12772 (SFD)t
Tay,,
rj
P.O. BOX 1504 N o .
Building 52-140 Ave. Monte um& 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner Bradon Croff
BUILDING: TYPE CONST. OCC. GRP.:
Mailing
Address 78-635 Saguaro Road A.P. Number 773-201-431
City Zip Tel. Lot 18 Rheic 39
La Cuinta. CA 1 92253 1 564-2189 Legal Description
Croff domes
78-635 Sauqaro Road
City Zip Tela
is Quinta, CA 92253 5&4-2289
State Ljc.$ 664523 City 2939
& Classif. Lic. #
Arch., Engr.,
Designer Greg Butler -
Address I Tel
(Zip I
State
C. #
LICENSED CONTRACTOR'S DECLARATION
that I am licensed under provisions of Chapter 9 (commencing w
i 3.0f the Business and Professions Code -and my llcensejs in,ful
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 Cod9: 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 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).
0 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 o`fered 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.)
p I, 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 contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 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 Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy 1No. Company
Dopy is filed with the city. ❑ Certified copy is hereby furnished.
/ r CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i1 the permit is for one hundred dollars ($100) valuation
or less.)
I certify that 'n the performance of thg work for which this,permit is issued, I shall not
employ ani per ton in any manner so as'to beco� (ne_, s -abject $ the�GVt rkecs�Compensation
Laws of Calif..
Date _%
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
Ihereby 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 sof this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant -Date-
Mailing
ateMailing Address
City, State, Zip
Project Description
SPD
12772
ZONE: BY: 1 - IJJ r IL/ I
Minimum Setback Distances:
Front Setback from Ce8Vr Line
—
R
Rear Setback from Rea.rop.- Ine +4----�
Side Street Setback from Center Line ti
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
I
Sq. Ft. No.
Size 1681 Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit includes 140 If of
51 high block
wall. Retaining wall and
pool permits
to be obtained separately.
Estimated Valuation $101,279.00
PERMIT
AMOUNT
Plan Chk. Dep. 250.00
Plan Chk. Bal.
300.73
Const.
646.50
Mech.
68.50
Electrical
132.42
Plumbing
1511;00
.S.M.I.
10.13
Grading
20.00
Driveway Enc.
.00
Infrastructure
2 ,1$9.04
Plan
25.00
-Precise
Arts in. Public Places
25.00.
TOTAL 3, 820:32
3r570.32
REMARKS
I n
/A I I n E
ZONE: BY: 1 - IJJ r IL/ I
Minimum Setback Distances:
Front Setback from Ce8Vr Line
—
R
Rear Setback from Rea.rop.- Ine +4----�
Side Street Setback from Center Line ti
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
I
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES .,
1ST FL. SO. FT. @ $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
2ND FL. SO. FT. @
HEATING (ROUGH)
Y
ARD SPKLR SYSTEM
POR. S0. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. @
DRAINAGE PIPING
WALL SO. FT. @
HEATING (FINAL)
DRINKING FOUNTAIN
SO. FT. @
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE 'DRYER
GRADING
cu. yd.
-plus-x$_=$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP. _ /i
V
LAUNDRY TRAY
AIR HANDLING UNIT CFM
ROOFING (� (�
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
FIREPLACE
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c'•
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING a -9-40f, (UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) t� �y0 METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BCND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
-plus-x$_=$
LUMBER GR.
FINAL INSP. _ /i
V
FRAMING !j _ —rtYC ®
FINAL INSP. O
ROOFING (� (�
_ ^ / �y
ll Fil'o- S
`s /Vj C47
,,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUNDWa
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
a DESERT SANDS UNIFIED .SCHOOL DISTRICT
- 82-879 Highway 111 r
NOTICE: Indio, CA 92201 ,
.Document Cannot Be Duplicated .619=775-3500
Date 2/4/94. Type of Permit La Quinta. '
No. 112645 ' Permit #
i.
Log '
OWner • Name Brandon Croff
No..52140 Street Avenida Montezuma 4
" City La Quinta Zio. ,92253 Study Area f 115
r
' APN # Tract # Lot # 0 Square Footage 11681
Type of Development Single' Family Residence No. of units %
Comments F
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'
h the above-named owner is exempt from, paying -school fees at, this time due to the
following reason:
EXEMPTION NOT APPLICABLE
' Thiscertifies that school facility fees imposed pursuant to ` Government Code53080
in the amount of 1.65 x 1681' or $ 2,773.65 have been paid .to D:S.U.S.D 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.
Fees Paid By Croff Homes 1 Telephone 564-2189
Name on the check" '
Dolores A. Ballesteros'
b *Superintendent
Fee collected /exempted by Vickie J. Durrett '
" Payment 'Received �
Signature r J�,C �C.�-
Check" No. 341
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 ,
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL 4640
Received From: LL it Lu C—, L' • Date:
Address: lA.� Lk Ute. 'CIA
�.
Account No. L2UL I o�i U 5 Lot(s) ( oi Tract 0(l�lrl �lLl�i.i
Service Address ( t t �tc�, tl f1�.`2ll ri-.[ a G.A. Code
,0 Service(s) I " 15 5C., C- I-)
❑ Backflow(s)
❑ House Lateral (s)
❑ DetectorCheck(s)
❑ Meter Surcharge —7
,O Sanitation Capacity Charge �— �5 1 5•
❑ W.S.B.F.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name
❑ Inspection Fee - Tract -
t Fee -
❑ Plan Check Fees Water / Sewer -
i
Tract -
❑ Bond Payment - A.D. - Bond
Assmt.
❑ Customer Deposit
❑ Other
ErGr TOTAL $
6 Remarks:
❑ Copy to:
Cash Water Service
Check
Money Cashier 4,_ _.
OrderCVWD-438 (111 eq)
MAIL TAX STATEMENTS TO:
LBradon W. Croff and Carla Crof�
78635 Saguaro Road
La Quinta, CA 92253
L
J
Lai
SME ABOVE THIS LIM'12ECORDER'S ttSE
THE UNDERSIGNED GRANTORS) CLARE(s)
DOCUMENTARY TRANSFER TAX i $ 52.8
[X] computed on full value of _ ert;r
conveyed, or
[ ] computed on,full value less value. of
liens or.encumbrances remaining at time
of sale.
C O R P O R A T I O N G R A N T D E E D
FOR •A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,'
ROGER S]RELLENBERGER & ASSOC., INC., a California Corporation
hereby GRANT(s) to:
BRADON W. GROFF and CARLA CROFF, Husband and Wife as Joint Tenants
the real property in the county of Riverside, State of California, described as:
Lot 18 of Block 39, Santa Carmelita at Vale Unit No. 3 as shown on a map
thereof recorded in Book 18 page 59 of Maps in the Office of the County
Recorder of Riverside County, California.
Lot 18, Block 3, Santa Carmelita/at Vale Unit No. 1, as per map recorded in.
Book 18, page 46 of Maps, in the office of the County Recorder of Riverside
County, California.
ALSO KNOWN AS
Vacant Land, La Quinta, CA 92253
DATED November 18, 1992
STATE OF CALIFORNIA
COUNTY OF Riverside
On. November 18. 1992 ,
before me, the undersigned, a Notary Public in
and for said State, personally appeared
Roger Snellenberger
personally known to me (or proved to me on the
basis of satisfactory evidence)' to be the
persons who executed the within instrument as
President
Secretary,
ROGER SWELLENBERGER & ASSOC., INC.,a
California Corporation
B
Roge nellenberger President
By:
Secretary
By:.
By:
on behalf of w '
the corporation therein named, and OFFICIAL SEAL
�•.. `S
acknowledged to me that such corporation Ifi°." RY nQ MILLER _ - N'07ARY PU5iIC.0
� •�. ALIFOi?NIA
:'
executed the within instrument pursuant to its �x.. .. . � PP,INCIr""A: OrFICE 1"!
by-laws or a 'resolution of its board of RIVERSIDE COUNITY
�•-r�r�._ . I n My CommiSUon FcNrcc Pfau 9d 1001