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05-0488 (SFD)�j• _ P.O. BOX 15044 w 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 rBUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 05-00000488 Owner: Property Address: 53504 VIA BELLAGIO BLAKE JUMPER APN: 772-510-067- - - 78900 AVE 47 #202 Application description: Property Zoning: DWELLING - SINGLE FAMILY DE LOW DENSITY RESIDENTI LA QUINTA, CA, 92253 Application valuation: 327441 D D Contractor: Applicant: rchitect,Qrt EnLgZe'&6 EHLINE COMPANY 55375 MEDALLIST DR LA QUINTA, CA 92253 (760)771-.8130 Lic. No.: 482086 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: S C t/1n License No.: 482086 "Date: Contractor: EhlinC/ 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 (5500).: (_ 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.). 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 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.1. Lender's Name: _ Lender's Address: LQPERDIIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/12/05 WORKER'S COMPENSATION DECLARATION 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 STATE 'FUND Policy Number 1814972 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 37700 of the Labor Code, ,IIshall forthwith comply with those provisions. ` ' Date: (�uuV� Applicant: Blit do 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 1$100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. ' 1 . Each person upon' whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La.Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to bu' in construction and hereby authorize representatives of this co/runt�ey1 to enter upon the above-mentioned pro r y or inspectio p rposes. .Date: OV VQ ignature (Applicant or Agent): -- - Application Number . . . . . 05-00000488 , ------ Structure Information 3781 SQ.FT. SFD ----- Construction Type . . . . TYPE V - NON RATED Occupancy Type . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . . NON -AO FLOOD ZONE Other struct info CODE EDITION 2001 CBC # BEDROOMS 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 727.00 PATIO SQ FTG 578.00 NUMBER OF UNITS 1.00 ------------------------ ---------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 3781.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee 1437.50 Plan Check Fee 934.38 Issue Date . . . . Valuation . . . . 327441 Expiration Date 11/08/05 Qty Unit Charge Per Extension BASE FEE 639.50 228.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 798.00 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 176.881. Plan Check Fee 44.22 Issue Date Valuation . . . . 0 Expiration Date 11/08/05 Qty Unit Charge Per Extension BASE FEE 15:00 3781.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 132.34 727.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 14.54 1.00 15.0000 --------------------------------------- EA ELEC TEMPORARY POWER POLE =------------------------------------ 15.00 Permit . . GRADING PERMIT Additional desc . Permit Fee . . . 15.00 Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date 11/08/05 Qty . Unit Charge Per. Extension ---------------------------------------------------------------------------- BASE FEE, 15.00 Permit MECHANICAL Additional desc . . LQPERAiIT i1 LQPERDIIT Application Number . . . . Permit . . . . . . MECHANICAL Permit Fee 134.00 Issue Date . . . . Expiration Date . . 11/08/05 05-00000488 Plan Check Fee . . 33.50 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 9.00 6.5000 EA MECH VENT FAN 58.50 1.00 ---------------------------------= 6.5000 EA MECH EXHAUST HOOD ------------------------------------------ 6.50 Permit . . . .PLUMBING, Additional desc . Permit Fee . . . . 211.50. Plan Check.Fee 52.88 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/08/05 Qty Unit Charge Per Extension BASE FEE 15:00 23.00 6.0000 EA PLB FIXTURE 138.00 1.00 15.0000 EA' PLB BUILDING SEWER 15.00 1.*00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1:00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 12.00 .7500 EA PLB GAS PIPE >=5 9.00 1.00 15.0000 EA PLB GAS METER 15.00 --------------------------------------7-------------------------------------- Special Notes and Comments 3781 sq. ft. sfd this permit does not include pool & spa block walls or driveway approach. 3/10/05 10:09:19 AM. jjohnson ---------------------------------------------------------------------------- _ Other Fees ART IN PUBLIC PLACES -RES 318.60 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 93.44 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE. .00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC -'RES 502.00 STRONG MOTION (SMI) - RES 32.74 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ------------------ Charged ---------- Paid Credited ------------------------------ Due Application Number . . . . . 05-00000488 Permit Fee Total 1974.88 .00 .00 1974.88 Plan Check Total 1064.98 250.00 .00 814.98 Other Fee Total 2849.78 .00 .00 2849.78 Grand Total 5889.64 250.00 .00 5639.64 LQPERAI1T Building Address 5 3 Tit uulGiCv P.O. BOX 1504 APPLICATION ONLY Off �/ 78-495 CALLE TAMPICO in :l ItJIQ l (� LA QUINTA, CALIFORNIA 92253 Mailing Address %-9oo Aye- e- y-' r1 SUI (oa City Zip Tel. L4 OLAMba 9aa53 -7e0_1'11 -61-90 Contractor EWIVie, 0,0 I Address '16-900 Axe, Hrl SLA'ife, 10a City. - Zip _ _ _ Tel. & Classif. I Lic. # Arcn., tngr., Designer ' Sn lit AA a" I iA-D r+ City zip State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). O I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure Is not intended or offered for sale. (Sec. 7044, Business and Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or im- provement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKER'S COMPENSATION DECLARATION I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. O Certified copy is 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 employ any person in any manner so as to become subject to Workers' Compensation Laws of California. 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 shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above-mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip BUILDING: TYPE CONST �UtW OCC. GRP A.P. Number -1-7a-5196- -T �l Z n% Gds, !- r6-1 Legal Description 1 f #331a Project Description One, Unl+ -Shale F:7hml I 14'Dwdl ivi ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Validated by: Validation: Date Permit WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE Sq. Ft. No. Size 1 Stories ( No. Dw. Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑ • Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. 0 Plan Chk. Bal. Const. Mech. Electrical Plumbing _ S.M.I. 111)1 %\ fl y Grading U)F— Driveway Enc N M 1 r - n Infrastructure MU I I _U IM 11U11 I Clk If Cyr LA QWNTA — 1 J 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: Validated by: Validation: Date Permit WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE i ,'-�. 14" -,t v Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVELTWOAMOUNT: MITIGATION AMOUNT: COMM/MD. AMOUNT: DATE, RFCFIPT- CHECK 8- INITIAL .', - CERTIFICATE CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: ;Residence is at The Hideaway, Owner's Name: Blake Jumper Project Address: 53-504 Via Bellagio La Quinta, CA Project Description: SFD APN: 772-510-067 Tract #: Date: Phone No. Lot #'s: Type of Development: Residential I X Commercial Industrial Total Square Feet of Building Area: 3,781 sq. ft. Certification of Applicant/Owners: The person signing certifies that the'above informati n s correct and makes this statement under penalty of perjury and further represents that he/she is orize to si on behalf of the wne developer. Dated: 12-7 10.5 Signatu e ' SCHOOL DISTRICT'S REQUIREMENTS FOR THE ACCORDANCE WITH ONE OF THE FOLLOWING: Education Code Gov. Code Project 17620 65995 Approval Number of Sq.Ft. 3,781 Amount per Sq.Ft. $ 2.88 Amount Collected $ 10,889.28 Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Business Services PROJECT HA(E BEEN Oa WILL BE SATISFIED IN .E ONE) \ Note: Agreement Existing Not Subject to Fee Prior to 1/1/87 Requirement Certificate issued by: Elvira Mattson, Office Technician Signature: NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein sef forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. At such time as this Certificate expires, if a building permit has not been issued for the project that is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. t1V:c:mydacshle� lees/certilicate o.rcompliance. ti)rm uibles'17 ? USE.doc ,10; 1/16/03 T May 1b U5 1UAta t3iaKe Jumper. UU3404ZtU P. 05•-1.8=2005 10:29am Fron-Fidelity llafl`oW Title g09 613 1436 -7-049 P.D02/003 F-495 RECORDING REQUESTED BY: Fidelity National Title Company Escrow Nv. 6601 -Ma Ti order No.9779667 When Recorded Man Document end Tax Statement To:. Mr. Danny Penrod 2021 E. 10095 B Sandy, UT 84092 oaC = 2004--0705873 WOV2e04 OE:000 F66:20.ee Pape 1 of.2 Doe T Tax Pale Recorded in Official Records County of Riverside Gary L. or: Aeseesor, County Clerk b Recorder i isms 11 �lfl l �l�i fl�ifl fl f �l ill ....... , _ ... - -.. - -!.w • -- . GRANT DEED - - The undersigned grartor(s) dec arele) Documentary tim far taF Is $622.60 ( X 1 computed on full value of property conveyed, or mpR [ 3 computed on full value We value of liens or encumbrances remaining at time of sale, ( 1 Unincorporated Area City of Le Ouinta FOR A VALUABLE CONSWRATION, mcdpt of which is hereby acknov W94d, 'Robot T. Ravis, A Single.Man hereby GRANT(SI to i D*noy I., Penrod, an unmarried man as to -an undivided 502 interest and !lark L. Rindleebacbr s married can as hie sole and separate property as to an uadived 502 the following doseded real property In rile Citir of La Quinta interest. County of Riverside. Guts of California: SEE EXHIBIT ONE ATTACHED HERETO AND MADE A PART HEREOF DATED: July 12, 2004 STATE OF CALlfQRNlA COUNTY Of lKi ON before me, personally appeared personally known to me jar proved to. me on the basis I satisf clary evideneeF to be the persontsl whose name( is SuttSQl To the within instrument and ack oari"if d m me thet�he/they executed the samauthorized cepecitAlee), and that by eir signatures) on the Watmment the person(s), or the entity upon behalf of which the person(sI acted, executed the instrument. Wttnessmy and oVicial seal. Signator _ __I�� Obert T. Ravin OONME O NCETi0 OOMM, #1417229 Nosna+r emuc - emma w RNEWDE CO" elk CarftrrMon Ezirw i 1, 2 MAIL TAX STATEMEWS AS DIRECTED ABOVE FD -213 (Rev 71961 GRANT DEED Des¢siption: Riverside,CA Document-roar.Um3TO 2004.705073 Page: 1 of 2 Order: A3 Co®ant: i Iviay Id U5.1u:4ta Blake Juniper.' 7603454270 p.3 05-18-2005 ain- Fran-lFldelity National Title 809 683-1436 T-949 P.003/003 F=485 EXHIBIT "ONE" PARCEL 1: Lot 336 of. Amended Tract No. 298942, In the City of La Quanta~ County of Riverside, State of California, as per Map recorded in Book 327, Pagelsl 56 through 88, inclusive of Maps, in the Office of the County Recorder of said County. Excepting therefrom to grantor, and its successors and assigns, interest in all water, minerals, oil, gas, petroleum, other hydrocarbon substances and all geothermal energy sources In or under said land or Which may be produced from said land. PARCEL 2• futon -exclusive easements for access, ingress, egress, drainage, metrimnence, repairs and for other purposes, eQ as described in the Declaration recorded December 13, 2002, Instrument No. 2002- 746938 of Official Records. 0 D99or1pCiea- Atweweade,CA 2004.705873 Pago; 2 o! 2 Orden AS Consent: ��- Certificate of Occupancy T4af ot C� OF'TY�Building & Safety Department . This Certificate is issued pursuant to the requirements of Section 109 of the California Buhding Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the; Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 53-504 VIA BELLAGIO i t Use classification: SINGLE FAMILY DWELLING Building Permit No.: 05-488 , Occupancy Group: R31 Type of Construction: VN Land Use Zone: RL Owner of Building: BLAKE JUMPER Address: 53-504 VIA BELLAGIO City, ST, ZIP: LA QUINTA, CA 92253 • By: STEPHEN WILLETT r Date: MAY 15, 2006 Building Official POST IN A CONSPICUOUS PLACE n_. �a��iu�vttQ,.c ,- Certificate of Occupancy Lco�oahn�4 G� OF 'T1 Building y p & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Buhding Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 53-504 VIA BELLAGIO Use classification: SINGLE FAMILY DWELLING Building Permit No.: 05-488 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RL Owner of Building: BLAKE JUMPER Address: 53-504 VIA BELLAGIO City, ST, ZIP: LA QUINTA, CA 92253 By: STEPHEN WILLETT Date: MAY 15, 2006 Building Official POST IN A CONSPICUOUS PLACE