04-3647 (SFD)e
•
° APR a 7 2004 flGlrlU�t/
IV ITY OF LA QUINTA
FINANCE DEPT. >AUILDIN6 &"SAFETY DEPARTMENT
Box 1504 (760) 777-7012
�OFT1�� 78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760)777-7153
BUILDING PERMIT
Application Number.
04-00003647 'l
Date 4/23/04
Property Address . .
. 5272-0-AVENIDA VALLEJO
APN:
773-293-011-13 -000000-
Appl-ication description
. . . DWELLING - SINGLE FAMILY.DETACHED
.Property Zoning
COVE RESIDENTIAL
Application valuation..
95503
Owner
Contractor.
POWER FINANCE
BRAUCKMANN INC
P.O. BOX 134
P 0 BOX 517
LA QUINTA..
CA 92253 LA QUINTA
CA 92253
(.760) 485=9269.
WCC: NONE
WC: EXEMPT,
07/31/D4
CSLB:. 781834.
07/31/74
CCC: B HIC
07/31/04
----=--=------------------
Structure Information -------------------------
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
3.00
FIRE SPRINKLERS
NO
GARAGE SQ FTG
467.00
PATIO SQ FTG
50.00
NUMBER OF UNITS
•1.00
FIRST FLOOR SQ FTG
1498.00
--------------------------------------------------------------------------
Permit
BUILDING PERMIT
-Additional desc..
Permit Fee
621.50 Plan -Check Fee
403.93
-Issue Date
3/24/04 Valuation
95503
Qty. Unit Charge
Per
Extension
BASE FEE
414.50
46.00 4.5000
THOU BLDG 50,001-1-00,000:207.00
Permit . . .. .
PLUMBING
Additional.desc
Permit.Fee
1.23.00 Plan Check Fee
30.73
Issue Date.
Valuation
D
Qty Unit Charge
Per
Extension
P.O. BOX 1504 s���w
VOICE (760) 777-7012
7E-495 CALLS TAM►ICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 epa
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 0-1/. 36 41 f Date: 'y -o2 •O
Applicant: I Architect or Engineer.
Applicant's Mailing Address:
Architect Or Engineers Address:
Lic. No.
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLAMATION
Code. and my Uoense k h U force and effect
I hereby affirm under penalty d perjury that I am Goensed under Wvvikm of ChaPMr 9 (Commencing with Section 7000) of Division 3 of the Business and Processionals
License Class License No.__2 9/ K Y
Dote 0 ct Contrclor
OWNEIWIVILDER DECLARATION
1 hereby altar under
penalty at ply that 1 a n Imn" from •me Corrtracbrs' State License Law for the following mason (Sec. 7031.6. Business and Professions Code: Any
dty or o xvty that rewires a Pemml b CWwbuct aper. brows. demoish, or repair arty druWse,
stolemmePrior b ks kwarwoe. also requires the appicent tot fa penmmll b iM o sipnmed
nt that he a she k licensed ptasurarmt b the provisions of M Contractors' State Licence Law (Chapter 9 (Cormbndn9 with Section 7000) of Division J of the Business
and Professions; Code) or that to or she is azerrpt therefrom and the basic br the alleged e,,,Wk 4 Any violation of section 7031.5 by" appic" for a pan* subjects
*0 applicant b a dvl penalty of not more than live hundred dollars
U I, as owner of the property. or my Wnployees with wages as thea sole oompensatiam, wit do the wok and the structure k not' mlendad or offered for sale (Sec. 7044, .
Business and Professions Code: The Contractors• State License Law does not appy b an owner of property who builds or improves themon• and who does the work
sold elhirnselor � or iaagh his or her own employees, provided that the improvements am not WA or or artered for sale. M, hwvraver. the bridsp or irnproveme r k
U I, as owner of on yo of d am the owner-bmnilder � h11e the burden of proving that he or she did not build or improve for the purpose d sa1e.).
State License Law doepropertys not vely � m hicermsed wntracba b construct the project (Sec. 7044. Business and Professions Code: The Coc*oclore
apply b an owner of property who binds Or inproves 9meison, and who contracts for the projects with a conbacbn(s) licensed pursuant b
the Conbacbrs' State License Law.).
U I am exempt under sec . S..& P.C. for this reason
Dale z ° Y
1 hereby affirm under penally, at WORKERS' COMPENSATION DECLARATION
Perjury one of the following declarations:
_ I have and will maintain a certificete of consent b seg4nsuae for workers• compensation, as
of the work for whicitis par.. k ksued provided for by section 3700 of the Labor Code, for e performanceh
_ I have gOW Mwilill maintain workers' compensation Insurance. as re(PA by section 3700 of the Labor Code. for the pertor n ince of the work for vrtrM this penmmi k
npentsft
Cartier .57.0-TS—l� workers'
✓iion ksurance martian and poiry�urnber iI�e
_ I oer4ty that, In the Poses Number
performance of the work for VA*h this permit is issued. I shall not employ any Person in any manner so as to become subject to the workers'
moon n taws of Caifonmia, and 09MO that, Y I should become subject b the workers' Compensation provisions of Section 3700 of the Labor Code. I shall
hwNh ,/comply wlli those pmvMor,&
Date Z% o 7 gppieant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL„AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CrM FINES UP TO ONE HUNDRED THOUSAND DOLLARS (=100.000), IN ADDITION TO TIME COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 8706 OF THE LABOR CODE. INTEREST, AND ATTORNEYS FEES. .
CONSTRUCTION LENDING AGENCY
1 hereby affirm ander penaly of perjury that imere k a oonstnrctien
/ l %*V agency tot the performance of the work for which Ins perm k issued (Sec. 309T. Civ. C.).
Lendees Name / K T
Lerden's Address
IMPORTANT APpication is hereby mode b the Dirocbr ofAPPLICANT ACKNOWLEDGEMENT
B'"ng and Safety for a permit subject b the cactitions and restrictions set forth an this appkaom
1. Issued as a result of Each person upon w� behalfDP S aPPication ft owner. &W�e. each Person at Whose request and for whose benefit work k Performed under or pursuant b any permit
officers. agents and employees for arty act a omission metaled to the woapplicant. each w to and shall. defend. indermily and hold harmless the City of La Qulrmh. its
2 Any permit issued as a result of thk sppication becomes mutt and void I work is no
t commenced eno�ed WF«t M 1190 ddaysfollowing �h mid ell Issuance ofsuch pentyl or
cessation of work for 150 days will subject permit to cancellation.
I certify that I have read this appicekm and stab that the above information k I
89, 7�7/7c?
arize representatives of:7)
b enterb cortply with cep uty srW county ondinanoes and sWa lows mlattinp b boldingData t^>4�°n purposes.
si9nab•a (Applicant a<
r
U
6
Page
2
Application Number
04-00003647 Date
4/23/04
Qty Unit
Charge
Per
Extension
BASE FEE
15.0D
9.00
6.0000
EA
PLB FIXTURE
54.0D
1.00
15.0000
EA'
PLB BUILDING SEWER
15.0D
1.00
7:5000
EA
PLB WATER HEATER/VENT
7.5D
1.00
3.0000
EA
PLB WATER INST/ALT/REP
3.0D
1.00
9.0000
EA
PLB LAWN SPRINKLER SYSTEM
9.0D
6.00
.7500
EA
PLB GAS PIPE >=5
4.5D
1.00
15.0000
EA
PLB GAS METER
15.0D
Permit .. . .
. . .
ELEC-NEW RESIDENTIAL
Additional desc
Permit Fee .
. . .
91,77 Plan Check Fee..
22.94
Issue Date
. . .
Valuation . . . ..
Qty Unit
Charge
Per
Extension
BASE FEE
15.0•D
1498.00
.0350
ELEC NEW RES - 1 OR 2 FAMILY
52.43
467.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL
9.34
1.00
15.0000
EA
ELEC TEMPORARY POWER POLE
15.0•D
------------------------
Permit . . .
---------------------------------------------------.-
. . .
MECHANICAL
Additional desc
Permit Fee .
. .
52.50 Plan Check Fee
13.13
Issue Date
Valuation. . . . .
N)
Qty Unit
Charge
Per
Extension
BASE FEE
15.0-D
1.00
9.0000
-EA
MECH FURNACE <=100K
9.01)
1.00
9.0000
EA
MECH B/C <=3HP/100K BTU
9.0.)
2.00
6.5000
EA
MECH VENT FAN
13.0)
1.00
6.5000
EA
MECH EXHAUST HOOD
6.5)
Permit . . .
GRADING
PERMIT
Additional desc
Permit Fee
15.00 Plan,Check Fee
.0-D
Issue Date .
. . .
Valuation . . . .
..Qty Unit
Charge
Per
Extension
BASE FEE',
15.0-)
Special Notes
and Comments
1498 SF, SFD PERMIT
DOES
NOT INCLUDE:
• t
Page 3
Application Number.
04-00003647
Date
4/23/04
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
40.40
DIF
FIRE PROTECTION -RES
97.00
DIF
LIBRARIES - RES
225.00
DIF
PARK MAINT FAC - RES
5.00 '
DIF
PARKS/REC.- RES
502.00.
COVE
PRECISE PLAN FEE
d
100.00
STRONG MOTION (SMI) - RES
9.55
DIF
STREET MAINT FAC -RES
15.00
-
DIF
TRANSPORTATION - RES
1098.00
Fee summary Charged
Paid
Credited
Due
Permit Fee Total
903.77-
.'00 .00
903.77
Plan Check Total
470.80
250.00. 001
220.80
Other Fee Total
2554.95
:00 �.00
2554.95
Grand Total
3929.52
.250.'00
.00
3,6:79.52
oyT3�y7
P.O. BOX 1504
Building�/` '/ / 78-495 CALLE TAMPICO
Address S2 72 J Qui 1/ 71,c e jo LA OUINTA, CALIFORNIA 92253
Mailing
Address
City Zip Tel.
/_>fi0✓rte 5'61119ZI-9
Acaress
so s ss rl �^ �•
CityZI
��✓//� �� � Z2 J Tel.r/91 ! 2 6 /n
State U. Q City?
& Classif. O Y Lic. #
Arch., Engr.,
Designer
Address Tel.
City(Zip I
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 DECLA4A ON -
I hereby affirm that I am exempt from the Contractors 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, demplish, or repair any structure, prior to 'its issuance also
requires the applicant for such permit fo'file assigned 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 ademption. 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, 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
or improvement 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.)
II 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
doesnot 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.)
I1 I am exempt under Sec. B. & P.C. for this reason
Date Owner
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
n 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.)
Icertify 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.
Date Owner
NOTICE TO APPLICANT: If, alter 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
Ihereby 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
APPLICATION ONLY
BUILDING: TYPE'CONST. /` OCC. GRP.
A.P. Number -173 2.93 C)/,'
Legal DescriptiokA"/ 3 2 -
Project Description .SF
Sq. Ft./
Size
New ❑
9 No. No. Dw.
d Stories Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
PERMIT AMOUNT
l7 C;7
Plan Chk. Dep.
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:_
Validated by:
Val
O ;N7A
WHITE = FINANCE YELLOW = APPLICANT PINK
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
Date 4/21/04 La Quinta, CA 92253
No. 25816 (760) 771-8515
• i
4����F1EDSC'S t
.� ''„ o
Q BERMUDA DUNES' h
rn RANCHO MIRAGE
INDIAN WELLS
�i PALM DESERT ,y
LAQUINTA
INDIO
Q1�
0
Owner Power Finance APN # 773-293-011
Address P.O Box 134 Jurisdiction La Quinta
City La Quinta Zip 92253 Permit #
Tract # Study Area
Type Single Family Residence No. of Units 1 .
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 13 52720 Avenida Vallejo 1498 Unit 6
Unit 2
Unit 3
Unit 4
Unit 5
Comments
Unit 7
Unit 8
Unit 9
Unit 10
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, 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 $2.24 X 1,498 S.F. or $3,355.52 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 CCNIB - Mike Brauckmann Check No. 305488
Name on the check Telephone 485-9269
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by haron MCGllvrey Payment Recd 1$0.00
$3,355:52 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 eopy -,Applicant/Receipt Copy - Accounting
w No. Ap r . 27. 2004
No. r
N RECORDED MAIL TO.
9:50AM WILLIAM BOFFIN
er Finance Assoc. Inc.
aliforinia Corporation
. Box 134
Quinta, CA 92253
.N. 773-293-001
No 9125 .P. 2
i 1 -s—v--t.D—vva I
)MENTARY 114ANSFER TAX $.................................... SPACE ABOVE THIS U VE FOR RECORDERS USE
:omputed on Iha conalderation or value of property convoyed; OR
;omputed on the consideration or value less liens or enoumbranees
omnlning at time of sale, ignature or Uectarant c r Agent detamdn no tau — Fiffn Ham
GRANT DEED
I A VAWA6L.E CONSIDERATION, receipt of which is hereby acknowledged,
,id B. Ortega, .a married man as. his soleand separat la *propeirty
aby GRANT(S) to William Thomas Buff in a married -man as his sole and
paxate property, and Power Finance ,Associates, Inc., a -California Corp.
real 'proporty in the City of -La Quinta
mty of Riverside . State of Califomia, described ae
13 Block 152 mb 018/099 Santa Carmelita Vale La Quinta Unit #16
20 Block 176 mb 019/030 Santa Carmelita Vale La Quinta Unit #1'8
led January 26t2004,___1
JE OF CALIFORNIA las•
LINTY OF }
before me,
sonally apps d
svneHr-kfloran-te-�ne- or pmvad to me on the basis of aatisfactory
dencei to be the persotl whoas name(;] lslwo subsalhed to tho within
trumant and acknowled®e0 to me mat holaheRkrycexecuted the same
hislh~ authorized capaoitydesh and that by hItftrAl%Ir el na.
a(sa on the Instrument the personN at the entity upon behalf of wwmh
person(ft ectad, exaeuted the Instrument.
TM MS my ha d offlolal saaL
(nature
AIL TAXSTATEMENT$ TO:
David B. orte.ga
"'6 0
EVERAN ZA CORM
Commission # 1414446
Q-') Notary Public . California
Riverside County
My Comm. Exptres Apr 29.2001
fTrdv we4 for offlofal rm0al spy
.V-
1002 0194)
Apr•27— 2004 9:5OAM WILLIAM BUFFIN
RECORDING REQUESTED BY
F1 vW- #W v i. t6A —v'+L-k
AND WHEN RECORDED MAIL TO;
No.9125 P, 3
D04= ss .7-004--011!5 —
02/19/2004 08:00A Fee:30.00
Pege 1 of 2 Doc T Tax Paid
Recorded in Official Records .
County of Riverside
Gary L. Orso
assessor, county Clerk a Recorder
11111111111 1111 113 1111111111
GRANT DEED
A,P.N.: 770.166-003-4 T.R.A. No. 020-016 File No.: RPD -1347321 (sl)
The Undersigned Grantor(s) Declare(s): DOCUMENTARY TRANSFER TAX $85.80; CITY TRANSFER TAX $0.00;
computed on the consideratlon or full value of property conveyed, OR
computed on the consideration or full value less value of liens and/or encumbrances remaining at time of sale,
unincorporated area; [ ] City of La Qulnta, and
t
(� FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknovvledged, Ann M. Richards, Trustee of
the Ann M. Richards Living Trust dated September 3, 1997 and, Ann M. -Richards, Trustee of Charles
�. L. Richards. Living Trust dated September 3, 1997
hereby GRANTS to Power Finance Associates, Inc., a California Ccirporation
the following described property in the of La Quinta, County of Riverside, State of California,
Lot 12 In Block 282, Santa Carmelita at Vale La Quinta, Unit #26 as per Map recorded in Book 20,
Page 50 of Maps In the office of the County Recorder of said County.
Dated: 01/28/2004
Ann M. Richards, Trustee of the Ann M.
Richards Living Trust dated September 3,
1999977 ��--
Ann M. Richards, Trustee
Ann M. Ric:hards,'Trustee of Charles L.
Richards Living Trust dated September 3,
1997
Ann M. Richards, Trustee
Mail Tax Statements To: SAME AS ABOVE
MEN
IMEMIUMINE
MEN
IMENEIMEM
GRANT DEED
A,P.N.: 770.166-003-4 T.R.A. No. 020-016 File No.: RPD -1347321 (sl)
The Undersigned Grantor(s) Declare(s): DOCUMENTARY TRANSFER TAX $85.80; CITY TRANSFER TAX $0.00;
computed on the consideratlon or full value of property conveyed, OR
computed on the consideration or full value less value of liens and/or encumbrances remaining at time of sale,
unincorporated area; [ ] City of La Qulnta, and
t
(� FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknovvledged, Ann M. Richards, Trustee of
the Ann M. Richards Living Trust dated September 3, 1997 and, Ann M. -Richards, Trustee of Charles
�. L. Richards. Living Trust dated September 3, 1997
hereby GRANTS to Power Finance Associates, Inc., a California Ccirporation
the following described property in the of La Quinta, County of Riverside, State of California,
Lot 12 In Block 282, Santa Carmelita at Vale La Quinta, Unit #26 as per Map recorded in Book 20,
Page 50 of Maps In the office of the County Recorder of said County.
Dated: 01/28/2004
Ann M. Richards, Trustee of the Ann M.
Richards Living Trust dated September 3,
1999977 ��--
Ann M. Richards, Trustee
Ann M. Ric:hards,'Trustee of Charles L.
Richards Living Trust dated September 3,
1997
Ann M. Richards, Trustee
Mail Tax Statements To: SAME AS ABOVE
AP r 21. 2004 9: 50AM WILLIAM hr,lt .
A,P 1v,: 770-166-003-4 Grant Deed - continued
No. 9125 P. 4
File No.:RPD-1307321! (sl)
Date: 01/28/2004
STATE OF Ga t� }
COUNTY OF _Q_ }
On a r � Lj e 2Oo LJ before
me, personally
appeared L)1 ,M , tG
(or proved to me on the lasis of satisfactcry evidence) to be the personal whose
name is/are-subscribed to the within instrument and acknowledged 0 me that be/5he%they-executed the same
in hi6 tier/tbeWtuthorized capacity oi!sTand that Jail'JFier/,IbsW-signaturei ej-Dn the instrument the persorl(s�-or the
entity upon behalf of which the person(sracted, executed the instrument.
WITNESS my hand and official seal. rr"nrr��rrn.�,,,,TOWAO� Nrr'��r�� %/]%S c�/Lc� J`Or O/`�/C%81
Comm. 13t•2156 . x
9 " q Notary PubA A=Na � notar%a/ seal
RMAtSldA O )linty ►�
x My Canmtsutgn Bi5kesN
Signature tura 2a..006
il' /� ' c,,.,.sn,rruunruu Urrrnurr�p�r Nr:
My Commission Expires,
e
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