9803-131 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby 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 # Lic. Class Exp. Date
a'
ate/Signature of Contractor
r
OWNER -BUILDER DECLARATION .
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason: 4
( )' 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 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
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty`of 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.
(\J 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:
Carrier Policy No.
LM;LAREE INS CJ
(This section neednot 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 provisio s offSection 3700 of the Labor
Code,- I shat' forth it ,comply with those pr visions
,%Date: Applicant j(��W�CF1
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 I have read this application and state that the above information is
correct,n 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
th above -mention
ed property for insp/etionpurposes..
,19ignature (Owner/Agent) r � - Date 3 7- '. ,
BUILDING PERMIT PERMIT#
°°NTR°`#
DATE / I VALUATION LOT: LOT TRACT Q �'I O
JOB SITE] F
ADDRESS .d'li�lti,d
477-0851114A
APN,
rp
OWNER
CONTRACTOR / DESIGNER / ENGINEER
C,*,Nc`1D Y,&.00.fV1PA. T.
CANADA & CONIPARFY
1570 BROOKITOLLOW i,)RIV`F, Svr E 0S
S.t1l�l A ANA CA, 92705
SA1',1'A ANA
C.A. 9270
71 1751--.9t51 ;
CRL9 448.5
USE OF PERMIT
51'1
-t'`U - r12RAs, t`.T)6_8 NOT iNCLUDt-0P1�> ONA1. con -A,
81—OCK VF/A1..3 O'k POOL. P1,AN t„ IH3 C,1L FEE REDID{ EI) 7.3`/K, Fbk
r na*tpi 1; tsqu (,X OF SAME PLAN1 v PPL .
A T CO. S RWM •race: Sr . Mi
a
R 2.7 1998
Pt3:i2C<�U��r`�1'I:t� • :Z�A.OEi_.�.l:
.
011AZ I if+: AIZl'f: R.r 6'�3 -00 iii%
CITY
1 T
FLA QUINTA
159164740
PJ7N"HT.1? 1».5,'. SUAL OUR V
t.
r:*NS'r12i.1*;;."riaigv.m 101--000-41MOO
KA14 C!%F'rwK #1,Z .- 101.41W-439-'318 X 1'9.€
��'i1tiA�tGAT'2E : ' i:t31-00047.1-000 A�B;ti
$ iG1f',ttft �a3 fL4: lOf.-010 �i2ii (KIA $1154.744 _
-
Pt
NrTION ,F09.1211,13115 10 r1-OOCI 24.11-00U $ f +5
(111A.T)"520,00
PJA AN 10!
JV.PT.nq PUMIC-Pi ACES sir�761-0.00Y255-fl(>;n
S15,y, rsX2
LESS PAID FEES
425-0,00
. "� FAX' St11�.,c91Y.i.Y � i? q:.�P' S 1.iUP, r11Qi�'�
, 2:3.a�2
RECEIPT
DATE
BY J
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
.Underground
Set Backs
Ducts
Forms 8 Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing d
Compressor
Insulation
Vents
Fireplace P.L.
I
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 A PROVALS
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 LateralB
Pool Cover
Sewer Connection Aw
Encapsulation
Gas Piping
Gas Test
Appliances
J
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Law Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
k p
Final
Utility Notice (Perm)
COMMENTS:
Certificate of. Occupancy
City of La' Qui.nta
Building and, Safety Department 'OF,�°
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=685 VIA MONTIGO
Use Classification:
SINGLE FAMILY DWELLING
Bldg. Permit No.: 9803-131
Occupancy Group:
R-3 Type of Construction:
VN
Land Use -Zone: RL
Owner of Building:
CANADAY AND COMPANY
Address:
17480 EAST 17TH ST. #106
City;
TUSTIN' CA 92780
-
By:
STEVE TRAXEL
Date:
12-31-1998
Building Official
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Cit of La' Q,uinta� � �. I.
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' La Uinta
„ ; CA 92253: ,
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Building Permit*plication and,°Tracking Sheet - : ': .
_
Project Address: / �o V 5�,VI . �/% p j o
Owner's Name: G h a. �' �o r"
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`A. P. Number i o;A ✓ ..1-2W
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Address: 1 15 %j// i K v ��o.J. �r W do "
Legal Description: .,Lo Zt06' .I.
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City,ST,ZipI-5'�rT� �%n�' �'�:q _
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Contractor: -` ,/• ;, a
6-n 44 • �OH" .fn
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Telephone: • 7 %S , S
Address: 5 O
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Project Description: r ' o?to So2r : LCiT ��O
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Siaie Lic. # : <-/I 5-71561,
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Arch Etigr., Designer: •� .:,r/ �n �o t4
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City. ST. ZiP: O r'31 i S
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Name of Contact Pelson:. �D `j.
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-Desert Sands Unified School District
Notice: 82-879 Highway 111
+ W 'Indio, CA 92201
Document. Cannot Be Duplicated {
c
to, 619-775-3500 -
CERTIFICATE OF COMPLIANCE h
Date 3/27/98 APN # 643-120-023
No. 16825 Jurisdiction La Quinta i
Owner NameCanaday& Company Permit #
No. 47-685 Street Via Montigo Log #
City La Quints 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'.lie is'si:ed'AV
Pees Paid By Cashier' Santee
Y Teleplione71 9636 'x
Name on the check^. t ?
By Dr. Doris- Wilson'` ¢ �A�,
Superintendent �� W41
14'
'4
Fee collected /exempted by Juanita Green Payment Received $5072t0`4n
Check No. , 161293
Signature
_ a
NOTICE: Pursuant of Ass y Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -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 countyor'city plan check application form to district copy for all waivers.
Embossed Original Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
IecoR riding Reqyested By
CHICAGO TITLE COMPANY
AND WHEN RECORDED MAX TO
f Name Canaday k,,,Company,
Adaleg
.1570,Brc;6khollow Drive
Cry & Suite 208
stote Santa Ana, - CA 92705
TT- )()0 (Rev. 41V4) 12
13
4196-16
RECEIVED FOR RECORD y,>'
A 00 O'CLOCK
PAIDNOV 14 1997
U0C. I ranister Tax
Couw . ...
Riv.
Fees $71L ..
SPACE ABOVE THIS LINE FOR RECORDER'S USE
GRANT DEED
X
APN No. -Title No. 7200662 Escrow No. 2-1872CB
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY TRANSFER TAX IS$ 726.00 CITY TAX $
* computed on full value at property conveyed, or
* computed on full value less value of liens or encumbrances remaining, at time of sale,
* Unincorporated area,- M City of LA QUINTA x. and
FOR A VALUABLE CONSIDERATION, receipt of which it hg:,rgNhxt neLnAwIq*.dned I
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
Countyof RIVERSIDE State of California:
Lots 224,225,247,248, 260, 261 of Tract 26152
SEE.EXHIBIT "A ATTACHED WILMA-LA QUINTA 'L.P. A DELAWARE_
LIMITED PARTNERSHIP
BY: CENTRUM PORT PAVILION LTD
A DELAWARE CORPORATION, AS GENERAL:
Dated: October .29, 1997 PARTNER
BY: WILMA'SOUTH MANAGEMENT CORP.,
A GEORGIA CORPORAT,;ON, ITS ATTORNEY
IN FACT
State of eoWww4iv Or io-o
ss.
County of _bWya I
On 11 before me hQAdQJ i4 j j 'b,C-jQtd,.5.Aj (here insert name) Notary Public.
personally appeared
personally'known to me (or proved to me on the basis at satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to
ine within Instrument and acknowledged to me all tMcrt he/She/they exeCUtecl the some In his/her/their authorized c0pocitY(ies), and
that by his/her/their signalure(s) on'the instrument the person(s). or the entity upon behalf of which the person(s) acted, 9xecurtecl the
instrument.
WITNESS my hand ono official seal. ONO N 0. GOOD"N,
COMMISSION # CC M14
EMMS. JLM 6.2001
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Signature
Lumd
U affix 5000 wiftn border
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EXHIBIT "A"
Parcel 1:
Lots 224, 225, 247, 248, 260, and 261 of Tract no. 26152 in the City of La Quinta, County 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,
.EXCEPTING 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
or into that portion of the subsurface, as reserved in deed recorded August 4, 1993 as instrument no.
303830 official records.
Parcel 2:
A nonexclusive easement for ingress, egress, use and enjoyment of the common area as defined in the
declaration of Conditions, Covenants, and Restrictions recorded November 27, 1991 as instrument no.
415112.
TRA: 020-024
APNo.: 643-110-025-2
-026-3
643-120-019-8
-020-8
-032-9
-033-0
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PARCEL 3:
A temporary nonexclusive easement appurtenant to Parcel 1 for pedestrian and vehicular access, ingress and egress over that .
certain real property more particularly described in Exhibit 1 which is attached hereto and incorporated herein by this
reference. The temporary easement g=ted in this Parcel No. 3 shall automatically terminate 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 I 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 pursuant to the Declaration. Upon
the termination of the temporary easement granted pursuant to this Parcel NoA, 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, appropriative, 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 Property in the exercise of such
rights, together with the right -=d 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 how acquired by Grantor.
B. Easements over the property for the construction, installation and maintenance of electric, gas, telephone, water, sewer,
private street, landscaping, trail and drainage facilities; provided tl;at 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: Nondelinqucnt general, special and.supplemental real property tastes and assessments;
2. Restrictions of Record: All covenants, conditions, restrictions, reservations, -dedications, easements, encumbrances, rights.
and rights of way of record.
3.. Assi nmcnt of Declarant Ri hts: 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;
respect to the P Y. �d all voting.
rights of Declarant with res
p property. Upon recordation of this Deed, Grantee shall have the same rights with
respect to the propeny under the Declaration as Grantor prior to the date of recordation of this Deed.
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