9803-136 (SFD)LICENSED CONTRACTOR DECLARATION
1U I hereby affirm under penalty of perjury that I am licensed under provisions of
H Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
CN U)
Professionals Code, and my License is in full force and effect.
O a M License # Lic. Class Exp. Date
c
oZ F-_ VDate Signature of Contractor
Zo0Yl�
J U C:) OWNER -BUILDER DECLARATION
HWW I hereby affirm under penalty of perjury that I am exempt from the Contractor's
in -
License Law for the following reason:
Z_ ( ) 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).
M () I am exempt under Section B&P.C. for this reason
LO)
N Date Signature of Owner
ON
d Q WORKER'S COMPENSATION DECLARATION
p Cc I hereby affirm under penalty of perjury one of the following declarations:
Hp () 1 have.and will maintain a certificate of consent to self -insure for workers'
X W �= compensation, as provided for by Section 3700 of the Labor Code, for the
Oro J Q performance of the work for which this permit is issued.
Q U ()) I have and will maintain workers' compensation insurance, as required by
Q UQ Section 3700 of the Labor Code, for the performance of the work for which this.
rn H permit is issued. My workers' compensation insurance carrier & policy no. are:
,It Z Carrier Policy No.
C) evoi".1 +G iJ'✓, �i��l �..a `,jd,.'�3:.1 At-���=.�-i�`'31
J
(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
3 sybject to the wgrkers' compensation provisions!of Se tion 3700 of the Labor
Code,, shbll fo bwilh comply with those-provi io
Date: V Applicant—
Warning:
r '
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. 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 irispectio, purposes.
/� Vii` �t-�xzSignature (Owner/Agent) - Date
• CONTRO
BUILDING PERMIT PERMIT // L #
DATE VALUATION LOT TRACT c �y
y� !� fd
0
JOB SITEY
APN
�y
ADDRESS l a9y r �i I" '"' lW9US E
OWNER LY 7.
CONTRACTOR / DESIGNER / ENGINEER
tY�t i� Y��lvgl,k;0a ,i%_AA4I_Av Y.�S SIT;.
�.)5��k;j 1nIIy�Y•a)JJ,i, Ykk iji,', �1� X441-iY,
IlR ((;;
USE OF PERMIT
;id�9 a
Pf, AN
N 1pp fi � f t++, L&,#J7 Yf'f'90 N1 , i t i,o, t!�:vi PAI D
g�f
MAR 2 7 1998
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(,4YYt lAR7lL�Wivktdk�sfS99lPCY DY Mi�1
OF to QUINTA
,CITY
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m rt1(. ovrs `3;I,9"r5
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j (') f - t;oil . 9V til)
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RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
'Forms & FootingsQ
Ducts
Slab Grade
� - _�
Return Air
Steel
Roof DeckExhaust
O.K. to Wrap
_ _
/
Combustion Air
Fans
F.A.U.
Framing
9
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
/�fy
��"Yhq
Drnrall -Int. Lath
Final
1 4�0 3 - z i ,
BLOCKWALL APPROVALS
Set Backs
Footings
Bond Beam
Final
Waste Lines
Water Piping
PLUMBING APPROVALS
AP,
Plumbing Top Out
Shower Pans 7—
Sewer Lateral
Sewer Connection
Gas Piping
Gas Test
Annliamp-q
Final
Steel
Electric Bond
Main Drain
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Te
Gas Piping
Gas Test
Electric Final
Heater Final
Plumbing Final
Equipment Enclosure
O.K. for Finish Plaster
POOLS - SPAS
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Otility, Notice (Perm)
I R 52
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Cit of La '. . z .
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78-495 Calle Tampico '
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La Quinta, CA 92253 k
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. Building Permit Application and Tracking Sheet .
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Owner's Name: �G h e- " A . - . �O —
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Pub. Wks.:
Desert Sands Unified School District
Notice 82-879 Highway 111
Document Cannot Be Duplicated Indio, CA 92201
a 619-775-3500
CERTIFICATE OF COMPLIANCE
}
Date 3/27/98
No. 16819 Jurisdiction
Owner NameCanaday & Company
No. 47-845 Street Via Trieste
City La Quinta zip 92253
Tract #
Type of Development
Comments
Lot #
Single Family Residence
APN # 643-130-052
La Quinta
Permit #
Log #
Study Area
Square Footage 2013
No. of Units 1
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 2,013 or $ 3,885.09 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 q
Fees Paid By Cashier Check/Steve Santee Teieghone x'71, X636 'd'r
Name on the check '_c
i
By Dr. Doris Wilson
=y
Superintendent`z;
Fee collected /exempted by Juanita Green Payment Received $3,885.09
Check No. 0.1058148
Signature
NOTICE: Pursuant of Assem$ly 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 dale 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
e6grdif`,g Requested F
9 s
CHICAGO TITLE COMPANY
'j ANO WHEN RECOROEO MAIL To
Canaday & Company
1570 Brookhollow Drive
Aco,ew Suite 208
c'^e
slate Santa Ana, CA 92705
rt- 100 (Rev. 4/94) 0
Lo7-5-�2
41.9582
RECEIVED FOR RECORD
AT 2:00 O'CLOCK
r'o�..'i^►w:. ; r NOV 14 1997
P`t , Co. P-!�.- 1140"wo in ornad moov
of fiIvmnbe crony. caeloede
Recorder I �'
Fees $___Lc
SPACE ABOVE 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
CS computed on full value of property conveyed, or
0 computed on full value less value of liens or encumbrances remaining of time of sale,
G Unincorporated area: 0 City of LA QUINTA
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
,and
the following'described real property in the
County of RIVERSIDE State of California:
11
Lots 49� through 59, inclusive, and 98, 99, 100, and 104/ofdTract 26152
SEE'EXHIBIT "A ATTACHED' WILMA-LA QUINTA L.P.•A DELAWARE
LIMITED PARTNERSHIP
BY: CENTRUM PORT PAVILION LTD.,
A DELAWARE CORPORATION, AS GENERAL
Doted: October 29, 1997 PARTNER
BY: WILMA .SOUTH MANAGEMENT CORP.,
A GEORGIA CORPORATION, ITS ATTORNEY.
State of aia Gf(ar,�(eL
County of
ss.
On I 1��_ before me.
/1 \ (here Insert name) Notary Publlc,
personouy oppeored_
Personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/ore .,wbscribed to
the within instrument and acknowledged to me 04 tt)ot he/she/they executed the some In his/her/thelr authorized c000city(les). and
that by tris/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.
RHDNDALYNN D. GOODWIN
My COMMISSION M CC M14
I EVIRES: June 8, 2001
Sor0d Ttrtu NOMY M* OV11 IMM
Signoture
-- oKi■ seal wimin ooraeM
L d ZS l 6 t SL V L L J NV&100 . V0VNV3 VdO�t� NVE. L: 5 86611. =c.' 1- 1
� 1 'J
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 nuinta, 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.
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
APNo's: 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
.� i;S 1615L. V lL J,Mb�I^i07 .�IVObNV7 VJO;d� VI'dr: I. S 8661 -Z l— l
PARCEL 3:
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 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. 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 No. 3, access to Parcel I 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 Propcny .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 TO:
I. Taxes and None Assessmen : Nondelinquent general, special end 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. Assignment 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, 211 exetnptions 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 l6 l SL V l L ANVdV100 Ab'GdNIVO VtOdA VPVV t : S g66 I. - l - I.
Certificate of Occupancy
City of La. Quin.ta -
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: 474-935 VIA TRIESTE
Use Classification:
Occupancy Group:
SINGLE FAMILY DWELLING Bldg. Permit No.: 9803-136
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: 06-25-99
POST IN A CONSPICUOUS PLACE