ATTACHMENT A
NOTICE OF COMPLETION
Name
Street
Address
City &
State
SPACE ABOVE THIS LINE FOR RECORDERS USE
NOTICE OF COMPLETION
(CA Civil Code §§ 8180-8190, 8100-8118, 9200-9208)
NOTICE IS HEREBY GIVEN THAT:
1. The undersigned is an owner of an interest of estate in the hereinafter described real property, the nature of which interest or estate is:
_________________________________________________________________________________ (e.g. fee, leasehold, joint tenancy , etc.)
2. The full name and address of the undersigned owner or reputed owner and of all co -owners or reputed co -owners are:
Name Street and No. City State
__________________________________________________________________________________________________________
3. The name and address of the direct contractor for the work of improvement as a whole is:
__________________________________________________________________________________________________________
4. This notice is given for (check one):
Completion of the work of improvement as a whole.
Completion of a contract for a particular portion of the work of improvement (per CA Civ. Code § 8186).
5. If this notice is given only of completion of a contract for a particular portion of the work of improvement (as provided in CA Civ. Code § 8186), the name and address of the direct contractor under that contract is:
___________________________________________________________________________________________________________
6. The name and address of the construction lender, if any, is:
___________________________________________________________________________________________________________
7. On the ____________ day of ___________, 20___, there was completed upon the herei n described property a work of improvement as a whole (or a particular portion of the work of improvement as provided in CA Civ. Code § 8186) a general description of the work provided:
___________________________________________________________________________________________________________
8. The real property herein referred to is situated in the City of __________________________, County of _______________________ _ State of California, and is described as follows:
___________________________________________________________________________________________________________
9. The street address of said property is:
___________________________________________________________________________________________________________
10. If this Notice of Completion is signed by the owner’s successor in interest, the name and address of the successor’s transferor is:
___________________________________________________________________________________________________________ I certify (or declare) under pe nalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date: _______________________________________ By: ________________________________________________________ Signature of Owner or Owner’s Authorized Agent
City of Palm Springs
Recording Requested By:
When Recorded Mail To:
City of Palm Springs
Brenda Pree, City Clerk
3200 E. Tahquitz Canyon Way
Palm Springs, CA 92262
Fee
City of Palm Springs 3200 E. Tahquitz Canyon Way Palm Springs CA 92262 Matich Corporation 1596 Harry Sheppard Blvd, San Bernardino, CA 92408 ✔
Not Applicable
Not Applicable
31 July
26 Palm Springs International Airport Airport Stormwater Hangar Repair Project. Airport Project PSP-01 Palm Springs
Riverside
Palm Springs International Airport
3400 Aviation Way Palm Springs, CA 92262
Not applicable
Joel Montalvo/City Engineer
VERIFICATION
I, _______________________________________________, state: I am the ________________________________ __ (“Owner”, “President”, “Authorized A
gent”, “Partner”, etc.) of the Owner identified in the foregoing Notice of Completion. I have read said Notice of Completion and know the contents thereof; the same is true of my own knowledge.
I de
clare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on _______________________, _______ (da te), at _______________________________________________ ______ (City), ________ (State). ______________________________________________________
Signature of Owner or Owner’s Authorized Agen
Joel Montalvo/City Engineer
City of Palm Springs
PROOF OF SERVICE DECLARATION
a.
b.
c.
_____________________________________________________________ (Signature of Person Making Service)
STATE OF CALIFORNIA
COUNTY OF ______________________________________
On _____________________________ ____________, ________ (date), before me, ________________________________ ____________, Notary Public (name and title of officer) personally appeared __________________________________________who proved to me on the basis of satisfactory evidence to be the person(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 authorize d capacity(ies), and that by his/her/their 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 PURJURY under the laws of the State of California that the foregoing paragraph is true and correct.
Witness my hand and official seal.
_____________________________________________
Signature
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.
Joel Montalvo
City Engineer
Palm Springs
CA