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9704-144 (SFD)` LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensedunder provisions of F- Chapter 9 (commencing with Sdction*7000) of Division.3 of the Business and T W ' ; Professionals Code, and my License..is in full force and effect. O :D M,y License # Lic. Class Exp: Dale r\ Q W /+ % 4 d Z r- /Date � Signature ofContractor� y.�. w 0 CO OWNER=BUILDER DECLARATION' , u1 ,Lu I hereby affirm under penalty of perjury that I.am exempt from the Contractor's ~ d License Law for the following reason: Z ( ) 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 with':licensed contractors_ to construct the project (Sec. 7044, Business & Professionals Code). _`.. I am exempt under Section' B&P.C. for this reason• �► Date Signature, of Owner bN . 'I . . 'WORKER'S COMPENSATION DECLARATION''" I hereby affirm under; penalty of perjury -one of.;the _following ,declarations: ( )• I have and will maintain a certificate of consent to self -insure for•workem' " 6ompensation, as :provided. for. by Section 3700 of the Labor Code, for the performance of the work for which this permit is. issued. ( ) I have and will'.maintain workers' compensation insurance, as required'oy Section 3700 of the Labor Code, for'the performance of the work for. which this permit is issued.'My workers' coriper'sation irisurance carrier,&,policy no. are: Carrier Policy No. I.IN:(G•'.i1�*t1g i�J'S G't� ', ,;; .. , .. • �5k35t71 i,9s�:14.I7ft '-: '.. (This section need not be completed if the permit valuation'is for $100.00 or less). ( ) ^I certify that in the performance of the work for which this, permit is, issued, I shall not employ any person in any manner'so as to beco� a subject to. the workers' compensation laws of California, and agre ' that I should become s'bject to the' workers' compensation prodilioRsS a doh 3700 of the L boi! ode,1 hal ` it comply with thoserav�s'en ate: _A Applicant �� 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 on 'his application. 1. Each person upon whose,behalf this application is made•& each person at whose request and for.whose benefit work is performed under or pursuant to . 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.l have read this application -and state that the above.information is .correct. I agree to'comply with:;all City, and State. laws relating to -the building construction, and hereby authoriz re p,. r sentatw hof this. City to enter upon the above-mentioned property for msjS cfi Moses. Si natureO/wnerA ent ( ) f PERMIT # CONTROL # BUILDING PERMIT 9704-1445.264 DATE VALUATIONX�,:.i.► LOT. TRACTt;l.s DRESS %-ii`SVIA V1,100 CC APN-y311.(E� OWNER CONTRACTOR / DESIGNER / ENGINEER • a ` t r�jll'e�:iJ+►a1' a f "L�9;tl!?�E,a°4f� Cts-lt? DAY 4 ; C..i'}Y;��'.�d`iNfY 1 OR, .. $snv. 2W 1570 MdO iP0401 J 0W DRIVE, SUM -208 QIIX 927135 SANTA ANA.. .. 'CA 92705 " (71A}75l���1S.1 6: E I„ 4-4 5 . USE OF PERMIT 81,1).- PL AN I; . MCC CONSTRUU l.iaj 6p' � •t}V e.H .. jxakE'`C•lit3xi`'tty 56_x€! Sia O ARAE,EIC AI2;4'e°7W.f 600.00 SF ' C°OS O C �P+3.�'�:$�RJ�' i lt�i�t -1414575.90 ay��+ p i. y �}e; {py A I3?y�°i""'.t'�iL�r�`I`.1+,d3 PrO c�:Pt,w't'I2UC't',te>N'i 7?t • 1t3.1<o00��11?S-Q{aG $7f 6I% s 1'f AN' CMI r;t � rtz 1(11: OUO-. z9 3:.t,�t CirJ;2! 4250.00 M!'�P. HANICA k'1ES,. .''- ' 1..):1,CJiifj-421 �0 S".50 Fash t °I`MLtC �i 1~ t, E Pi, L1.MJ1tt4O_113P $1,611215 ,.. Sa 1'C, ioL1 t%IJ'.I,[ f`l A .f:I 121.!'iil� 101:-000441-000 $14,16 ��r;taaaiNs� 1'ii�. •, 1:U1-i►►Ufi-4�3 fiat► .. �2t�.ix) f_N141i�,S'E`Fd'UCT0 it E,Li 2: �5 O(1(1-AtEz-3�1 `. �?,j.c :7fi hiT".!N ^ioC�5-tUL:: STfl3:5'4 +Eil?i=141"�i?,CC1�a�!'l�tic,%1t7A1 �1s�� 1'[:�NN 0� .J.EG?� 1"'Ess :1p 6 R,k .C1 FE E, > 41250,flfj C!`,1'ri:>X..]F'8 [t{9�'1'@ 1' 1r a t1`5..1V()1it 5A,!D 19.96 ECEIPT DATE BY ; y r i ' y'dATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING AP MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel V2 Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation 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 POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings OP 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 COMMENTS: 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) - • � �� • I�.PPLICATION.ONLY •. ... P O BOX 1504 Building 7 ��y t �' T'/ 78-105 CALLE ESTADO Address / y !G� % orr'" f C LA QUINTA, CALIFORNIA 92253 Owner �G h 4 t_N/4,to, d co.;7"a u N Mailing 70 /6`UfAddress 1:5 City Su h � ���. zl 17d ITel. Wel 7S7 713-/ Contractor . Ctih4d4„/ i.rarb.�M� Address C-- / City IZip I Tel. State Lic. City & Classif. I I I Lic. # Arch.; Engr., Designer as M �fJr/sa f til /7 �6v�J Address / ! Tel. 760 3d0/2// City l r Zip State c ' y A ! M 'h yl %.� (p� Lic. # i / 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 1 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 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 five hundred dollars ($500). 17 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.) t'1 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.) 7 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' 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 the 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. BUILDING: TYPE CONST,.. . OCC. GRP. A.P. Number y Legal Description Project Description Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY: Sq. Ft.No. Size o?3-77 No. Dw. Stories Units New ❑ Add O Alte, ❑ Repair ❑ Demolition ❑ F. Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY ide 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.) ide Setback from Property Line Lender's Name `jp Estimated Valuation FINAL DATE INSPECTOR PERMIT �.�JO Op AMOUNT i` Plan Chk. Dep. _ ev � .— Plan Chk. Bal. ry Const. Mech. Validated by ►� Electrical Plumbing Va Nation: S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: Front Setback from Center Line F. Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY ide 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.) ide Setback from Property Line Lender's Name `jp 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. Qi r-•: - p�P •^ ' I certify that I have read this application and state that the above information is correct. I Issued 6`y” Gate 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 Va Nation: City, State, Zip BUILDING DIVISION CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING F 9q IST FL. SO. FT. @ $ 2ND FC. • SQ. FT. POR. SQ. FT. , GAR. SO. FT. CAR P. SQ. FT. G?? WALL SQ. FT. SO. FT. ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE:.Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE 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. F7. c BATH TUB SQ. FT. p c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ IVa c SEWAGE DISPOSAL HOUSE SEWER REMARKS: ZR GAS PIPING PERMIT FEE Ff P PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.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 APPJEQUIP. 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 Desert Sands Unified School District Notice ,. 827879 Highway,111 M Indio, CA 92201 = Document Cannot Be Duplicated 619-775-3500 ' CERTIFICATE OF COMPLIANCE s Date 6/6/97. APl`i# . 643-130-061', No. 15610' - Jurisdiction La Quit to . Owner NameCanady &Company Permit #9704-144 . No. 78-885" Street Via Florence ~. Log'# ` City La,Quinta Zip '92253 Study Area 123 Tract # .' Lot# Square Footage 2377 + • _ Type of Development Single Family ResidenceNo. of Units Comments At the present time, ythe Desert, Sands,'Unified School District does not' collect fees on garages/carport's, 'covered, patios/walkways, residential additions under. 500, square feet;"detached accessory structures o- replacement mobilehomes. It has been determined the above-named: owner is exempt from paying school fees at thin time `due to the following t reason: I F EXEMPTION NOT APPLICABLE f This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.84 X 2,377 or'$ 4,373.68 �' the property listed above ane that •bu i ld ing permits ;and/or Certificates of Occupancy for this square footage in this;proposed project may now be issued Fees Paid By Cashier's Check'Pacific National Bank Telephone, (714) 75179,151 ' • Name on the check ' By Dr. Carol McGrew Administrator in'Charge� , -Fee collected /exempted by Peggy Reyes Payment Received:` ' .''$4;373 68r ' Check No. 67528 n ; Signature r ICE: Pursuant of Assembly Bill 3061 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 day approvalperiod in which'youiriay polest'lhe fees or other payment idenled' e will begin to run from the date on which the building or installation permit fol this project is sssued or on which they are paid to the Districts) or to another public entity authorized tod 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, _-I' Applicant/Receipt Copy: Accounting MAI,B-97 12:00 FROM:FORESITE ESCROW INC. AND WKN MCOROCD h1An t0 name Canaday and Co. "," 1570 Bro0kh0110M Drive ID:619 7739263 PACE S/6 care, Suite 298 state Santa Ana, CA 92705 TT -100 caw. p SPACE ABOVE THrS UNE FOR RECORDER'S t1SE GRANT DEED APN No. Title No. Escrow No. 2-22095 THE UNDERSIGNED GRANTOR(s) DECLARE(s) DOCUMENTARY TRANSFER TAX is S 231.00 CITY TAX S O computed on full value of property Conveyed, or O computed on fug value less value of liens or encumbrances remaining at time of sale. O Unincorporated area: L)U City,of LA QUINTA , and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, WILMA-LA QUINTA L.P'., A DELAWARE LIMITED PARTNERSHIP hereby GRANT(s) to CANADAY AND COMPANY, a California Corporation the following described real property in the County of RIVERSIDE , State of California: SEE EXHIBIT "A ATTACHED WILMA-LA QUINTA L.P. A DELAWARE LIMITED. PARTNERSHIP BY:, CENTRUM PORT PAVILION LTD., A DELAWARE CORPORATION, AS -GENERAL Dated: PARTNER BY: WILMA SOUTH MANAGEMENT CORP., A GEORGIA CORPORA ON, ITS ATTORNEY StoleotGnttOmaj2, FIV12- 1DA 1>C11arles D. Craham County of 1J [.L VA L. 1 before me. h (here insert name) Notary Pubic. personwy oppeored personoUy known to me (o(proved to me on the basis of sotisfoctoryevidence) to be the pewr•Qs) whose ncnWs) is/are subscribed to true win -in instrument and ocknowieaged to me oU that he/she/they executed th® some in siker/tt,eir outh=ed copocity m), and that by his/her/their signatures) on the.irW(ument the person(s), or the entity upon beholf of wtKh the per"(s) octed, executed the, instrumenl. WITNESS my hand and offi iol seat.•-'•. PAONOALr<!8r D. DOOOM . `E►�i' M1' WZ"SSi011 i OC 290213 pr ; t7�ftiES: AA9 tl, tf)$f Sisrwt�re _ L��h-/ �✓� i'•f.L'��Ii/..'v r aax ced ..antis oaae+ �P�- G43�300b) MAR -016-97 12:`01 FROM:FORESITE ESCROW INC ID:619 773 9269 Exhibit "A" Parcel l: Lots 103 and 113 of Tract 26152, in the City of La Quinta. Cotinty of Riverside, State of California, 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. 91-108, recorded March 26, 1992, as Instrument No. 105176 of Official Rexrds. EXCEPTING therefrom all oil, gas and other hydrocarbons 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 or into that portion of the subsurface thereof, lying below a depth of 500 feet, pleasured vertically from said surface. as nxerved.in deed recorded August 4, 1993, as instrument no. 303830 official records. PARCEL 2: A nonexclusive easement for ingress, egress, M and enjoyment of the comma area as defined in the Declaration of Conditions. Covenants, and Restrictions recorded November 27, 1991, as instrument no. 4151.12. PARCEL 3: A temporary nonexclusive casement appurtenant to Parcel 1 for pedestrian and vehicular access, ingress and egress over that certain real property more panic lady described in Exhibit 1 which is attached hereto and incorporated herein by this reference. The temporary easement granted in this Parcel No. 3 shall automatically terminaoe and be of no further force or, effect upon annexation of the Lots describe on Parcel No. 1 under the Declaration of streets providing vehicular and pedestrian access to Parcel 1 herein and the transfer of fee title to or an easement over said streets to the Lake La Quinta Homeowners Association, a California nonprofit corporation ("Association") for access and use purposes _lursuant to the Declaration. Upon. the termination of the temporary easement granted pursuant to this Parcel No. 3, access to Parcel l of the Property shall be pursuant to the nonexclusive easement granted pursuant to Parcel No. 2 above. RESERVING THEREFROM UN'T'O GRANTOR, is successive owners and assigns, together with the right to grant and transfer all or a portion of same as follows: A. All water rights or interest in water rights that may be within, under or on the property, whether such water rights are riparian, overlying. appropriadve, percolating, prescriptive or contractual; provided however. that the reservation made herein shall not reserve to or for the benefit of Grantor any right to enter upon the surface'of the Pwperty in the exercise of such rights, together with the right and power to use or utilize on any other property owned or leAsed by Grantor any and all water rights or interest in water rights no matter bow acquired by"Grantor. B. Easements over the property for the construction, installation and waiatmance of electric, gas, telephone, water, sewer, private street, landscaping, trail and drainage facilities, provided that the construction and installation of such facilities shall not unreasonably interfere with Grantee's development or use of the Property. SUBJECT TO: 1. Taxes and None Assessments: Nondelinquent general, special and supplemental real praperty taxes and assessments; 2. Restrictions of Record: All covenants, conditions. restrictions, reservations. dedications, easements, encumbrances, rights, and rights of way of record. 3. Assiglunent of Declarant Rights: Effective upon recordation of this Deed, Grantor assigns to Grantee with respect to the property, all of Grantor's rights, exempu6w and entitlements as 'Declarant' under the Decl1hration and any amendments or annexation documents recorded in connection therewith, including without limitation, all exemptions from Association, Architectural and other review and approval; development rights, entitlements and access over all portions of the Rancho La Quinta development for purposes of constructions, development and sale of residences within the Property; and all voting tights of Declarant with respect to the property. Upon recordation of this.Deed, Grantee shall have the same rights with resow to the vrovertv under the Declaration as Grantor orior to the date of recordation of this Deed.