07-2261 (DSF)P.O. BOX 1504
Tiht 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: C07-00002261 Owner:
Property Address: 79890 RIVIERA CAPOBIANCO PETER T
APN: 762-070-006- - - 40 BEAVER ST NO 10
Application description: DEMO - SINGLE FAMILY WELLSELEY HILLS, MA 2481
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 0
Contractor:
Applicant: Architect or Engineer: EDWARDS CONSTRUCTION INC,
51455 DESERT CLUB DRIVE
LA QUINTA, CA 92253
(760) 777-8202
Lic. No.: 684857
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/31/07
p � 0
SEP 04 2007
'CITY OF LA QUINTA
FINANCE DEPT.
---------------------•-----------------------------
LICENSED CONTRACTOR'S DECLARATION
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
1 hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License'is in full force and effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: B License No.: 684857
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
te: ontra
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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier GRANITE STATE Policy.Number 3368904
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to.
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if.I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the bor Code, I shall forthwith comply with th S.
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):
at e. plicant:
(_) 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
WARNING: FAILURE TO SECURE WORK ERS''COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, -
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION,' DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.)
APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.'
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
. whose benefit work is performed under or pursuant to any permit issued as a result of this application,
1 _) I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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 Name:
Lender's Address:
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 b�����,esentalrves'tatives
o_f/this/jp�quyt/y tVgnoat.re
the above-mentioned prop
P11 `^ (Applicant or Agentl:
LQPERMIT`
Application Number 07-00002261
Permit . . . DEMO PERMIT
Additional desc .
Permit Fee 45.00 Plan Check Fee .00
Issue Date Valuation . . . . 0
Expiration Date 2/27/08
Qty Unit Charge Per Extension
BASE FEE 45.00
------------------- --------------------------------------------------------
Special Notes and Comments -
DEMO OF EXT. WALLS @ DINING RM, MBR/BR.
DEMO ADJ. WALL TO DINING RM/POOL EQUIP.
DEMO TILE/POOL DECKING
Fee summary Charged. Paid Credited Due
-------------- -- ---------
Permit Fee Total 45.00 .00 .00 45.00
Plan Check Total .00 .00 .00 .00
Grand Total 45.00 .00 .00 45.00
LQPERMIT
Bin #
Cit/ of La Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
dam'
Project Address: 9 — 990 R) V i 1.R64
Owner's Name: + 'TA /VAV Y COO &An/ C 0
A. P. Number: 7 6 o%d `- o0
Address: y O SEA V E `Z S-7' */0
Legal Description: o'T S 2/2 - .3. L — /
Contractor: EDWARDS' rCONSTRUCTION INC, 'BOB
City, ST, Zip:
Telephone: ? .. .•' •>
,IN
Project Description:
Address: 51455 DESERT CLUB DRIVE
NTA CA 922S3--
City, ST, Zip: LA Q I
Telephone: 777-8202 Ext 102
<'"` < ' ' t '
State Lic. # : 684857
City Lie. #, z l2
.
�-x�'e ��sC/PT �, ,,,, •tom N
Arch., Engr., Designer. . �K't; r� '' i ' �t)2
Address:
�� • 1gi Q�r� i71n1 Nei') f� �.. 1iG'�o /11
(7 n
City., ST, Zip: A un C4-`7 Z Z t 4%
Telephone: -7%-0 - 3y' 6 "-
State Lie. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair
Name of Contact Person: Ed Randall
Sq. Ft :
# Stories:
# Units:
Telephone # of Contact Person: 777-8202 Ext 102
Estimated Value of Project:
APPLICANT: -DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERWr FEES
Plan Sets
p�
Plan Check submitted
%07
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
20° Review, ready for correctionWissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S,Mj,
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
8/� = �M I v
31.07
> 4/7 zZ
PIPASE COMPLEF E V= Dwiw"ran
ROCORDI icRECIIJEstIEner:
FNTIC/RLV
AILD Wry ReoOROw§L%L TOc
PETER T.' CAPOBIANCO
41 HUNDREDS ROAD
WELLESLEY. MA 02181
081968
pNED FOR RECORD
rte.
PA f �. ,_ 1 AT B.00
-ram.-Or Tax MAR -6 1998
dd10'"A,�Irb==
Fl
Fan
BAACEA80MEFOR USHOUY
CRAZIT DEED
Tltl� of Doasmart
TM PAGE AWED TO PROVIDE ADEQUATESPACE FOR REOOPUNG DWORMAIM
(SUO AdMgoaW Reeonfiy Tee Appiiesj
„may —
REQUESTED BY:
# WHEN RECORDED, MAIL TO:
.;,�w Mr. Peter T. Capobianco
91 Hundreds Road
' Wellesley. HA 02181
(Space Above Line For Recorder's Use Only)
GRANT DEED
Tract 28340-1
City of La Quinta, Coumy ofRiverside, `
State of California A.P.N. 761-550-006-8
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THE UNDERSIGNED GRANTOR DECLARES:
DOCUMENTARY TRANSFER TAXIS S 424.05
AND IS COMPUTED ON THE CONSIDERATION OR VALUE OF PROPERTY CONVEYED.
FOR' VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, KSL
LAND lit CORPORATION, a Delaware corporation ("Grantor'). hereby GRANTS to
Peter T. Capobianco, a married man as his sole and separate property
(the'Grantee°), the real property in the City ofLa Quinti, County ofRiverside; State of Califbniva,
described as follows:
*r,.;'yszarr- t as nPr man filed in Honk 259. Panes 44 to 47 of
`y Maps, records of said CMudy;
I PARCEL: 2: Nonexclusive easements and rights for access, ingress, egress, enforcement and other
purposes as set forth in the Declaration of Covenants, Conditions and Restrictions,
PGA West 11 Residential Project. recorded on Aug= 3, 1990, as Instrument No.
288874 of the Official Records of said County (the "Declaration'l, and the
Supplementary Declaration of Covenants, Conditions ad Restrictions by which the
Lot described in Parcel 1 above was annexed thereto (the "Supplementary
Declaration"); which include, but are not limited to, the easement for drainage through
Storm Drain Improvements identified upon the map of Tract 28340-1 and , the easement
for ingress and egress over Street Improvements as such easements are more particularly
described in the Supplementary Declaration
PARCEL 3: Nonexclusive easements and rights for acxess, ingress and egress and other purposes
as set forth in the Master Declaration of Covenants. Conditions and Restrictions for
PGA West Riverside County, California recorded on January 22. 1986, as Instrument
No. 15569, of the Official Records of said County (the "Master Declaration").
MAIL TAX STATEMENTS'110 B. ETURN ADDRESS ABOVE
28340-tldeeds t
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E:SF:RVING UNTO GRANTOR, its successors and assigns, together with the right to grant and
transfer all or a portion of the same, except as granted hereby:
A. all oil, minerals, natural gas, and other hydrocarbons by whatsoever name known,
geothermal resources, metaAiferous or other ores, and all products derived from any of the foregoing,
that may be within or under Parcel 1, and all rights associated with the foregoing, together with the
perpetual right of drilling, mining, exploring and operating therefor and storing in and removing the same
from said land or any other land, including the right to whipstock or directionally drill and mine from
lands other than Parcel 1, oil or gas wells, tunnels and shafts into, through or across the subsurface of
Parcel I and. to bottom such whipstocked or directionally drilled wells, tunnels and shafts under and
beneath or beyond the exterior limits thereof, and to redrill, retunnel, equip, maintain, repair, deepen and
operate any such wells or mines without, however, the right to drill, mine; store, explore and operate
through the surface or the upper five hundred (500) feet of the subsurface of Parcel 1; and
B. easements and rights as reserved to Grantor in the Declaration and the Master
Declaration.
SUBJECT TO:
Current Taxes and Assessments.
2. The Declaration and the Supplementary Declaration, and any amendments to either of
the foregoing documents, and the covenants, conditions, restrictions, rights, easements, reservations,
benefits and burdens therein contained, each and all of which are covenants running with the land
established in accordance with Section 1468 of the California Civil Code for the benefit of and binding
upon the parties hereto and eacb successive owner of all or any portion of the land affected thereby and
are herehv axnrnaa u inrmmwsrntad k-" *--r-
3.
--r
3. The Master Declaration and the Supplemental Declaration ofCovenaM Conditions
and Restrictions for PGA West (Master Association) by which the property conveyed hereby was
annexed thereto, and any amendments to either of the foregoing documents, and the covenants,
conditions, restrictions, rights, easements, reservations, benefits and burdens therein contained, each and
all of which are covenants running with the land established in accordance with Section 1468 of the
California Civil Code for the benefst of and binding upon the parties hereto and each successive owner
of all or any portion of the land affected thereby and are hereby expressly incorporated herein by
reference as though set out herein in full.
4 All other covenant,, conditions, restrictions, reservations, rights, rights of way and
easements of record as well as any of such matters that are apparent.
DATED: KSL Lr 111 CORPO ION, a Delaware corporation
1
By:
28340-1 Weeds
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STAVE OF CALIFORNIA ss
COUNTY OF RIVERSIE ) a notary
bdIbm Mt. �h� Underai nee
1998 Larry �• Lschliter sao iwh
se
On TAfLr�h State, pway aD � dl to be the pe ecemied the
public in and for said*ML �vtedgt hels
Wally knoam to me b� 0°°°d instnuuW fin° ed �gnature(t9 on the instruct the
l0 � to the with+ and that by hi ted the Is+sttunt'
isle 0 a� ap w •the person{1A teed• exec p om `d r
Sam in p nggaj• or the entity ►�p(m U M0,.4
and offic�l s�L � cam E� rw �. zaoo ''
WITNESS my hand
S'tignature h4 ill r
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STAVE OF CALIFORNIA ss
COUNTY OF RIVERSIE ) a notary
bdIbm Mt. �h� Underai nee
1998 Larry �• Lschliter sao iwh
se
On TAfLr�h State, pway aD � dl to be the pe ecemied the
public in and for said*ML �vtedgt hels
Wally knoam to me b� 0°°°d instnuuW fin° ed �gnature(t9 on the instruct the
l0 � to the with+ and that by hi ted the Is+sttunt'
isle 0 a� ap w •the person{1A teed• exec p om `d r
Sam in p nggaj• or the entity ►�p(m U M0,.4
and offic�l s�L � cam E� rw �. zaoo ''
WITNESS my hand
S'tignature h4 ill r
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