9807-017 (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
vDat�e Sig nature of Contractor
f �
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:-toconstruct the, project (Sec. 7044, Business & Professionals
Code).
() I am ex mpt 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 Lair Code, for the
performance of the work for which this permit is issued.
(y() 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.
1.1NICAW lav` CO Sh,5,0-1«97-'4179
(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 woAers' compensation provisions of%Section 3700 of the Labor
Code, I slIf f rt wit t comply with those provision .
✓Date: v� �� Applicant h �/-.
Warning: Failure to secure Workers' Compensation coverage overage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize repref'entatives of this City to ente upon
t e above-mentioned property fo ' ins�iection purp ses.
'
Signature (Owner/Agent) J'u/� Date t�
•..
BUILDING PERMIT PERMIT# CONTROL# sw
9:17-Op'7 :'� •.• ':�
DATE VALUATION -LOT 5g TRACT �'•{�
«lfl4,0•
.{4
JOB SITE a
APN
ADDRESS 78-905 WA�,I��! i C
FhL��i Y�$�-����
OWNER
CONTRACTOR / DESIGNER / ENGINEER
CANt',DA.Y &C:CJMt)AN1'
3'.,.1iNti1")AY &COMPANY
1.57Q,B1t00K*101,;i,:0V-V- DPLIVE', W I'E.268
1570 B►di)f3KHOLLOW DAWE, SUITE 208
S.A: iTA.A:tIA. CA 92?05
SA'NTA..ANA. CA 92705
(7:14Y15 -R-9151 4485
.
ti
S
USE OF PERMIT
SN U - PLAN 41RT141—Wil, i' DOUNOT { Ivax—DE,u.. cll WkLug C)it k+o'L
PLAN CHFC K @ FE RliOtUC°ED BY 730/9 F0fit V1U1.'# PLfs 1SSUANCh OF StCMS s '
t: fAs;�'l.AG&C AKPL1RT 624.00 kt.F
'
T�'i)iCCt•4/]��diT.fC> St39.0+3 S:i°
1%LAC.'1 CCSf4S`1'RU .CION 2,9)•7.00 `F
i
or��3�vi�.�btucdmv.
iai�Aaa� i.�{�i
V1t,'Rh!1T PEE SUMiMA.t"1V -
F i fs i�[?1 51',C - 101 -OW -439-318 4250.00
P1.•AN C 11, ;C`K NE t 0 -t (i-439-31 R 5173.73
CoKsfK,u `I:CiNgFri 1t011-000.4118-�0/0j0 �Q�/tjl,tU't1�
•.fl.AYif.4A1''41CAJ.6•d:E 1 101.-W0421-000 S105•00
1,41-:EC'I TICAL i-rr H 10,1-001-120-000 $172.73
'PL-ON[131140 ITTE 101 -MG -40 -ow g- $162150
NG MIO`171014 FE -RES 10 10.1-0100-211-•000• $:1.5.09
GIRADI G i/EC. 101-400-423-000 $20.00
1NFRAS RUC7'1JRE FE- 22:5 -OM -443-342 $3,338.13,
Awl, {731, J91_TC; .P1,ACE.3 - 701-000-255.000 $127,0
SL82T(YrA1. C()rISl'J(,-7110N kNDP1,AN01,fiF K.
ESS PRE -PAID FEES
�25i1.00
' 4 TA!.:i' "EtSi1111' FE08.0UEN0W
$4,682.35
k
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
In
INSPECTION RECORD
I
a�
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings_/ 9
Ducts
Slab Grade ��
ReturnAir
-Steel
Combustion Air
Roof Deck �/�—
Exhaust Fans
Wrap
F.A.U.
Frami 3-72- tCompressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior lath
Drywall -Int. Lath
_Q
Final _
BLOCKWALL APPROVALS
Final
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
Waste Lines
Gas Test
Electric Final
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 7
Final
COMMENTS:
Final
Utility Notice
ELECTRICAL APPROVALS I
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbctures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
t
Final
Utility Notice (Perm)
C..
Certificate of Occupancy
City of La Quin.ta
Building and Safety Department
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: 78-905 VIA TRIESTE
Use Classification:
SINGLE FAMILY DWELLING
9807-017
Bldg. Permit No.:
Occupancy Group:
R-3 Type of -Construction:
VN Land Use Zone:
RL
Owner of Building: CANADAY AND COMPANY
Building Official
Address: 17480 EAST 17T" ST. #106
City: TUSTIN, CA 92780
By: STEVE TRAXEL
Date: 08-03-99
POST IN A CONSPICUOUS PLACE
4 2/7
P.O. BOX 1504 APPLICATION ONLY
Building78-495 CALLE TAMPICO
Address 78-905 Via Trieste LAQUINTA, CALIFORNIA 92253
Canaday & Company/LLQ, LLC
Address 1570 Brookhol low Dr.. 0208
City
Santa Ana
Zip
92705
ITO.
714/751-9151
Contractor
Canaday & Company
Address
1570 Brookhollow Dr., 0208
CityZi
Santa Ana
X2705
Tel.
714/751-9151
State Lic.
& Classif. 591561
City
Lic. a 4485
Arch., Engr.,
Designer Len Nobel Company
itltlff:s Box 16606
71114/559-4305
Cit
i rvi ne
Z'
X2713
State
Lic. a
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 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.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
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 such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor'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 thealleged exemption. Any violation or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
(: 1, 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, Buisness and
Professions 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.)
FI 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct 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 the Contractor's License Law.)
I 7 I am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's CQr�p tion 1�syr n�� or 1lified co thereoVffrg 8
Policy No.3V:7Y-1 17�Coihpa�ijr�� cop,
UI1lQf'C�li1�Q♦
n Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg 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.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate or 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
ame
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it 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
ILDING: TYPE"CONST. OCC. GRP,
1. Number 643-140-002
Description Tract 26152, Lot 58
1t Description Single Family Detached Residence
Sq. Ft. 2 507 No. 1 No. Dw. 1
Size > Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback frop Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Perrrdtw
�q
Validated by:
Validation:
p
APR 2 919989 1990
L I
1. eIT OFF LX Q"Ul I NTA
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
41
Desert Sands Unified School District
47-950 Dune Palms Road
Notice: La Quinta, CA 92253
Document Cannot Be Duplicated 760-771-8515
CERTIFICATE OF 'COMPLIANCE
Date 7/15/98
No. 17329 Jurisdiction
Owner NameCanaday & Company
No. 78-905 Street Via Trieste
APN # 643-140-002
La Quinta
Permit #
Log #
City La Quinta Zip 92253 Study Area
Tract # Lot # Square Footage 2,507
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 2,507 or $ 4,838.51 ` the property listed above and: fhat>bui]ding
permits and/or Certificates of Occupancy for this square footage in this proposed projec may now b e issued 4Gif`f,
Fees Paid By City National Bank/Canaday &Company Tesepbone� 7L4=a-51-9151'.
Name on the check R=h ` •4
By Dr. Doris Wilsonrt�' i
Superintendent
Fee collected /exempted by Juanita Green
Signature
Payment Received $4,838.51
Check No. 01058491
NOTICE: Pursuant of Ass);/nbly 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 frool 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
I
Desert Sands Unified School District
� Notice: 82-879 Highway 111
Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
CERTIFICATE OF COMPLIANCE
Date 3/27/98
No. 16818
Owner NameCanaday & Company
APN # 643-130-051'
Jurisdiction La Quinta
Permit #
No. 47-905 Street Via Trieste Log #
City La Quinta Zip 92253 Study Area
Tract # Lot # Square Footage 2591
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 2,591 or $ 5,000.63 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,,
Fees Paid B Cashier Check/Steve Santee 1y '�
By Telephone , 771,-•9636
Name on the check
• 'r
By Dr. Doris Wilson r<- _u
Superintendent
Fee collected /exempted by Juanita Green Payment Received. $5;000:63'
r. l
Check No. 01058148
Signature
NOTICE: Pursuant of Assly 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 identifiedabove will begin to run fro 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 Dislrict('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
;.''acordff5g Requested Ry
CHICAGO TITLE COMPANY
t. r� AND WHEN RECORDED MAIL TO
Canaday &' Company
°"° 1570 Brookhollow Drive
'i00'Os6 Suite 208
c1ty PA
stota Santa Ana, CA 92705
ft- 100'(Rey. 4/94) J)
40 >L 5
41.9582 u
RECEIVED FOR RECORD
.� ,�,A„ �, r...� .,,_..• AT 2.00 O'CLOCK
N O V 14 1997 ;
V, Rowtvw in 001" pawde
Rewrder
Fees $___L�_
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
13 computed on full value of property conveyed, or
0 computed on full value less value of liens or encumbrances remaining at time of sole,
G Unincorporated area: 0 City of LA _QU INTA and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
WXLMA-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 R'I V E R S I D E State of California:
Lots 49 through 59, inclusive, and 98, 99; 100, and 104�ofa11
Trscct 26152
SEE EXHIBIT "A " ATTACHED WILMA-LA QUINTA L.P. A DELAWARE
LIMITED PARTNERSHIP
BY: CENTRUM.POFT PAVILION LTD.,
A DELAWARE CORPORATION, AS GENERAL
Dated: October 29, 1997 PARTNER
BY: WILMA SOUTH MANAGEMENT CORP.,
A GEORGIA CORPORATION, ITS ATTORNEY
IN F C.T
State ogia 76
County of Ck q l
ss.
ii�
On (+ before m�Le, \\ nnLJ (here Insert name) Notory PvbllC, 2
Personally appeared—
personally known to me (or proved to me on the basis of satisfactory evidence) to be the persons) whose name(s) is/ore subscribed to
the within instrument and ocknowledged to me all that he/she/they executed the some In his/her/thelr authorized copocity(les). and
that by his/her/their signatvre(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.
RF{ONDALYNN D.1300OV N
OKI. seal within borde,
ZS L 6 L SL V L L ANVdN00 AV0VNb'0 NOdj L^tbl_ L: S 866 L -C L- L
r -
h
MY COMMISSION 0 rx I'�Q814
:, Ae EXPIRES: June 8, 2001
k0ed TMU Notary PJ* tinder ftO
Signature
OKI. seal within borde,
ZS L 6 L SL V L L ANVdN00 AV0VNb'0 NOdj L^tbl_ L: S 866 L -C L- L
r -
h
EXHIBIT "A"
Parcel 1:
Lots 49, 50, 51, 52, 53, '54, 55, 56, 57, 58, 59, 98, 99, 100, 104, and 110 of Tradt 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 portion of the subsurface, asnd, lying below a depth ore reserved d in, deed recorded August 4, 1993 asasaid
nstrumentland
no.
or into thatpp
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
APNos: 643-130-049-6
-050-6
-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
.� ZS I6 LSL V lL LI\IVdHoo AVGVNV7 HOd-d VNb;_ I S 866 1 L- I.
14%W*
PARCEL 3:
419582
A temporary nonexclusive easement appurtenant to parcel I 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 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. i 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 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 I 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 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, telephone, 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 T0:
1. Taxes and None Assessmen : Nondelinquent 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. Assi nment of DecInrant 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.
1- ZS L 6 t SL V l L M)Vc-JH07 .,VV01VNb0 t OdA Hvv I.: S 8661. -CL -I.