BPOL2020-002278-495 CALLE TAMPICO � D 4-v Q"
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: POOL/PRIVATE
Application Number: BPOL2020-0022
Property Address: 49688 AVILA DR
APN: 646270008
Application Description: CROOK / SPA AT FRONT COURT YARD
Property Zoning:
Application Valuation: $20,000.00 n
Applicant:
nD
CURDES POOLS D
P 0 BOX 10472 MAR 0 9 2020
PALM DESERT, CA 92255
CITY OF LA QUINTA
DESIGN & DEVELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
(commencing with Section 70001 of Division 3 of the Business and Professions Code, and
my License is in full force and effect. 9 0995
License Class: C53 License No.:
Date: S '_(— ZO Contractor:
OWNER -BUILDER QECLARATION
I hereby affirm under penalty of perjury that I em exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any
structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he or she 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).:
(_) 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 and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the 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
or she did not build or improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State
License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors' State License Law.).
(_) I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Na
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-71S3
Date: 3/9/2020
Owner:
FREDERICK & CATHERINE CROOK
49688 AVILA DRIVE
LA QUINTA, CA 92253
Contractor:
CURDES POOLS
P 0 BOX 10472
PALM DESERT, CA 92255
(760)574-3711
Llc. No.: 970995
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.
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 and policy number are:
CarrW, kREMPI Policy Number:
certify that in the performance of the work for which this permit is issued, I
sha not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I shecorne subject to the
workers' compensation provisions of Section 3700 of thef�6bor Code, I shall forthwith
comply with those provisions. y -
Date:"[--20 Applicant:
WARNING: FAILURE TO SECURE WORKERS' COIPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this 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 application , the owner, and the applicant, each agrees to, and shall
defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
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 county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city pon the above -
mentioned property for inspection purposes. to a /
Date 3 "40 —W Signature (Applicant or Agent)
Date: 3/9/2020
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
CURDES POOLS
P 0 BOX 10472
PALM DESERT, CA 92255
BPOL2020-0022
49688 AVILA DR
646270008
CROOK / SPA AT FRONT COURT YARD
$20,000.00
Owner:
FREDERICK & CATHERINE CROOK
49688 AVILA DRIVE
LA QUINTA, CA 92253
Contractor:
CURDES POOLS
P 0 BOX 10472
PALM DESERT, CA 92255
(760)574-3711
Llc. No.: 970995
Detail: CROOK/ SPA AT FRONT COURT YARD. EQUIPMENT TO BE INSTALLED IN GARAGE [21 POSTS TO PROTECT EQUIPMENT NOT TO BE LESS THAN 18'
CLEAR SPACE IN GARAGE.TWO DROWNING SAFETY FEATURES AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. PLEASE
PROVIDE WET STAMPED POOL ENGINEERING SHEET ON SITE FOR INSPECTION. NEW EQUIPMENT MUST BE LOCATED IN AN APPROVED LOCATION
EITHER WITHIN THE REAR YARD SETBACK OR 5' MINIMUM FROM THE SIDE P/L FIELD VERIFY. THIS PERMIT DOES NOT INCLUDE EQUIPMENT
ENCLOSURE. 2019 CALIFORNIA BUILDING
ta Qaiwra
PERMIT #
(i Fi'd aI,b,-UCLf ti R.—
p J PLAN LOCATION:
Project Address:q� , �f Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
Iq
APN #:
Applicant Name: JQvt�T��uti,_ C'u r5
Address:
City, ST, Zip:
Telephone: -26-�' O 5-7 q _ ` j
Email: G w J-abel- (-,cz::) ( -, ® ( Go'.-, I Valuation of Project $
'Jame:
-ip
. elephone:
Email:
State Lie: '? 7 D g % s-- City Bus Lie:
Construction Type:
Grading:
ioD, oocn
Bedrooms: i Stories:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
Occupancy:
# Units:
Recording Requested By
First American -ritie Company
RECORDING REQUESTED BY:
First American Title Company
MAIL TAX STATEMENT
AND WHEN RECORDED MAIL DOCUMENT TO:
Frederick W. Crook, Jr. and Catherine A. Crook
PO Box 2743
Space Above This Line for Recorder's Use Only
GRANT DEED
T.R.A. No.020-007
File No.: RIW-5958420 (SL)
The Undersigned Grantor(s) Declare(s): DOCUMENTARY TRANSFER TAX $385.00; CITY TRANSFER TAX $0.00;
X computed on the consideration or full value of property conveyed, OR
computed on the consideration or full value less value of liens and/or encumbrances remaining at time of sale,
unincorporated area; [ X ] City of La Quinta, and
EXEMPT FROM 9EJILDIh7G NOl1E5 Ah1 A P R VERhlhl ODE 27 88.1 a�(2j
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Gordon David Hanson-Grodsky
and Massachusetts Eye and Ear Infirmary and Administrators to The Estate of Jay Putnam Holland
hereby GRANTS to Frederick W. Crook, Jr. and Catherine A. Crook, husband and wife as joint tenants
the following described property in the City of La Quinta, County of Riverside, State of California:
PARCEL 1:
LOT 8 OF TRACT NO. 6064, AS SHOWN BY MAP ON FILE IN BOOK 81 PAGES 78, 79 AND 80
OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA;
EXCEPTING THEREFROM A NON-EXCLUSIVE EASEMENT IN, OVER AND ACROSS THAT
PORTION OF SAID LOT, DESCRIBED AS FOLLOWS:
THE NORTHWESTERLY 66 FEET OF THE SOUTHEASTERLY 95 FEET OF THE NORTHEASTERLY 5
FEET OF LOT 8 OF SAID TRACT, SAID NORTHWESTERLY AND SOUTHEASTERLY DISTANCES
BEING MEASURED ALONG THE NORTHEASTERLY LINE OF SAID LOT. SAID EASEMENT IS FOR
THE USE AND ENJOYMENT OF LOT 9 OF SAID TRACT, AS SET OUT IS EXHIBIT "A" OF THAT
CERTAIN COVENANTS, CONDITIONS, RESTRICTIONS AND RESERVATIONS RECORDED ON
JUNE 18, 1975 AS INSTRUMENT NO. 71218 AND RE -RECORDED SEPTEMBER 19, 1975 AS
INSTRUMENT NO. 114905 BOTH OF OFFICIAL RECORDS OF RIVERSIDE COUNTY,
CALIFORNIA.
PARCEL 2:
A NON-EXCLUSIVE EASEMENT IN, OVER AND ACROSS THAT PORTION OF LOT 7 OF SAID
TRACT, DESCRIBED AS FOLLOWS:
THE NORTHWESTERLY 70 FEET OF THE SOUTHEASTERLY 97.00 FEET OF THE
NORTHEASTERLY 5 FEET OF LOT 7 OF SAID TRACT, SAID NORTHWESTERLY AND
SOUTHEASTERLY DISTANCES BEING MEASURED ALONG THE NORTHEASTERLY LINE OF SAID
Mail Tax Statements To: SAME AS ABOVE
Grant Deed - continued
Date: 06/ 19/ 2019
LOT. SAI❑ EASEMENT IS APPURTENANT TO LOT 8, HEREINABOVE REFERRED TO AS PARCEL
1, FOR THE USE AND ENJOYMENT OF SAID LOT 8, AS SET OUT IN EXHIBIT "A" OF THAT
CERTAIN COVENANTS, CONDITIONS, RESTRICTIONS AND RESERVATIONS RECORDED ON
JUNE 18, 1975 AS INSTRUMENT NO. 71218 AND RE -RECORDED SEPTEMBER 19, 1975 AS
INSTRUMENT NO. 114905 BOTH OF OFFICIAL RECORDS OF RIVERSIDE COUNTY,
CALIFORNIA.
Page 2
Grant Deed - continued
Dated: June 19, 2019
The Estat 61f Ja P,r ; Holland
ordon vid H son-(;rodsky, Administrator 1
Massachusetts Eye & Ear Infirmary, T
Administrator
SIGNED IN COUNTERPART
By: Melissa Paul , Administrator
A notary public or other officer completing this certificate
verifies only the identity of the Individual who signed the
document to which this certificate is attached, and not the
truthfulness, accuracy, or validity of that document,
STATE OF M A
)SS
Date: 06/ 19/2019
COUNTY OF Avk XCU� _rc')L _) r
On 'I r 1 txi r: f c'r before'me, Kjj'S►,' Notary Public, personally appeared
r _ _
who 0oved to me on the basis of satisfactory evidence to be the erson(s) whose name(s) is/are subscribed to the within
Instrument and acknowledged to me that he/she/they executed the same In his/her/their authorized capaclty(ies), and that by
hls/her/their slgnature(s) on the Instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the
Instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph Is true and correct
WITNESS my hand and official seal.
Notary Signature
This area for official notarial seal,
\ KU9UiA GAUTAM
Notary Public
I COMMONWEALTH OF MASSACHUSETTS
My Commission Fxpires
August 24, 2023
Nc%6e*y' ont
�iiorclsi�ri `1�7- [t� �r� rlCtrtsc�n- (,,rod;��,
Page 3
Grant Deed - continued
Dated: June 19, 2019
The Estate of Jay Putnam Holland
SIGNED IN COU` TERPART
Gordon David Hanson-Grodsky, Administrator
Massachusetts Eye & Ear Inflrmary,
Administrator ��1�K./ �
By. I - —
Date: 06/19/2019
A notary public or other officer completing this cer"cate
verlfles only the Identlty of the Individual who signed the
document to which this certificate Is attached, and not the
truthfulness, accuragy, or validity of that document.
STATE OF
COUNTY OF
)SS
before me, _ , Notary Public, personally appeared
ho proved to me on the basis of satlsfartary evidence to be the person(s) whose name(s) ks/are subscribed to the within
Instrument and acknowledged to me that he/she/they executed the same In his/her/their authorized capaclty(es), and that by
his/her/thelr signature(s) on the Instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the
Instrument.
I certify under PENALTY OF PERJURY under the laws of the State of Callfomla that the foregoing paragraph Is true and correct
4NotBignature
hand and official seal, Th/sarea for oli9da/notarladseal
AMY M $AND$
� -- �Y , Cofru�an>i d�t�ssachl�eeM
MYCanmissW Erpk%AprII2%2021
Page 3
BOE-502-A (PI) REV. 13 (06-17)
PRELIMINARY CHANGE OF OWNERSHIP REPORT
To be completed by the transferee (buyer) prior to a transfer of subject
property, In accordance with section 480.3 of the Revenue and Taxation
Code. A ftliminary Change ofOs+irership Report must be filed with each
conveyance in the County Recorder's office for the county where
the property is located.
ASSESSOR'S PARCEL NUMBER
646-270-008-3
SELLER/TRANSFEROR
The Estate of Jay Putnam Holland
BUYER/TRANSFEREE
Frederick W. Crook Jr. and Catherine A. Crook
BUYER'S DAYTIME TELEPHONE NUMBER
BUYER'S EMAIL ADDRESS
STREET ADDRESS OR PHYSICAL LOCATION OF REAL PROPERTY
49688 Avila Drive, La Quinta, CA 92253
❑ YES' _ i NO This property is intended as my principal residence. If YES, please indicate the date [t�DAY YEAR
of occupancy or intended occupancy.
❑ YES [4 NO Are you a disabled veteran or a unmarried surviving spouse of a disabled veteran
who was compensated at 100% by the Department of Veterans Affairs?
MAIL PROPERTY TM INFORf�tF�1TION TD NAME}
MAIL PROPERTY AX INFORMATION TO (ADDRESS CITY STAT ZIP CODE
PART 1. TRANSFER INFORMATION Please complete all statements.
This section contains possible exclusions from reassessment for certain types of transfers.
YES NO
❑ A. This transfer is solely between spouses (addrtron orremoval of a spouse, death ofa spouse, divorce settlement, etc.).
❑ ❑B. This transfer is solely between domestic partners currently registered with the California Secretaryof State (aa*W orremoval ofa
PM
Yc.
Y* D.
E2 *E.
E/*F.
[�/G.
EZ,H.
y I.
�J.
[2(K,
LS/J �•
M.
N.
[, 0.
D. Other. This transfer Is to
* Please refer to the instructions for Part 1.
partner, death of a partner, termination settlement, etc.).
This is a transfer: ❑ between parent(s) and child(ren) ❑ from grandparent(s) and grandchild(ren).
This transfer is the result of a cotenant's death. Date of death
This transaction is to replace a principal residence by a person 55 years of age or older.
Within the same county? ❑ YES j2 -NO
This transaction is to replace a principal residence by a person who is severely disabled as defined by Revenue and Taxation Code
section 69.5. Within the same county? ❑ YES iNO
This transaction is only a correction of the name(s) of the person(s) holding title to the property (e.g., a name change upon
marn.a e). If YES, please explain:
The recorded document creates, terminates, or reconveys a lender's interest in the property.
This transaction is recorded only as a requirement for financing purposes or to create, terminate, or reconvey a security interest
(e.g., cosigner). If YES, please explain: _
The recorded document substitutes a trustee of a trust, mortgage, or other similar document.
This is a transfer of property:
1, to/from a revocable trust that may be revoked by the transferor and Is for the benefit of
❑ the transferor, and/or ❑ the transferor's spouse ❑ registered domestic partner.
2. to/from an irrevocable trust for the benefit of the
❑ creator/grantor/trustor and/or ❑ grantor's/trustor's spouse ❑ grantor's/trustor's registered domestic partner.
This property is subject to a lease with a remaining lease term of 35 years or more including written options.
This is a transfer between parties in which proportional interests of the transferor(s) and transferee(s) in each and every parcel
being transferred remain exactly the same after the transfer.
This is a transfer subject to subsidized low-income housing requirements with governmentally imposed restrictions.
This transfer is to the first purchaser of a new building containing an active solar energy system.
Please provide any other information that will help the Assessor understand the nature of the transfer.
THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION
COMPLETE, ,1
ANO RETVt:.
BOE-50.2-A (P2) REV. 13 (06-17)
PART 2. OTHER TRANSFER INFORMATION Check and complete as applicable.
A, Date of transfer, if other than recording date:
r f
8.
T tans
y - ❑ ❑ ❑
urchase Foreclosure Gift Trade or exchange ❑ Merger, stock, or partnership acquisition (Form BOE 100 B)
g
❑ Contract of sale, Date of contract: ❑ Inheritance. Date of death:
❑ Sale/leaseback ❑ Creation of a lease ❑ Assignment of a lease ❑ Termination of a lease. Date lease began:
Original term in years (including written @lotions). ^ Remaining term in years (including written godonsr
❑ Other. Please explain:
C. Only a partial interest in the property was transferred. ❑ YES
PART 3. PURCHASE PRICE AND TERMS OF SALE
A. Total purchase price
NO
If YES, indicate the percentage transferred:
Check and complete as applicable.
$ 350,000.00
t
B. Cash down payment or value of trade or exchange excluding closing costs Amoun $
C. First deed of trust @ % interest for years. Monthly payment $ Amount $
❑ FHA (_Discount Points) ❑ Cal -Vet ❑ VA (_Discount Points) ❑ Fixed rate ❑ Variable rate
❑ Bank/Savings & Loan/Credit Union ❑ Loan carried by seller
❑ Balloon payment $ _ Due date:
D. Second deed of trust @ % interest for _years. Monthly payment $ Amount $
❑ Fixed rate ❑ Variable rate ❑ Bank/Savings & Loan/Credit Union ❑ Loan carried by seller
❑ Balloon payment $ Due date:
E. Was an Improvement Bond or other public financing assumed by the buyer? ❑YES []NO Outstanding balance $
F. Amount, if any, of real estate oommi traough
n fees paid by the buyer which are not included in the purchase price $
G. The property was purchased: real estate broker. Broker name: Bennion & Deville Fine Phone number: ( j
Homes
❑ Direct from seller ❑ From a family member -Relationship
I —I nl ha DIPacP Pvnlain-
H. Please explain any special terms, seller concessions, broker/agent fees waived, financing, and any other information (e.g,, buyer assumed the existing loan
balance) that would assist the Assessor in the valuation of your property.
PART 4: PROPERTY INFORMATION Check and complete as applicable.
A. Ty f property transferred
Single-family residence ❑ Co-op/Own-your-own ❑ Manufactured home
❑ Multiple -family residence. Number of units: ❑ Condominium ❑ Unimproved lot
❑ Other. Description: (i,e., timber, mineral, water rights, etc.) ❑ Timeshare ❑ Commercial/Industrial
B. ❑ YES St NO Personal/business property, or incentives, provided by seller to buyer are included in the purchase price. Examples of personal property
are furniture, farm equipment, machinery, etc. Examples of incentives are club memberships, etc. Attach list if available.
If YES, eVNO
value of the persona$/business property: $ Incentives $
C. ❑ YES A manufactured home is included in the purchase price,
IF YES, enter gN6 value attributed to the manufactured home: $
❑ YES O The manufactured home Is subject to local property tax. If NO, enter decal number:
D. ❑ YES EqN0 The property produces rental or other income.
If YES, the income Is from: ❑ teaselrent []Contract ❑ Mineral rights ❑ O r:
1e
E. The condition of the property at the flme of sale was: ❑ Good El Average Fair ❑ Poor
Please describe:
CERTIFICATION
I certify (or ded") that the forego/ng and all information hereon, including any accon4vnying statements or documents, is true and correct to the best of my
knowled ie and belief.
SIWh'MRFTY BUY f05FE RE OFFI R" _ DATE I MtpmuNt _
NAM F BUYERnRANSF RfE/PFRSONAL RE PRE. SENTATIVE/CMPORATE OFFICER (PLEASE PRINT) TITLE E-MAIL ADDRESS
The Assessor's office may contact you for additional information regarding this transaction.
Recorder
LARRY W. WARD P.O. Box 751
COUNTY OF RIVERSIDE Riverside, CA 92502-0751
ASSESSOR -COUNTY CLERK -RECORDER (951) 486-7000
Website: www.riversideacr.com
DOCUMENTARY TRANSFER TAX AFFIDAVIT
WARNING
ANY PERSON WHO MAKES ANY MATERIAL MISREPRESENTATION OF FACT FOR THE PURPOSE OF AVOIDING ALL OR ANY PART
OF THE DOCUMENTARY TRANSFER TAX IS GUILTY OF A MISDEMEANOR UNDER SECTION 5 OF ORDINANCE 516 OF THE COUNTY
OF RIVERSIDE AND IS SUBJECT TO PROSECUTION FOR SUCH OFFENSE.
ASSESSOR'S PARCEL NO. 6462700083 I declare that the documentary transfer tax for this
Property Address: 49688 Avila Drive La Quinta, CA 922S3 transaction is: $ 385.00
If this transaction is exempt from Documentary Transfer Tax, the reason must be identified below.
I CLAIM THAT THIS TRANSACTION IS EXEMPT FROM DOCUMENTARY TRANSFER TAX BECAUSE.
(The Sections listed below are taken from the Revenue and Taxation Code with the exception of items 9 and 10
which are taken Fronr Riverside County Ordinance 516). Please check one or explain in "Other':
1. _ Section 11911. The consideration or value of the Property, exclusive of any liens and encumbrances is $100.00 or less and there
Is no additional consideration received by the grantor.
2. _ Section 11911.
The conveyance transfers to a revocable living trust by the grantor or from a revocable living trust to a
beneficiary.
3. _ Section 11921,
The conveyance was given to secure a debt.
4. _ Section 11922.
The conveyance is to a governmental entity or political subdivision.
5. _ Section 11925.
The transfer is between Individuals and a legal entity or partnership, or between legal entities, and does not
change the proportional interests held.
6. _ Section 11926.
The conveyance is to a grantee who is the foreclosing beneficiary and the consideration paid by the Foreclosing
beneficiary does not exceed the unpaid debt,
7. _ Section 11927.
The conveyance relates to a dissolution of marriage or legal separation.
(A spouse must sign a written recital in order to claim this exemption. This form may be used for that purpose.)
8. _ Section 11930.
The conveyance is an inter vivosgift* or a transfer by death.
*Please be aware that information stated on this document may be given to and used by governmental
agencies, including the Internal Revenue Service. Also, certain gifts in excess of the annual Federal gift
tax exemption may trigger a Federal Gift Tax. In such cases, the Transferor (donor/grantor) may be
required to file Form 709 (Federal Gift Tax Return) with the Internal Revenue Service.
9. _ Section 8,
The easemient is not perpetual, permanent, or for life.
10. Section 9.
The document is a lease for a term of less than (35) years (including written options).
11. Other
(Include explanation and authority)
I DECLARE UNDER PENAL TY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
E is 15th day of ]", 2019 at Indian Wells
City
_Stacey toper
Slg re ant Printed Name of Affiant
First me n Till Company 74770 Highway 111,_Suite 101, Indian Wells, CA 92210
Name of Firm (if applicable) Address of Affiant (including City, State, and Zip Code)
California
State
760-469-8891
Telephone Number of Affiant (including area code)
This form is subject to the California Public Records Act (Government Code 6250 et. seq.)
For Recorder's Use:
Affix PCOR Label Here
ACR 521 (Rev. 11/2014) Available in Alternative Formats
tev a�traCALIFORNIA -
City of La Quinta
Design and Development Department
78-495 Calle Tampico
La Quinta, California 92253
Telephone: (760) 777-7125 Fax: (760) 777-1233
htt s: www.la uintaca. o1
PLANNING APPLICATION
CASE NUMBER(s):
�oao�FEB 14 2020
CITY OF LA QIUINTA
a DEVELOPMENT DLIPARTMENT
DATE P,;;D STAMP
OFFICE Uc'E ONLY
A.
APPLICATION TYPE (each application type includes a records management and $5 technology enhancement fee)
-DEVELOPMENT
ADJUSTMENT
-.__
❑
Minor Adjustment
$415
❑
General Plan Amendment
$10491
❑
Modification by Applicant
_ $415
_
❑
Pre -Application Review*
$2-269
❑
Variance
~ $2430
❑
Site Development Permit - Planning Commission
$8935
SUBDIVISION AN
❑ Administrative
$7636
❑
Amended Final Parcel Map
$4051
❑ Amendment
$4695
❑
Amended Final Tract Map
$6466
❑ Time Extension
$1706
❑
Tentative Condomunium Map
❑
l
`$8398
Specific Plan
$10706
❑
Tentative Parcel Map
$5071
❑ Amendment
$4802
El Amendment
$3031
❑
Village Use Permit 4 -
___�,__
❑ Time Extension—_
- $981
-
-
p Amendment �y
$4550 L'
❑ Revision
$3031
❑ Time Extension T
$1653
❑ Waiver _ _
$1384
❑
Zone Change
$9418 i
❑
Tentative Ma Tract p
$8398
OTHERAPPLICATIONS
❑ Amendment
I
1 $3997
❑
li
Certificate of Compliance
$510
Time Extension (Council) T
$1878
❑
Street Name Change
$1857
❑ Time Extension (Admin)
$1062 _
❑
Development Agreement ~
$3342�
❑ Revision
$3947
❑
Director's Determination
$410
USE
PERMITS 1
❑
Environmental Assessment
$488
❑
Conditional Use Permit
$6439
_ .
❑
Final Landscaping Plan (New/Major Rehab)
$1797
❑ Amendment
_ T
$3152
❑
- - - — -- _---
Sign (❑Temporary, ❑Semi Permanent, ❑Permanent)
r 370
$
_
❑ Planned Unit Development
_ _
$6439
❑
—'` - — -� -
Sign Program
-
$2859
❑ Time Extension T
$1706
❑ Amendment
$981
❑
Minor Use Permit
_ _ $415
1
❑
Zoning Letter
❑ Amendment
$415
❑ Basic Property Information -
$268
❑
Temporary Use Permit
.__._______
❑ With Additional Information Required
$1374
❑ Temporary Use Permit (Major)
$2108
❑
Zoning Text Amendment
$9450
❑ Temporary Use Permit (Minor)
$415
❑
Landmark Designation/Cert. of Appropriateness
$1325
a
Special Event Permit - Residential
___________
❑
Appeal
-
$1526
❑ 1-3 Events
$415
❑ 4-11 Events __
- - ❑ 12 + $6439
❑ Special Event Permit - Non -Residential ______-____ -'
- ❑ 1-4 Events $415
0 -5 + _- $415 -
*50% of fee may be credited toward entitlement application submittal
Updated: 9/16/2019
B. APPLICATION INFORMATION 11
Project Name � a, K, 1 dl, _ 2 r �Gc•i,"T r7
Site Address/Location L,.{
! 4T-& ?Au;la Or.
Tract No and/or APN(s)
Project Description L Gtr L,,0 6E (fcP tH 94
C. APPLICANT/OWNER INFORMATION
Primary
Contact:
(Name) (Telephone) (Email)—�
Applicant: _
(Name) (Telephone)
(Mailing Address)
Owner(s): _ i�Q ?'2 'A rl:� c
(Email)
L4. 0�rK!-a Glad S- 3
(Mailing Address) (Email)
D. APPLICANT CERTIFICATION
act
I certify that I have read this application packet in its entirety and understand the City's submittal and review process and the requirements
for this applIca tIon. I further certify that each application Item submitted as part of this appIIca tlon Is consistent w€th the minimum requ€red
contents for that item as described in the submittal checklist. I understand and agree that, If during the processing of the application, it is
determined the information does not strictly meet such standards or contains errors or omissions, clariFcatlon and/or supplemental
InFormation may be required and the preparation of such information may be considered, in the Design and Development Director's or his/her
designee's judgment, an unreasonable delay and will result in a suspenslon of processing time limits as may apply pursuant to California
Government Code Section 65943, Regulations, Title 14, Section 15109, or other applicable law.
Applicant's Signnatur Date 2
Print Name _ `���i"�J� 1
OWNER CERTIFICATION / AUTHORIZED AGENT
I certify under the penalty of the laws of the State of California that I am the property owner of the property that is the subject matter of this
application and I am authorizing and hereby do consent to the Fling of this application and acknowledge that the final approval by the Cityof
La Quinta, if any, may result in restrictions, lim[tatfons and construction obligations being imposed on this real property.
Owner/Authorized Agent Signature
Date
Print Name
*An authorized agent for the ner must attach a no d lerfoc-qf &UtftQr1z0t10 from the legal property owner. Any off =site
nrork identfFed on the plans must be accompanied by a statement of authorization with a notarized signature of the subject
VapQrty owner.
20 Section 3. Installation Instructions
36" MIN.
Combustion Air Intake
F-- 3" PVC Pipe
(Alternate Location)
Flue Exhaust Vent _-
Cap and Riser ,-
provided by installer
12" MIN.
Chimney '
or Gas Vent
(Category I or III)
F
Side
Wall Vent
Flue Exhaust
Vent Cap
(Alternate Location)
_ � r
----+- ------ l r
Chimney or Gas Vent
`Combustion
Air Intake
(Category I or III) 3" PVC Pipe
36" MIN.
` I
v p
p n p P p
p p p p 6" MIN. 12" MIN.
p O p p
v v o Heater
v v .
v v v
Combustion 3 in. PVC Pipe
Inlet Air Intake Duct Requirements*
Combustion Air Intake 3 in. Pipe
(Vertical or Horizontal)
No. of 90' Elbows
Maximum Length in Feet (M)
0
70 ft. (21.3 M
1
58 ft. (17.7 M)
2
46 ft. (14.0 M)
3
34 ft. (10.4 M)
4
22 ft. ( 6.7 M)
Table 5.
WARNING!
DO NOT USE PVC PIPE FOR FLUE
EXHAUST VENT. FLUE EXHAUST
VENT TEMPERATURES CAN BE IN
EXCESS OF 4000 F. FLUE EXHAUST
VENT MUST BE CATEGORY I or
CATEGORY III METAL VENT.
Note (*): Combustion Air Intake Duct Connection Kit (Part Number 461031) for all MasterTemp heater models can be
purchased separately. See page 52 for parts list.
NOTE
Each 90-degree elbow reduces the maximum horizontal PVC air intake duct run by 12 feet and each 45-
degree elbow in the PVC air intake duct run reduces the maximum run by 6 feet. See the Table 5 above for
the maximum lengths using 90-degree elbows.
Corrosive Vapors and Possible Causes
Area
Likely Contaminants
Chlorinated swimming
Pool or spa cleaning chemicals Acids,
pools and spas
such as hydrochloric or muriatic acid.
Glues and cements, construction
New construction and
adhesives, paints, varnishes, and paint
remodeling areas
and varnish strippers. Waxes and
cleaners containing calcium or sodium
chloride
Permanent wave solutions, bleaches,
Beauty parlors
aerosol cans containing chlorocarbons
or fluorocarbons.
Refrigeration plants or
Refrigerants, acids, glues and cements,
various industrial finishing
construction adhesives.
and processing plants
Bleaches, detergents, or laundry soaps
Dry cleaning and laundry
containing chlorine. Waxes and cleaners
areas
containing chlorine, calcium or sodium
chloride.
ACAUTION
Chemicals should not be stored near the
heater installation. Combustion air can
be contaminated by corrosive chemical
fumes which can void the warranty.
Table 6.
MASTERTEMP Pool and Spa Heater Installation and User's Guide Rev. N 10/2018