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9803-129 (SFD)LICENSED CONTRACTOR DECLARATION Lhereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ' Professionals Code, and my License is in full force and effect. . License # t j Lic. Class Exp. Date 351 598 ate b Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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, Business & Professionals Code). ( ) I, as owner Iof the -property, am exclusively contracting with licensed contractors 'to .construct', the project (Sec. 7044,• Business & Professionals Code). O I am exempt under Section 3 B&P.C' for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm, under penalty oP perjury one of .the following declarations: O I 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 performance of the work for which this permit is issued. - ( ) 'I have and will maintain workers' compensation insurance, as required by Setion 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: Carrier. Policy No. I..rN.1Cr- 22M.'3Ctl SC Y -Q1.9 "1r 179 (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 become subject to the workers' compensation laws of California, and agree/that if I should become Subject to the workers' compensation provisions of Section 3700of the Labor ¢Code, I. s all-fo 4iwith comply with those proVISIOn bate: _ ' Applicant— Warning: pplicant 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. , 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 I 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 authorize representatives of this City to enter upon the/above-mentioned property for inspection purposes. Signature (Owner/Agent d, ZD Date J 7 /// PERMIT# "' BUILDING•PERMIT CONTROL# TRACT DATE VALUATIONS $15.9t64!1�40 LOT,. 247• ��1.�G,�' . 17,E f _ ADDRESJOB S 37-�r o ��,�L� t� �- �.�9�si1 TAPN OWNER •~ CONTRACTOR /DESIGNER /E.NGIINEER ;> ' + 'c ..: CFt.ADAAY.& CVMyAN'.r CA1'�Nq4AP&401PAA�C 1570 RROO'HO.i7'v:7TIVE -Wf"r'°208 i57d 33RC3Ui� i.�.LLC3ei+ DRIVE, SUm>t: 208 SAN` A ANA CES. 92705 SANTA AN CA 92705 f714i751-1S1 C3,O 40 i USE OF PERMIT S.I' ' SFO - P fi iT'b6FS kr 6S Gam' .: ,�, .1�0 C rrsLQC war es crit Pct'!? A MAR t7,199R i!'c.AQT rw.r ;iST UC -r ION ITY''r' F'I A' i cx �i?1�f37 'FiY.(.Ci 34.Oi1 �i /� t� QUINTA Co�1ttA.f-'ri..iCtiittyi32t'J' '63 1"; 0.5!' ( •. lc •' r r L r. .. w r 0 4 a�]� a' qy�, a f, yt/� 3 {'p�lic 41.1 ON i:rk�0 Jr. �l�D.' i+•VS'Ri7�Q'&�Y.J.i.. 8. i.e yit `• yy(� � sty - ,9..Dd'�eJ1v /�.�i�T p y,�. �j• �(ryG �Lr.�6.�,t94A n �BJ��6il..l.l Y'i!`J'0.1.1.��j,I�11.\•V'• . y r , , - • , ' C_0NS'17RX+"w1102 M, * •1(3:4-o00~4lmw S849.50 n:�►��iA� �i tMH>c:. ':.P E. t l,l .i -ll0( -•43.9.3-18: 3NiIt'.13ANICA.L FE -6, ' . ' A.01-100424-000 $98.50 t irC: t !t! C rpt 1:'L 101-W-420-000 � 1843-1 ?r,1�T�.�i�?=�.:h'��� .. . �t�a: t,'Ofl=4� �) Rllt? . � . • .'5.+51.23 � • ` • 0:t,AbtN0 M- '10 1 #000-423-000 1NF 11AJS TRtJCTLH.iT� FEE _ -22, -OW-4432342 4t {.F1C. !(3t (fDiJ- I 4ti. . 'M(XI 1? ?'t 'ttl P'UIaI.'IC 6?i.AG S' ttGS. `�0t-tiilf)-^.fi.5 a00 .S 149.:12 - Via-TC�I'.gT, CION IRUC-MN AND 1: LAN CHECK $5,714.71 F.r S R P I UD F f 'S -Q2, Q.00 . - - •.. I`W'•!4M./;C:HJ SO%I,H S•r.1J iSiF . DUE NOW* $5,464.71 RECEIPT DATE BY / DATE FI NAILED. INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade _ Return Air Steel Combustion Air Roof Deck /, Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. 17 Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath EIZ 11-7r Drywall - Int. Lath Final Final t _¢ POOLS - SPAS BLOCKWALL APPROVALS 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 e�_p 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) ► . }, 2�7 r - ..�• 1 . _ .,, • -Bin !i - . i ,C_ity�of La..Qu n•ta : V Z,. a w Bullding'8z Safety Division ' .. ti ,^ P.O. Box 1504 y" Permit '_ 1. , .. - Ca In�i P 8 495 Ile Ta co r11 -', ,: _ . . La Quetta; CA.92 53 • . 1. 4.1.: Building Permit Application and Tracking Sheet . . .-Project Address: ��1� Vf4 t, o :' •Af1. Owner's Name: C-G,he- s;. • . ' -0!501 t Ila. A. P:�Number. � z 3 oZ 00 , , � /.� -:.. Address:`�570 %jroo �( el%N �r #o%O� ' . Legal Description: LO. e� Al. % , ' r ;. City,ST, Zip; `S4 tiT', #.I.. C4 , . .� Contractor: w f �D /'it ,. f l Telephone: 7 %S S Address:• 5 D -. o I O" . r #.�Oj' r -.. Project Description: . 26 � S�, . La- c7 7 ro 'Cit)•.ST, Zip: �,5G .ATL h4 `64 N76.5' 14-kC 24 QU/k f" G4 Q&,". 4 c-_ + hri. Tee o e' P %� s S i r - �. - _ State Lic. it : 6I _' 5; rV _5-61 ' 611 _ City Lica# S _ f. /;.'I'� .� ;�� i . -. Arch-Ei,er:: Designer' Mf k'ir. �e'4'dro i 4- „ r .' . /OU. SA O res , f .1 I�- ,.:,� q Address: - O. 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Z si : Si ff::::iY:: 3i'i% ? i i%?':: `?% '``' •`i #> ............... >' `. .:.:r; :»`:::::>::>;:::?>E::><:>:::>::>:::E:':E:E:::::;: .:::::.:::;,::;;;>;:::;::: Ah pppro�:al:;::;::::>:<::; :—.:::..:.".»:x:..:%::Date.oLlinall »:r:<»::::;:<;;:::z::>s<:<:<>;»:<::>s>::;::::..:::::::::::::::.:::: <: ='>::::::: ::<>:>:>> :>s> ::>< :< »'E: `>'<'::: ::>::>:::: coon....:.::`: ................_::::::.:..:::. u P :.::::: _:....:::::::::.::: ': `%:'::> : <:;: :;::':: ::;: ::::::::::............ 'i:<;:>:'`'%: .2:<;;:;>?;<`E: >>::; ::::i::: ,Total ermlt..:_................_:.... :>i:% [:?%:;:?':::;:> > >'::::°E;>:;; ::i::i >:<s:>:: .::.. 4_.,_-__-.- - .. _ .., _... , V, Desert Sands Unified School District Notice: f 82-879 Highway 111 Document Cannot Be Duplicated Indio, CA 922,01,619-7175-3500 2201619-775-3500 CERTIFICATE OF COMPLIANCE Date 3/27/98 APN.# 643-120-019 No. 16823 { Jurisdiction La Quinta Owner NameCanaday & Company Permit # No. 47-680 Street _Via Montigo Log # k City La Quinta • Zip 92253 Study Area Tract # Lot # ) ` Square Footage. 2628 Type of Development Single Family Residence No. of Units 1 , Comments 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, detached 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: , EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.93 X 2,628 or $ 5,072.04' the property listed above and that building permits and/or Certificates of Occupancy for this square footage. in this proposed project may now, bP`t5,laed i Fees Paid By Cashier Check/Steve Santee 1'ja�aS�� { TeiepSone 771-9636 • Name on the check , _ � �4 Ql- By Dr. Doris Wilson rk`� Superintendent r 1 .. Y • Fee collected /exempted by Juanita Green Payment Received Check No. 161293 Signature NOTICE: Pursuant of Assembly Bill 3MI (CHAP 549, STATS. 1996) this will serve to notify you that the 913 -day approval period in which you may protest 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 another public entity authorized to collect 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 G -Recor�ling Requested $y 1' ' CHICAGO TITLE COMPANY, AND wt EN RECORDED MAX TO Nome Canaday & Company, "a°'ef6. 1570 Brookhollow Drive ON& Suite 208 State Santa Ana, CA 92705 r { La �. ;' 419616 -9 7 RECEIVED FOR RECORD •�_��-" - . - AT 2:OU O'CLACK 1997 Pyre© r NOV 1,4 Doc. Transfer Tax _ r pseotdrd to CE8ri�1 - , - .R{V. Co.-iAt►�:�+��'�r fi.�,.: of i;lre� ���� � . _., � I fees w ,..�...,._,+. GKAN I UttU APN No. _ Title No. 7200662 ;' ; - fs'crow No. 2-1872CB THE UNDERSIGNED GRANTOR(s) DECLARE(s)'. 5' DOCUMENTARY TRANSFER TAX 1s $ 726.00 •:CITY TAX $ ®computed on full value of property conveyed, or x Q computed on full,volue-less value of liens or encumbrances remaining at time of sale, 0 Unincorporated •area: M City of LA Q U I N T A and . FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, WILMA—LA QUINTA 'L P-, A, DELAWARE LIMITEb-�PARTNERSHI'P x hereby GRANT(s) to - „CANADAY AND COMPANY, a. California Corporation • ... rf '' °_ - r _ . ' s" ^r it the following described reel propefty:in the ,, 3 County of. RIVERSIDE • , , State of California: \ Lots 224,225,247,248, ::260, 261. of, Tract 26152 °• - SEE EXHIBIT "A "'.-ATTACHED s WILMA-LA.QUINTA L.P. A DELAWARE ~ LIMITED PARTNERSHIP BY: CENTRUM PORT:,PAVILION LTD:, +ADELAWARE. CORPORATION, AS GENERAL Dated..,0 . ctober 29, '1997 A PARTNER BY : .WILMA ,SOUTH MANAGEMENT' CORP-•, A }GEORGIA- CORPORAT ON, ITS ATTORNEY. -FAQT State' ofec*@r4m Ftc`iaa ss. County of va pnl I I before me!9A1'' w! ►-i 'L �"t Dais=�' (here insert name) Notary Pub1fC. nn RR /�J personallyoppeored l�1iQ✓�t.S - (ter ,arA o personally known to me proved to me on the basis of sgtlSraCtory evidence) to be the person($) whose names) is/are subsCnbed to ine withtn Instrument ana ocknowtedged to me CIl thCt he/She/they executed the Some In his/her /their Outhorized capecity(ies), and that by Itis/her/their signatures) on the instrument the perSon(s). of the entity upon behalf Of which the.perSon(s) oCted.,4xeWe0 the instrument. c , WITNESS my hand and official seal. r �4 WONOALYNN 0. GOODWIN 3 s 11a COMMtf)N / a 8f08/A OMM! JIM 81'lOOt " ;i 3' �.' 4r F - illfll NOtiry ftm WON*"" Signature --•— oKix soot w;ttun bwa« t a - _ZS L 6,l 5&V l L ANV&403 XV(3 /NbO HOdj VJd L l•: 6 8661-8 l 7 l d -�n . �,.• 41yb1b PARCEL 3: A temporary nonexclusive easement appurtenant to Parcel 1 for pedestrian and vehicular accessingress and egress over that . certain real property more particularly describedin. Exhibit 1 which is attached hereto and incorporated herein by this reference. The temporary easement granted in this Parcel No. 3.shall automatically' terminate and be ofn' further force or effect upon annexation of the'Lots describe on Parcel No. l 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 Quinti Homeowners Association, a California nonprofit corporation ("Association") for access and use purposes Pursuant to the .Declaration. Upon the termination of the temporary casement granted pursuant. to this Parcel No. 3, access to Parcel 1 of the Property shall be pursuant to the nonexclusive easements granted .pursuant 'to' Parcel No. 2 above. RESERVING THEREFROM UNTO 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, approprsatv`e., 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 upod'the-surface of We Property is the .exercise m such rights, together with the right and power to use or utilize on any other property owned or Rased by Grantor any and all water rights or interest in water rights no matter how, acquired by Grantor. B. Easements over the'property for'the construction, installation and maintenance of electric, gas, telephone, water, newer, private street, landscaping, -trail inti drainage facilities, provided that the construction acid 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 ptoperty'taxes and assessments; 2. Restrictions of Record_ `All coven_ ants, conditions, restrictions, reservations, dedications. easements, encumbrances, rights and rights of way of record. 3. Assignment of Declarant. Rights: Effective upon recordation of this Deed. Grantor assigns to Grantee with respect to the property, all of Grantor's rights, exemptions and entitlements as "Declarant' under the Declaration 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 rights of Declarant with respect to the property. Upon recordation of this Deed, Grantee shall have the same rights with respect to the properly under the Declaration as Grantor prior to the date of recordation of this Deed. ZS l 61 SL . V i L ,.A NVdH00 ?.V0VINb'0, 110-dJ L td8 1 0 1 866 1 -E: I - l Certificate -of Occupancy ' og City of La Quinta Building and Safety'Departmen-t. This Certificate issued pursuant 'to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS: '47-680 VIA MONTIGO Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9803-129 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL Owner of Building: CANADAY AND COMPANY Address: 17480 EAST 17TH ST. #106 Building Official City: TUSTIN CA.92780 By: STEVE TRAXEL Date: -06-29-1999