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04-4789 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number Prope- ty^ Address ~ . APN: Application description Property Zoning . . . . Application valuation . Owner BOYLE JOHN 50 FEDERAL ST. S BOSTON SEBRING BUILDING & SAFETY DEPARTMENT (760) .777-7012 ` FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT . . . 104-00004789 Date' 11/30-/04 X53709 VIA BELLAGIO 772-510-053- - - . . . DWELLING - SINGLE FAMILY DETACHED . . . LOW DENSITY RESIDENTIAL '�)Qa1 n -z C t t on rac or , -------------- - - - - W - - -- ' �KG CONSTRUCTION 73416 SILVER MOON TRAIL.' PALM DESERT CA 92260 WCC: EXEMPT WC: EXEMPT R�� .05/31/05 EVplTA CSLB: 819174 04/30/05 CCC: B ------ Structure Information 3641 SQU FT.SFD ----- Construction Type . . . . . TYPE V -_ NON RATED Occupancy Type DWELLG/LODGING/CONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info CODE EDITION 2001 # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 800.00 PATIO SQ FTG 268.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 3641.00 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ' --,- - - - - - - - - - - - - - - - - - - - -r- - ' - - - - - Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee 1322.00 Plan Check Fee 859.30 Issue Date . . . . -Valuation 294193 Expiration Date 5/28/05 Qty Unit Charge Per Extension BASE FEE 639.50 195.00 ------------------------------------------ 3.5000 THOU BLDG 100,001-500,000 682.50 Permit . . . . ---------------------------------- . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee 173.44 Plan Check Fee 35.61 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/28/05 Qty Unit Charge Per i Extension BASE FEE 15.00 P.O. BOX 1504 • VOICE (760) 777-7012 78495 CALLE TAMPICO FAX (760) 777-7011 LA• QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 Application Number: Applicant: Applicant's Mailing Addr s . 1.1.11 J7 BUILDING & SAFETY DEPARTMENT Date: /_ .S Architec ngineer: im- _Z Architect or Engineer's Address: Lic. No. 0 4/f / O BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penaltyof erjury that I am licensed under provisions q(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in fu rce and effect. (r J1 Z License Class License No. 91 Date Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a pennit 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 Contractors' 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).): U 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reascn Date WORKERS' 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 1 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 3700 of the Labor Code, I shall forthwith comply with those provisions. Date ^ 5'., as� Applicant 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. 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 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 Ouinta, 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 construction, �(and hereby authorize representatives of this county to enter upon the above-mentio ed property for inspection purposes. Date/ ✓ 403 0 - Signature (Applicant or Agent): r � z 0 Page 2 Application Number . . . . . 04-00004789 Date 11/30/04 Qty Unit Charge Per Extension 3641.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 127.44 800.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 16.00 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 5/28/05 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc ' Permit Fee . . . . 141.00 Plan Check Fee 27.75 Issue Date . . . . Valuations . . . . 0 Expiration Date 5/28/05 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 9.0000 EA MECH FURNACE <=100K 36.00 2.00 9.0000 EA MECH B/C <=3HP/10OK BTU 18:00 2.00 16.5000 EA MECH B/C >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 237.75 Plan Check Fee.. 59.44 Issue Date '. Valuation 0 Expiration Date 5/28/05 Qty Unit Charge Per Extension BASE FEE 15.00 26.00 6.0000 EA PLB FIXTURE 156.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 2.00, 6.0000 EA PLB ROOF DRAIN 12.00 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 7.00 .7500 EA PLB GAS PIPE >=5 5.25 1.00 15:00.00 EA PLB GAS METER. 15.00 ----------------------- Special Notes ----------------------------------------------------- and Comments 3691 SQ FT SFD. THIS PERMIT DOES NOT Page 3 Application Number . . . . . 04-00004789 Date 11/30/04 ---------------------------------------------------------------------------- Special Notes and Comments INCLUDE DRIVE WAY APPROACH,SWIMMING POOL/SPA OR BLOCK WALLS. ------------------------- Other Fees . . --------------------------------------------------- . . . . . . ART IN PUBLIC PLACES -RES 235.48 DIF COMMUNITY CENTERS -RES 98.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 85.93 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 29.41 . DIF TRANSPORTATION - RES 1098.00 Fee.summary ----------------- Charged Paid Credited Due Permit Fee Total ---------- 1889.19 ---------------------------_--. :00 .00 1889.19 Plan Check Total 982.10 6.00.00 .00 382.10 Other Fee Total 2741.82 .00 .00 2741.82 Grand Total 5613.11 600.00 .00 5013.11 Cief TWTuu'Ittcv ,� - ®G/ P.O. BOX 1504 APPLICATION ONLY Building � �� a y Airk 7UINT CALLE CALIFORNIATAMPIO Address �1.�'�{v LA QUINTA, ORNIA 92253 Owner A {� / a► `l\ %� �V[�� � 1��, BUILDING: TYPE CONST. OCC. GRP. Mailing r� .J �/ P. Number Address �Q��LJ��`�/� �� 1 • c`�� � l`...- -7 C,? Zip © Te Legal Description 1 2Q-Q/�� 10-05-3 Project Description �+ / T Contrac or � w � 1 P � , Address ��• �l�.J CO3 Z' Z 22op T State Lic. City r �/ Sq. Ft. No. No. Dw. & Classif. Lic. # J / SizeiEyStories Units Arch., Engr., �-,, (( New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Designer Address T I. Cit Z122ZO State 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 Estimated Valuation 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 PERMIT AMOUNT 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 Plan Chk. Dep. for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty o/ not more than five hundred dollars ($500). Plan Chk. Bal. ❑ 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- Const. 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 Mech. that such improvements are not intended or offered for sale. If, however, the building or im- ElectrlCel provement is sold within one year of completion, the owner -builder will have the burden o/ 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 Plumbing the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does S.M.I. 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.) Grading I d ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. h, / - Date owner Infrastructure WORKER'S COMPENSATION DECLARATION I 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. r CERTIFICATE OF EXEMPTION FROM TOTAL WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation REMARKS or less). I certify that in the performance of the work for which this permit is issued, I shall not empoy 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. ZONE: BY: Minimum Setback Distances: CONSTRUCTION LENDING AGENCY Front Setback from Center Line 1 hereby affirm that there is a construction lending agency for the performance of the work Rear Setback from Rear Prop. Line for which this permit is issued. (Sec. 3097, Civil Code.) Lenders Name Side Street Setback from Center Line Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to Side Setback from Property Line 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. FINAL DATE INSPECTOR 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. Issued by: Date Permit Signature of applicant Date Mailing Address Validated by: City, State, Zip Validation: WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE 0 0 F CITY OF LA QUINTA BUILDING & SAFETY DEPARTMENT AFM OF 777-7012 INSPECTION REQUEST LINE 777-7153 Owner BOYLE JOHN Contractor OWNER BUILDER Permit Number 04-4789 POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 53709 VIA BELLAGIO 3691 SQ FT SFD. THIS PERMIT DOES NOT INCLUDE DRIVE WAY PPROACH,SWIMMING POOL/SPA OR BLOCK WALLS.AS OF 4-11-05 CHANGE FROM KG CONSTRUCTION TO OWNER BUILDER WITH WORK COMP 4/11/05 10:30:59 TYPE OF INSPECTION I DATE I INSP. TEMPORARY POWER SETBACKS U/G PLUMBING / WASTE U/G ELECTRICAL / GROUNDING FOOTINGS / STEEL CONCRETE SLAB DO NOT POUR CONCRETE UNTIL ABOVE SIGNED 1 FRAMING (COMBINATION) I ROUGH ELECTRIC COVER NO WORK UNTIL ABOVE SIGNED INTERIOR GYP. BD. DRYWALL EXTERIOR LATH GAS TEST SEPTIC ABANDONMENT SEWER CONNECTION SEPTIC / GREASE INTERCEPTOR MASONRY INSPECTIONS FOOTINGS / STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE / SETBACKS U/G PLUMBING U/G GAS U/G ELECTRICAL PRE -PLASTER (ALARMS/ BARRIERS FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER ELECTRICAL PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT COMMUNITY DEVELOPMENT DEPT. FINAL / JOB COMPLETED I f ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING Coachella Valley Unified School District '83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1.224 Project Name: This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMM/IND. AMOUNT: n ATF.• RF.r..FIPT- r..HF.CK s* INITIAIS- CERTIFICATE OF COMPLIANCE (California Education Code 17620) Date: December 20, 2004 Owner's Name: M/M John Boyle Phone No. (760) 275-4920 Project Address: 53-709 Via Bellagio La Quinta CA 92253 Project Description: 1 Single Family Home APN: 772-510-053 Tract #: 29894-2 Lot #'s: Type of Development: Residential X»Xi Commercial Total Square Feet of Building Area: 3641 Sq. Ft. Industrial 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 to sign on behalf of the owner/developer. Dated: 12/20/04 Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code 17620 65995 Number of Sq.Ft. 3641 Amount per Sq.Ft. $ 2.68 Amount Collected $ 9,757.88 Building Permit Application Completed: Yes/No Project Agreement Existing Not Subject to Fee Approval Prior to 1/1/87 Requirement By: Carey M. Carlson, Asst. Supt., Business Services Certificate issued by:. Leticia C. Torres, Facilities Clerk NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STAMEMENT 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 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. MtV:c/mydoci:devfcrs cortific;iie ofu)mplianoo fonn t-blesT'('.) USFi.doc 1/16/03 T DEC -08-2004 13:51. THE DRLIKER LTD. - VII)r:l.l IA NAll0NALTi'1lXC0M1'Ao i !XW)TVISION I DEPARTMITNt' WHEN RECOR )ED MAIL TO: Joos J. Boyle 43 Broadway Arj,jagt 9n, 1l0, 02.474 MAIL TAX STATENSNT TO; SAME AS ABOVE 6173576494 P.02 DOC M 2 03-091706 &ZA71200 •600 Fee: 16.N Pe" I. of a," t Yat Padd Recorded In rJnlal Reaerdo csunty o . Uyseelde Gary L. Area Reeaseuor. . Caun y Clerk a Reser, 4or 1111111111Nib I IM 1 DOCUMENT TRANSFER TAX S .?? I. 1 5 XX Computed on the consideration or value of property convcycd, OR( � Computed on the considerazioh or value less liens or encumbrances "r\� remaining at the time of sale. 0-7 5igltatvre of t)cclarant or Aecm dei I" - Firm Name OZ GRANT DEED FOR A VALUABLE CONSIDERATION, receipt of which'is hereby icknowledged. ND LA QUTN'TA PARTNERS, LLC, a Delaware limited liability company ("Gr toll'), hereby GRANTS) to J= J - BOYLE ASID VIANE 8. so LE, uusxmW AlaD W. I X15 R .10INT TtUR s ('Grantee"), the real property located ,n the city of La L4111r1a, t.ounty of Ntvers►ac, aW« V1 California, described as: See Legal Description attached hereto and incorporated herein as Exhi it "A". : SUBJECT TO all. matters of record'including, without limitation, the vEtia7lts and agreements described in Exhibit "A" attached hereto. Dated: January 20, 2003 vD LA QUINiA PARTNERS. LLC, a Delaware limited liabilil:y company By: Nationwide Aealt� (nvestom, Ltd., an Ohio limited liability company its managing el tier By.. J eph L. enson Authorize I Reptca¢rttative 1.1,oVG27%9, l I request prop., Lot 322 of Tra - AV -,).nn; nnnot ?nr. 1 Q TOTAL P.O�