13326 (SFD)4
�iGGifl�l�iV
Pr
7% % W., .4
P.O. BOX 1504
Building 47-355 Via Cordova 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner Holmer
Mailing
Address 1:54 E. Desert Falls Drive
City lZip Tel.
Palm Desert, ' 922.11 340--3522
Contractor
'Manner Construction
154 E. Desert Falls Drive
clyalm Desert, iZjp 2211 Tel 340-3533
State Lic. City
& Classif. $ 180530 Lic. # 2.579
Arch., Engr., John Walling
Designer
At d e,ss.40 ClUb t)rive Tel. 360-0250
CYndiWe e11s � l ePA _ l int# 611424
I LICENSED CONTRACTOR'S DECLARATION
I hereby affirmj(hal)I am licensed underfrrovisions of Chapter 9 (commencing with Section
j7000) of ivision 3 of the.Business antlPy fessions Code, aRS1 4JY license is in full force and
I OWNER -BUILDER DECLARATION
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
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 or completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
• O 1, 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
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.)
Poli y No. Company
py is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
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
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
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 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 sof this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 13326
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number &1-7-k
Legal Description�-
Project Description
Sq. Ft. No. No. Dw.
Size 2640 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit does not include block wall
or pool.
Estimated Valuation $155,267.00,
PERMIT
AMOUNT
Plan Chk. Dep. 250.00
Plan Chk. Bal.
500.17
Const.
835.50
Mech.
109.00
Electrical
171.40
Plumbing
181.50
.S.M.I.
15.53
Grading
20.00
Driveway Enc.
.00
Infrastructure
3,424.68
Arts In F=11c Places
11 3�3.1 r
TOTAL s�`-� s�5
�r�U-�•��
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 DAl
Issued by:_
Validated t
Validation:
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING _
UNDERGROUND
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINg Fk
1ST FL. SO. FT. ® $
UNITS
HEATING (ROUGH)
STORAGE TANK
FORMS
YARD SPKLR SYSTEM
2ND FL. SO. FT.
DUCT WORK
ROCK STORAGE
/
FOUND. REINF. /
✓l
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
OTHER APPJEOUIP.
REINF. STEEL
GAR. SO. FT. ®
POWER OUTLET _
ROOF DRAINS
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
WALL � SO. FT.
WATER SYSTEM
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FRAMINGC10
WATER PIPING
NOTE: Not to be used as property tax valuation
67-3 /'%
7
FLOOR DRAIN
MECHANICAL FEES
REMARKS:
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(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, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
MESH
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FINIS RADING
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES j
ICRO 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. /
✓l
GAS (ROUGH) clep
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
�V—cu. yd.
$ —plus—x$_=$
LUMBER GR.
FINAL INSP.
FRAMINGC10
FINAL INSP. A-20
`
ROOFING / �� -
67-3 /'%
7
q F�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWAL�7-
LATHING
MESH
INSULAT IONISO UND � Ll
FINIS RADING
FINAL INSPECTION
CERT. CC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
a
SENT_BY:nXEROX Te I ecopier 7017; 3-2.1-94••';11:14AM
RECORDING REQUESi£D BY
CONTINENTAL, LAWYERS TITLE
AND WHEN RECORDED MAIL THIS DEED AND, UNLESS
OTHERWISE SHOWN BELOW MAIL TAX STATEMENTS TO:
NAME FXr &Mrs. -Robert A. Holnt�
STREET 2953 Monte Cresta Drive
AMESs
cTy Belmont, CA 9,1002
STATE
IIP L
6197739289-►
1 214'386 2909;# 2
SPACE ABOVE THIS UNE FOR RE :'ORDER'S USE —
Title Order No.
Escrow or ioan No, 2,17 Cha n
GRANT DEED
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY TRANSER TAX is $ 148.50
I computed on full value of property conveyed, or CITY TAX $
❑computed on full value less value of liens or encumbrances remcining at time of sole
❑ Unincorporated area: ❑ City of _ LA []UIN rA
_-�-,--� ,and
FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknewisdaed.\
WILMA-LA QUINTA L.P., A DELAWARE LIMITED PARTNERSHIP
hereby GRANT(s) to
ROBERT A. HOLMER and H. LYNNE
PAID 12-1.5-87 HOLMER, Zruatees of
the following described real property In the CITY OF LA gUINTA
County of RIVERSIDE State of California:
SEE EXHIBIT "A° ATTACHED
Holmer T,inst:
v
WILMA-LA QUINTA L.P.,
ALL
_
BY CENTRUM PORT PAVILIONrLTO _
_
APORA710Pd, AS
- - --
-�EkkRA .
L PARTNER-
BY.,' WILMA ' SOUTH MANAGED
PTN
A GEORGIA CORPDRATIpNT,CDAP ,
ITS ATTORNEY IN PAW
State of '
'
.�
County of -...—_ d[ ) �
J
,
6197739289-►
1 214'386 2909;# 2
SPACE ABOVE THIS UNE FOR RE :'ORDER'S USE —
Title Order No.
Escrow or ioan No, 2,17 Cha n
GRANT DEED
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY TRANSER TAX is $ 148.50
I computed on full value of property conveyed, or CITY TAX $
❑computed on full value less value of liens or encumbrances remcining at time of sole
❑ Unincorporated area: ❑ City of _ LA []UIN rA
_-�-,--� ,and
FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknewisdaed.\
WILMA-LA QUINTA L.P., A DELAWARE LIMITED PARTNERSHIP
hereby GRANT(s) to
ROBERT A. HOLMER and H. LYNNE
PAID 12-1.5-87 HOLMER, Zruatees of
the following described real property In the CITY OF LA gUINTA
County of RIVERSIDE State of California:
SEE EXHIBIT "A° ATTACHED
Holmer T,inst:
v
WILMA-LA QUINTA L.P.,
A DELAWARE LIMITED PARTNERSHIP/''
_
BY CENTRUM PORT PAVILIONrLTO _
_
APORA710Pd, AS
- - --
-�EkkRA .
L PARTNER-
BY.,' WILMA ' SOUTH MANAGED
Dated Ja g
A GEORGIA CORPDRATIpNT,CDAP ,
ITS ATTORNEY IN PAW
State of '
.�
County of -...—_ d[ ) �
SS.
on
L} l d
before me,
personally appeared
. i
personally known to me (or proved to me on the balls of
d sotisfgGjbry evidence) to be the persons) whose name(s) Is/
are subscribed to the within instrument
��.�`�i
S N0Tgq���o
Ond acknowledged to
me that he/she/they executed the some in hls/her/their
riled
.Q�
.� •�
autho.
capacity(les), and that by his/her/their signature(s) on the
Instrument the person(s), or the entity upon behalf of which the
person(s)
a �
a G�AGIp�
Acted, executed the instrument.
WITNESS my hand and official seal.
=
._ 24 Ise
Signature
TT_1nAr6w 7ini.
•iat seol)
y:�
SENT BY:Xerox"Telecopier 7020 3-21-94 4 12:25 6197739269-+ 1 214 386'2909;# 2
EXHIBIT "A"
PARCEL 1:
LOT 204 OF TRACT' NO. 261521. IN THE CITY OF LA QUINTA., COUNTY OF RIVERSIDE, STATE OF
CAL1 WA, AS.PER MAP RECORDED IN BOOK 227, PAGES 77 THROUGH 85, INCLUSIVE, OF MAPS, IN
THE OFFICE OF THE -COUNTY RECORDER OF'SAID COUNTY' AND AMENDED BY RESOLUTION NO. 91-1081
RECORDED MARCH 261 1992, AS INSTRUMENT NO. x.05176, OF OFFICIAL RECORDS.
RESERVING THEREFROM ALL OIL, GAS AND OTHER HYDROCARBON SUBSTANCES LYING WITHIN AND UNDER
THAT'PORTION OF SAID LAND, LYING BELOW A DEPTH OF 500 FEET, MEASURED VERTICALLY FROM THE,
SURFACE OF SAID LAND,- ITHOUT HOWEVER ANY RIGHT TO 'ENTER UPON THE'SURFACE OF SAID LAND
OR INTO THAT PORTION OF THE SUBSURFACE `THEREOF, LYING BELOW A DEPTH .OF 500 FEET,'
MEASURED VERTICALLY FROM SAID SURFACE.
PARCEL 2:
A NONEXCLUSIVE EASEMENT FOR INGRESS,EGRESS, USE,AND ENJOYMENT OF THE COMMON AREA' (AS
DEFINED IN THE DECLARATION REFERRED ,TO BELOW) INCLUDING ANY COMMON AREA ANNEXED TO THE
PROPERTIES (A8 DEFINED IN THE DECLARATION REFERRED TO BELOW).
SUBJECT T0:
THIS DEED IS MADE AND ACCEPTED UPON THE COVENANTS, -CONDITIOMS, RESERVATIONS,
RESTRICTIONS; EASEMENTS AND OTHER MATTERS SET FORTH 'IN THAT CERTAIN AMENDED AND RESTATED
DECLARATION OF ESTABLISHMENT OF CONDITIONS, COVENANTS •AND RESTRICTIONS FOR LAKE LA
QUINTA (THE "DECLARATION"), RECORDED NOVEMBER .,27, 1992, AS INSTRUMENT NO. 415112;
OFFICIAL RECORDS, RIVERSIDE, COUNTY AND -ANY AMENDMENTS AND ANNEXATIONS THERETO, ALL OF
WHICH PROVISIONS ARE INCORPORATED HEREIN BY REFERENCE THERETO WITH THE. SAME FORCE .AND
EFFECTAS THOUGH FULLY SET FORTH* HEREIN AT LENGTH, AND GRANTEES, 'BY ACCEPTANCE OF THIS
DEED APPROVE, ADOPT, RATIFY AND AGREE TO BE BOUND BY THE PROVISIONS OF SAID DECLARATION
AND ANY AMENDMENTS 'AND ANNEXATIONS THERETO AND AGREE TO PAY PROMPTLY WHEN`DUE, ANY AND'
ALL MAINTENANCE ASSESSMENTS AS REQUIRED UNDER SATE) ..DECLARATION AND ANY AMENDMENTS- AND
ANNEXATIONS THERETO.
-GRANTEE:
Robert Holmer
ne Holmer