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10-1383 (SFD)_C 4 P.O..BOX 1504 �VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (766) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/12/11 Application Number: 10-00001383 Owner: Property Address: 77153 CASA DEL SOL ROGER & ANN ADAMS TRUST APN: 773-360-014- - - a D Application valuation: 212656 Contractor: 4`iA 2 ,, 2011 Applicant: Architect or Engineer: ANTHONY & ASSOCIATE s ., OHN //__ __ __ !tel j ,?' C�+����s �/. �A �d 80591 TANGELO COURT INDIO; CA CITYOF1 E QUINTA 92201 t F:SQ?'a•ti. ('760)57.8-6441. t Lic. No,.: 845082 LICENSED CONTRACTOR'S DECLARATION I.herebyaffirm under penalty of perjury that Iam licensed under provisions of Chapter 9 (commencing with Section 7000) of-Division3 of the Business and Professionals Code, and my License is in,full force and effect. License Class: BB) License ` .: §4 5 0.8 2 __�DaVr�✓Contractor: ' ( OWNER BUILDER DEC TION I, hereby affirm under penalty of perjury that i am exempt from the Contractor'sState 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 anystructure, prior to'its issuance;,also requires the applicant for the permit to file a.signed statement that he or she is licensed,pursuantto the provisions of the Contractor's State License Law (Chapter9 (commencing with Section 7000) of Division 3 of the Business and Professions Code). or that he orshe is exempt therefrom and the basis for the alleged oxemption. AnyviolatlomofSection 7031.5 by any applicant.for a permit:subjeets 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 isnot 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 burdemof proving that he.or she did.not build or improve for the purpose of sale.). i,_) I, asowner of'the property, am exclusively contracting. with licensedcontractors 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 orimproves .thereon, and who contractsfor the projects with a contrector(s)licensed pursuant to the Contractors' State License Law.). ( ) 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: LQPEHMIT WORKER'S, COMPENSATION DECLARATION I hereby affirm under penalty of perjury one ofthe following declarations: I.have,and.will m ilmain,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 insurenceicarrier and policy number are: Carrier EXEMPT Policy Number EXEMPT _ [:certify that, in theperformance 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 70 ate 0 of the Labor, rthw' h com ly itkthoseprovisions. / � t /b�Applioarit: WARNING: AILURE TO SECURE RKERS' COMPENSATION CO RAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO. CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS i18100;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 persorrupon whose behalf'thisapplication is made, .each:persomatwhose request and for whose benefit work is performed under or pursuant to any permit issued as a.resuft 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, andemployees forany act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a resultof this application becomes null'and void if work is -not commenced within 180 days from data of issuance of such,permit;;or cessation of work for 180 days will subject permit to cancellation. I certify that 1 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 buildirt ons ion, and hereby euthoriie representatives /ol.,�s c my enter u on the above-mentioned propert 'ns _ purp s. � ignature (Applicant or Agent): ,1 - LQPERNUT Application Number . . . . . 10-0000.1383 Structure Information Construction Type . . . . . TYPE V, UNPROTECTED Occupancy Type . . . . DWELLG/LODGING/CONG <=10 - Other struct info . . . . . CODE EDITION 2007/0.8 ENERGY # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 884.00 PATIO SQ FTG 180.00 NUMBER•OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 3373..00 -------------------------------------------------------------------------- Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 1035.00 Plan Check Fee.. 672•.75 Issue Date . . . . Valuation . . . . 212.656 Expiration Date . . 11/08/11 Qty Unit Charge Per Extension BASE FEE 639.50 113.00 3,,5000 THOU :BLDG 100,001-500,0.00 395.50 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 150.74 Plan Check Fee 37.69 Issue Date . . . . Valuation . . . . 6 Expiration Date 1T/08/11 Qty Unit Charge Per Extension BASE FEE 15.00 3.373.00' .0350 ELEC NEW RES - 1 OR .2 FAMILY 118.06 884.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 11.68 ------------------------------------------------------------------------- Permit . . . GRADING PERMIT INV FEE Additional desc . . Permit Fee 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . 0 Expiration Date . . 11/08/11 Qty Unit Charge Per Extension BASE FEE 30.00 Permit MECHANICAL .Additional desc . Application Number . . . . . 10,-00001383 Permit Extension MECHANICAL 15.00 1.8.00 6.0000 EA PLB FIXTURE Permit Fee 1.00 15.0000 EA PLB BUILDING SEWER 123:0'0 Plan Check Fee 30.75 Issue Date . . . 1.00 9.0000 EA PLB LAWN_ SPRINKLER SYSTEM Valuation 0 Expiration Date . . 11/08/11 ----------------- Special'Notes and Comments Qty Unit Charge Per TO PERMIT ISSUANCE. CBC APPENDIX CHAPTER_ Extension 1 SECTION 108.4. NOTICE ISSUED TO STOP BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 2.00 16.5000 EA MECH B/d >3-15HP/>100K-500KBTU 33.00 5.00 6.5000 EA MECH VENT FAN 32.50 1.00 ------------------------------------------------------------------------------ 6.5000 EA MECH EXHAUST. HOOD 6.50 Permit . . . PLUMBING Additional. desc Permit Fee . . . . 186.75 Issue Date . . . . Expiration Date . . 11/08/11 Plan Check Fee . . 46.69 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.8.00 6.0000 EA PLB FIXTURE 108.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 2.00 7.5000 EA PLB WATER .HEATER/VENT 15.00 1.00 3:0000 EA PLB WATER INST/ALT/REP 3:00 1.00 9.0000 EA PLB LAWN_ SPRINKLER SYSTEM .9..00 9.00 .7500 EA PLB GAS PIPE >.=5 6.75 1.00 15.0000 EA PLB GAS METER 15.00 ----------------- Special'Notes and Comments 4/20/2011 GRADING WORK PERFORMED PRIOR TO PERMIT ISSUANCE. CBC APPENDIX CHAPTER_ 1 SECTION 108.4. NOTICE ISSUED TO STOP WORK BY M. MORRIS PER CBC APPENDIX CHAPTER 1 SECTIONS 113 AND 114. INVESTIGATIVE. FEE ASSESSED FOR GRADING WITHOUT.A PERMIT. April 27, 2011,11;34:35 AM bhanada. 3373 SF SFD W/ CASITA. [LIVING = 2907 SF; CASITA = 466 SF] TYPE V -B CONSTRUCTION R-3 OCCUPANCY. 2008 DIF. **PERMIT DOES NOT INCLUDE BLOCK WALLS, FENCES, SWIMMING POOLS, SPA, BBQ'S, FIRE PITS and DRIVEWAY APPROACH** Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 31.64 BLDG STDS ADMIN (SB1473) 9.0.0 LQPERMIT Application Number . . . . . 10-00001383 - ----------- - - -- - Other Fees . -- - . . . . . . -------- - - --- - DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 67.28 DIF FIRE PROTECTION --RES -140.00 DIF LIBRARIES - RES 355.00 MULTI -SPECIES (MSHCP) FEE 1284.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI') - RES 21..27 DIF STREET MAINT FAC -RES 67.00. DIF TRANSPORTATION - RES 1930.00 Fee summary Charged Paid Credited Due ----------------- Permit Fee Total --------- 152.5.49 ---------- --------- .00 .0.0 - ---- 1525.49 Plan Check Total 787.88 60`0.00 .00 187.88 Other Fee Total 5888.19 .00 .0,0 5888.19 Grand Total 82bi.56 600.00 .00 7601.56' i,QrEx�►5r Titif 4 4 " P.O: BOX 1504 BuildingQ 78-495 CAL.LE TAMPICO Address - 15 3 SA DE L SD LLA OUINTA, CALIFORNIA 92253 Mailing Address & Classif. I Lid. # Mllil l'., CII{J. 1., Designer Aciaress Lic. # APPLICATION ONLY BUILDING: TYPE CONST.�`ur`� OCC. GRP. V7, 3 A.P. Number --I 11 _J�l - 3 o0 - o 4 Legal Description LSC Mj�r Proje t Description hlt�fl /moi kLt%f w Sq. Ft. No. No. DIN. I Size Stories Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑ 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 repaireny structure, prior to its Issuance also requires the applicant for such; permit'to file e:siyned statement that he is licensed pursuant to the rovisions of the Contractor's License Law Chapter 9 (commencing with Seotion 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 703 1. 5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑Y; as owner ofthe property, or my employees with wages as thelrsole compensation„wwill do the work, and the structure is not intended or offered for sale. (Sec. 7044, Business; and Protes- sions Code: The Contractor's License Law does not apply to an.owner or properly who buildi. or improves'thereon and who'does such wprk,himself or through his own emp/o ees, provided that such improvements -are not intended.or offered for "sale. If, however„the building orrim- provement is sold within one year of completion, the owner -builder will have the burden. of ,ppwing that.he did not build or improve for the purpose of sale). ISISas owner of the property, am exclusively contracting with licensed contractors to construct , project. (Sec. 7044, Business and Professions Code:, The Contmotors License Law does not apply to an owner of property who builds or improves thereon, and who contracts forsu'ch projects with a contractor(s) licensed pursuant to the Contractor's License Law) O 1 am exempt under Sec.— B. B. & P.C. fgtthja';eason Date 1! "—wner WORKER'S.OPPENSATION DECLARATION I hereby affirm that.l have a ceftillreate of consent to self -insure, or a certificate.of Worker's Compensation Insurance, ora o@rWed copy thereof. (Sec. 3800,; Labor Code.) Policy No. Company ❑ Copy is filed with the city. ❑ Certified copy, s hereby furnished. CERTIFICATE 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 empploy any porson In any manner so as to'become subject to Workers' Compensation. Laws of CalHomis. Date Owner 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 shallbe deemed revoked. CONSTRUCTION LENDING AGENCY thereby; 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 permtt.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 th1weity'to enter the above-mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zap Estimated Valuation PERMIT Plan Chk. Dep. Plan'Chk. Bal., Const. Mech. Electrical Plumbing S. M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS 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: Date Permit Validated by: Validation: WHITE = BUILDING DEPARTMENT YELLOW =APPLICANT PINK = FINANCE LIK-0ll 11 ' 1"=. At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the above-named owner is exempt from paying school tees at this time due to the.following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.97 X 3,373 S.F. or $10,017.81 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By CC/Wells Fargo - John Hinojosa Check No. 7234702602 Name on the check Telephone Funding Residential BY Dr. Sharon P. McGehee Superintendent Fee collected /exemp spy SharoCGilVre Payment Recd $10,017.81 ovrlUnder Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will�rve ton youthatthe 90 -day approval period in which you -may protest.the fees or other payment identified above will begin to run.from the date on whe b Iding or installation permit for this project is issued,. or from the date on which those amounts are paid to the D"istrict(s).or to another public entrued to collect them on the Districtrs) behalf, whichever is earlier. NOTICE: This Document NOT VALID without embossed seal Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting Flores De Montanas Homeowners Association C/O Gold Coast Management Company May 25, 2011 Roger Adams Re: Lot 14, Application for Architectural Approval Dear Mr. & Mrs. Adams: The rBoard of Directors and the Architectural Review Committee have reviewed your plans to build your new home and we are pleased to inform you that they have been approved as submitted. The landscape plans will have to be submitted at a later date for approval. You will need to submit your construction deposit of $2500.00 payable to Flores De Montanas before construction can start. If you have any questions, please do not hesitate to contact me by calling (760) 202- 9880, extension 264 or email me at GayleCct?Goldcoastent.com. Sincerely,. FOR THE BOARD OF DIRECTORS Flores de Montanas Homeowners Association Gayle Bock, CCAM Community Association Manager Enclosures cc: The Board Homeowners' File -75.178 Gerald .Ford Dr., Suite B-1, Palm Desert, CA 92211 760.202.9880 W '760.202.9260 Fax www.goldcoastent.com RECORDWO REQUESTED BY: ORANGE OAST TITLE CO. AND WHEN RECORDED MAIL TO: AND MAIL TAX STATEMENT TO: Roger Adams 77911 Little Eagle Court La Qufift CA 92253 Order No. 1155635-10 Escrow No. 10 -07012 -CK Parcel No. 773-360-014-5 DOC # 201.0-0165586 04112/2818 111& MR Fee :13.00 Page 1 of 1 Doc T Tax Paid. Recorded in Official Records County of Riverside Larry M. Mard Assessor. C=mty Clerk A Recorder 11111111111111 IN 111111 GRANT DEED THE UNDERSIGNED GRANTORS) DECLARE(S) THAT DOCUMENTARY TRANSFER TAX IS`I�24M and CITY $ X computed on full value of property conveyed, or computed on full value less liens or engumbrances remaining at the time of sale. unincorporated area: OR City of La Quinta and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Janres C. Ckmbr@N and Mary J. Umnin8-CkGaroUL husband and wNb ars joint townts : - hereby GRANTS toI Roger P. Adams and .Ann C. Adams, Trustees of the Roger P. Adams and Ann C. Adams Revocable Trust'Dated December 10, 2009 the following described real property in the County of RiversideState of California: Lot, 14 of Tract 28409, in the City of La Quinta, County of Riverside, as per map recorded in Book 296, pages 81-84, inclusive of miscellaneous maps, in the Office of the County Recorder of said County. Commonly known as: 77153 Casa Del Sol, Lot 14 , La Quinta, CA 82253 r%-&- .4 /. /!1. STATE OF CALIFORNIA } }S COUA!#O r s,`s before me,(lid-{r; , ?1L r' }`rT I =� r��.' , a Notary Public in and, for said County and State, personally appeared James C. CicchffW and Mary J. MannhgpChmbrelp who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) isfare subscribed to the within instrument and acknowledged to me that helshelthey executed the same in his/herAheir authorized capacity(iss), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behaff of which the person(s) ailed, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of Califomia that the foregoing paragraph is true and correct: WITNE y hand andofticial seal. ! Sign { '4 VICTORIA KRAFT PABEN ` Commission # 1716223 ..ic Notortr Public • California Los Angeles County MVCwv 8#%Jan12,2011