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9706-066 (AR)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapte;r�,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 Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the follow ' ing reason: ( ) 1, 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). 1, as owner`of the property, am exclusively contracting I with licensed contractors to construct the project (Sec..7044, Business & Professionals Code). O I am exempt xempt under Section B&P.C. for this reason Da4t-., Signature. of Owner WORKER'S COMPENSATION DECLARATION I 'hereby affirm under penalty of'perjury one ' of the following declarations: .1 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 PM(rFormance 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: Cartier Policy No. STur: i�k.,rN)0 (This section need not be completed if the permit valuation. is for $100.00 or less). 4 (. ) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner soZ asIto become subject to the % Workers' compensation laws of California, and,agree that if I should become subject to the'workers' compensation provisions of Se lc:tiQn 3700 of the Labor .Code, I shall forthwith compl� with those prbvi's"ro—p s.� v/Date:Q/ 1-0' i ApplicanCL-i Warning: Failure to secure Workers' Compensation coverage is unlawful and 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 of Building and Safety for a permit subject to the conditions and restrictions set forth om his application. A. Each person upon whose behalf this application is made .& each, person,ati,,� whose request and for whose benefit work is performed under or pursuant Fo 1`5 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 correct. I agree toco I with f1'City and statelflaw's relating to . the buildin I g construction, and hereby yautho?z.e-re�6esentatives of this City to enter upon' the above-mentioned pro rty f r iA, s!n.ection,purposes. 1Signature (Owner/Agent (e Date N_ PERMIT # CONTROL #. BUILDING PERMIT 970&006 '5715 1 LOT T TRAC DATE VALUATION. T_ JOB SITE ADDRESS 79-8110A VIA (14ARN04% APN 649-110-004 OWNERCONTRACTOR DESIGNER ENGINEER 1328 BALDV%mj 44161 a &Avil-RoIN cov,,r (7,'A 1, Gf A R Y, A,L1.4 1 3 , R I *A C ANr'!.. TV"21ig L A� QlANIA CA 922_,3 'lei 48,75 USE OF PERMIT At 400 :LF. 0088T Q 11 C "'T OF PRANTur gum NMARV PLAIN 41 11jCKFf< J011-0004.19-318 1*19338 1104000AMMI M 4 Ec HANIf NPe"Ti 10 P'1'XMB1Kr0 IM9. . S'P(MG N.1CM,0N fi,'E -12: SM 10Y-000-241' 0 7110TAL C f J- N SNAL _-Y"i ON A N. D P.0 PLAN CHECK ss -P N w C09 RECEIFUV%1* DATE J B' 7 DATE FINALED INSPECTORi4 i. INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings - Ducts Slab Grade '1 Return Air Steel Combustion Air Roof Deck _ Exhaust Fans O.K. to Wrap Q F.A.U. Framing Q— Compressor Insulation —C7, Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall 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 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: - w Bin # ::>::::'::»;::::>:><:::: (�c�j•�l2-�`,,tJj�'D, f- o La rota City.' ,. Q u -�' • ;.;: ::::>>:>:::>:> :<:::: �......:. - ,:. Division� •' �''"'' Building 8i Safety p,: � P.O. °Box 1.504 ' .......... ............. P' rrn :.::::::::... � � .' 7 -495 II Tampico, A^ 8 Calle `° , � • , La Uinta CA 92253 ":":..:::.:'.�� '. , ,Building Permit Application and Tracking Sheet�..� • � x Project Address:. 1 N � ,' � Owner's Name: , •�fl/�� - �. �A}2�A�Q �'o• � � ' s `A. P. Number: (�4g _�2, 'Q._�DO �. * Address: c m Y �"� r �d. �c�T'C�� •; Legal Description: ... � - "• - `. `' City,ST; Zip:.'��pzO' /J� �.Cr El/ _. M 6c� "Contractor. . Telephone: ` ...Address. " .� fl •. �o • ' � �- � � •,-, . f Project Description: •City ST, Zip... L� N G4 9 j2S3 • cQ:l= Cvvs oJ��• �` •�' Telephone:, P L 'State Lic: City Lic. #: � ��l �iA/� � ' ��$ p�iN CF_E<J=dQT. • , .Engr . Designer.: V � 1�-t . ' Address ? off' t. S$�w 7 t ����. .li { ,"j,�+ ZV'2L - r �.+City. ST.'Zip :�� t:h' )^ .S"' ^ _%J O1��Z '�t.L��'�-{� ���`�J` 2ra�S•- % 'T le h ne. S Construction Type:. Occupancy:,an c5t •` StateL�' �a Pro'ect " e (circle one :'New• Reir � Dem- o'- Name of Contact Person ,.1� l t �l U�� Sq. Ft.; ©rte # Stones: # Units ­' Telephone # of Contact Person: �� ` "�'� l 3 , Estimated Value of.Project: ` : ».. F :<:::»::<>:::<:::>::>:::::....A.....> P::;:2:i:: '• , `.:..,':.::: `::::NF1`:,, ,. i / N�...i 0..� ' �V#�T I�I�.. .......FS.. 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ELECTRICAL FEES UNDERGROUND A.C. UNIT COLL AREA N0. PLUMBING FEES tST FL. SO FT ;i S UNITS HEATING (ROUGH) 2NO FL. SQ. FT_ ,g FORMS YARD SPKLR SYSTEM POR. SO FT ,4r MOBILEHOME SVC. BAR SINK GAR. SO. FT. POWER OUTLET ROOF DRAINS CAR P SO. FT •.Z OTHER APPJEOUIP. DRAINAGE PIPING WALL SO FT 't TEMP. POLE DRINKING FOUNTAIN 50 cT. GROUT URINAL ESTIMATED CONSTRUCTION VALUATION S FINAL INSP. BOND BEAM WATER SYSTEM WATER PIPING NOTE: Not to ba ;,sea aS prooeny tax wa!uation e= LUMBER GR. FINAL INSP. FLOOR DRAIN MECHANICAL FEES ROOFING WATER SOFTENER VENT SYSTEM FAN EVAP.000L :+GOD SIGN VENTILATION WASH ER(AUTONDISH) APPLIANCE DRYER FIREPLACE GARBAGE DISPOSAL FURNACE UNIT 'WALL FLOOR SUSPENDED SPARK ARRESTOR LAUNDRY TRAY AIR HANDLING UNIT CFM GAR. FIREWALL 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. g. c BATH TUB SO. FT. to c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SU. FT. RESIO to I�4 c SEWAGE DISPOSAL SO.FT.GAR y x.c HOUSE SEWER FENCE FINAL GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE OBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING A AIR GOND. 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 V"K ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL► OTHER APPJEOUIP. REINF. STEEL GAS (FINALS TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING Cu = plut x>f e= LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMMK& VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATK)WSOUND FINISH GRADING FINAL INSPECTION CERT. OCC, FENCE FINAL GARDEN WALL FINAL a s Desert Sands Unified School District Notice: 82-879 Highway 111 f� Indio CA 92201 , ' Document Cannot Be Duplicated " f S 619 7753500 ' p -` ` CERTIFICATE OF COMPLIANCE ' Date 8/11/97. APN # 649-210-004 No. 15923 Jurisdiction La Quinta Owner NameJOhn & Barbara Storwick Permit # . No. 78-888 ` Street. Via Carmel Log City La`Quinta zip 92253 r -Study Area Tract # Lot # Square Footage 400 Type of Development ResidentialAddition No. of Units 1 Comments ddition. to Guest House . r 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, detach_ ed'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: Residential Addition 500 Sq Feet or Less , EXEMPT This certifies that school ,facility fees imposed pursuant to Government Code 53086 in he amount of 0.00 X 400 or$ 0.00 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 N/A 'Telephone 1345-9274 2 Name on the check Y. By Dr. Doris Wilson M`,r� a ' Superintendent C ri Fee collected /exempted by Ellen Patino Exempt $0.00 C ? Check No. N/A Si; nature__`�'�/%(/ alt? ,/ /04 . NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protea t the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to 3nolher public entity authorized to called them on the District('s)(s') behalf, whichever is earlier. 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 i ,.. r%# -.- Recording Requested By: When! When Recorded Mail To: JASFAM EMTERPRISES, LTD. 1328 Baldwin Cr. S.W. Calgary, Alberta Canada T2V 2B8 D //7 ail8�� TRA: (Space Above Line For Recorder's Use) APN:. City of La Quinta - Riverside Co-.inty Documentary Transfer Tax 428.45 Agent Determining Tax GRANT DEED RANCHO LA QUINTA (Lots 50 to 75 and A of Tract No. 28343) FOR A VALUABLE CONSIDERATION; receipt ofwhich is hereby ` acknowledged, T.D. DESERT DEVELOPMENT LIMITED PARTNERSI- F;:A DELAWARE LMTED PARTNERSHIP ("Grantor."), hereby'grants to: JASFAM ENTERPRISES,LTD., a Canadian Corporation ("Grantee"), the following described real property situated in the City of La Q _iinta, Riverside County, California ("Property" ): PARCEL 1: " Lot 69 " of Tract No. 28343, as shown by Map .recorded on October 25 " 1996 in Book 260, Pages 40 to 44, inclusive, of Maps, Records of Riverside County, California (the "Property"). RESERVING FOR THE BENEFIT OF GRANTOR, its successors and assigns, (except to the extent that certain mineral rights are previously reserveA in the Deedrecorded on June 26, 1986, as Instrument No. 148312, of Official Records of Riverside County, California) together with the right to grant and transfer all or a portion of the same, as`klo'wws: unprocessed oil; oil 'rights;;mirierals,: nuneral --rights and"natural gas rights and other hydrocarbons by. whatsoever°name;known;`geothermal steam -and -1- S other geothermal resources as defined in California Public Resources Code Section 6093, et seq., and all products derived from any of the foregoing, that may be within or under the Property, together with the perpetual right of drilling, mining, exploring and operating therefor and storing in and removing the same from said Property or any other land, including the right to whipstockor directionally drill and mine from -lands othe- than the Property, wells, tunnels and shafts into, through or across the subsurface of the Property, and to bottom such whipstocked or directionally drilled wells, tunnels and shafts under and beneath or beyond the exterior limits thereof, and to redrill, retunnel, equip, maintain, repair, deepen and operate any such wells or mines without, however, the righ;. to drill, mine, store, explore or operate through the surface of the upper 500 feet of the subsurface of the property. 2. Any and all water, water rights or interests therein appu-tenant or relating to the Property or owned or used by Grantor in connection with or with respect to the Property (no matter how acquired by Grantor), whether such water rights shall be riparian, overlying, appropriative; littoral, percolating, prescriptive, adjudicates, statutory or contractual, together with the right and power to explore, drill, redrill, remove and store the same, from or in the Property or to divert or otherwise utilize such water, rights -or interests on,any other property owned by or leased by Grantor; but without, however, any right to enter upon the surface of the Property in the exercise of such rights. 3. The right to place on, under or across the Property, transmission lines, and other communication facilities for a complete community cable antenna, television and. communications system ("CATV System"), and thereafter to own and convey such CATV System, and the right to enter upon;the Property to service, maintain, operate, repair, reconstruct and replace the CATV System; provided, however, that the exercise of such rights shall not unreasonably interfere with Grantee's reasonable use and enjoyment of the Property. 4. Nonexclusive easements and rights of access, ingress, egress, maintenance, repair, drainage, encroachment, support, and for other purposes, as described in the recorded Subdivision Map(s) for the Property. FURTHER RESERVING THEREFROM, for the benefit of Grantor, its successors -in -interest and others, easements for access, ingess, egress, encroachment, support, maintenance, drainage, use, enjoyment, repairs,'and for other purposes as described in the Master Declaration of Covenants, Conditions, Restrictions and 'Reserva`tion of Easements for Rancho La Quinta, recorded on June 2, 1994, as :Instrument No. 226508, as amended or restated from timeto time (collectively, the "Master - Declaration") and the Supplemental Master Declaration of Covenants, Conditions, Restrictions and Reservation of Easements for Rancho La Quinta, recorded on November 21, 1996 as Instrument No. 445647, as amended or restated from time to time (collectively, the "Supplemental Declaration"), all of Official Records of Riverside County, California. -2- FURTHER RESERVING THEREFROM, nonexclusive easements for access, ingress, egress, maintenance and repairs over that portion of the Property described.as a Landscape Maintenance Area in Section *1.30 of the Master Declaration and in Section 2.0 of the Supplemental Declaration. PARCEL 2: If the property is a Burdened Lot as defined in Section 5 of the Supplemental Declaration, Use Easements, as described in Section 3. 10.1 of the Master Declaration and shown and assigned on Exhibit "1" to the Supplemental Declaration. PARCEL 3: - Nonexclusive easements for access, ingress, use, enjoyment, drainage, encroachment, support, maintenance, repairs and for other purposes, all a's may be . described in the Master Declaration and the Supplemental Declaration. - SUBJECT TO: 1. General and Special Real Property Taxes,- and special assessments, if any, for the current fiscal year. 2. Covenants, conditions, restrictions, easements, reservations, rights and rights -of -'way of record, including without limitation, the Master Declaration and the Supplemental Declaration. GRANTEE, by acceptance and recordation of the Deed, expressly accepts, covenants, and agrees to be bound by and to assume performance of all of the provisions and requirements as set forth in the Master Declaration Supplemental Declaration which provisions and'requirements are acknowledged to be ;reasonable and incorporated herein by this reference thereto. This*grant is subject to -and expressly conditioned upon the performance of such provisions and requirements to be performed by Grantee thereunder. IN WITNESS WHEREOF, said Grantor has caused this instrument to be executed on 11111Ae % �l7 1997, at La Quints; Cal forma. T.D. DESERT DEVELOPMENT LIMITED PARTNERSHIP, a Delaware Limited Partnership By: Thomas Cullinan, its Vice President ("Granter") -3- STATE OF CALIFORNIA ) ss - COUNTY COUNTY OF RIVERSIDE " On 1997, before me, the undersigned, a Notary Pubic in and for. said State, personally appeared THOMAS CULLINAN, personally known to me (or proved to me on the basis of satisfactory evidence) to be the person who name is susbscribed to the within instrument and acknowledged to me that he execute] the same in his authorized capacity, and that `by his signature on the instrument the person or the entity upon behalf of which the person acted, executed the instrument. WITNESS my hand and official seal: Notary Public in and for said State (SEAL) ae- ARY BRANSON comm. #1098183 TARY PUBLIC CALIFORNIARIVERSIDECOUNTYC) omm. Exp. May 19, 2000 1 Word6/deeds/28343 -4- r a tt'SChrt ��• 1 - 1eIlla1t July 14., 1997" Mr. John A. Storwick 1328 Baldwin Crescent S.W. Calgary, Alberta, CA T2V2B8 Re: Master Association for Rancho.La Quinta 78-888 via Carmel Dear Mr. Storwick: r The Architectural Control Committee for the Master Association for Rancho La Quinta .has reviewed and approved your plans to add an additional bedroom on the guest house subject to the following conditions: Construction must commence by September 1, 1997 with completion no later than October 31, 1997; Signed copy of the Construction Regulations provided to Association prior to the commencement of construction. An approved stamped set of plans is available for p-ck up at the offices of Desert Resort Management. Your contractor will need these approved plans in order to obtain the proper permits from the City of La Quinta. • If you have any questions please contact me. Sincerely, ' Carol Whitlock Community Association Manager for the Architectural Control Committee Encl. Post Office Box 4772. Palm Desert, CA 92261-4772 W46 Mc 73-550 Alessandro, Suite 5 . Palm Desert, California"'.' 619 346-1 161 . FAX,,.619) W "«'� ; � ) 619) 346-9918