14-0244 (SFD)81328 Amundson Ave
14-0244
L
4sIE
ZO.•BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 14-00000244 Owner:
Property Address: 81328 AMUNDSEN AVE MARK MCCLURE
APN: 767-200-998-26 -330762- 6415 MUIRLANDS DR
Application description: DWELLING - SINGLE FAMILY DETACHED LA JOLLA, CA 92037
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 759582
Contractor:
Applicant: Architect or Engineer: DBCA INC
P.O. BOX 1482
LA QUINTA, CA 92247
(760)393-5271
Lic. No.: OOR SQUARE FOOT Lic. No.: 915336
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:---- 51(11-,/2/14
-- - n ,
110 '.
4 r
L1 @CL_ce B Pl.
-
'------------------------------------------------------------------------------------------ - - - - -—
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with -
Section 7000) of Division 3 of the Business and rPfessionals Code, and my License is in full force and effect.
License Class: B: License No.: 915336
Date: Contractor:
`_ WNE - UILDER DECLARATION
I hereby affirm under penalty of perju hat m exempt from the Contractor's State License Law for the
;P Ifollowing reason (Sec. 7031.5, Bus' ess 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
fpermit 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).:
(_ 1 1, 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.).
(_) 1, 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 contractors) licensed
pursuant to the Contractors' State License Law.).
1 _ 1 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 Name:
Lender's Address:
LQPERMIT
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: -
Carrier TRAVELERS PROPT - Policy Number YJUB282D7797-14
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 California,
and agree that, if I should become bject to the workers' compensation provisions of Section
3700 of the Labor Code, 1 all hwi comply with those provisions.
Date:_ - Applica :
WARNING: FAILURE TO SECURE KERS' COMPENSATION 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 Director of Building and Safety 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 county to enter upon the above-mentioned property for inspec ' purposes.
Date: Signature (Applicant or A tl: - -- - - - _ -
Y
LQPERNI[T
�= a
Application Number . . . . . 14-00000244
Permit
. . .
BUILDING 2013
Additional
desc .
Permit Fee
. . . .
887.03
Plan Check
Fee
00
Issue Date
. . . .
Valuation
. . . .
759582
Expiration
Date
11/10/14
Qty
Unit Charge
Per
Extension
BASE
FEE
573.43
560.00
----------------------------------------------------------------------------
.5600
THOU BLDG
$200,001-$1M
313.60
Permit
. . .
ELECTRICAL 2013
Additional
desc .
Permit Fee
. . . .
240.28
Plan Check
Fee
.00
Issue Date
. . . .
Valuation
. . .
. 0
Expiration
Date
11/10/14
Qty
Unit Charge
Per
Extension
1.00
143.0000
LS ELEC
NEW RES, FIRST 1
KSF
143.00
8.00
------------- --------------------------------------------------------------
12.1600
EA ELEC
NEW RES, ADD'L 1
KSF
97.28
Permit
. . .
MECHANICAL 2013
Additional
desc . .
Permit Fee
. . . .
536.28
Plan Check
Fee
.00
Issue Date
. . . .
Valuation
. . .
. 0
Expiration
Date
11/10/14
Qty
Unit Charge
Per
Extension
6.00
35.7500
EA MECH
FURNACE
214.50
1.00
11.9200
EA MECH
APPL REP/ALT
11.92
6.00
35.7500
EA MECH
CONDENSER/COMP
214.50
7.00
11.9200
EA MECH
VENT FAN
83.44
1.00
----------------------------------------------------------------------------
11.9200
EA MECH
EXHAUST HOOD
11.92
Permit
. . .
PLUMBING 2013
Additional
desc . .
Permit Fee
. . . .
595.99
Plan Check
Fee
.00
Issue Date
. . . .
Valuation
. . .
. 0
Expiration
Date . .
11/10/14
Qty
Unit Charge
Per
Extension
30.00
11.9200
EA PLBG
FIXTURE/TRAP
357.60
1.00
11.9200
EA PLBG
BUILDING SEWER
11.92
12.00
11.9200
EA PLBG
ROOF DRAIN
143.04
2.00
11.9200
EA PLBG
WATER HEATER/VENT
23.84
Application Number . . . . . 14-00000244
Permit . . . . . . PLUMBING 2013
Qty Unit Charge Per
Extension
1.00
11.9200 EA PLBG WATER INST/ALT/REP
11.92
1.00
11.9200 EA PLBG BACKFLOW DEVICE
11.92
1.00
35.7500 LS PLBG GAS SYS, 5+ OUTLETS
35.75
----------------------------------------------------------------------------
Special Notes and Comments
NEW SFD 8633
SQ.FT. 1788 SQ. FT. PATIO.
THIS PERMIT
DOES NOT INCLUDE POOL, SPA,
BLOCK WALLS
, DRIVEWAY APPROACH,
FIRE -PIT, WATER FEATURES.HOME IS FIRE
SPRINKLED PER 2013 CRC CODES.
May 14, 2014
10:39:36 AM jjohnson.
May 21, 2014
9:03:07 AM jjohnson.
REVISED A/C
SQ. FT.REMOVED GARAGE A/C
----------------------------------------------------------------------------
Other Fees
. . . . . . . . . ART IN PUBLIC PLACES -RES
1405.98
BLDG STDS ADMIN (SB1473)
31.00
DIF COMMUNITY CENTERS -RES
129.00
DIF CIVIC CENTER - RES
942.00
DIF FIRE PROTECTION -RES
433.00
HOURLY PLAN CHECK
143.00
DIF LIBRARIES - RES
344.00
MULTI -SPECIES (MSHCP) FEE
1278.00
PLAN CHECK, ELECTRICAL
87..27
DIF PARK MAINT FAC - RES
40.00
PLAN CHECK, MECHANICAL
328.89
PLAN CHECK, SFD GRADING
143.00
PLAN CHECK, PLUMBING
567.38
DIF PARKS/REC - RES
2048.00
BLDG PC 200K -1M
1929.74
STRONG MOTION (SMI) - RES
76.24
TUMF: RESIDENTIAL
1837.44
DIF STREET MAINT FAC -RES
116.00
DIF TRANSPORTATION - RES
2842.00
Fee summary
Charged Paid Credited
--------------------
Due
-----------------
Permit Fee
--------------------
Total 2259.58 .00 .00
2259.58
Plan Check
Total .00 .00 .00
.00
Other Fee Total 14721.94 1500.00 .00
13221.94
Grand Total
16981.52 1500.00 .00
15481.52
LQPERMIT
„-r - a-,-+ 4 4 4 a”
P.O. BOX 1504 APPLICATION ONLY
Building 78-495 CALLE TAMPICO
Address al ".�j2 c3 j�MV Delo{.! �4� LA QUINTA, CALIFORNIA 92253
Owner
M%t'is"K- tACI C_LLV rav BUILDING: TYPE CONST V—N OCC GRP S
Mailing
Address 64„113 M V (Cil.P1Jv5 S7(�-1�/l�
City LP` J ol._Lr` Zip
so1-7 Tel.
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Contractor IV
G�I.I%�iT-tJIA I,NG� t713�A
Address
01
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State Lic. City
& Classif. 9 1 ci 3 3 (p Lic. # 1 04 804
Arch_'Engr., l LCL.
Designer r
1,Tp C
q�-
tv12 5 V 1'fG -?,So —7 q 2% 2 800
CityState
TV920
bb�- Mi�Ct 1�{•Lic.# otri(noZ
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 affirm that I am exempt from the Contractor's License Law for the following reason:
(Sec. 7031.5, Business and Professions Code: 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 Contrac-
tor'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).
❑ 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 Profes-
sions 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).
O I, as owner of the property, am exclusively contracting with licensed contractors to construct 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
-• M A, —
Date Owner
WORKER'S 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 thheo_ 1Sgc, 3�OO&�bo�Z�
Policy No. Company rL+� V
{Copy is filed with the city. ❑Certified cooppy is hereby furnished.
Y� V �?' t7
ERRTIFICA OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less).
I certify that in the performance of the work for which this permit is issued, I shall not employ
any person in any manner so as to become subject to Workers' Compensation Laws of California.
Date Owner — N^ -..
NOTICE TO APPLICANT.' If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for
which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter the above-mentioned
property for inspection purposes.
Signature of applicant ... Date
Mailing Address
City, State, Zip
WHITE = BUILDING DEPARTMENT
A.P. Number —I &-7 - (Oq O - O 1
Legal Description LOT _Z41•TI2AG-T 1� 0-7(o - 2
Project Description MAP 1V Eiz-SI D� Gi.fTwe
`
8 I � 6 � 1-1 p13 - 5 F �i (3 � I� at•�
9 1 V G V jz;, fW-M1 L.Y
Ill 0 3 G N(L G 1 Poolk S I -re v
Sq. Ft-$ No ( No. Dw.
Size , (I,� O GhR Stories Units
Newt' Add ❑ Alter ❑ Repair ❑ Demolition ❑
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line —
FINAL DATE INSPECTOR
Issued by: —
Validated by:
Validation:
YELLOW = APPLICANT
Date Permit
PINK = FINANCE
k,
Cell
C2 J1
�F
Estimated Valuation
71 (000
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
r, IIU 11
1F0
tu
TOTAL
CONTACT INFORMATION
NAME:
PHONE:
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line —
FINAL DATE INSPECTOR
Issued by: —
Validated by:
Validation:
YELLOW = APPLICANT
Date Permit
PINK = FINANCE
k,
S ^E
COO , Valley Unified School District
83-733 Avenue 55, Thermal, CA 92274
(760):398-5909 — Fax (760).398-1224
This Box For District Use Only
DEVELOPER FEES PAID
AREA:
AMOUNT
LEVEL ONE AMOUNT:
LEVEL TWO AMOUNT:
MITIGATION AMOUNT:
COMWIND. AMOUNT:
DATE:
RECEIPT: -
. CHECK #: - TTNITIALS
CERTIFICATE OF COMPLIANCE
(California Education Code 17620)
Project Name: Mark McClure (Residence @Hideaway) Date: June 5, 2014
Owner's Name: Mark McClure Phone No.
Project Address: 81-328 Amundson, La Quinta, CA 92253
Project Description: 1 Single Family Dwelling Unit
APN: 767-690-018 Tract #: Lot #'s:
Type of Development: Residential . XX! Commercial' Industrial
Total Square Feet of Building Area: 8,633 SQ. FT.
Certification of Applicant/Owners: The person signing certifies that the above information is correct and in s this ement under
penalty of perjury and further represents that he/she is authorized o on b hal the o r e lamer.
Dated: / Signature:
SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN
ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE).
Education Code Gov. Code Project Agreement Existing Not Subject to Fee
17620 65995 Approval Prior to 1/l/87 Requirement
Number of Sq.Ft. 8,633
Amount per Sq.Ft. $3.20
Amount Collected 27,625.60
Building Permit Application Completed: Yes/No
By: Elsa F. Esqueda, Director of Facilities and Maintenance
Certificate issued by: Leticia Torres, Facilities Analyst Signa re: -
NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STAXEMIRNT OF FEES
Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that s District provide (1) a written notice to the
project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these
Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to
advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other
requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this
time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of
Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up
to three (3) such extensions may be granted.
M V:c/mydgcsldevfees/certificate of compliance form updated 3-2007 11/2010
McClure Homes,, LLC , A CALIFORNIA. LIMITED LIABILITY COMPANY
("Grantee"), the real
property located in the City of La'Quinta, County of Riverside, State of California, described as:
See Legal Description attached hereto and incorporated herein as Exhibit "A".
SUBJECT TO all matters of record including, without limitation, the covenants and agreements
described in Exhibit "A" attached hereto.
Dated: 9 1 EAST OF MADISON, LLC,
a Delaware limited liability company
By: 120 Acre Partners, LLC,
a Delaware limited liability company
Its: Managing Member
By: Discovery La Quinta Investors, LLC,
A Delaware limited liability company
Its authorized Repres ative
By:
ph L. Arenson
Its: Authorized Representative
DOC # 2013-0560868
12/02/2013 01:58 PM Fees:. $30.00
Page 1 of 6 Doc T Tai Paid
1=iGEtl 11' P:F,TiCN,'-!L Ti -I Li O!!^,PANY
Recorded in Official Records
1' PA R T1hF^T
County of Riverside
Larry W. Ward
WHEN RECORDED MAIL TO:
Assessor, County Clerk & Recorder
McClure Homes LLC
6415 Muirlands Drive
La Jolla CA 92037
--This document was electronically submitted
to the County of Riverside for recording—
MAIL TAX STATEMENT TO:
Receipted by: LCWEATHERS
SAME AS ABOVE
APN • 767-690-018
(This space for Recorder's use only)
Tit •' GSD- / %a --
DOCUMENT TRANSFER TAX $1 ,100.00
XX Computed on the consideration or value of property conveyed; OR
Computed on the consideration or value less liens or encumbrances
remaining at the time of sale.
Signature of Declaran r Agent determining tax — Firm Name
GRANT DEED
FOR A VALUABLE CONSIDERATION,
receipt of which is hereby acknowledged, EAST OF .
MADISON, LLC, a Delaware limited liability company ("Grantor"), hereby GRANT(S) to,
McClure Homes,, LLC , A CALIFORNIA. LIMITED LIABILITY COMPANY
("Grantee"), the real
property located in the City of La'Quinta, County of Riverside, State of California, described as:
See Legal Description attached hereto and incorporated herein as Exhibit "A".
SUBJECT TO all matters of record including, without limitation, the covenants and agreements
described in Exhibit "A" attached hereto.
Dated: 9 1 EAST OF MADISON, LLC,
a Delaware limited liability company
By: 120 Acre Partners, LLC,
a Delaware limited liability company
Its: Managing Member
By: Discovery La Quinta Investors, LLC,
A Delaware limited liability company
Its authorized Repres ative
By:
ph L. Arenson
Its: Authorized Representative