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06-2947 (SFD) (2)4 i °- P.O. BOX 1504. 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: r06-00002947 78611 TALKING ROCK TURN 770-300-030- - - DWELLING - SINGLE FAMILY LOW DENSITY RESIDENTIAL 736051 ceqtt 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: -DAVID VAN DEN BERG .49832 VIA CONQUISTADOR DETACHED LA QUINTA, CA 92253 Architect or Engineer: Lic. No.: OOR SQUARE FOOT ---------------------------- - --------------------- 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: B License No.: 346196 Date: Contractor: - 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. 703.1 .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).: + (_ 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.). ' 1 _V) 1, 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 am exempt under Sec. , BAP.C. for this reason Owner: T CONSTRUCTION L NG 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: yl' LQPERMIT + VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/29/06 Contractor: 6 ------ KELLY KELLY PACIFIC CONSTRUCTION 100 DRAKE'S LANDING ROAD, 0 p� GREENBRAE, CA 94904 1Y�V 29 Z006 (415)464-0900 Lic. No.: 346196 CITY OFLq FI111A4fk1^ QUINTA ----------------------------------------------- WORKER'S 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 STATE FUND Policy Number 0001375-2006 ,,6 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 c, 3,7��000� of the Labor Code, I shall fort) with comply with those provisions. Date: i %i/ : Applicant: WARNING: TO SECURE WORKERS' COMPENSATyQN 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 Ouinta', its officers, agents arid employees for any act or omission related to the work being performed under or fallowing 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//countpy to n r upon the 6bove-mentioned property for inspection purposes.' �Date:f�.7 Gt�Signature(Applicant orAgent): - LQPERMIT Application Number 06-00002947 Permit . . . BUILDING PERMIT Additional_ desc . Permit Fee 2750.50 Plan Check Fee 1787.83 Issue Date . . . . Valuation . . . . 736051 Expiration Date 5/28/07 Qty Unit Charge Per Extension BASE FEE 2039.50 237:00 3.0000 THOU BLDG 500,001-1,000,000 711.00 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 355.87 Plan Check Fee 88.97• Issue Date Valuation . . . . 0 Expiration Date .5/28/07 'Qty Unit Charge Per Extension BASE FEE 15.00 8627.00 .0350 ELEC NEW RES - 1 OR 2 -FAMILY 301.95 1196.00. .0200 ELEC GARAGE OR NON-RESIDENTIAL 23.92 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 5/28/07 Qty Unit_ Charge Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 - Permit MECHANICAL Additional desc.. Permit Fee . . . . 275.00 Plan Check Fee 68.75 - -Issue Date Valuation 0 Expiration Date 5/28/07 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE .<=100K 9.00 6.00 11.0000 EA MECH FURNACE >100K 66.00 1.00 4.5000 EA MECH VENT. INST/ DUCT ALT 4.50 7.00 16:5000 EA MECH B/C >3-15HP/>100K-500KBTU 115..50 9.00 6.5000 EA MECH VENT FAN 58.50 LQPERMIT Application Number . . . 06-00002947 Permit . . . . . . MECHANICAL Qty Unit Charge Per Extension - 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit . . . PLUMBING Additional desc . Permit Fee . . 334.50 Plan Check Fee 83.63 Issue Date Valuation 0 Expiration Date 5/28/07 Qty Unit Charge' Per Extension BASE.FEE 15.00 36.00" 6.0000 EA PLB FIXTURE 216.00 1.00 15.0000 -EA PLB BUILDING SEWER 15.00 4.00 6.0000 EA PLB ROOF DRAIN 24.00 2.00 7.5000, EA7 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 4.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 12.00 14.00 .7500 EA -PLB GAS PIPE >=5 10.50 1.00 15.0000 EA PLB GAS METER 15.00 Special Notes and -Comments --------- 8,627 SF DWELLING/V-NR/RES-3/NO SPRINKLER. THIS PERMIT DOES NOT INCLUDE• BLOCKWALLS, POOL AND BPA, OR DRIVEWAY APPROACH. October 10, 2006 9:39:15 AM AORTEGA ------------=--------------------------------------------------------------- Other Fees ART IN PUBLIC PLACES -RES 1340.12 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER -'RES 480.00 ENERGY REVIEW FEE 178.78 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE 15.00 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 73.60 DIF STREET MAINT FAC -RES 67.00 DIF TRANSPORTATION - RES` 1666.00 Fee summary Charged Paid Credited Due Permit Fee* Fee Total --- ---------- ---------- 3730.87 .00 .00 3730.87 .Plan Check Total 2029.18 750.00 .00 1279.18 LQPERMIT Application Number . . . . 06-00002947 Other Fee Total 5303.50 .00 .00 5303.50 Grand Total 11063.55 750.00 .00 10313.55 y � 1 ' LQPERMIT _ , J w BOX 1504 APPLICATION ONLY Building ` "P C G� 78 495 CALLE TAMPICO Address v J LA QUINTA, CALIFORNIA 92253 O r 1 / ,t,'� �� Vlto 'Dew BUILDING: TYPE CONS�!u'e r"CC. GRP. Mailing O '710 ^'3 30 `" CO µAddress 4q ZYlOo,.3 QV,S A.PNumber_ tL.��j f� ,City Zip Tel. Legal Descri tion L—wT L4 � � � 28 ' "/ 0 �,Z' 0^,� 22 4io-77/- 27,3 c -�►,� %- (Pq ofa- Contractor n Project Description Address O o Cit Zip Tel, AA_e State Lic. City & Classif. ,'Lic. # Arch., Engr., 0 AT 1� �a rJE� Designer FW6sscf4q sp eLs.T.. #-r2O 'i F*t=tNCIS'eo zp gglo State 2Z Lic. # LICENSED CONTRACTOR'S DECLARATION I ereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 700 of Division 3 of the Business and Professions Code, and my license is in full force and OWNER -BUILDER DECLARATla N I hereby ffirm that I am exempt from the ContractorLicense Law for the foil wing reason: (Sec. 31.5, Business and Professions Code: Anity or county which re ires a permit to conslru , alter, improve, demolish, or repair any sture, prior to its issue ce also requires the applic t for such permit to file a signed statemthat he is licensed p rsuant to the provisions of the ontractor's License Law, Chapter 9 (cmencing with Secti 7000) of Division 3 o/ the Busi ss and Professions Code, or that he iempt therefrom, d the basis for the alleged exemptidp�e, y violation of Section 7031.5 by applicant for a p mit subjects the applicant to a civil py of not more than five hundred llars ($500). ❑ I, as owner of the or my employees with wages aheir sole com nsation, will do the workand the structnot intended or offered for sale.ec. 7044, Bu ness and Profes- sions Code: The Contractor a`License Law does not apply to owner of operty who builds or improves thereon and who oes such work himself or throhis own ployees, provided that such improvements are n intended or offered for salf, howev , the building or im- provement is sold within one y ar o/ completion, the owneuilder 11 have the burden of proving that he did not build or imerove for the purpose o/ s. O I, as owner of the property, am exclusively contracting withens contractors to construct the project. (Sec. 7044, Business aA Professions Code: Tho actor's License Law does not apply to an owner of property wh buildsorimproves theand who contracts for such projects with a contrac[or(s) licensed ursuant to the Contras License Law.)❑IamexemptunderSec._B.&P.C.forthisren Date Owner WORKER'S COMPENSATIO ECLARATION I hereby affirm I have a certificate of copse to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy there . (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. 0 Certified py's hereby furnished. CERTIFICATE EXEMPTION FROM WORKERS'CO ENSATION INSURANCE (This section need not be completed if a permit is fo� pne hundred dollars ($100) valuation or less). \ I certify that in the performance f the work for which this permit is issued, I shall not employ any person in any manners as to become subject"too Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT. If, ati6r making this Certificate of � emption you should become subject to the Workers' Co ensation provisions of the Labor Code, you must forthwith comply with such provisionstiltir this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm th there is a construction lending agency for the ert.rmance of the work for which this permit s issued. (Sec. 3097, Civil Code.) Lender's/ifrk Lender's Thisng permit when properly filled out, signed and validal.i: and is subject to expiratioereunder is suspended for 180 days.\I ceave read this application and state that the above information is correct. I agree twith all city and county ordinances and state laws relaiieg to building construeereby authorize representatives of this city to enter the above-mentioned of applicant State, WHITE = BUILDING DEPARTMENT Ft.�L No. No. Dw. kW (4T Stories Units v ❑ Add ❑ Alter ❑ Repair ❑' ion ❑ ,1 c? 'V4M L A o- '(8 Y 75 CITY of LA •QAC Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. S� 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: YELLOW = APPLICANT PINK = FINANCE Comments At the present time; the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 5 00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho mes. 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 $2.63 X 8,627 S.F. or $22,689.01 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/PDNB - David Van Den Berg Check No. 097820 Name on the check Telephone 771.2736 Funding Residential By Dr. Doris Wilson Superintendent 41,, x- 16�,a1 a. •Y Fee collected /exemp d y S aro CGilvrey Payment Recd $0.00 r Over/Under, K $22,689.01 L"- ��-rra _ •N'1 Signature 1• NOTICE: Pursuant to Government Code Section 66020(d)(1), is will serve to notify you that the 90 -day approval period intwhich `you �may protest the fees o r 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 CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road ¢ BERMUDA DUNES O Date 10/20/06 La Quinta, CA 92253 to RANCHO MIRAGE d �. INDIAN WELLS r No. 28986 (760) 771-8515 PALM DESERT �' LA QUINTA y �QINDIO O Owner David Van Den Berg APN # 770-330-004 Address Jurisdiction La Quinta City Zip Permit # Tract # Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F.° Unit 1 78611 Talking Rock Turn 8627 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments At the present time; the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 5 00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho mes. 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 $2.63 X 8,627 S.F. or $22,689.01 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/PDNB - David Van Den Berg Check No. 097820 Name on the check Telephone 771.2736 Funding Residential By Dr. Doris Wilson Superintendent 41,, x- 16�,a1 a. •Y Fee collected /exemp d y S aro CGilvrey Payment Recd $0.00 r Over/Under, K $22,689.01 L"- ��-rra _ •N'1 Signature 1• NOTICE: Pursuant to Government Code Section 66020(d)(1), is will serve to notify you that the 90 -day approval period intwhich `you �may protest the fees o r 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 RECORDING REQUESTED BY: SOUTHLAND TITLE - INLAND EMPIRE (Title) AND WHEN RECORDED MAIL•TO: David Van Den Berg and Prentiss Van Den Berg 40 Rock Road Kentfield, CA 94914 Order No.: 64603049 Escrow No.: IN6415-RS A. P. N.: 770300-030-2 fpno2"D DOC a 2003-0050789 01/19/2005 08:00A Fee:10.00 Page 1 of 2 Doe T Tax Paid Recorded in Official Records County of Riverside 111111111111111111111111111111111111111111111111111111nty M $ U PAGE size DA PCO NOCOR SMF WSC. i A R L COPY LONG REFUND : NCNG EXAI GRANT DEED THE `UNDERSIGNED GRANTORS) DECLARt(S)�- DOCUMENTARY TRANSFER TAX IS $973.50 [ x ] computed on full value of property conveyed, or T [ ] computed on full value less value. of liens or encumbrances remaining at time of sale. [ ] unincorporated area [ x ] City of La Quinta FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Ned K. Ryder and Ann Ryder, Trustees of the Ryder Family Revocable Trust herebyGRANT(S)to David Van Den Berg and Prentiss Van Den Berg, husband and wife as joint tenants the following described real property in the County of Riverside, State of California Lot 47 of Tract No. 28470-2, in the City of La Quinta, County of Riverside,. State of California, as per map recorded In Book 266, Page(s►'(2) 57 through 60.of Miscellaneous Maps, in the office of the County Recorder of said County. Dated: November 29, 2004 STATE OF CALIFORNIA COUNTY OF On V(Dxic,. ' '7,;)00q before me C; A.0 C_ ii 5Te6C1, a Notary Public in and for said County and State, personally appeared VO -to 1L. .L s_Mo Z e ll known to me (or ` f satisfaEteryrew epee) to be the person(s) whose name(q) ®are subscribed to the within instrument and acknowledged to me that (&he/they executed the same in Gher/their authorized capacity(ies) and that by is er/their signatures) on the instrument the person(c), or the entity upon behalf of which the person(4 acted, executed the instrument. WITNESS my h d and officlal seal. Signature (3. j" Signature of Notary SS. i Ned K. Ryder anTruees of the Ryder FamilyJe=g/rustst By: Ned K.,,2ydey, By: Ann Ryder, STO DME ItOPS r„ C .... COIAL/1 ... CONTRA COSTA COUIVY .. Al1r Cann EON Apra 23.2M (This area for official notary seal) MAIL TAX STATEMENTS AS DIRECTED ABOVE Vit•',; ~4�it.14 .S�tf`�t; y^7� �k`. 1r i :i�; I •.�s..` +' �.' .. '.�..i �. :. -.i f"' f,. _•.. �. .. ��ti yIVY(,�V t Certificatd,oF,0 ccupanc.- -:Ry I.NCO LATH _ OF9w s Building & Safety DepartmentV 34 This Certificate is issued pursuant to the "requirements of Section 109` of the California_ Building Code, certifying ,:that; at 4he 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:, 78-611 TALKING ROCK-TURN,,,,�. ' f Use'' classification: SINGLE FAMILY DWELLING -'Building Permit,Nb -. 06-2947' f Occupancy Group: R3 �Type of Construction: VN t `' a� - ' M` La6d Use.Zone:RL — VN .. ,— Owner of Building: DAVID VAN DEN BERG - Address`- 49-832 VWCONQUISTADOR ; 3 City,. ST, ZIRAA QUINTA; CA 92253 ^ ,By: STEVE TRAXEL > . -.• `�' s Date: MARCH 28, 2008 ' uilding O Icla - v j POST IN A CONSPICUOUS PLACE