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2934 (SIGN)P.O. BOX 1504 Building 78.105 CALLE ESTADO Address Colmar U ��� r LA QUINTA, CALIFORNIA 92253 Owner .F Mailing Address City Contractor No. 002934 BUILDING: TYPE CONST. OCC.-GRP. 101 AD N b ��.?—?': w�ai' 2: 769-030 -032 wyc; • • • aM um er_ Zip ITel. —,uws A 1 Legal Description Project Description Address City Zip Tel. State Lic. City & Classif. Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer New IKI Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I 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 afflrfn that I am exempt from the Contractor's License Law for the following reason: (Sac. 7031.5.%uirrsss and Professions Code: Any city or county which requires a permit to construct, after. Improve, demolish, or repair any stmctura, prior to its Issuance also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to the provisions of the Confraclor's License Law, Chapter 9 (commencing with Section 7000) of Estimated Valuation + 3 90 . Gr t' PERMIT AMOUNT 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'Rve hundred dollars ($500). ❑ 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, Bufsness and Professions Code: The Contractor's License Law does not apply to an owner of property who Plan Chk. Dep, Plan Chk. Bal. Const. nA@Cil buNds or Improves thereon and who does such work himself or thmugh his own empfoyees, prevfded that such imprvvaments are not intended or offered for sale. If, however, the building Electrical 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.) _ Plumbing ❑ 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 contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason S.M•j, Grading Driveway Enc. Date Owner Infrastructure 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 No. Company O Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS (This section need not be completed if the permit is for one hundred dollars ($100) valuation 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 Cali crnia. DateOwner 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- ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line 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.) Side Street Setback from Center Line Side Setback from Property Line Lender's Name. FINAL DATE INSPECTOR 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 ordlnancf:s and state laws relating to building Conslmction, and hereby authorize representatives Hof this city to enter the above• mentioned property for inspection purposes. Issued by: Validated by: Date Permit Signature of applicant Date Mailing Address Validation: A 7 3 4 2 Z 18 20,0G U City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIN , FEES 1ST FL. SQ. FT. @ 2ND FL. SQ. FT. POR. SQ. FT. @ GAR. SQ. FT. @ CAR P. SQ. FT. @ WALL SQ. FT. SQ. FT. ESTIMATED CONSTRUCTION VALUATION $ UNITS YARD SPKLR SYSTEM MOBILEHOME SVC. BAR SINK POWER OUTLET ROOF DRAINS DRAINAGE PIPING DRINKING FOl1NTAIN URINAL $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. @ c BATH TUB SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 11/a c SEWAGE DISPOSAL SQ.FT.GAR @ 3/nc HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE JONST. FEE ELECT. FE l SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND SOLAR SETBACK GROUND PLUMBING UNDERGROUND A C- UNIT COLL, AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP BOND BEAM WATER SYSTEM GRADING Cu. yd. $ plus x$ -$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING t I D4E REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL ,YW•.. oF PA R C E L . 5 1 Ur 1•: 1 /a t)r N"11 / � h!n . l�c�l!T I r,�•t 1 �r M 1 /■'- ter' �:�;� 1 /4er.i• ALL IN rr:r:TI(W S. _t T.I.? 71:. s �■ 19dy 3Aa Poor er. I'a�. Tom. FZ C. L.. 3 V u V b A' 26■' ��.as' - SECTION • 6 FEW W Not a WRVZT OF TIIC LANU BUT 11 COM}ILRD IOU iNMRM&T7DM ONLY FROM DATA MHO N YT ORIICILL RiWRI16 EXCLUSIVE AUTHORIZATION AND RIGHT TO SELL THIS IS INTENDED TO BE A LEGALLY BINDING AGREEMENT —READ IT CAREFULLY, CALIFORNIA ASSOCIATION OF REALTORS1- STANDARD FORM 1. Right to Sell. I hereby employ and grant —CoAC-RiELL09 WALLiEy.E AL2 X hereinafter call d "Agent;' the exclusive and irrevocable right commencing on JAN - i S ,19 9 7 , and expiring at midnight on H pQ I i i 5 19A '7—, to sell or exchange the real property situated in —LA Qui N T 4 _, County of , California described as follows: eqRS=CL If•4 c :&- / ASSEScraS faac-et- 1$.490-AC42ES —SEE ATTACHED 64.AI0:92 0[2S PAJZC.E L ►q0 IEP - -JAeq-09J0- 001 J1J. SS0 AC-4—ES- SEE ATtAGt-tEp 04A4 003 otz5 _PAR-CCL fAtJ t-9•_ACRES - SEE ATTACf-PCs] 04A1002 2. Terms of Sale. The purchase price shall be $ , to be paid in the following terms: C-A 5H At C LOSt a_F _rFSC-{Z0t.[.1 (a) The following items of personal property are to be included in the above -stated price: uVIV n1UNl?V' i cUt u:-i; l:ri �;,_�' (b) Agent is hereby authorized to accept and hold on my behalf a deposit upon :he purchase price. (c) Evidence of title to the property shall be in the form of a California Land Title Association Standard Coverage Policy of Title Insurance in the amount of the selling price to be paid for by LLE 2 (d) I warrant that I am the owner of the property or have the authority to execute this agreement. I hereby authorize a FOR SALE sign to be placed an my property by Agent. I authorize the Agent named herein to cooperate with sub -agents. 3. Notice: The amount or rate of real estate commissions is not fixed by law. They are set by each broker individu- ally and may be negotiable between the seller and broker. CompensatioV Agent. I hereby agree to compensate Agent as follows: (a) % of the selling price if the property is sold during the term hereof, or anyextension thereof, by Agent, on the terms herein set forth or any other price and terms I may accept, or through any other person, or by me, or % of the price shown in 2, if said property is withdrawn from sale, transferred, conveyed, leased without the consentof Agent, or made unmarket- able by any voluntary act during the term hereof or any extension thereof. (b) the compensation provided for in subparagraph (a) above itprope rty is sold, conveyed or otherwise transferred within 6f'.5 days after the termination of this authority or any extension thereof to anyone with whom Agent has had negotiations prior to final termination, provided I have received notice in writing, including the names of the prospective purchasers, before or upon termination of this agreement or any extension hereof. However, I shall not be obligated to pay the compensation provided for in subparagraph (a) if a valid listing agreement is entered into during the term of said protection period with another licensed real estate broker and a sale, lease or exchange of the property is made during the term of said valid listing agreement. 4. If action be instituted to enforce this agreement, the prevailing party shall receive reasonable attorneys fees and costs as fixed by the Court. 5. In the event of an exchange, permission is hereby given Agent to represent all parties and collect compensation or commissions from them, provided there is full disclosure to all principals of such agency. Agent is authorized to divide with other agents such compensation or commissions in any manner acceptable to them. v 6. 1 agree to save and hold Agent harmless from all claims, disputes, litigation, and/or judgments arising from any incorrect information supplied by me, or from any material fact known by me concerning the property which I fail to disclose. 7. This property is offered in compliance with state and federal anti -discrimination laws. 8. Other provisions: 9. 1 acknowledge that I have read and understand this Agreement, and that I have received a copy hereof. Dated ,19 , California Ce yAh"ll:f OWNER Address City, State, Phone 10. In ❑nsideration of the bove, Agentt agrees to use diligence in procuring a purchaser. Agent �Ey �C EAG,z Y Address, City.}d- &X /QI By Phone, Date fo�9 S61�6f f NO REPRESENTATION IS MADE AS TO THE LEM VALIDITY OF ANY PROVISION OR THE ADEOUACY OF ANY PROVISION IN ANY SPECIFIC TRANSACTION. IF YOU DESIRE LEGAL ADVICE, CONSULT YOUR ATTORNEY. To order, contact —California Association of Realtors` 525 South Virgil Avenue, Los Angeles, California 90020 Copyright c 1978 by California Association of Realtors` 12r (Reviewed 1984) FORM A-11 oeraxruxm