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04-3834 (SFD)° 0:� 0 52004 4 u�l'Cv crj I yo AQUI BUILDING& SAFETY DEPARTMENT w P.O. B°ox,.04 (760) 777`7012 OF9 78-495 CALLS TAMPICO FAX (760) 777 -7011 - LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application -Number .--04-00003834 Date 5/04/04 Property.Address .---54515 AVENIDA VELASCO APN: 774-283-011-1 -000000- Application description . . ." DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . . . COVE RESIDENTIAL Application valuation . . ... 100849 = Owner Contractor DGH DEVELOPMENT CORP DGH.DEVELOPMENT CORPORATION PO BOX 2982 P.O. BOX 2982 PALM,DESERT. CA 92261. PALM DESERT CA 92261 (760) 360-8706 -WCC: STATE FUND WC: 1640"909`. 02/01/05 CSLB: 480121. 09/30/05 CCC: B -C36 -C20. = ----=--=----------=--=--- Structure Information ---------=--------------- Construction Type TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG.<=10 Flood Zone... . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC # BEDROOMS 3.00 FIRE. SPRINKLERS NO . GARAGE SQ FTG 507.00 PATIO.SQ FTG 122.00 NUMBER OF UNITS. 1..00 FIRST.FLOOR SQ FTG 1561.00 Permit . . .. . . . -------------------------- BUILDING.PERMIT, Additional desc Permit Fee 643.00. Plan Check Fee .167.95 Issue _Date. Valuation.. .. 10084.9 Qty Unit Charge Per. Extension BASE FEE 639.50 .1.00 3.5000 -------------------------------------------------------------------------------- THOU BLDG 100,001.-500,000 3.50 Permit . . . . . MECHANICAL Additional desc Permit. Fee 52.50 Plan Check Fee 13.'13 Issue Date Valuation. 0 Qty Unit Charge Per Extension P.O. Box 1504 • �� VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011. LA QUiNTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING &: SAFETY DEPARTMENT Application Number: Ow/- 393-V Applicant: CON7-2.4C.70 Applicant's Mailing Address: Date: .5 • D el Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 License No. 4 QO /.Z Date D Contractor OWNER -BUILDER D CLARATION 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 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 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 Heir 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 Lave 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 reason Date Owner WORKERS' COMPENSATION DECLARATION hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to sel`-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 n bar are: Cartier .01,413 AII�lb Policy Number X 6'4 O 9 0 `� _ 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 3700 of the Labor Code, I shall forthwith comply with those provisions. / 1 Date Applicaqt 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 ththat —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. I. 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, indemnity 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. 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-mentioned property for inspection purposes. Date — Signature (Applicant or Agen . Application Number . 04-00003834 Page 2 Date 5/04/04 Qty Unit Charge Per, Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1:00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 2.00 6.5000 EA MECH VENT FAN 13.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 -------------------------------------------------------------------------=-- Permit . . . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . 94.78 Plan Check Fee 23.70 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1561.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 54.64 507.00 .0200 ELEC.GARAGE OR NON-RESIDENTIAL 10.14 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 ------------------------------------------=--------------------------------- Permit PLUMBING Additional desc Permit Fee . . . . 123.00 Plan Check Fee 30.75 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 9.00 6.0000 EA PLB FIXTURE 54.00 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 6.00 .7500 EA PLB GAS PIPE >=5 4.50 1.00 15.0000 EA PLB GAS METER 15.00 -------------------------------- Permit . ... . . . GRADING -------------------------------------------- PERMIT Additional desc Permit Fee . . . . 15.100 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 x Qty Unit Charge Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 Special Notes and Comments 1561 S.F. SFD PERMIT DOES NOT INCLUDE Fee summary Charged Permit Fee Total 928.28 Plan -Check Total 235.53 Other Fee Total 2556.88 Grand Total 3720.69 Paid Credited Due ---------- ---------- ---------- .00 .00 928.28 .00 .00 235.53 .00 ..00 2556.88 .00 .00 3720.69 Page 3 Application Number 04-00003834 Date 5/04/04 7 ------------------------------------------------------------------------- Special Notes and Comments BLOCK WALL, POOL/SPA OR DRIVEWAY - APPROACH ---------------------------------------------------------------------------- Other Fees . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 41.80 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 COVE PRECISE PLAN FEE 100.00 STRONG MOTION (SMI) - RES 10.08 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Permit Fee Total 928.28 Plan -Check Total 235.53 Other Fee Total 2556.88 Grand Total 3720.69 Paid Credited Due ---------- ---------- ---------- .00 .00 928.28 .00 .00 235.53 .00 ..00 2556.88 .00 .00 3720.69 Date 3/16/04 No. 25689 Owner DGH Development Corp Address 78921 Runaway Bay City Bermuda Zip 92261 Tract # BLK304 Type Single Family Residence CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 Lot # No. Street Unit 1 1 54515 Avenida Velasco Unit 2 Unit 3 Unit 4 Unit 5 APN # Jurisdiction Permit # Study Area No. of Units S.F. Lot # No. 1561 Unit 6 Unit 7 Unit 8 Unit 9 Unit 10 • 4��ZFIED'?rS�C�O z cS��UU� o Q BERMUDA DUNES r 040 RANCHO MIRAGE INDIAN WELLS PALM DESERT y LA QUINTA 4 INDIO y� O 774-283-011 La Quinta 0401-417 1 Street Comments over pymt of .46 cents paid in cash. Reprinted on 5/5/04 as original has been misplaced. S.F. 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 fees 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 $2.14 X 1,561 S.F. or $3,340.54 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/PD National Bank -David Heusinkveld. Check No. 088080 Name on the check Telephone 760-360-8706 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Yolanda Garcia Payment Recd $3 341 00 $0.46 Over/Under Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you.that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting OLD AMU TITIk,"d RECORDMG REQUESTED BY: Re/Mhx Real Estate Consultants/Escrow Division AND WHEN RECORDED MAIL TO: AND MAIL TAX STATEMENT TO: DGH Development Corp. P.O. Box 2982 Palm Desert, CA, 92261 Order No. 2807006855 Escrow No. 03 -02617 -KT Parcel No. 774-283-011 DOC p 2003-756246 09/26/2003 08:00A Fee: 20.00 Page 1 of 2 Doc T Tax Paid Recorded in Official Records County of Riverside j Gary L. Orso Assessor, County Clerk 8 Recorder � 1111111 111111 III 1111111 111111 III 1111111 III IIIII IIII IIII 0 _ O 15 SPACE GRANT DEED RECORDER'S USE THE UNDERSIGNED GRANTOR(S) DECLARE(S) THAT DOCUMENTARY TRANSFER TAX IS $60.50 and CITY $ X computed on full value of property conveyed, or computed on full.value less liens or en,cumbrances remaining at the time of sale. unincorporated area: OR %/ City of La Quinta and FOR A'VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Jennie Williams,a married woman who acquired title as Jennie Williams, an unmarried woman hereby GRANTS to DGH Development Corp., a California Corporation the following described real property in the County of Riverside, State of California: AS PER LEGAL DESCRIPTION HERETO DESCRIBED AS "EXHIBIT A" AND MADE A PART HEREOF. _-Commonly known as: Avenida Velasco, La Quinta, CA 92253 Date A/2003 vA JennieY"ams STATE OF CALIFORNIA } I/ } S.S. COUNTY OF �I y} On �2EV 'eA l e -)"/ a6(7c�•-before me, the undersigned, a Notary Public in and for said County and State, personally appeared Jennie Williams personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their'signature(s) on the instrument the person(s), or the �en't�Cu If of ch e. person(s) acted, executed the instrument. WITNESS m Signature KEVIN B. TRUDGEON N Comm. i 1397759 'A NOTARY PUBLIC -CALIFORNIA =' Ri"I'lide County .+ My Comm. EW(ee Feb. 2. 2007 M s U PAGE SIZE DA PCOR. NOCOR4NCHGEXAM - A R L COPY LONG REFUND 0 _ O 15 SPACE GRANT DEED RECORDER'S USE THE UNDERSIGNED GRANTOR(S) DECLARE(S) THAT DOCUMENTARY TRANSFER TAX IS $60.50 and CITY $ X computed on full value of property conveyed, or computed on full.value less liens or en,cumbrances remaining at the time of sale. unincorporated area: OR %/ City of La Quinta and FOR A'VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Jennie Williams,a married woman who acquired title as Jennie Williams, an unmarried woman hereby GRANTS to DGH Development Corp., a California Corporation the following described real property in the County of Riverside, State of California: AS PER LEGAL DESCRIPTION HERETO DESCRIBED AS "EXHIBIT A" AND MADE A PART HEREOF. _-Commonly known as: Avenida Velasco, La Quinta, CA 92253 Date A/2003 vA JennieY"ams STATE OF CALIFORNIA } I/ } S.S. COUNTY OF �I y} On �2EV 'eA l e -)"/ a6(7c�•-before me, the undersigned, a Notary Public in and for said County and State, personally appeared Jennie Williams personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their'signature(s) on the instrument the person(s), or the �en't�Cu If of ch e. person(s) acted, executed the instrument. WITNESS m Signature KEVIN B. TRUDGEON N Comm. i 1397759 'A NOTARY PUBLIC -CALIFORNIA =' Ri"I'lide County .+ My Comm. EW(ee Feb. 2. 2007 Order No. : 2807006855-1 EXHIBIT "A" LEGAL DESCRIPTION The land referred to is situated in the State of California, County of Riverside, City of La Quinta, and is described as follows: Lot 1, Block 304, Unit No. 28 of Santa Carmelita at Vale La Quinta, in the City of La Quinta, County of Riverside, State of California; as per map recorded in Book 19, Page(s) 59, of Maps, in the Office of the County Recorder of said County. 2 -756246 883 09/26,�2063 08 GEM Building A-_ Owner maning Address (r. _,LO Ctoi -44 4 P.O. BOX 1504 APPLICATION ONLY 78-495 CALLE TAMPICO Kd� QUINTA, CALIFORNIA 92253 Tel. ractor Lg) Gil 9—V- L T t', Address Ip l. ` f:z Te o tk-^X/ State Lic.I City S Classif. 14Oy O / ;L%Lic. # Designer Address Tel. City IZip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I herebyy affir hat I am licensed under proy{� ns of Chapter 9 (cc 7000) of Df ' ion - of the fus n�ss a �Nisp(ons Code, and.¢lv�t effect. .�// / / ``�" 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 thathe 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': 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, Buisness and Professions 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 orimprovement 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.) I1 I, as owner of the property, am exclusively contracting with licensed contractors to con. struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) I'! I am exempt under Sec.B. & Pte. for this reason i Date i 1 WORKERS' 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 C71 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.) N I certify that in the performance oft ork for which this permit is iss , I shall not employ ny p rson i�.makirg become subject to the Work ation Law in' . Da NO E TO AP LICAthiof Exemptionyou 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 aOplicant Date Mailing Address City, State, Zip BUILDING: TYPE'CO1NST. S I� 1�-�j�+OCC. GRP. A.P. Number /// �y�6Y 7 "g) Legal Description Project Description WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE Sq. Ft. Size No. No. Dw. Stories I Units Newx Add O Alter O Repair O Demolition ❑ r Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. s p-�-- Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure HM z6X =J YY YY qq 1 111111 TOTALA LI�i nnk M! Ill REMARKS `" `N— _ R I ,/1,!' I A 41 FINANCE DEFT. 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 Certificate of Occupancy Building & -Safety Department. 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. BUILDING ADDRESS: 54-515 VELASCO Use classification:'SFD Building Permit No.: 04-3834 Occupancy Group: R3 Type of Construction: VNLand Use ZoneCR Owner of Building: DGH DEV CORP Address: PO BOX 2982 City, ST, ZIP: PALM DESERT CA 92261 By: KIRK KIRKLAND Date: 11-22-04 Building Official POST IN A CONSPICUOUS PLACE