14218 (SFD)Building
Address 78.-815 Lima
Owner S.W. simors
Mailing �.
Address P.O. $fags 376
City tesz., . GR zIp 92320
Contractor
Same
Address
4 �iGG�1�IGV
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No.
14218
s
BUILDING: TYPE CONST. V'OCC: GRP. -R3
A.P. Number 769-600--010
Tel. Lot 22 Tract. 24890-4
( 'Legal Description
Project Description
City lZip I Tel.
State Lic. A B-356905 (City
& Classif. Lic. #
Arch.- Engr.,'- __•. Mike Pool —
Designer
Add s'eY vine Tel.
City zip -CI�i alp 92373 utc.a 49585
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
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Buslness 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 thathe'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.)
❑ 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 contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
1 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 it 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, 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
Ihereby 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 A L 3 - i a~ J+
Lender's Address '• 1f t}_ ., - • 4
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.
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 relating to building
construction, and hereby authorize representatives of this city to enter the above.
mentioned property for inspection purposes. r -
Signature of applicant � 3' '' . Date
Mailing Address --+�•*='•• .-
City, State, Zip t. t r . f fl to!
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Ce i r Lin
Side Setback from Propertya-21—
DATE
Issued by:
Validated by:
Validation:
r
Sq. Ft.
Size 3219
No. No. Dw.
Stories Units
N 0 ' Add ❑
Alter ❑ Repair ❑ Demolition ❑
Permit does
nod. - in- clUde block wall or
Pi)Oi.
N
Estimated Valuation
$258,035.€30
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
0
Plan Chk. Bal.
760..04
;Const.
1,231.00
Mech.
96.00
Electrical
217.97
Plumbing
205.50
.S.M.I.
26. go:
Grading
20.00
Driveway Enc.
a00
Infrastructure
5r946.39
Arms in ffu�blkc
Places 420.08
r•
TOTAL -
9,174.58 92• 5858 /
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Ce i r Lin
Side Setback from Propertya-21—
DATE
Issued by:
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
B GRADE
0 a V.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. p
FORMS
SEWER OR SEPTIC TANK
POR. SO. FT. p
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. Q. FT.
OTHER APPJEOUIP.
DRAINAGE PIPING
WALL SO. FT.
TEMP. POLE
DRINKING FOUNTAIN.
SO FT ®
GROUT
URINAL __. _
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
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
REMARKS:
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
MESH
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 lollGROUND
PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
S (ROUGH) 1q! 0915
J
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.
�IINAL INSP. 12— S-7
FRAMING ►«�
FINAL INSP./�'
ROOFING L
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
AL INSPECTION _
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
FROM 714 7951356 E.W. SIMMONS INC OCT .17.94 10:37 AM P-001
Post -Fax Note 7672 No. ofPages ............................_ TodaysDaa.,......._............_......_..Tme .:.......,.M... _.
1
77
-.__....,...._................_ ........... ...............:.........:..., ................... .._. _...._.._....:; .................... ..........:, -.,,:-,.,..,..,.......M..........._.,.,: «., :.».-...,,, w, , ............
� l Z � From .. ,.....:.�.. ,-., ._.,..,m
_ Bill W. Simmons_
:To K
._.....M:.........,._..,.,,..:_..,.,w,M..,_.......:._,........_..................-----....---.---.......:.........._......,:..........,. Y.._ .................._.- __,....w..,...,,.,.m.:......,w......,,...,...,w..._
Cwpanv
City of LaQuinta B. W. Simmons Inc.
'Lo,,tk , -Locat=ion Dept, Charge
i.,. .:..:e..., .,.........y.........._,_..,. ,_........._.................................. ,........... ....... ... ......:.,...,.....,,...,...... ..... ............ ..... -............_..._._......,..,...................._................._...._.,...._ _ _ ..
:fact # Telephone Fax i! Teleph
619-7.77--7011 = -7.9
--...._....-----•--._..........:.........:......:.... ...,......:_...........,..................._...,._...9Q9.......5......1:.3..5..6.:1,.:.,...,,,.,,...-.........9.09.:,.,7.,5......&92&.,..,.v....,:..,...M,....
k..--.. morns — _ ,Orlginet (� Destro, Rdwrn. Call for pickup
'......,............_......._.................._...._....._............ ....... ....... ........ D anon:.:..,...,_.......,....—..I..:...:.......n......,µ.� ...,_..__........:....._......r.-_..:...._..._...,,.....�....,....._..............„
Grant Deed to follow fdr Lot. 22 Tr.,,...2,4.8.0,.4.,....-7..8_-815.._Llma................................_...---.........._..---.._..._
_..._.._........�_,,._.... ,...,....,....._..._...._......_..._._.....__._..._...._..._................._..................._,..:.,w.., ...
_..._...._.,._.,..,.Citrus Golf Course ...:.....:........:............. ...... ...................
tF&RWAY HOMES'=-.
Order No.
-:Escrow No.
'Loan.No.,
{
WHEN -RECORDED MAIL TO:
Mr. and .Mils. Billy W. Simmons
P:O. Bok 376
'Calimesa, CA 92320
r
6
a��
7
a9
x�4V
CCE
LL
W
t�
SPACE ABOVE TIES LINE FOR RECORDER'S
USE
"
MAIL TAX STATEMENTS TO: Docl�I�rrTnRY TRANSFER TAX s ........ .............................7av .....................
X,.Computrd on the consideration or value of propem- wmc�rod; OR
SAME AS ABOVE ..:::.Computed on the consideration or value less He, or oocumbrances
THEE[NDERSI sal
ICED GRANTOR 4
Signature of Declarant or Ageot detcrMining tax -Finn acme
111•—" 111 1 • � Y rel Yl 11111 1
CORPORATION GRANT DEED
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
J.M.'PETERS COMPANY, INC.
a corppration organized under the laNys of the State of WDA DELAWARE
,does hereby 1
GRANT -10 BILLY W. SIMMONS and .MARGIT SIMMONS, Trustees of. The Billy W. Simmons Family '
Trust dated March 6, 1990,
the real property in the City of LA QUINTA
County of RIVERSIDE
, State of.California, described as .
LOT 22 OF TRACT 24890-4, AS MORE PARTICULARLY DESCRIBED IN EXHIBIT "A" ATTACHED
HERETO AND INCORPORATED HEREIN BY THIS REFERENCE.
GRANTEE BY ACCEPTANCE AND RECORDATION OF THIS DEED,.EXPRESSLY ACCEPTS, COVENANTS, AND
AGREES TO BE BOUND BY AND ASSUME PERFORMANCE OF ALL APPLICABLE PROVISIONS AND
REQUIREMENTS SET FORTH IN THE MASTER DECLARATION AND ALL SUPPLEMENTARY DECLARATIONS
ATO, AND ANY AMENDMENTS THERETO ("MASTER DECLARATION") ALL AS DESCRIBED IN EXHIBIT
"A", WHICH PROVISIONS AND REQUIREMENTS ARE ACKNOWLEDGED TO BE REASONABLE AND ARE
INCORPORATED HEREIN BY THIS REFERENCE. THIS GRANT IS EXPRESSLY SUBJECT TO THE PERFORMANCE
OF SUCH PROVISIONS AND REQUIREMENTS To BE PERFORMED BY.GRANTEE THEREUNDER. THE USE FOR
WHICH THE PROPERTY IS INTENDED IS RESIDENTIAL, AND THE RESTRICTIONS ON ITS USE ARE SET
FORTH IN THE MASTER DECLARATION AS SUPPLEMENTED AND AMENDED, AND THE SUBDIVISION MAP
FOR THE PROPERTY TO WHICH THIS DEED IS SPECIFICALLY AND -EXPRESSLY MADE SUBJECT TO.
DATED: March 1, 1994
Dated -
March -1, .1994
StATE OF CAL ORNLk
COtwry 0)= t~
Ott before me.
lfj Q i2 L{
p&bonastly. a#ipg{rred _:–
personally known to tn,�(or proved to me on the basis of satisfactory
.evidenee) to be the personW whose narne(�) is/wc7subsoribed to the within
urwrurnent and acknowledged to me that helshe"ey executed the same
in his/het.#anir authorized capacity(ies), and that by hiwly_ 3eir siggna-
ture(A_on.the instrument the persolo or the entity upon behalf of whioh
the person{. acted, executed the inst=ent.
WITNBSS hand and official seal.
Si=ature / /
J.M. PETERS COMPANY, INC.,
A NWPRA CORPORATION
DELAWARE
1
By
Craig jfos4r., Vice President
BY
Secretary.
J. smutbf
_.
IDT I
NOINT RtR: - cdoloft I
c4E tY
MY cam f. Sa- ts, tee?
(This area for offtciW notarial seal)
MAIL TAX SI<'ATEMEIN'rS AS DERECTED ABOVE
1144(1/91)
FROM 714 7951356 E.W. S IMMONS INC OCT .17.94 10:38 AM P-002
i.,<µ�,Rw l�✓.i.
EXHIBIT
ALL THAT CERTAIN LAND SITUATED IN THE STATE OF CALIFORNIA, COUNTY OF RIVERSIDE
CITY OF LA QUINTA, AND IS DESCRIBED AS FOLLOWS:
PARCEL 1:
LOT 22 , OF TRACT N0. 24890-4, AS SHOWN ON A MAP FILED IN BOOK 218 PAGES 1
THkOUGH 9 INCLUSIVE OF MISCELLANEOUS MAPS, RECORDS OF RIVERSIDE COUNTY,
CALIFORNIA.
ALSO EXCEPTING AND RESERVING THEREFROM, FOR THE BENEFIT OF THE
J.M.. PETERS COMPANY, INCORPORATED A NEVADA CORPORATION, ("DECLARANT")
ITS SUCCESSORS AND ASSIGNS, TOGETHER WITH THE RIGHT TO GRANT AND TRANSFER ALL
OR A PORTION OF THE SAME, AS FOLLOWS:
A.. THE;':RIGHT':TO PLACE ,ON,. UNDER OR ACROS5 THE PROpFt'I'Y, TPANSMISSZON,I,NES.
AND Ohtk FACILITIES FOR A COMMUNITY ANTENNA OR CAKE TELEVISYCJI�. SYaTEMAND
TMEAFTEA TO OWN. AND CONVEY SUCH LINES AND FACILITIES, ' AND THE Rl= TO -EN R
UPON THE PROPERTY -TO SERVICE, MAINTAIN, REPAIR, RECONSTRUCT AND REPLACE SAID
LINES AND FACILITIES,. PROVIDED, HOWEVER, THAT THE EXERCISE OF SUCH RIGHTS
SMALL NOT UNREASONABLY INTERFERE WITH GRANTEE'S REASONABLE USE AND ENJOYMENT
OF THE PROPERTY.
B. NON-EXCLUSIVE EASEMENTS OF INGRESS, EGRESS, UTILITIES, DRAINAGE, AND FOR
OTHER PURPOSES, AND EASEMENTS AND RIGHTS AS RESERVED TO DECLARANT AS DEFINED
AND DESCRIBED IN.THE "MASTER DECLARATION" HEREINAFTER DESCRIBED, AS
SUPPLEMENTED AND AMENDED.
RESERVING THEREFROM UNTO LANDMARK LAND COMPANY OF CALIFORNIA, INC., ITS LEGAL
REPRESENTATIVES, SUCCESSORS AN17 ASSIGNS, ALL WATER, MINERALS., OIL.,, GAS,
P tOLEUM, OTHER HYDROCARBON SUBSTANCES AND ALL GEOTHERMAL ENERGY SOURCES IN
OR UNDER OR WHICH MAY BE PRODUCED FROM THE LAND WHICH UNDERLIES A PLANE
PARALLEL TO AND FIVE HUNDRED (500) FEET BELOW THE PRESENT SURFACE TO THE LAND
TO WHICH LANDMARK LAND COMPANY OF CALIFORNIA, INC., HAS ANY RIGHT, TITLE OR
INTEREST. SUCH RESERVATION SPECIFICALLY RESERVES TO LANDMARK LAND COMPANY OF
CALIFORNIA, INC. THE RIGHTS OF PROSPECTING, EXPLORATION, DEVELOPMENT,
PRODUCTION; -EXTRACTION, AND TAKING OF SAID MINERALS, OIL ,.GAS, PETROLEUM;
.HYDROCARBON SUBSTANCES, WATER, AND GEOTHERMAL ENERGY (AND/OR ITS SOURCES) FROM
LAND BY MEANS OF MINES, WELLS, DERRICKS, AND/OR OTHER"EQUIPNENT FROM
SURFACE LOCATIONS ON ADJOINING OR NEIGHBORING LAND OR LYING OUTSIDE OF THE
LAND; PROVIDED, HOWEVER, THAT THE OWNER OF SUCH MINERALS, OIL, GAS, PETROLEUM,
HYDROCARBON SUBSTANCES, WATER, AND GEOnMfflAL ENERGY (AND/OR ITS SOURCES), AS
ABOVE SET FORTH, SHALL HAVE NO RIGHT TO ENTER UPON THE SURFACE OF THE LAND NOR
TO USE THE LAND OR ANY PORTION THEREOF ABOVE SAID PLANE PARALLEL TO AND FIVE
HUNDRED (550) FEET BELOW THE PRESENT SURFACE OF THE LAND -FOR ANY PURPOSE
WHATSOEVER.
PARCEL 2:
NON-EXCLUSIVE EASEMENTS FOR INGRESS, EGRESS, UTILITIES, DRAINAGE AND FOR OTHER
PURPOSES, ALL AS DESCRIBED IN THE DECLARATION OF COVENANTS, CONDITIONS AND
RF,STkICTIONS FOR THE CITRUS COURSE HOMEOWNERS ASSOCIATION ("MASTER
DECLARATION") RECORDED NOVEMBER 6, 1990 AS INSTRUMENT NO. 406990.
8,0WECT TO:
1. NONDELINQUENT REAL. PROPERTY.TAXES AND ALL NONDELINQUENT UNPAID GENERAL
AND:SPECIAL ASSES;
2. COVENANTS, CONDITIONS, RESTRICTIONS, EASEMENTS, RESERVATIONS,
................ DEDICATIONS, RIGAND RIGHTS -0' -WAX OF RECORD OR .APPARENT INCLUDING WITHOUT
LLTATION, THE MAST9R DECLARATION, AND SUPPLEMNIARY DECLARATIONS AND ANY
AMENDMENTS THERETO, DESCRIBED ABOVE.
FROM 714 7851356 E.W. SIMMONS-INC FEB -02.95 2:47 PM P.001
Pages Today's-'Trrne
Fax .Note .7672
. .... ......... . ......
....... ..... ... ..... ......... ....... . ......... .... ... ............... ........ ... ...........
From
4 ......... ........... ...
`Company
....... . ... ... .......
.' .,.
LQCZW Dept- charge
i� ......... ...... ....... .......... ........... ..... ....................._._._......:....•. ................ ..... ....................
Fax 0 �Fax#
�e Ile # J&phom#
77 .............
ReUm
=Op; E ElCall w pimp
... ........ . . ..... . ........
................ . .... ..... ........ . . ..... ................ ...... . .... ... .... . ........ . .... .
IS....... .....
. .......... ...... .. ... .. . ......... ..... . ...
. ..... . . ........
............ ........... ...
February 2, 1995
Wayne Simmons
Simmons Construction
Calimesa,-CA ".9232Q..'
Re: -Lot .22, La Quinta
This is to confirm that I have performed a visualinspection of the rebar
size and placement for grade beams and footings. Reinforcement is in
accordance with the approved plans.
If you have any questions, please call.
Thank you,
K
Michael. Pool
-Civil'Engineer
KtiV
No. 49585
EXP_ 9-30,96 Y.
e
4
November 4,1994
Simmons Construction
P.O. Box 848
Calimesa, CA 92320
Re: Lots 22 & 63
Citrus Golf Course, La'Quinta
This is an acceptance of the truss layout. and engineered drawings from
Brown and Honeycutt Truss Systems Inc. The drawings are dated
September 13, 1994 for Lots 22 and 63 at the Citrus Golf Course in La
Quinta.
Q�OFE/ Nq
KEA/T !�
c� V� O
W p
t N0.49585
Exp. 9-30.96
Michael K. Pool
Civil Engineer `fglF of cAVF����P