0303-136 (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 .
Date 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
`safe (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
�r,Zate Signature of Owner
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 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 & policy no.,are:
Carrier Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
'(A:)a1 certify that -in the performance of the work for which this permit is issued,
Ifshall 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
lsubject to the workers' compensation provisions of Section 3700 of the Labor
.Code, I shal1.forthwith comply with those provisions.
Date: _ Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for' a permit subject to the conditions and restrictions set forth !on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall,. indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any'permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellatio r
I certify that I have read this application and state that the above information i,
correct. I agree to comply with_ all City, and State laws relating to the buildin
construction, and.,hereby authorize representatives of this City to enter upo
the above,mentioned proprd tyfor inspection purposes• '
Sig nafu[e,,(Owner/Agent),,-_Tf Date
T#
E N ='BUILDING PERMIT. PERMI,,
,..
DATE`'
-VALUATIONa� t �+Y LOT i� TRACT 7c0'" 'fir
.'ADDRESS 48-�hf�'j VIAL 14cl�.a. IR -A. JOB
APN
OWNER
CONTRACTOR / DESIGNER / EN &NEER
t I
A7 5-37'7 W'Ys'.+�aP� ,"08 Z
s. LA
Cox:�
,
USE OF PERMIT
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:x.DEPOSIT 1(11.000-x:19.3t&11 •�3,�1]f�,t)D
S:>rX3E.C�':x-1:�..4?i�.r`�:,•trPt;� �7i%:•liU .
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PLC 14.61NO FEE -000;4 19-000
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;51T,1.M1'.A", CL3kva`$��,'!.WCCWON /N3D PLAN MI3' rV-41
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'NJI-,rikel, 11KRWT V!111,131,4 DUE NOW
't�Y 15.7.903_ f�
r
RECEIPT
.-. ..
DATEE
"+!I'j
BY �.. _"..
D FINALED
INSPECTOR
C9TY Or E � 11tf1?
ITA d4 >_,
2
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
(S
Underground Ducts
Forms & Footings
Ducts
Slab Grade
_'127
Return Air
Steel
Z rj
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
�
10,
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
=�� G
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) i
ELECTRICAL APPROVALS
Temp. Power Pole �j 3
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels .
Exterior Receptacles
G.F.I..
Smoke Detectors
Temp. Use of Power . at
Final���
Utility Notice (Perm)
COMMENTS:
' rCERTIFICATE OF COMPLIANCE SFS°
Desert Sands Unified School District
' 47950 Dune Palms Road °
a,, BERMUDA DUNES r
Date 5/15/03 La Quinta, CA 92253
RANCHOIANWE LS
f � INDIAN WELLS
760 771-8515 PALM DESERT y
No. 24425 () � LA QUINTA
INDIO y7
YYY O
Owner Brian & Alexsandra McGuire APN # 658-200-016
Address 75-377 Spyglass Drive, Jurisdiction La Quinta
City La Quinta Zip 92253 Permit # 0303-136
-Tract #` 25237 Study Area
Type Single Family Residence No. of Units 1 r-
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 16 48685 ' Via Sierra 4099 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8 z
Unit 4 Unit 9 -
Unit 5 Unit 10
Comments _
At the present time, the Desert Sands Unified School District does not.collect fees on garages/carports, covered patios/walkways, residential additionsunder
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
� 1
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government. Code 65995 Et Seq.
in the amount of $2.14 X 4,099 S.F. or $8,771.86 have been paid for 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. J
Fees Paid By OC/US Bank = Brian McGuire Check No. 503770832
Name on the check Telephone 760/568-2609 `
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sharon McGilvrey $8,171.86- Iso.w
Payment Recd Over/Under
Signature C l
NOTICE: Pursuant to Government Code. Section 66020(d)(1), 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 issued, or from the date on which
those amounts are paid to the, District(s) or to another public entity authorized to collect them on the District('s)'behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
RECORDIN6�EOUESTED BY:
Sodland
WHEN
AND WHEN RE MA0198:
Brian P. & Alexsandra C. McGuire
75377 Spyglass
Indian Wells, CA 92210.
DOC tj 2003-003163
01/03/2003 08:00A Fee:13.00
Page 1 of 3 Doc.T Tax Paid
Recorded in Official Records
County of Riverside
Gary L. Orso
Assessor, County Clerk 8 Recorder
M S • IJ r....� UA PCOR NOCOR SMF MISC.
A R L COPY LONG REFUND NCHG EXAM
i3
ASSESSOR'S PARCEL NO.: 658-200-016-0 The undersigned Grantor(s) declare(s) that the DOCUMENT TRANSFER
TAX IS:
$ TITLE ORDER NO.: .,... County $ city. I-
a
`
ESCROW NO.: 21720-001 XX computed on the full value of the interest of property conveyed, or
— computed on the full value less the value of liens or encumbrances
GRANT DEED remaining thereon at the time of sale
OR transfer is EXEMPT from tax for the following reason:
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Philip N. Chironis and Gina R. Chironis, Trustees of The Chironis Family Trustdated
December 27, 2000
hereby GRANT(S) to Brian P. McGuire and Alexsandra C. McGuire, Trustees
of the Brian P. McGuire and Alexsandra C. McGuire Revocable
Living Trust December 26, 2002
all that real property situated in the City of La Quints
County of Riverside State of California, described as:
Complete legal description attached hereto.and made a part hereof
Dated December 09, 2002
STATE OF CALIFORNIA, . }
COUNTY OF ;)RA ni'5E. } ss.
On Dcc t r;•, ia_o I I L 7 o Z before me I ejL G2
Notary Public, personally appeared
Ph+IIP N. (i,,, -arils t (-31tiA k.
--__
Pl#ip N. Chironis, Tru
Gina R. Chironis, Trust'
personally known to me (or proved to me on the basis of
satisfactory evidence) to be the person(s) whose name(s) LEIGH GRIFFITH
is are subscribed to the within -instrument and acknowledged OM F • CALIFORNIA
/ g � COMMISSSS IOO N # 1371543
to me that he/she/they executed the same in his/her/their ORANGE COUNTY
authorized capacity(ies), and that by his/her/their signature{s) ; My Comm. Exp. AUG. 24, 2008
on the instrument the person(s), or the entity upon behalf of
which the person(s) acted, executed the instrument.
WITNESS my h nd a o ' ial se
Signature
,MAILTAX TATEMENTS
(Brian . and Alexsandra C. McGuire-75377Spyglass,
NAME ADDRESS
ee
(This area for official notary seaq
Indian Wells, Ca: 92210
CITY, STATE & ZIP .
_ EXHIBIT "All
Lot(s) 16 of Tract No. 25237, in the City of La Quinta, County of Riverside, State of California,
as per map recorded in Book 228 Page(s) 95 to 99 inclusive of Maps, in the office of the
County Recorder of said county, and amended by Certificate of Correction, recorded November
22, 1991 as Instrument No. 406705, Official Records.
Excepting therefrom 1/16`h of all coal, oil, gas and other mineral deposits of that portion of said
land, as reserved in patent recorded June 20, 1928 in Book 9 Page(s) 319 of Patents, records
of Riverside County.
Also except all previously unreserved oil rights, mineral rights, natural gas rights and rights to all
other hydrocarbons by whatever name known, to all geothermal heat and to all products derived
from any of the foregoing (collectively, "subsurface resources"): and
Except all oil, oil rights, minerals, mineral rights, natural gas, natural gas. rights, and other
hydrocarbons by whatsoever name known that may be within or under said land, together with
the perpetual right of drilling, mining, exploring and operating therefore and removing the same
from said land or any other land, including the right to whipstock or directionally drill and mine
from lands other that said land, oil or gas wells, tunnels and shafts into, through or across the
subsurface of said land, and to bottom such whipstocked or directionally drilled wells, tunnels
and shaft 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 right to drill,
mine, explore and operate through the surface of the upper 500 feet of the subsurface of said
land or otherwise in such manner as to endanger the safety of anyhighway that may be
constructed on said lands, as reserved by deed recorded November 17, 1995 as Instrument
No. 385088, Official Records.
ILLEGIBLE NOTARY SEAL DECLARATION
GOVERNMENT CODE 27361.7
r
I CERTIFY UNDER PENALTY OF PERJURY THAT THE NOTARY SEAL ON THE,
DOCUMENT WHICH THIS STATEMENT IS ATTACHED, READS AS FOLLOWS: .
NAME OF NOTARY: Le\,(q\-) C�Yl
:
COUNTY WHERE BOND IS FILED:CCS"c�CL
DATE COMMISSION EXPIRES:
PLACE.OF EXECUTION OF THIS DECLARATION:
DATE: 12 -2 L4 --C2
COMMISSION NUMBER:
AUTHORIZED MANUFACTURES CODE: CJ i
SOUTHN TIT E t.
BRENDA PLEVYAK
TITLE OFFICER
III pill 11111111111111111111111 0",
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Cert�fica`te,of Occu�� aan,c
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�oF • Building -&;Safety Department
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This 'Certificate, is issued to the'requirementsY of Section 109' of the -California Building,?
pursuant,
Code, certifying, . that; at the -time - of;�: issuance; this , structure. ;was 'in,compliance wifli ;,the .
provis ons;,'of `tlie `Building.,Code and the various„ ordinances=of,, the City. regulating buildinglow,
construction'and/or` use
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DDRESS. 48=685 A SIERRA'
SINGLE DWELLING `, �•ti;. z. �,,Building¢Permit N6.:.0303-136
-4s
USeClasslfication: FAMILY '
Occupancy.Group: R3, .�_ ~Type of Construction: VN Land Use' Zone:'RL
,
Owner of Building:,BRIAW& ALEXSANDRA,MCGUIRE = , ;, Address: 75-377 SPYGLASS DRIVE ; w
Y City, ST, ZIP.'LA,QUINTA, CA 92253'
a' -.��{-ter •. yf
• t• k � r� BY KIRK KIRKLAND/
K_y
Date: •FEBRUARY 27
.2004
�a '4 'Building r,:. ci 7 .� ' . is 7 .
-Official
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POST, INA CONSPICUOUS PLACE
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