10-1315 (SPIN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00001315
Property Address: 50565 BREVA
APN: 776-330-002- - -
Application description: SPECIAL INSPECTION
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 0
T4ht 4 Xfv Q"
Applicant: 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
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 _ 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 _ 1 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
( 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 construction lending agency for the performance of the
work for which this per is issued (Sec: 30 C.1.
xLender's Name:
Lender's Address:
LQPGRAIIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/03/10
Owner:
ALEESHA & MARK WINKLER
---------------------------------
Contractor: D
Owner
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 w4';s
it iissued, I shall not employ any
person in any manner so as to become subject tcompensation laws of California,
and agreethat,fIshoul become subject to thepensation visions of Section
3700 of the Labor e I shall forthwith com 1provisions.
Dat�� Applicant:
WARNING: FAILURE TO SEC RE WORKERS' CO ENSATION COVERAGE IS UNLAWF L, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTI S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 15100,0001. IN ADDITION TO THE C ST 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 restrictionsset forth on thisapplication.
1 . Each person upon whose beha,lf 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 onstruction, and hereby thorize repr entatives
of this county toenterupon the above-mentioned proper r inspection purposes.
Date;t 6-�? Signature (Applicant or Agent):
Application Number . . . . . 10-00001315
Permit SPECIAL INSPECTION
Additional desc .
Permit Fee . . . . ,100.00
Plan Check Fee
.00 -
Issue Date . . . .
Valuation . . .
. 0
Expiration Date .. 6/01/11
Qty Unit Charge Per
Extension
BASE FEE
100.00
----------- ----------------------------------------------------------------
Special Notes and Comments
SPECIAL INSPECTION TO FINAL SFD -
PERMITS [08-0366/07-2942] THIS PERMIT
INCLUDES INSPECTION FOR ELECTRICAL AND
GAS METER RELEASES.
December 3, 2010 12:15:29 PM AORTEGA
Fee summary Charged Paid
-----------------
Credited
Due
--------------------
Permit Fee Total 100.00
--------------------
.00 .00
100.00
Plan Check Total .00
.00 .00
.00
Grand Total 100.00
.00 .00
100.00
R
LQPERn1IT
Temporary Power of Attorney
I, Mark Winkler, hereby give Terry W. Smith specific power of attorney to act as my
agent regarding matters relating to the house know as 50565 Breva Street in La Quinta,
California and the adjacent lot know as Lot #1 of Track No 32068 in La Quinta,
California with regards to matters dealing with the city of La Quinta Building
Department.
The term is valid 11/23/10-3/31/11.
Mark J. Winkle Date
-/10
State of California
County of Riverside
On 86V. 10 before me, "/ i&10. 4eAc�o, d obl t e.
personally appeared MACK 1. I/V/<L E'
who proved to me on the basis of satisfactory evidence to be the person
whose name is subscribed to the within-rinstrument and acknowledged to me
that he executed the same in his authorized capacity and that by his
signature on the instrument the person, or the entity upon behalf of which
person 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.
CM M Oil$"
%L NOVI ma . adftill
Add M4
"am" - -- I 4�
Signature of Wotary Public
STATE OF CALIFORNIA )
ss.
COUNTY OF
On this ��_ day of I\j �.>c..r , in the year 2.D 1 'D , before me,
f ►'S ' h e a Notary Public in and for said state, personally
appeared 136 C%S 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 authorized 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 PERJURY under the laws of the State of California, that the
foregoing paragraph is true and correct.
WITNESS my hand and official seal.
(SEAL)
Notary Public in and for said State
CM8I� i�NECW6Ht$�KI�
Commission #f 1862513 L
•r Notary Public • California
orange County
M Comm. Expires Aug23, 2013
PURCHASER DEED
EXHIBIT "A"
All of that certain real property located in the City of La Quinta, County of
.Riverside, State of California, described as follows:
PARCEL NO. 1
Lot(s) 1 and 2 of Tract No. 32068, as shown on a Subdivision Map (the "Map',
recorded on October 24, 2006, in Book 411, Pages 100, et seq., inclusive, of Maps, in the Office
of the Riverside County Recorder ("Lot"}.
PARCEL NO.2
Nonexclusive easements of access, ingress and egress for use, maintenance,
repair, replacement, drainage, encroachment, support and for other purposes, as described in the
Declaration of Covenants, Conditions, Restrictions and Reservation of Easements for The Citrus
Course, recorded on November 6, 1990, as Instrument No. 406990, in Official Records of
Riverside County, California ("Official Records'; and the First Amendment to the Declaration
of Covenants, Conditions, Restrictions and Reservation of Easements, recorded May 25, 1999, as
Instrument No. 228447 in Official Records (jointly, the "Declaration'; and the Supplemental
Declaration for Establishment of Covenants, Conditions, Restrictions and Reservation of
Easements for The Citrus Course Homeowners Association and Ratification of Annexation
("Supplemental Declaration's dated July 13, 2010, recorded on July 27, 2010, as Instrument
No. 2010-0350204, in Official Records.
EXCEPTING AND RESERVING for the benefit of Grantor, together with the
right to grant and transfer all or a portion of the same:
All oil, minerals, natural gas, and other hydrocarbons by whatsoever name
known, geothermal resources, metalliferous or other ores, and all products derived from any of
the foregoing, that may be within or under the property, and all rights associated with the
foregoing, together with the perpetual right of drilling, mining, exploring and operating therefore
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 the lands other than the property, oil or gas wells,
tunnels and shafts into, through or across the subsurface of the property and to the bottom such
whipstocked or directionally drilled wells, tunnels and shafts under and beneath or beyond the
exterior limits thereof, and to re -drill, re -tunnel, 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 of the upper five hundred (500) feet of the subsurface of the property as reserved by
KSL Land Corporation, a Delaware corporation, in Deed recorded October 21, 2004 as
Instrument No. 2004-832582 of Official Records.
FURTHER RESERVING THEREFROM, the right without any obligation to
enter the Lot for a term of twelve (12) months following the recordation date of this Grant Deed,
to complete and repair any improvements or landscaping located thereon as determined
necessary by Grantor, in its sole discretion, in order to comply with requirements (a) for the
recordation of the Map, (b) of applicable governmental agencies, and (c) of Grantor's
development plan. Such entry by Grantor shall be preceded by reasonable notice to Grantee
before such entry. If this reservation of right of entry is not complied with by Grantee, Grantor
may enforce this right of entry in a court of law. Grantee shall be responsible for all damages
arising out of said breach including attorneys' fees and court costs. This reservation of right of
entry shall automatically expire twelve (12) months from the recordation of this Grant Deed.
ALSO RESERVING FURTHER THEREFROM for the benefit of Grantor,
together with the right to grant or transfer all or a portion of the same, nonexclusive easements
and rights of access, ingress, egress, maintenance, repair, drainage, encroachment, support, and
for other purposes, as described in the Declaration.
SUBJECT TO:
1. Taxes/Assessments. General and special real property taxes for the
current fiscal year; and
2. Record Matters. Covenants, conditions, restrictions, easements,
reservations, rights, and rights -of -way of record including, without limitation, the Declaration,
the Supplemental Declaration, and Map.
ACCEPTANCE BY GRANTEE:
Grantee, by acceptance and recordation of this Deed, hereby (a) accepts and
approves all of the foregoing in this Deed, (b) grants to Grantor and The Citrus Course
Homeowners Association such powers and rights as are set forth in the Declaration and the
Supplemental Declaration and (c) accepts, covenants, and agrees to be bound by and to assume
performance of all of the applicable provisions and requirements set forth in the Declaration and
the Supplemental Declaration including, without limitation, the dispute resolution provisions of
the Declaration, the Notice of Declaration of Elections Under California Senate Bill 800, and in
the Notice of Non -Adversarial Procedure, which provisions and requirements are acknowledged
to be reasonable and incorporated herein by this reference thereto. This grant is conditioned
upon the performance of such provisions and requirements as are to be performed by Grantee
under the Declaration and the Supplemental Declaration. The restrictions on use and occupancy
of the Lot are set forth in the Declaration and the Supplemental Declaration to which this Deed is
specifically and expressly made subject.
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(760) 777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits
Imuny—TI NOTLCE Tea PROPE"y O
Dear Pvaperty Owner.
An. application for a building permit has been submitted in your name listing yourself as the builder of the property
improveurents specified at
We are .providing you with an Owner -Builder Acknowledgment and information Verification Form to snake you awake of your
responsibilities and possible risk you may incur by having this permit isswt in your name as the
Owner -Builder. We will not issue a bufiding permit until you have read, initialed your Understanding of each'pruvision,
signed, and returned this form to us at our official address indicated. An agent of the owner cannot exec%* tlis notice
unless you, the property owner, obtain the prior approval of the permitting authority.
OM2WS A.CKNOMMEOG `W A WCA.TWN OF II Q S'f N
D MECITOACS. Read and initial each statement below to signify you understand or w'er* this information.
T1. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
ilding 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 msurance 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 Ptoperty-
�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.
3.1 understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
mysel€from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
4. I uaderstand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
pe�rmrts and contracts.
."�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 "employee"
under state and federal law.
6. 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.
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 ticensed
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.
"��71 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
►f nanc8.ial or personal bogries sussed by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
-:C:19. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Rovenues
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 (C3LB) at 1-
800-321-CSLB (2752) or www.cs[b.ca.gov for more information about licensed contractors.
g510. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party legally and financially responsible for proposed construction activity at the following address:
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. 1 agree to notify the issuer of this form immediately of any additions, deletion, or chess to any of the illfwMiNtim I
have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you Duct with
someone who doers not have a license, die Contractors' State License Board may be unable to aft you with any ftsrt loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil roar#- It is also
important for you to understand that if an unlicensed Contractor or employee of that individual or firnn is Miumd while working
on your property; you may be Reid liable for cis. If you obtain a permit as Owner -Builder and wish to hire Contractors,
you will be responaile for verifying whether or not those Contractors are properly tieenaed and the status of their worke W
compensation i ce 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 issaWC dw permit. Naar: A copy of Ae prep. atgr owner's &*W'a i fam nawkwom or
other verification acceptable to the ey is required presented when dw pennk is issued to vm* dw property
owner's signature.
Signature of property owner Date: J
Note: ?'he 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 persons) 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: --T—r-T24 L b 41- Tel No IS 36,
Address of Authorized Agent:
1G�13 7>
I declare under penalty of perjury that I am the property owner for the address listed above and I personallk' illed 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 requir be presented when the permit is issued to verify the Property er's signature.
Property Owner's Signa Date: �y
eX8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
ial or personal. iouries sustainedby any subsequent owner(s) that result from any latent construction defects in the
workmanship or materiels.
!�9. I understand I may obtain more information regarding my obligations as an "employer" from the Ill Bevenue
Service, the United States Small Business Administration, the California Department of Benefit Payments, and theCalifornia
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-
800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors.
-2�10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party legally and financially responsible . for proposed construction activity at the following address:
S -I 1. I agree that, as the party legally and fuumially responsible for t hiss proposed construction activity, [ will abide by all
applicable lives and requirements that govern Owner -Builders as well as employers.
12. 1 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 coact with
someone who does not havea license, the Contractors' State License Board may be unable to assist YOU with any financial loss
you may sustain as a resultof a complaint. Your only remedy against unlicensed Contractors may be iit`civil court- It is also
impcntant for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working
on your property; your may be htU liable for damages: If youobtain a permit as Owner -Builder and wish to We Contractors,
You will be responsible for verifying whether or not those Contractors are property licensed and the status of their workers'
coition 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 issu ft tthe.per=IL Nota: A copy of the propergr owow s d6ver='sRmtsei fOrm ft0kMk"bn or
other verification acceptable to die a O' is required a presented when rile perrrrit is issued m verify the property
owner's signature.
Signature of property owner Date: 1 f 7- 1 0
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 exemtion 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: ��Q.��i, 5�: OZ)A (CA 1,-y5ZA ►, S
Name of Authorized Agent: ����2� Lb -f!5 m r+A- Tel No 2&2 - a 3s�6 >
Address of Authorized Agent:
'ice
OMM
I declare under penalty of perjury that I am the property owner for the address listed above and I personallk"filled out the above
information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification
acceptableto the agency is requir be presented when the permit is issued to verifyJtdhe 7roperMly ers signature.
Property Owner's Signa Date: ° ` o
Bin #
Qty Of La Quinta
Building 8r Safety Dh4sion
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
. InA5,
Project Address:
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip: t-
Contractor:
Telephone: '
Address:
Project Description:
City, ST, Zip:
Telephone:
City Lie. #:
State Lie. # :
Arch., Engr., Designer:
i 4
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:""' YA 4
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft..
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calls.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calls.
Called Contact Person
Plan Check Balance
Title 24 Calls.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d Review, ready for corrections/issue
Electrical
Subcontector List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees