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RR (11-0517)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&ht 4,4 Q" Application Number: 11--00000517 Property Address: 54050 AVENIDA MENDOZA APN 774-223-004-19 -000000- Application description: RE -ROOF Property Zoning: COVE RESIDENTIAL Application valuation: 3800 Applicant: 1.7 Architect Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Professionals Code, and my License is in full force and effect. License Class: License No.: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am 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 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$500).: 1 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.). (_ 1 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.Cfor this reason Date:. - �uU11I t - 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/18/11 Owner: HABERMAN KATHLEEN & MITCHELL 54050 AVENIDA MENDOZA LA QUINTA, CA 92253 (530)277-5402 Contractor. Owner �J .0 2011 CITY OF LA CAUINTlA 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 - - - - - - - - - - - - - - - - - - - ---- Policy Number 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 subject to the workers' compensation provisions of Section 3700 of the LaborffiJVZ;;::ose provisions.- _ Date:�l i- Applicant: WARNING: FAILURE TO SECURE WORKERS' 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 Ouinta, 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 c sI uction, and hereby authorize representatives of this c nt to enter upon the above-mentioned pro r f i p ction poses. Date I Signature (Applicant or Agent): Application Number Permit . . . Additional desc . . Permit Fee . . . . Issue Date . . . . Expiration Date . . . . . 11-00000517 RE -ROOF 30.00 Plan Check Fee . Valuation 11/14/11 Qty Unit Charge Per Extension BASE FEE 30.00 ------------------------------------------ Special Notes and Comments 7 ---------------------------`----- RE -ROOF PER 2010 CODES APPROVED PER S.T. --------------------------------------7------------------------------------- Other Fees . . . . . . . ... BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged ---------- Paid Credited -------------------- Due ----------------- Permit Fee Total ---------- 30.00 .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 31.00 .00 .00 31.00 LQPERMIT P.O. Box 1504 ' LA QUINTA, CALIFORNIA 92247-1504 BUILDING & SAFETY DEPARTMENT 78495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 PROPERTY OWNER'S PACKAGE 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at j 05c)Auernl dc— �- noln2A We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS.- Read and initial each statement below to signify you understand or verify this information. OM1 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 4 2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. A3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my ojw,n. 7 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on 1 permits and contracts. ,� Y� 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. U6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. A-7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. �M M8. ,I understand as an Owner -Builder if I sell the property for which this permit is issued; I may be held liable for any financial or personal injuries sustained by any subsequent ownei(s) that result from any latent construction defects in the workmanship or materials. 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration', the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State _License Board (CSLB) at 1- -- 800-321-CSLB C2752 or www.cslb.ca.gov for more information about licensed contractors. - &10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legallyand financially response le for proposed construction activity at the following address: �CA 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. 5lSignature of property owner � Date: Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: C A L I F Q PN ' RE I A AL ESTATE TRANSFER DISCLOSURE STATEMENT :WY OF REALTORS (CALIFORNIA CIVIL CODE 1102, ET SEQ) _/� (C.A.R. Form TDS, Revised 10/03) THIS DISCLOSURE STATEMENT CONCERNS THE REAL PROPERTY SITUATED IN THE CITY OF LaQuinta , COUNTY OF Riverside , STATE OF CALIFORNIA, DESCRIBED AS 54050 Avenida Mendoza, LaQuinta THIS STATEMENT IS A DISCLOSURE OF THE CONDITION OF THE ABOVE DESCRIBED PROPERTY IN COMPLIANCE WITH SECTION 1102 OF THE CIVIL CODE AS OF (date) Tune 24, 2010 . IT IS NOT A WARRANTY OF ANY KIND BY THE SELLER(S) OR ANY AGENT(S) REPRESENTING ANY PRINCIPAL(S) IN THIS TRANSACTION, AND IS NOT A SUBSTITUTE FOR ANY INSPECTIONS OR WARRANTIES THE PRINCIPAL(S) MAY WISH TO OBTAIN. I. COORDINATION WITH OTHER DISCLOSURE FORMS This Real Estate Transfer Disclosure Statement is made pursuant to Section 1102 of the Civil Code. Other statutes require disclosures, depending upon the details of the particular real estate transaction (for example: special study zone and purchase -money liens on residential property). Substituted Disclosures: The following disclosures and other disclosures required by law, including the Natural Hazard Disclosure Report/Statement that may include airport annoyances, earthquake, fire, flood, or special assessment information, have or will be made in connection with this real estate transfer, and are intended to satisfy the disclosure obligations on this form, where the subject matter is the same: ❑ Inspection reports completed pursuant to the contract of sale or receipt for deposit. ❑ Additional inspection reports or disclosures: 11. SELLER'S INFORMATION The Seller discloses the following information with the knowledge that even though this is not a warranty, prospective Buyers may rely on this information in deciding whether and on what terms to purchase the subject property. Seller hereby authorizes any agent(s) representing any principal(s) in this transaction to provide a copy of this statement to any person or entity in connection with any actual or anticipated sale of the property. THE FOLLOWING ARE REPRESENTATIONS MADE BY THE SELLER(S) AND ARE NOT THE REPRESENTATIONS OF THE AGENT(S), IF ANY. THIS INFORMATION IS A DISCLOSURE AND IS NOT INTENDED TO BE PART OF ANY CONTRACT BETWEEN THE BUYER AND SELLER. Seller ❑ isM is not occupying the property. A. The subject property has the items checked below (read across) Range Cff Oven Microwave ❑ Dishwasher ❑ Trash Compactor Garbage Disposal Washer/Dryer Hookups ❑ Rain Gutters ❑ Burglar Alarms ❑ Smoke Detector(s) ❑ Fire Alarm ❑ T.V. Antenna ❑ Satellite Dish ❑ Intercom f$ Central Heating ® Central Air Conditioning ❑ Evaporator Cooler(s) ❑ Wall/Window Air Conditioning ❑ Sprinklers ❑ Public Sewer System ® Septic Tank ❑ Sump Pump ❑ Water Softener ® Patio/Decking ❑ Built-in Barbecue ❑ Gazebo ❑ Sauna ❑ Hot Tub ❑ Locking Safety Cover' ❑ Pool ❑ Child Resistant Barrier' ❑ Spa ❑ Locking Safety Cover* ❑ Security Gate(s) ❑ Automatic Garage Door Opener(sp ❑ Number Remote Controls Garage: ❑ Attached ❑ Not Attached ❑ Carport Pool/Spa Heater: ❑ Gas ❑ Solar ❑ Electric Water Heater: ❑ Gas Water Heater Anchored, Braced, or Strapped' Water Supply: B City Well ❑ Private Utility or Gas Supply: ❑ Utility ❑ Bottled Other ® Window Screens ❑ Window Security Bars ❑ Quick Release Mechanism on Bedroom Windowg' / Exhaust Fan(s) in 220 Volt Wiring in Fireplace(s) in L ❑ Gas Starter ❑ Roof(s): Type:. ff6cg Age: 28 (approx.) ❑ Other: Are there, to the best of your (Seller's) knowledge, any of the above that are not in operating condition additional sheets if necessary): 5( No. If yes, then describe. (Attach ('see footnote on page 2)The copyright laws of the United States (Title 17 U.S. Code) forbid the Buyer's Initials unauthorized reproduction of this form, or any portion thereof, by photocopy Seller's Initials ( ) ( ) machine or any other means, including facsimile or computerized formats. Copyright © 1991-2003, CALIFORNIA ASSOCIATION OF REALTORS®, Reviewed by Date INC. ALL RIGHTS RESERVED. 121 TDS REVISED 10/03 (PAGE 1 OF 3) EUUAE HOUSING REAL ESTATE TRANSFER DISCLOSURE STATEMENT (TDS PAGE 1 OF 3) OPPORTUNITY Agent: Alan Fisher Phone: 760.567.2220 Fax:. Prepared using zipForm® software Broker: Tarbell Realtors 1526 Adam Street Banning . CA 92220 Property Address: 54oso Avenida Mendoza. La011inta Date B'. Are you (Seller) aware of any significant defects/malfuncti-ons in any of the following? ❑ Yes ❑ No. If yes, check appropriate space(s) below. ❑ Interior Walls ❑ Ceilings ❑ Floo'rs ❑ Exterior Walls ❑ Insulation ❑ Roof(s) ❑ Windows ❑ Doors ❑ Foundation ❑ Slab(s) ❑ Driveways ❑ Sidewalks ❑ Walls/Fences O Electrical Systems ❑ Plumbing/Sewers/Septics 0 Other Structural Components (Describe: If any of the above is checked, explain. (Attach additional sheets if necessary): "This garage door opener or child resistant pool barrier may not be in compliance with the safety standards relating to automatic reversing devices as set forth in .Chapter 12.5 (commencing with Section 19890) of Part 3 of Division 13 of, or with the pool safety standards of Article 2.5 (commencing with Section 115920) of Chapter 5 of Part 10 of Division 104 of, the Health and Safety Code. The water heater may not be anchored, braced, or strapped in accordance with Section 19211 of the Health and Safety Code. Window security bars may not have quick release mechanisms in compliance with the 1995 Edition of the California Building Standards Code. C. Are you (Seller) aware of any the following: 1. Substances, materials, or products which may be an environmental hazard such as, but not limited to, asbestos, formaldehyde, radon gas, lead-based paint, mold, fuel or chemical storage tanks, and contaminated soil or water on the subject property.......................................................... ❑ Yes 19 No 2. Features of the property shared in common with adjoining landowners, such as walls, fences, anal driveways, whose use or responsibility for maintenance may have an effect on the subject property ....... F.E144C$ ... I$Yes ❑ No it 3. Any encroachments, easements or similar matters that may affect your interest in the subject property ......... ❑ Yes EgNo 4. Room additions, structural modifications, or other alterations or repairs made without necessary permits....... El Yes ® No 5. Room additions, structural modifications, or other alterations or repairs not in compliance with building codes.... ❑ Yes ® No 6. Fill (compacted or otherwise) on the property or any portion thereof .................................... ❑ Yes P?1 No 7. Any settling from any cause, or slippage, sliding. or other soil problems ................................. ❑ Yes O No 8. Flooding, drainage or grading problems......................................................... ❑ Yes ® No 9. Major damage to the property or any of the structures from fire, earthquake, floods, or landslides ............. ❑ Yes 15a No 10. Any zoning violations, nonconforming uses, violations of "setback" requirements ......................... ❑ Yes [Z No 11. Neighborhood noise problems or other nuisances ........................................... [I Yes ® No 12. CC&R's or other deed restrictions or obligations ............................................. ❑ Yes ® No 13. Homeowners' Association which has any authority over the subject property ............................ ❑ Yes ®No 14. Any "common area" (facilities such as pools, tennis courts, walkways, or other areas co -owned in undivided interestwith others)................................................................ ❑ Yes ® No 15. Any notices of abatement or citations against the property ........................................... ❑ Yes [jJNo 16. Any lawsuits by or against the seller threatening to or affecting this real property, including any lawsuits alleging a defect or deficiency in this real property or "common areas" (facilities such as pools, tennis courts, walkways, or other areas, co -owned in undivided interest with others) ..........:................................. ❑ Yes qJ No If the answer to any of these is yes, explain. (Attach additional sheets if necessary): 61C.-KE5 5_#Ae P 1A1 c4 m wail Seller certifiesthatthe information herein istrue and correct to the best of the Seller's knowledge as of the date signed by the Seller. Sellefd&41 ��' ` ^LXX_ ems, Date ( -30 J b fkd_ .. Padilla — -Seller's David Pa Copyright © 1991-2003, CALIFORNIA ASSOCIATION OF REALTORS®, INC. TDS REVISED 10/03 (PAGE 2 OF 3) Date 6 -J*6 - /0 Buyer's Initials Reviewed by Date rOUAL NwsOIC OPPORTUNITY REAL ESTATE TRANSFER DISCLOSURE STATEMENT (TDS PAGE 2 OF 3) Prope rty.Add ress: 54050 Avenida Mendoza, LaQuinta Date: June 24,. 2010 III. AGENT'S INSPECTION DISCLOSURE (To be completed only if the Seller is represented by an agent in this transaction.) THE UNDERSIGNED, BASED ON THE ABOVE INQUIRY OF THE SELLER(S) AS TO THE CONDITION OF: THE PROPERTY AND BASED ON A REASONABLY COMPETENT AND DILIGENT VISUAL INSPECTION OF THE' ACCESSIBLE AREAS OF THE PROPERTY IN CONJUNCTION WITH THAT INQUIRY, STATES THE FOLLOWING: C] Agent notes no items for disclosure. C3 Agent notes the following Items: See attached AVID. Anent reconnmends an inspection by a professional Agent (Broker Representing Seller) Tarbell Realtors By Date �i (Please Print) to Licegogee or Broker Signature) IV. AGENT'S INSPECTION DISCLOSURE (To be completed only if the agent who has obtained the offer is other than the agent above.) THE UNDERSIGNED, BASED ON A REASONABLY COMPETENT AND DILIGENT VISUAL INSPECTION OF THE ACCESSIBLE AREAS OF THE PROPERTY, STATES THE FOLLOWING: O Agent notes no items for disclosure. ❑ Agent'notes the following items: _ Agent (Broker Obtaining the Offer) _Z By (1016as6 Print) V. BUYER(S) AND SELLER(S) MAY WISH TO OBTAIN PROFESSIONAL PROPERTY AND TO PROVIDE FOR APPROPRIATE PROVISIONS IN SELLER(S) WITH RESPECT TO ANY ADVICF1INSPFCTInNsmFFF IIWE ACKNOWLEDGE RECEIPT OF A COPY OF THIS STATEME Seller �"— Date (9 Buyer Pdilla . Seller U//,�ti.14/ &zlz Date Buyer David Padilla Agent (Broker Representing Seller) Tarbell Realtors By (Please Print) Agent (Broker Obtaining the Offer) lry�1,,& &gp B� (Please Print) J ADVICE AND/OR INSPECTIONS OF THE A CONTRACT BETWEEN BUYER AND Date 6' `eu -.,Id Datey� SECTION 1102.3 OF THE CIVIL CODE PROVIDES A BUYER WITH THE RIGHT TO RESCIND A PURCHASE CONTRACT FOR AT LEAST THREE DAYS AFTER THE DELIVERY OF THIS DISCLOSURE IF DELIVERY OCCURS AFTER THE SIGNING OF AN OFFER TO PURCHASE. IF YOU WISH TO RESCIND THE CONTRACT, YOU MUST ACT WITHIN THE PRESCRIBED PERIOD. A REAL ESTATE BROKER IS QUALIFIED TO ADVISE ON REAL ESTATE. IF YOU DESIRE LEGAL ADVICE, CONSULT YOUR ATTORNEY. THIS FORM HAS BEEN APPROVED BY THE CALIFORNIA ASSOCIATION OF REALTORS® (C.A.R.). NO REPRESENTATION IS MADE AS TO THE LEGAL VALIDITY OR ADEQUACY OF ANY PROVISION IN ANY SPECIFIC TRANSACTION. A REAL ESTATE BROKER IS THE PERSON QUALIFIED TO ADVISE ON REAL ESTATE TRANSACTIONS. IF YOU DESIRE LEGAL OR TAX ADVICE, CONSULT AN APPROPRIATE PROFESSIONAL. This forth is available for use by the entire real estate industry. It is not intended to identify the user as a REALTOR& REALTOR® is a registered collective membership mark which may be used only by members of the NATIONAL ASSOCIATION OF REALTORS® who subscribe to its Code of Ethics. Published and Distributed by: N REAL ESTATE BUSINESS SERVICES, INC. � a subsidiary of the California Association of REALTORS® EQUAL 525 South Virgil Avenue, Los Angeles, California 90020 Reviewed by Date OPPOPTUUSINGI NITY TDS REVISED 10/03 (PAGE 3 OF 3) REAL ESTATE TRANSFER DISCLOSURE STATEMENT (TDS PAGE 3 OF 3) David and Deborah `i�rbell REALTORS AFFILIATED BUSINESS ARRANGEMENT DISCLOSURE NOTICE Property This is to give you notice that Tarbell, Realtors® has a business relationship with Mission Hills Mortgage Bankers, Landwood Title®, Hartford Escrow and Tarbell Insurance Services®. Each of these companies, including Tarbell, Realtors®, is wholly owned by Tarbell Financial Corporation and Tarbell, Realtors may refer business to these companies in connection with your real estate transaction. Because of this relationship, this referral may provide Tarbell Financial Corporation a financial or other benefit. This is also to give you notice that Tarbell, Realtors® has an affiliated business arrangement with Western Resources Title Company and may refer business to it in connection with your transaction. The cost of services provided by the above named entities will be determined by agreement with all the parties involved, in accordance with the normal, customary and reasonable practices of the real estate industry and the laws and regulations of the real estate industry and the laws and regulations of the various state and federal regulatory agencies. Set forth below is an estimated charge or range of charges for the following: Hartford Escrow Inc. Fees are based on services provided and the sales price of the home. Fees range from $200 to $1,500 or more. Landwood Title® Title fees are filed with the state Department of Insurance. Fees are based on the sales price and services provided and range from $300 to $2,000 or more. Tarbell Insurance Services® Insurance prices are dependent on factors such as size and condition of property, coverage limits of the policy, deductible amounts and other factors. The fees range from $150 to $2,000 or more. Mission Hills Mortgage Bankers Fees are based on the size and type of loan and range from 0 to 2% or more of the loan amount. Interest rates fluctuate based on market conditions, the type of the loan, and the size of the loan. Rates and fees are adjusted often to reflect market conditions and a current quote should be obtained. Western Resources Title® Title fees are filed with the state Department of Insurance. Fees are based on the sales price and services provided and range from $300 to $2,000 or more. You are not required to use the above -listed providers as a condition for the purchase of the subject property. There are other settlement service providers available who may provide similar services and you are free to shop around to determine that you are receiving the best service and rate for such services. Buyerelle signature: Date: r/ • Zt'o - 16 Print Name: Buyer/Seller signature: Date: Print Name: Affiliated Business Arrangement Disclosure Notice 6026FM (Rev 03/10) Manager's Initials Prescriptive Certificate of Contpliance• Residential Reroof Project Address CF 1R ALT ReRoof , , , M ROOFING PRODUCTS (COOL ROOFS) §151(1)12 When the area of exterior roof surface to be replaced exceeds roofing area must meet the roofing product "Cool Roof" requi, Check applicable alternative or exception below if the roof afterati % of the existing rents of PUMP is exempt from the Zone oof area, or 1,000 ff, whichever is less, the new 1, 152(b)1Hil, or 152(b)1Hill. roofing product "Cool Roof requirements:: ❑ Cool roofs not required in Climates Zones 1-12, 14, and 16 with a low sloped roof pitch (less or 2:12 pitch). ❑ Cool roofs not required in Climates Zones 1-9, and 16 with a steep -sloped roofs (greater pitch than 2:12) and product weightless than 511b/ft?. Alternatives to §152(b)1 HI and §152(b)HII, Steep -slope roof (pitch > 2:12) ❑ Insulation with a thermal resistance of at least 0.85 haft.*FIBtu or at least a 3/4 inch air -space is added to the roof deck over an attic; or ❑ Existing ducts in the attic are insulated and sealed a000rding to §151(f)10; or ❑ In climate zones 10, 12 and 13, with 1$2 of free ventilation area of attic ventilation for every 150 ft2 of attic floor area, and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge; or ❑ Building has at least R-30 ceiling insulation; or ❑ Building has radiant barrier in the attic meeting the requirements of §151(f)2; or ❑ Building has no duds in the attic; or O In dimate zones 10, 11, 13 and 14,.R-3' or greater roof deck insulation above vented attic. Exception to §152(b)l Hill, Low -slope roof ( pitch 5 2:12) ❑ Building has no ducts in the attic. Other Exceptions ❑ Roofing area is covered by building integrated; photovoltaic panels and solar thermal O Roof constructions that have panels are exempt from the Cool Roof criteria. . Thermal mass over the roof membrane with at least 25 Iblft2 are exempt from theCoo and Thermal Emiffence l Roof criteria. NOTE: ff any one of the alteratives or exception is checked the Aged Solar Reflectancerequirements for roofing products in §118(1) are not applicable. Do not fill table below. I CRRC Product ID Number Roof Slope s 2:12 > 2: �W Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, The CRRC Product !D Number can be obtained from the Cool Roof Rating Counars Rated product Diredory ai www. coofroofs om4Dwducts/seaMh Indicate the type of product !s being used for the roof top, i.e. single,* roof, asphalt If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated product D tsl roof etc, oho directory grid use the equation (0.20.7 �rY then use the Initial Reflectance value from the same (prw - 0.2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance. Check box if the Aged Reflectance is a calculated value using the equation above. Calculate the SR! value using the SRI- Worksheet at AINW.ene aoopy of the SRI- Worksheet to the CF -1R. MCI,o9,2nre24/ and enter the resulting value in the SRI Column above -and attach 'roduct Weight MUMi 5fb/ft2 Product T 2 Aged Solar ReflectancW Thermal Emittance S SRI `I 13 a61 • D� t� ❑ ❑ ❑4 o apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry ml thickness or coverag %commended by the coatings manufacturer and meet minimum performance requirements listed inf� 118 I . Select the § applicable coating: 7 Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other MOTE: When a Cool Roof is required, the installing contractor shall complete and submit the CF -6R -ENV -01 for final inspection. Declaration Statement • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is accurate and complete. • I certify that the energy features and performance specifications -identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Reaulations. \ Name: Company: P. :ss: Lam. CA 01 2� s a S9 License: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.' Bin # Qty of LQ QumtQ 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 Pennit # Project Address:5n OSD Vim, 0. \e -a 0. Owner's Name: Kt�`I een ISG 1 A. P. Number: 1 _ a a ?J d� Address: 5 g05D _A\_) 6,� VV,.o n �JZC, Legal Description: lQ, City, ST, Zip: Lo,,� CA q Contractor:, -.--Telephone: Address: : S 1O L �:�' Project Description: City, ST, Zip: Telephone: Stale Lic. # : City Lic. #; Arch., Engr., i ner: Address: City., ST, Zip: Telephone::<:; State Lic. #: .:>::><:F>:f mak• ; *a?:.•' ' Construction Type: Occu anc Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Name of Contact Person: jr\ \4C30eX' MQ.,,_ Telephone # of Contact Person: S 3D all 5 OZ Estimated Value of Project: , APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit . Truss Cates. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2e° Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3d Review, ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees