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BRES2016-0366LICENSED CONTRACTOR'S 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 Professions Code, and my License is in full force and effect. License a License No.: 655874 Dt- ate: i Contracto OWNER -BUILDER ECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section.7000) of Division - 3 of the Business and Professions Code) or that he or she 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 k;'3 - compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself.or herself through his or her own employees, provided that the 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 or she did not build or improve for the purpose of sale.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ( ) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: (760)340-9800 Llc. No.: 655874 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjuryone of the following declarations: 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 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Car ' EMPT Polity Number: r 1 certify that in the performance of the work for which this permit is issued, I s F nofemploy 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 3 0 of the Labor Cod Is all forthwith comply wit thos provisions. Date: ' Applica WARNING: FAILURE TO SECURE WORKER COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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: " APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this 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 application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or . following issuance of this permit. 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 county ordinances an'd state laws relating to building construction, and hereby authorize representatives of this city to enter upon the. above mentio ped p operty for inspection purposes. Date: O Signature (Applicant or Agen :4 j . VOICE (760) 777-7125. 78-495 CALLE TAMPICO 7-701 LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPE NS.(760 -715.1 BUILDING PERMIT Cr i Date 3/8/ o LO z Application Number: BRES2016-0366 Owner: c Property Address: 52983 VIA SAVONA PAUL DEWEY cv APN: 777380001 PO BOX 12793 C� C CX. Application Description: HIDEAWAY/ SUNLITE / SFD 6888 SQ FT PALM DESERT, CA.92255 ® � 0 Property Zoning: Application Valuation: $634,359.10 U Applicant: Contractor: ® Z ESU /FMESUNLITE DEVELOPMENT 1 C tri 180016TH ST P 0 BOX 10668 p SANTA ANA, CA 92701 PALM DESERT, CA 92255 LICENSED CONTRACTOR'S 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 Professions Code, and my License is in full force and effect. License a License No.: 655874 Dt- ate: i Contracto OWNER -BUILDER ECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section.7000) of Division - 3 of the Business and Professions Code) or that he or she 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 k;'3 - compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself.or herself through his or her own employees, provided that the 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 or she did not build or improve for the purpose of sale.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ( ) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: (760)340-9800 Llc. No.: 655874 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjuryone of the following declarations: 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 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Car ' EMPT Polity Number: r 1 certify that in the performance of the work for which this permit is issued, I s F nofemploy 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 3 0 of the Labor Cod Is all forthwith comply wit thos provisions. Date: ' Applica WARNING: FAILURE TO SECURE WORKER COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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: " APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this 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 application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or . following issuance of this permit. 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 county ordinances an'd state laws relating to building construction, and hereby authorize representatives of this city to enter upon the. above mentio ped p operty for inspection purposes. Date: O Signature (Applicant or Agen :4 Date: 3/8/2017 Application Number: BRES2016-0366,; Owner: Property Address: 52983 VIA SAVONA I PAUL DEWEY APN: 777380001 PO BOX 12793 Application Description: HIDEAWAY / SUNLITE / SFD 6888 SQ FT PALM DESERT, CA 92255 Property Zoning: Application Valuation: $634,359.10 Applicant: Contractor: " ESU /FME SUNLITE DEVELOPMENT INC 1800 16TH ST P O BOX 10668 SANTA ANA,, CA 92701 PALM DESERT, CA 92255. • (760)340-9800 Llc. No:: 655874 Detail: NEW 6888 SQ. FT. SFD THIS PERMIT DOES•NOT INCLUDE POOL,SPA, BLOCK. WALLS, DRIVEWAY APPROACH, FIRE PIT, BBQ, OR -WATER FEATURE: HOME IS FIRE SPRINKLED PER 2013 CRC CODES. FINANCIAL •• • DESCRIPTION ACCOUNT QTY AMOUNT ART IN PUBLIC PLACES - RESIDENTIAL 270-0000-43201 0 $1,085.90 Total Paid for ART IN PUBLIC PLACES - AIPP: $1,085.90 DESCRIPTION ACCOUNT QTY. AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $26.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $26.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - CIVIC CENTER 252-0000-43200 0 $942.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 DESCRIPTION. ACCOUNT QTY AMOUNT DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - LIBRARIES 253-0000-43200 0 $344.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - PARKS/REC 251-0000-43200 0 $2,048.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 DESCRIPTION ACCOUNT QTY AMOUNT TEMP POWER SERVICE 101-0000-42403 0 $25.33 DESCRIPTION ACCOUNT QTY. AMOUNT TEMP POWER SERVICE PC 101-0000-42600 0 $17.73 Total Paid for ELECTRICAL: $43.06 ,DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $103.36 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF, PC 101-0000-42600 0 $42.56 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $152.00 DESCRIPTION ACCOUNT QTY AMOUNT . RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $50.16 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $348.08 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT >7KSF 101-0000-42408 0 $38.00 DESCRIPTION ACCOUNT QTY AMOUNT. RESIDENTIAL. PRECISE GRADING - CUSTOM HOME LOT >7KSF PC, 101-0000-42600.0 l $190.00 Total Paid for GRADING: $228.00 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR 101-0000-42402 0 $190.00 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR PC 101-0000-42600 0 $126.65 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD 101-0000-42402 0 $25.34 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD PC 101-0000-42600 0 $10.14 DESCRIPTION ACCOUNT QTY AMOUNT, FURNACE 10170000-42402 0 $190.00 DESCRIPTION ACCOUNT QTY AMOUNT FURNACEPC 101-0000-42600 0 $126.65 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN 101-0000-42402 0 $126.70 DESCRIPTION ACCOUNT QTY AMOUNT .. VENT FAN PC 101-0000-42600 0 $50.70 DESCRIPTION ACCOUNT QTY AMOUNT WALL HEATER 101-0000 42402 0 $50.66, DESCRIPTION ACCOUNT QTY AMOUNT WALL HEATER PC 101-0000-42600 0 $25.34 Total Paid for MECHANICAL: $922.18 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION. PERMIT 101-0000-42400 0 $866.17 Total Paid for NEW CONSTRUCTION PERMIT: $866.17 DESCRIPTION ACCOUNT QTY AMOUNT' NEW CONSTRUCTION PLAN CHECK 10170000-42600 0 $1,200.00 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $721.10 Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,921.10 DESCRIPTION ACCOUNT QTY AMOUNT BACKFLOW DEVICE 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT BACKFLOW DEVICE PC 101-0000-42600 0 $5.07 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER 101-0000-42401 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT' BUILDING SEWER PC 101-0000-42600 0 $17.73 .DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP 101-0000742401 0 $392.77 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $392.77 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $38.00 DESCRIPTION . ACCOUNT QTY AMOUNT GAS SYSTEM, 5+ OUTLETS PC 101-0000-42600 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT ROOF DRAIN .101-0000-42401 0 $25.34 DESCRIPTION ACCOUNT QTY AMOUNT ROOF DRAIN PC 101-0000-42600 0 $25.34 DESCRIPTION ACCOUNT ` QTY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $25.34 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT PC 10170000-42600 0 $15.20 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.67 Total Paid for PLUMBING FEES: $1,026.23 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $82.47 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $82.47 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 _ $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 DESCRIPTION ACCOUNT QTY AMOUNT SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 Total Paid for TUMF - RESIDENTIAL: $1,837.44 r '� CV P.O. BOX 1504 BuildingpO 78-495 CALLE TAMPICO Address 5z 9O 3 V//T<�10/Vyf LA QUINTA, CALIFORNIA 92253 S�iYG /T� G Mailing Address pG &,Y l dl.&A WA Address City lZip JTel. State Lic. // .•,�•-� City I & Classif' 77L1 Lic. # Arch., Designer Address Tel. -7 LICENSED CONTRACTOR'S DECLARATION I hereby affirm tbaHem licensed un ovisions of Chapter 9 (commencing with Section 7000) of Division 3 the siness rid P ofes ions Code, and my lic �s in toll force d effect. SIGNATURE DATE O R -BUILDER D LARATION 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 suchpermit to file a signed statement that he is licensed pursuant to the provisions of the Contrac- tor'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). 0I, as owner of the property, or my employees with wages as their sole compensation, will do rthe work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Profes- sions 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). O 1, as owner of the property, am exclusively contracting with licensed contractors to construct 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 tractor's License Law) ❑ 1 am exempt under Sec. _ I . & P.C. for ttt e"ason WORKERIS COMPENSATION DECLARATION I hereby affirm that I hav 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 Workers' Compensation taws 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 of this city to enter the above-mentioned property for inspection purposes. Signature of applicant �� Date Mailing Address City, State, Zip WHITE = BUILDING DEPARTMENT 00, APPLICATION ONLY BUILDING: TYPE CONSTT,OCC. GRP.'-7,/�i� A.P. Number -7'7. 3 !30 Z Legal Description :17:9 � g - Project Description Sq. Ft. /0' G41_7 No. Newly Add ❑ No. Dw. Alter ❑ Repair ❑ Demolition ❑ IEstimated Valuation / rI �O ,O O �,,C PERMIT Plan Chk. Dep. Plan Chk. Bal, Const. Mech. Electrical Plumbing S.M.I. Driveway Enc. Infrastructure TOTAL CONTACT INFORMATION NAME: PHONE: AMOUNT 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 DATE INSPECTOR Issued by: Date Permit Validated by: Validation: YELLOW = APPLICANT PINK = FINANCE 11 Coaches' Walley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: - MITIGATION AMOUNT: COMMAND. AMOUNT: DATE: - RECEIPT: CHECK #: - INITIALS • CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: The Hideaway Date: February 21,.2017 Owner's Name: Sunlite Development Phone No. Project Address: 52-983 Via Savona Project Description: SFD APN: 777-380-002 Tract #: Lot #'s: Type of Development: Residential XX! Commercial Industrial Total Square Feet of Building Area: 6888 Sq. ft. Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized to sign on behalf of the owner/developer. Dated: February 21; 2017 Signature: . SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) k*j#**####***k*##*###* EN OR WILL BE SATISFIED IN Education Code Gov. Code Project Agreement Existing Not Subject to Fee 17620 65995 Approval Prior to 1/1/87 Requirement Note: q.Ft. b888 Pursuant to AB 181 any room additions or enclosures of 500 Number of S Amount per Ft688 8 sq. ft. or less are exempt from developer fees. Any mobile homes being relocated within the same school district's Amount Collected $23970.24 jurisdiction are exempt from developer fees. Building Permit Application Completed: Yes/No By: Elsa F. Esqueda, Director of.Facilities and Maintenance Certificate issued by: Laurie Howard, Secretary Signature: NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. IN1V:c/mydocs/devfees/eciiificate ofcomipliance form updated 3-2007 11/2010 RECORDING REQI;,.:;1LL) ur: T r�►G�iLTA��... Tv AND WHEN RECOrt.,..0 Mwu 'ro: Paul Dewsy PO Box 12711,j Palm Deser L , i.:; , j2255 Order No.: _910-1t. .. , ... Escrow .No.: Fsi,,. A.P.N.:77T3so-oot 3 1t;;•. 0:u -2o5 DOC # 2016-0449509 10/13/2016 02:06 PM Fees: $-763.00 Page 1 of 2 Recorded in Official Records County of Riverside Peter Aldana Assessor -County Clerk -Recorder "This document was electronically submitted to the County of Riverside for recording" Receipted'by: MARY #420 SPACE ABOVE THIS LINE IS FOR RECORDER'S GRANT DEED THE UNDERSIGNEu C1v\N1'0R(S) DECLARE(S) DOCUMENTARY TRANSFER -TAX IS $ 781 . 00 [ X ] cc:. ;ted on full value of property conveyed, or {. ) c rnputedon-full-value-lessvalue-of-ikmor-encumbrancesremaWngattil eof.sale. X ) City of La Quinta FOR A -VALUABLE CL f-!' ,.;DERATION; receipt of which is hereby acknowledged, —Huntington Beacn t roporties,.11-C, a Wyoming Limited Liability Company hereby GRANT(S)'i., - Paul Dewey , r,_ L cd man as his sole and separate property the foiiowtng desct;t.,,d real property in the County of Riverside, State of California See Exhibit'A" ak.;ched hereto and made a part hereof. Commonly knows; ,._ : :cant Lot (52983 Via Savona) , La Quinta, CA 92253 Dated: October 4,21.;16 A notary public or ur, r,i uniwr cumpieting this certificate veriHes_cnly_the_idt_L,; ut uio individual who signed.the document to whist .0 c oi.t, icate3 is attached, and not the t uwwness.'accura< ;,'off vc�uJity of that document. STATE OF CN COUNTY OF 'r O On / ?._ before me, A 2 a notary public, personally appeared i S who proved to me on u,e basis of satisfactory evidence to be the person(s) whose namo(s) is/;,re subscribed to the within Instrument and ackm ::•edged to me that he/shelthey executed the same in his/her/their authorized capaeity(les), and that by hi.Vher/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument I certify under PENALTY -OF. PERJURY -under the laws of the State of Califomia•thar,fhe foregoing par'agriapti is true;and correct._. :�• WITNESS my hand and official scut. (Seal) (This area for official notary seal) =NTS AS DIRECTED ABOVE Huntington Beach. Properties, LLC, a Wyoming Limited Liability Company } SS.: Autho ignerjZAM U IA5 JEFF SCHWARTZ Comm.. #2075608 u, -Notary Pubis[ •California n i ° .. Orange County 1 `•� Comm. Expires Jul 24, 201 a