9804-159 (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 V Signature of Contractor
k
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 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:
( ) 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.
Se( ) I have and will maintain workers' compensation insurance, as required by
ction 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.
1�;)1C111'tll41)7..111741
(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 proVisl fis of Section 3700 of the Labor
Code, I sh I4ure
th comply with thos roisiors?
Date: �an�`Warning: Fsecure 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. 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 it spection pur oses.
ignature (OwnedAgent)•�� =�� Date 8
BUILDINGPERMIT PERMIT# CONTROL#
DATEJ� VALUATION �1:LD��J LOT y TRACT 9
678
N
,�
JOB SITE1 /A 3
ADDRESS %3-•�i _;
APN
OWNER
CONTRACTOR/DESIGNER/ENGINEER
%; Y
v :A j '� Ve'"N,I V`." N
24i
} y"'0 1 iivv a:jRI VE, :/�-�!S i',: .,V'9 _
Vhf B A Al' A CA
SXNA'i AN A !_'A W? GoN y
.9110 111Xq
USE OF PERMIT
�wi) iLEli�i _ti f aZF,+ iil t:>;.i i G dd il) #. AaSZ 13 Y!� >dxsY ,v! r r . 4 tl.lt.l Je:
WK OR 110' 4, .4iANJ ('HhVK .1'h0.K-00,14)) �'1 ® AID
r
MAR 2 71998
f'tikG, ti,'!'t11 fLx oiu;
1,R),V t' � i R . Y'k1G'i't� 4 �.' � !ni t° Irl
iv
�y
tlFLA Q T�
PLAN iWit's 'kV°i< 101101)4*51'=304
�°v 1e�� yCtd3f! tt)r'1 rr.� 101
1If1b-fiOM
GIAt `o �r�:�i.. .t L71,', � loll-�CXMlt "7L'i"fi) �r3� ft11
rt tx"lttR�.-r11I, fed d 41t1 -t17 stt�!!
�IAToVL 011 )Ri't Yd9 g rir`) (f1yy1 f d3 1A=81.aQp}f<G)(t Fe'
�gI
tfUt/ 4 '1 -_Vii .e lc6lt Gi
ART iNVi9!<J('PLAt 1<.; k1H`+6i- 701400-2 i-,49'0 Kul�fj.
R l Y3filaClfyf'r 1,t'1Z•(too 441-318 oil
k�tLPt ICYI'-Af,C`'Gfi
• . wi a
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade ILF
Steel
Return Air
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 - o—
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 I
Gas Piping
PLUM NG APPROVALS
Gas Test
Electric Final
Waste Lines 6
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)
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)
COMMENTS:
• ", -• I I
BI"# -
.A
-'-.-"-.�-..,-.
..-.
-..:.'....:...
.
City of. La• Quinta � '. ,
•.
<
Building ex Safety Division. I • - -
...:...�...-..,.:.*.
.;.: P.O.-Box 1504 . . r ' -fit . -
...--..:1....-.'
.M
..,...*.*....�.."............""..'.-,. ..:.
Perrnit # :.::<>''><:>> `
%'/::
78-495 Calle Tampico • ' • • . - . ,
-...'
. .: ....-...�..:....'..... .,. . .*.-.--..:..,.'..-:-...,
- '
, La,Quinta, CA 92253 L
..,.'.
-
.
, Building Permit Application and Tracking Sheet t
Project:Address: 5r (J/4 Tries�c •
Owner's Name:, �G h4 ,4, �o1 '
A. P. N umber. 6 • l 300 S `) - -
Address: 16 /3` a K v M. N dJr # o%OJ
Legal Description:
r L
Ciry,ST, Zip: S� ti � /gMAI Cry _ , . •
Contractor:-~ 4
C0 P t z rn*f
Tele o -7 f
h ne:
P 7 / S
Address: 5 O ", 0 0✓ 1- .7�o%t7�
Project Description: r ,.7�p�S�, LD/. 'rj
.Citj.ST, Zip: 5e. -w% --& .,�
c � ..9a7oS "
,,...�� k, •Z< Qu, k f•� • �.4 Qom',., f� 4- +
Tee hone:
P 7� s
y
, -
State Lic. # : wig SSI S(1. 3
City Lic. #: � l
/ 4 YL 3 - O C� V �� '
.
Arch . EiiSr../D�esigner/
o
��^ �O Z.4
i
Address: I - �. 13O x 75-
..
z . ,-.
/ /
City. ST. Zip: Ol3CiT //OT � ri-� f G� 1
i r
• • .
Telephone: 3J�i
-
n
C3onstruNupanc :
Y'cuon TYPe: VOccTeIePi
Lic.#.
Demo
N•ro1 Add'n Al ePair. Dem
Pecthc ew
Name of Contact Person: 6 `j
4 � 4-
Sq. Ft.: t�p%( G
# Stories: �
# •Units: , .
Telephone # of Contact Person: �p 0 (p'
Estimated Value of Project:, -
.
::::.::::::.:::;:::.:._:.:::::..::..APPLtGAIV...:i�Q:.:NQT.;VlrfiiT:BELUW.:THfS;I::;:E,:.;;>:::::>::.::::.:::::::::.:::::.::::::1.:::.:......:::
k.
.:::..:::::::::::..
N
t
.. . ..........:..
t _, .:..;•::Re
Submittal ...: ;..: «; :.
.d:.:,::::iter:d..::::.::.::::.:::::::::,::::::::::<:
,;>•:::.4.:::..:::.:::,:::::::.
::..
,
;:•;:;:::;•;;:....:.. ::':>':%>»<»':i<::>;>::»::::
.....1!?G.:::;:;.:..:::::>:::::::::::;;;:..
::<>;:»:>::i:::>:::::i::>:;:>::;:: ERMIT:.FEES ;:
;:::.;::;:.;;::.;:;:;:::;;;;:;:<;p:::::.::....:... ..:.::..::'::.:..;.
.
:: ;:<>;>:::::
:....i::::...-::::--::i:::::::•::::::;:;::::=:
.......................................................P7aD::.'Desk:su
PIaDSets.:..::;;:;.::::::::::.::::::.:.::
..
>:>:;:>:;:>:::<;<:>:>
.
;>;>::>:::::....:::,::.:::;:;::;;;:<•::.;:.;:;:::>::;:;;:<•;;;::.:;:;:;:;:•>:>:;:;::;:::::;..;:;;;:.;.;;::,;:;;;:;:.;:;:;:;::
.1-1-:::::%:'::j:;F::;:::::;:;:;;:::;::::::'::?>;::;:::':::?
............:......
.1.1..1...1....
:::.....::::::::::::::5:::::::::i;:::::::::::::::;:::;:.;::::::;::;:;:;:;:;:
:;;:<.;:;;:;:;:•::•;:;;::::,:<:C;::::::::;1111:;>:i:::::::::>:
Dotted.::::::::::.>:.:;;:>:;
1111....��....::::::::b:::::::.:::::.:::.::.......
:...:-, ::::::::::::::::::::....
:.:.,:.:::::•: ,,.
;:;:;;:•:;;:;:;:;;:;.... .:1:•1......11:::: :.::::.::::::::.
.................::::;:-
:::::::;:::;':>::;<»::::::::::`.::::>:<>.
tem; .:..; ;:; :;:;;:;:;;:;:•:;:;:..., .::.:::.:.
:. .:....
.
;I.-:::.-.-.-
;:'::t::::::rS
,.. A oa. ..; :::::•:::.::
..:
-
Structural Gla ......:::;;•;
1111
.:..:.::
:<>:%6:::'%1111:::
::;
.. "
Rovxwed, setisy fer eormHoar..
:::X.....
:
'
Yta-- Check:.:.: it
2 -
:1111
.
r ,.,
.. ...:::::.:.:
;>>:::.::>::::>>::::>:::<::<::::»»:>::>:1.::
?cuss Cakt:..:.......................:.:.:::....:...:::::.:::.:G
.:: .:::.::::::::::::::;:::.
-.-.::::::.':'.:::.%1
................................
1;111::::;::.:•S::Y:::;:::::::::;:::;:i:i:`:i::.::<:::[;:::::<:»>.
..." :Caotast?Par ed::>::»::>:>:<:>::>::>:::::.:::>::>:»::>
%ITed:..:.:.........................:::::::::::::.::.:::::.::.:::.:........:..::.::•::.:::::::::::::::::::::::.::::::::::.::::::::.
�
..................
>:>::::'.>`..>':.
.. PI
..
::::::.
1111::
*1;641;::.-:
1.
>:._?:'>:::':::;:z
Trt}e 20 Cala.:.:.::.::::;
-..::...:::.::..::::::::::.:.....:::::::.:::.:.:::::
> <::%64.'64:%1111
::..::.:::.::::::::•.:«::1Plaas:.tckrd:u
...:.::::::::.::::.::....::::::::::.........:.:::1R.:::::::::::P:.::.::::::.::.::::::::::::::::....::..:::.:..
;.% --'-'-'-,:::::>>:.:%
:::.::.;:::;:•::;»::::>:>::;>:::;;:>....:.:•.:::..:::•.::::.::.:::............:
..........................................................
%.1111::::::..::
:Coristcucti4a::':>::::::...?:>::::':':<>
.............:...............
;;:::::::.:.::::::::::::::::. ;::::::::::::;:::>:::::::>
.
. . ,.. :::':;.:_,.;;.
77-7
,
...:.....:>:::-,.:::::>:::>:>:::si::::>::::i::-:-:..i::>-.
Gcaut Deed...::::::1...:::::
•::::::::::::::.::::::::::::::..;:::
-:%1111»::;<:%1111
4.
:: aaa'B::resu:tiiuitled:'.rt:>:<::<:»'.::::>:':<::::>::::>::::>::::<:::>::::>::<z:?;::<
:::::::::::::;:::::::::.::::.:.::::::.::::::::....::::::,::-.-'X;:::.:::.::::.::::.:::.::..:::::::.%,..::::..:::::.:::::::::.::.........
'
:>:::><>:'i:%::...:.:......:....:
: h. clrarr cal `:`: ': `:' i:??
Notice:
F Document Cannot Be Duplicated
Date 3/27/98
Desert Sands Unified School District
82-879,Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
No. 16822 Jurisdiction
Owner NameCanaday & Company
No. 78-875 Street Via Trieste ,
City La Quinta zip 92253
APN # 643-130-055
La Quinta
Permit #
Log #
Study Area
Tract # Lot # Square Footage 2286
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 2,286 or $ 4,411.98 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may now hie issuk. t►.
Fees Paid By Cashier Check/Steve Santee
_Tele hrnp`� 7?`1-9636
Name on the check
r
ell
By Dr. Doris Wilson `_
Superintendent+t�`-
Fee collected /exempted by Juanita Green Payment Received $4; 11 98` �:
Check No. 01058148
Signature
NOTICE: Pursuant of Assembly 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 county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
;,4ecordltrg Requested By
�r
CHICAGO TITLE COMPANY
ANO WHEN RECOR0E0 MAIL TO
Canaday &' Company
NOTO 1570 Brookhollow Drive
ada,esa Suite 208
City 6,
State Santa Ana, CA 92705
sl
rr.100 (Rev. 4/94) 0
1.952 zo 7 5 s
RECEIVED FOR RECORD
AT 2.00 O'CLOCK
NOV 1 4 1997
Pit', 00. C'n' R W(ftdANaslQe I
Recorder I �/ •�
Fees
SPACE A80VE THIS LINE FOR RECORDER'S USE
GRANT DEED
APN No. Title No. Escrow No. 01873CB
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY TRANSFER TAX is S 616.00 CITY TAX S
IX computed on full value of property conveyed, or
0 computed on full value less value of liens or encumbrances remaining at time of sale,
G Unincorporated area:. 0 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:
11
Lots 49 through 59, inclusive, and 98, 99, 100, and 100 ofdTract 26152
SEE EXHIBIT "A ATTACHED WILMA-LA QUINTA L.P. A DELAWARE
LIMITED PARTNERSHIP
BY: CENTRUM PORT .PAVI.LIO\' LTD.,
A DELAWARE CORPORATION, AS. GENERAL
Dated: October 29, 1997 PARTNER
BY: WILMA SOUTH MANAGEMENT CORP.,
A GEORGIA CORPORATION, ITS ATTORNEY
IN FACT
State oia ��GYI'GlQ
ss.
County of Ct eA_
On i (A/q7_ before me. (here Insert name) Notory PubllC,
Personally oopeored__ _ nra
Personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose nome(s) is/are subscribed to
Ina within instrument and acknowledged to me ou thot he/stye/they exacuted the some In hls/her/their authorized COPOCIty(les), and
that by his/her/their signoture(s) on the instrument the person(s). or the entity upon behalf of which the person(s) acted. executed the
instrument.
WITNESS my hand and official seal.
° RHONDALYNN D. G000WIN
♦ }' Poly COMMISSION M CC 840914
EXPIRES: June 9, 2001
/1 "3 Sor4ad Thru NMY PU* Unden+rt 1
Signature fin`--'/ ~
`o
—� oK■ tool wiTin cord& —�—
I _d ZS.L 6 l SL DLL ANVdHOO AVOVNVO WOd_� 1177 I : S R_ 66 1 I. - I
41�JUL
1 EXHIBIT "A
Parcel 1:
Lots 49, 50, 51,'52, 53, 54, 55, 56, 57, 58, 59, 98, 99, 100, 104, and 110 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 THE all oil, gas and other -hydrocarbon substances lying within and under that
.measured vertically from the
portion said land,of he subsurface, as rese0rved indeed recorded August 4 1993 asace of instrumeilalying below a depth of nd
or into that portion
303.830 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
APNos: 643-130-049-6
-050-6
-051-7
-052-8
=057-3
-059-5
-055-1
-056-2
-054-0
643-140-001-3
-002-4
-003-5
643-130-058-4
-053-9
-063-8
-047-5
Z 'd
ZS l6 l SL . V L L .II�IddW07 J.bOVNd7 VJO;d� VI d : I. S %6 t -:_: l - L
PARCEL 3:
two,
u
419582
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 casement granted 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 veliicular 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 pursuant to the Declaration. Upon
the termination of the temporary easement granted pursuant to this Parcel No. 3, access to Parcel 1 of the Property shalt 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 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 how acquired by Grantor.
B. Easements over the property for the construction, installation and maintenance of electric, gas, telcphone, 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. Tnxes and None Assessmen : Nondclinquent general, special and supplemental real property taxes and assessments;
2. Restrictions of Record: All covenants, conditions, restrictions, reservations, dedications, easements, encumbrances, rights
and rights of way of record.
3. AssiPnment of Declnr2nt 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 property under the Declaration as Grantor prior to the date of recordation of this Deed.
d ZS l 6 l SL V l L JANIV6100 J.bGb'Nb0 H0d� H)Vr I. S S66 I. l- t