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05-5515 (SFD)r� 4 4 " P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/12/06 Application Number: 05-00005515 Owner: Property Address: 53677 VIA BELLAGIO CHASE APN: 772-510-052- - 53-677 VIA BELLAGIO Application description: DWELLING - SINGLE FAMILY DETACHED LA QUINTA; CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 372699 D n Q Contractor: Applicant: Architect or Engineer: ALPHA OMEGA COMMUNICATIO C 42829 COOK STREET SUITE SEP 12 1006 PALM DESERT, CA 92211 (760) 568-1712 CITY OF LA Lic. No.: OOR SQUARE FOOT Lic. No.: 820066 QUINTA CIG�A&r -M. —� 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 Professionals Code, and my License is in full force and effect. Lic 1 Class. B License No.: 820066 Dat / Contract y - 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).: (_) 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 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.). 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 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 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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 AON RISK Policy Number 1488491 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 me subject to the workers' compensation provisions of Section 3700 of the Labor C I forthwith comply with those provisions. DApplican glm 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-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 nstruction, and hereby authorize representatives of � uryyy enter upon the above-mentioned "ro inspection purposes. Dat ! " ignature (Applicant or Agent Application Number . . . . . 05-00005515 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 1595.00 Plan Check Fee 1036.75 Issue Date . . . . Valuation 372699 Expiration Date. .2/07/07 Qty Unit Charge Per Extension BASE FEE. 639.50 ..273.00 ---------------------------------------------------------------------------- 3.5000 THOU BLDG 100,001-500,000 955.50 Permit ELEC=NEW RESIDENTIAL Additional .desc :. . Permit Fee . . . . 199.31 Plan Check Fee _ 49.83 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/07/07 Qty Unit Charge Per Extension BASE FEE 15.00 4 4246.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 148.61 i 1035.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 20.70 ! 1.00 --------------------------------------------------- 15.0000 EA ELEC TEMPORARY POWER POLE ------------------------- 15.00 Permit . . . GRADING -PERMIT Additional desc . Permit Fee . . . . 1.5.00 Plan Check Fee .00 - - Issue Date Valuation . . . . 0 Expiration Date 2/07/07 Qty Unit Charge Per Extension BASE FEE 15.00 Permit MECHANICAL Additional desc . Permit Fee 172.50 Plan Check Fee 43.13 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/07/07 - Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 3.00. 11.0000 EA MECH FURNACE >100K 33:00 2.00 9.0000 EA MECH B/C <=3HP/100K BTU 18.00 3.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 49.50 5.00 6.5000 EA MECH VENT FAN 32.50 LQPERAIIT Application Number . . . . . 05-00005515 Permit . . . . . . MECHANICAL Qty Unit Charge Per Extension 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit PLUMBING Additional desc . Permit Fee 255.75 Plan Check Fee 63.94 Issue Date . . . . _ Valuation . . . . 0 Expiration Date 2/07/07 Qty Unit Charge Per Extension BASE FEE 15.00 27.00 6.0000 EA PLB FIXTURE 162._00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 2.00 6.0000 EA PLB ROOF DRAIN 12.00 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 13.00 .7500 EA PLB GAS PIPE >=5 9.75 1.00 15.0000 i------------------------------- EA PLB GAS METER 15.00 ----------------------------- Special Notes and .Comments ------------ - 4246 SQ. FT. SFD THIS PERMIT DOES NOT INCLUDE POOL & SPA BLOCK WALLS OR DRIVEWAY APPROACH.August 11, 2006 -- 4:33:54 PM jjohnson - -----------------------------------------------------------.------------- Other Fees . . . . . . . .. . ART IN PUBLIC PLACES -RES 431.74 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 480.00 ENERGY REVIEW FEE 103.68 ' DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 355.00 -� -" DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC.'- RES 892.00 ' STRONG MOTION (SMI) - RES 37.26 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES 1666.00 Fee summary Charged Paid Credited Due Permit Fee Total 2237.56 .00 .00 2237.56 Plan Check Total 1193:65 500.00 .00 693.65 Other.Fee Total 4268.68 .00 .00 4268.68 Grand Total 7699.89 500.00 .00 7199.89 LQPERA11T ,� ' �. _ � ...• r._. G h t Building C� Address Y/ Owner� S r1 mauing Address f�',K,icu P.O. BOX 1504 APPLICATION ONLY (AIIa 1 078-495 CALLE TAMPICO A Lp<QUINTA, CALIFORNIA 92253 �j CNBC UICDING: TYPE CONST 0CC. GRP. A.P. Number =►- S 10— T^__ ,r,_ t,,4-11Legal Description w� 32) MUUrCJJ '�Iml�ese rr Zlp��� � Tel. -I bo -IC-Mg - II I& State Lic.�p,�� City & Classif. Lr S 2-00 lo � Lic. # 02-3S7 nl�li LIlyl Dessigl-1"aYI RV55 I D citu A I hn�l�5� Zlp��� I I. Lic.t# C D-1- 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• 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 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 hereby affirm that I 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 O Copy is filed with the city. ❑ 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 Project Description L CITY OF u+ Size Ft Ss✓'T Stories ��CE New CU/ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. AMOUNT 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 Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 Project Name: Ch sa e This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT ' LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMWIND. AMOUNT: DATE: RECEEPT: CHECK #: INITIALS CERTIFICATE OF COMPLIANCE (California Education Code 17620) Owner's Name: Gordonross/Chase Project Address: 53677 Via Bellagio La Quinta, CA Project Description: APN: 772-510-052-5 1 SFD Tract #: Type of Development: Residential Xx Commercial Total Square Feet of Building Area: 4246sq. ft. Date: 08/24/06 . Phone No. 760-565-1712 Lot # Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized tojsign on behalf of the owner/developer. Dated: 08/18/06 Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE'PROJECT HAVE -BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) 9 Education Code Gov. Code Project Agreement Existing Not Subject to Fee 17620 65995 Approval Prior to 1/1/87 Requirement Number of Sq.Ft. 4246 sq. ft. Amount per Sq.Ft. $ 0.00 3. -15 - Amount . -15 - Amount Collected $ 15,992.50 Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Business Services Certificate issued by: Maria L. Angulo, Facilities Secretary Signature: NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES ANIJ STATEM$NT OF FEtt 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 set 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. [.I:-mtciu��rdev ;;e:> certiticate csf'ccrai;iialtc, f?rrn taGles:C�? l"SL.�)?� 1/16/03 T Apr 12 05 09:54a Goble Properties Plstn. A, l NEIN CEN'T'URY TITLE COMPANY RECORDING REQUESTED BY: r'.Century Title Company -Riverside Title 'ORDER NO.: 2351414 ESCROW NO.: 33041782 -SP AND WHEN RECORDED MAIL TO: Roy Goble Patrlcla.Goble 7923 Sawgrass Court Pleasanton, CA 94588 7 2-5-7 os -2 -s-- C-> !`- v r GRANT DEED THE UNDERSIGNED GRANTOR(S) RECLARE(S) that documentary transfer tax is $605.00 (County) $,00 (City) ( X) computed on full value of property conveyed, or ( ) computed on full value less liens or encumbrances remaining at time of sale ( X) City of La Quinta (925)485-9251 p.2 DOC a 2004--1012485 12/22/2004 08:00A Fee:10.00 Page 1 of 2 Doc T Tax Paid Reeoded Coun in Official Records County of Riveraide Gary L, orso Assessor, County Clerk $ Recorder 1111111111111111111111111111 ILII 11111, 11111,11-111, 111, Ini FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged, Brent Platt, an unmarried man and Virginia A. D'Addario, an unmarried woman, as joint tenants hereby GRANT(S) to Ernest L. Goble and Patricia D. Goble, Co-I`Fustees of the Goble Family Revocalle Trust the following described real property in the City of La Quinta, County of Riverside, State of California: Please see attached Exhibit "A" Dated: December 10, 2004 STATE OF CALIFORNIA COUNTY OF, Onz (4j , before me Personally appeared -� v�L c�• r `Person Ir -known -tome' (or proved to me on the,basis of satisfactory gvidence) to be the person�f��vhose names),15K/9rg subscribed to the within Instrument and acknovAdged to me that haAhe/they executed the same in hlsjfterjtheir authorized capacityfes , and that by glsfher/their slgnature(s) on the Instrument the personW or the entity upon behalf of which the person(s) acted, executed the Instrument. WITNESS -my hand dd Mciallsse�all,,, Signature Grant Deed - Individual (290) 10-04 MAIL TAX STATEMENTS AS DIRECTED ABOVE V STACEY M. DEAN Commission # 1438222 Notary Public. California Riverside County My Comm, Expires Sep 8, 2007 (This arca for official notary seal) FS U PAGE SRE DA PCOA ,-NOCOR 8MF mc. ._ Ot RR L' COPY LOND REFUND NCHG E7(AM Ini FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged, Brent Platt, an unmarried man and Virginia A. D'Addario, an unmarried woman, as joint tenants hereby GRANT(S) to Ernest L. Goble and Patricia D. Goble, Co-I`Fustees of the Goble Family Revocalle Trust the following described real property in the City of La Quinta, County of Riverside, State of California: Please see attached Exhibit "A" Dated: December 10, 2004 STATE OF CALIFORNIA COUNTY OF, Onz (4j , before me Personally appeared -� v�L c�• r `Person Ir -known -tome' (or proved to me on the,basis of satisfactory gvidence) to be the person�f��vhose names),15K/9rg subscribed to the within Instrument and acknovAdged to me that haAhe/they executed the same in hlsjfterjtheir authorized capacityfes , and that by glsfher/their slgnature(s) on the Instrument the personW or the entity upon behalf of which the person(s) acted, executed the Instrument. WITNESS -my hand dd Mciallsse�all,,, Signature Grant Deed - Individual (290) 10-04 MAIL TAX STATEMENTS AS DIRECTED ABOVE V STACEY M. DEAN Commission # 1438222 Notary Public. California Riverside County My Comm, Expires Sep 8, 2007 (This arca for official notary seal) j r ,- Certificate of Occupancy S oF T9� Building & Safet Department Y, p This Certificate is issued pursuant to the requirements of Section 109 of the California Building 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. L BUILDING ADDRESS: 53-677 VIA BELLAGIO Use classification: SINGLE FAMILY DWELLING Building Permit No.: 05-5515 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RL y Owrier of Building: CHASE Address: 53-677 VIA BELLAGIO y • City, ST, ZIP: LA QUINTA, CA 92253 -By: STEVE TRAXEL - Date: November 20, 2007 Building Official POST IN A CONSPICUOUS PLACE A_ _.... ... • . , r