Add 0 Alter ❑ Repair ❑ Demolition ❑
RSL' ftL-A AA
TOTAL
REMARKS
Estimated Valuation
BY:
PERMIT
AMOUNT
Plan Chk. Dep.2�►
* ��
Plan Chk. Bal.
Rear Setback from Rear Prop. Line
Const.'
d
Mech.
_SGAU
Electrical
-INSPECTOR'
Plumbing
77 10. a 00
S.M.I.
n a 27
Grading
Driveway Enc.
2 ;
Infrastructure
RSL' ftL-A AA
TOTAL
REMARKS
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:.
GOLDENROD .--AssESSows OFFICE, HARD COPY- FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL TEES
NO. PLUMBING FEES
IST FL $O FT (Ir S
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM •
2ND FL SO FT. Q
FORMS
SE!YR OR SEPTIC TANK
ROUGH WIRING
MOBILEMOME SVC.
BAR SINK
POR SO FT v
UGH) 52
METER LOOP
GARSO, FT, M
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
MP. POLE �•- /
DRAINAGE PIPING
CARP SO FT M
GROUT
WATER HEATER
WALL SO FT M
FINAL INSP..
DRINKINGFOUNTAIN
BOND,BEAM
WATER SYSTEM
FINAL INSP.
URINAL
- SO. FT. g
=S
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION S
OOFING
3
WATER PIPING
NOTE: Not to be used as property toxmalualion
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING. UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T:U.
SO. FT. ®c
BATH TUB
SO. FT. a c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID a 1 V4 c
SEWAGE DISPOSAL
SO.FT.GAR g qac
HOUSE SEWER
FINAL RJSeECTION
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 HEATINGd AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SE!YR OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK,STORAGE.
FOUND. REINF.
UGH) 52
METER LOOP
HEATING (FINAL)
OTHER APR.IEOUIP.
REINF. STEEL 4
GAS (FINAL)
MP. POLE �•- /
GROUT
WATER HEATER
SERVICE
FINAL INSP..
BOND,BEAM
WATER SYSTEM
FINAL INSP.
ry 1:0
FINAL (NSP.
i
GRADING
d
` �(-cu. yd.
c
S plus xf
=S
LUMBER GR.
FRAMING
OOFING
3
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPW ARRESTOR -
WALL f �/
THING
MESH
GKJNSULATION/SOUND
GRADING
FINISH GRADING
FINAL RJSeECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S'SIGNATURESIINITIALS
GARDEN WALL .FINAL
02/04/97
t/"-
15:35:
FAX 619.568 9728
ntleoRvn+a•eeauen+o � ev
CHICAGO TITLE
hQ as W.. Dodd
16178 811100 We
Huntington 9ee0h. ea 92549
`mow
%amp, as 'above
C•i.' �rb�r,� f
it
mvi»!+t•e .6g$g07,rY, eau M 4336 -JC
FATCO P.D.
py ti31-3e1-.00e-a GRANT ''DEED
TME UNDERSIGNEC GRANTORIS) DECLARE(S)
444 DIXIE
002
DOCUMENTARY TRANSFER TAX A 3530.00
Q computed on full value o) oreperty conveyed, or
EI Colllputed ori full .value less value of liens or eneumbranees remaining at time of sale
0 unrneorporstud area
Ceeyof La Quinta AND
FOR, A VALUABLE CONSIDERATION. rKelpt of which Is hereby acknowiwg0d,
.Tani'ue Luchini, an unmarried woman
hereby GRANTIlf) t0 THMtAS N. DODD, Be Mai tf to of the 720HAS H. DODO TRUgx
Patted August 20. 1986
,Ise foll*Wln7 denrlbod roe! property in th- City ofL2 Cui ^ta
Counly of ttiverside , State of Cellfornid
Lox 1.11 of LA QUINTh COLD 2920ATES NO. 1, As shown by flap on file in. Book
37 Pages 96 through,98 of Maps, P.eCords-of Riverside County, California.
[apn #6.31-341-008J
Oeded May 29, 1990
STATE OF CALIFORNIA
COUNTY Oft ktViRS±DE �SS.
onints—& H—daym .ill Y ,IndheywIlLM
befinw'.Mw Ina undan laltae a 140tary Publit M and tot aid StMfe,
ar�onat
ply a0oaarod ..i A Y tom- Ili 1111
—.+ w{A�Oaell.aelaa��ma
to, proved to me on Ino edits of awataadwy ,.Idents► to be the
v -row— qmm name – i S wbaob" to the WHhtn
irafhln.ant, and actirp. 4d"d`to me that S. he_ a.aa.Aad It,
wiymt3$ my 1e?qd gold official Med;
11 i'�ry.iyl.
AN" rga !!.d•I.STATI
"it TAX ETArFWN M
Amp
ryyfpel SERI
JOM OLUOM
FWAQVPaNK snag
Irnnt,etam
1ne;.+•Ma�.. tiN4 tr luta
Ith o.. ON M%.a •wwr MPI
I -ft-4q
Desert Sands Unified School District
CERTIFICATION OF PAY14ENT
OF
JVA,r,CE.
SCHOOL FACILITY FEES
MENTCAWHOT
99 ON
TO: City of La Quinta. DATE: /0 -/'7 8K
Department of Community Development
78-105 Calle Estado
La Quinta, CA 922,53
This is to certify that Jaln^U Lai4-6. jtuat r
developer of. i� — -JLr S&WIa"Ck, which is
locat,ed at 6,1 tV3 AOL 1 '61 A/ withim
an - 'eh. /�,zpal
this Dist.rict, has paid ity fees imposed o the
pursuant t
author ge rat,�d by G ernMent CodbSectiolt 630.80 in the amount of
W/; I/% /A 1114.-4
$ (1111 W —I A,14 41-4- W1 4rj civ
covering�-a total of- Wo M.,hl'f fjVquar� fe.etUof (k) residential or
( ) industrIal/commercial development and that building permits for
this footage in this developm ent may now be issued by your jurisdiction.
All 1A
a� ')- �4 6 for r;Kk bPMIUb U141 ED SC;HO0T, DISTRICT
White - Building Department 0 Yellow - Facilities Planning 0 Pink - Accounting 0 Gold - Develooer
(10)-37