003406 (SFD)44
P.O. BOX 1504 No, 003406
Building 78-105 CALLE ESTADO
Address 53"365 Eisenhower LA QUINTA, CALIFORNIA 92253
Owner
Coachella Valley Land- Co.
Mailing BUILDING: TYPE CONST:'- OCC. GRP.
Address 24 P,. ahanitz Wast 42 A,P.,Number 774-085-019
City Zip Tel.
t�s►'�m ,� Ira � x n2 -'102€I
Legal Description
i Contractorplan A
y Project Description
flJ-•r.rr f'i+tn�all+�r.s4#^ {_
,Address - - -
same
city, Zip Tel."
State Lic. City
& Classif. Lic. # Sq. Ft. No. No. Dw.
3€7934 `' • 895
Size. I Al n Stories Units
-Arch.; Engr., -
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
ITel.
Address
City Zip State
{ 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
�. effect.
SIGNATURE'. '' - DATE
" .•`
OWNER -BUILDER DECLARATION Estimated Valuation
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 PERMIT AMOUNT
I the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/ `
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 `permit Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
0 I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. $ 39.11 h4
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. � .�Q
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,. 33.00
Mech.
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 Electrical 74.17
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- Plumbing 103.00
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 S.M.I. 3
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
{ E3I am exempt under Sec. B. & P.C. for this reason Grading 20.00
Driveway Enc.
20.00
Date Owner Infrastructure 1,121.12
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to seWinsure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, labor Code.)
Policy No. Company
O Copy is filed with the city. 0 Certified copy is hereby furnished.
TOTAL 7 �q
CERTIFICATE OF EXEMPTION FROM REMARKS `f
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is' for one hundred dollars ($100) valuation '
or less.) -
I certify that in the performance of thg work for which this permit is issued, I shall not - n.R • ti r .•,•; .3 !.
employ any person in any manner so as to become subject to the Workers' Compensation'- ~ h ,
Laws of California. v►;{ }" frill tj 1 .1' r r•�. r. .
Date Owner "
NOTICE TO APPLICANT: If, alter making this Certificate of Exemption you should become - ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
Rear Setback from Rear. Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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.) Side Setback from Property Line
Lender's Name
Lender's Address FINAL, DATE INSPECTOR
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. j ts.,a
I certify that I have read this application and state that the.above information is correct. Issued by: Date % 9 ► o Permit
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. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
HARD COPY
T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE `� J7
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
ROCK STORAGE
FOUND. REINF. /O O
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
OTHER APP./EQUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. SO. FT. ®
TEMP. POLE
WALL SO. FT. ®
GROUT
DRINKING FOUNTAIN
SO. FT. ®
SERVICE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
BOND BEAM
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
LUMBER GR.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING � O
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, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LATHING d% 4(/ 171 1,'3 (�
SQ.FT.GAR g 3/ac
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
INSULATIONISOUND
FINISH GRADING
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE LPL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
ROUND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE `� J7
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SKEPIT X
r
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. /O O
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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 / �� _
FINAL INSP.
17
r
ROOFING � O
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING d% 4(/ 171 1,'3 (�
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS.
GARDEN WALL FINAL
RLCORDING REQUESTED BY
AND WHEN NECONDED MAIL THIS 0110 AND UNLESS OTHERWISE SHOWN SELOW
MAIL TAI STATEMENT TO:
Name COACHELLA VALLEY LAND CO.
ATTN: TOM STAR
Street
Address 732 WILLIAMS ROAD
City& PALM SPRINGS
State CA. 92262
MAIL
Name
Street
Address SAME AS ABOVE
City a
State
TITLE ORDER 00. ESCROW N0. 2 0 7 7 6 6 PB .
SPACE ABOVE THIS LINE FOR RECORDER'S USE
GRANT DEED
THE UNDERSIGNED GRANTOR(S) DECLARE(S)
DOCUMENTARY TRANSFER TAX is $ 17.60
IN computed on full value of property conveyed, or
0 computed on full value less value of liens or encumbrances remaining at time of sale.
It unincorporated area
0 city of AND
FOR A VALUABLE CONSIDERATION, receipt of which is hereby -acknowledged,
PHONSINE THORBURX, WHO ACQUIRED TITLE AS PHONSINE THORNBURN
hereby GRANT(s) to
COACHELLA VALLEY LAND COMPANY, A CALIFORNIA LIMITED PARTNERSHIP
the following described real property in the
County of RIVERSIDE State of California:
LOTS 6 ANDBLOCK 210 OF SANTA CARMELITA AT VALE LA QUINTA, UNIT 20,
AS PER MAP CORDED IN BOOR 19, PAGE 38 OF MAPS, RECORDS OF RIVERSIDE
COUNTY, CALIFORNIA:
Dated July 21, 1987
STATE OF CALIFORNIA
COUNTY OF SS.
On this _ day of—AU L►t in the year 19A2
before me. the undersfggned, a Nipry Public in and for said State,
personally appeared f 110 WE 7#oAAyA,-J
personally known to me
(or proved to me on the basis of satisfactory evidence) to be the
person_ whose name 1 S subscribed to the within
instrument, and acknowledged to me that he_ executed it.
WITNESS my hand and official seal.
Signature
40T�AIIY PUBLIC IN AND OFOR $AID STATE
3 6 a
12,6(0
PHONSINE *THDRBUI �
(This area for official notarial seal)
OFFICIAL SEAL
LIONEL PETERS
roc. vt
NOTARY PUBLIC - CALIFORNIA
LOS ANCELES COUNTY
t.".y Comm. expire. JAN 21, 1989
(This area for official notarial seal)
T4'y� 4 4 " 7,0>
P.O. BOX 1504 APPLICATION ONLY
Buildingi 7&105 CALLE ESTADO
Address % S&5' t�.5�oVk:il2 LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address 2w7 "en
City I Zip ITel.
Address
e. o
1117
Tel.. °
z G.7 3z 2
State Li/7 �e�r,.
Lic. I City
& Classif. ,-. Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Di/vislon 3 of the Busin/ess and P/rote sions Code nd my license is in full force and
effect. K P? R7
SIGNATURE: -I'— ••KK -DATE
OWNER -BUILDER DECLARATION
I herby 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 rile 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 live 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 or 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, 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 contractor(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'COMPENSATIONINSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg 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
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 it 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 retating 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
BUILDING DIVISION
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number 1_o7_7
Legal Description %1�T��►--r�! 2!,,l /1A)
Project Description
iJU':)YLitt Yt1' ryii.9 � 'U'Y"c:'f: � t l.:r
. �o.�.o W _
ZONE: BYd
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:
Sq. Ft.
Size /!,///a
No.
Stories �/
No. Dw.
Units /
Newer Add ❑
Alter ❑
Repair ❑ Demolition ❑
r
Estimated Valuation
"!
71
F
PERMIT
AMOUNT
Plan Chk. Dep.
510' .0 O
Plan Chk. Bal.
R47.
Const.
001
Mech.
3 .00
Electrical
-7 , / 7
Plumbing
Oa
S.M.I.
,
Grading
. Om
Driveway Enc.
Infrastructure
/ / _►
A
Z <- !i o
TOTAL
4
REMARKS
iJU':)YLitt Yt1' ryii.9 � 'U'Y"c:'f: � t l.:r
. �o.�.o W _
ZONE: BYd
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. @
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT. @
GROUT
WATER HEATER
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN
SO. FT. @
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
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
FIRE ZONE ROOFING
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
LATHING
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
FINISH GRADING
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
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
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
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL