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
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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