Loading...
04-7998 (SFD)v � BUILDING & SAFETY DEPARTMENT P.O. Box - 1504 M (760).777-7012 OFTl9 78-495 CALLE TAMPICO E' FAX (760) 777-7.011 LA QUINTA, CALIFORNIA 92253 INSPECTION'Zk°EQUESTS (760) 777-7153 } BUILDING PERMIT Application'Number -. X04-'0000 7998'`' .Date 3/29/05' Property 'Address - i 80=6`46'VIA PESSARO APN: ;772-500-011 Application description DWELLING SINGLE. FAMILY DETACHED Property Zoning,. aLOW DENSITY RESIDENTIAL 'Application valuation :" 456224- Owneri Contractor' --------------------•_. '.----------------------- ,. ' DARRIN CAMPBELL PINNACLE COMMUNITIES, INC. 3 SAN RAFAEL y .15 -ENTERPRISE, SUITE. #250 LAGUNA 'NIGUEL _ ' ,•;'_ CA 92677'' " ALISO VIEJO:, CA 92656 +. (949) 609-0740 WCC: STATE FUND, ' WC:' 15,94304 07/14/05 CSLB:,755775 10/31/06 ' CCC: B ---- _Structure Information, .5354"'SQ. FT..SFD ---- Construction, Type .. TYPE *V ,- : NON- RATED Occupancy Type. DWELLG/LODGING/CONG <=10 Flood Zone NON -AO FLOOD, ZONE ` Other st.ruct,i e:' EDITION 2001 CBC # ROOMS:'.; . , . -4.00 'F t SPRINKLERS: NOSFTe ` 629.00, MAR 29 2005p ESQ4FTGG- 849.`00" CITY,OFLAQUIR OF UNITS r FINANCE DEPT: 1 S T, FLOOR SQUARE FOOTAGE 4468.00 FLOOR SQUARE_FOOTAGE 886.00 -------------------------------------- , --- ,-- -,F^ ---.--------- --�---- Permit -PERMIT -PERMIT Additional desc Permit Fee 1889..00`1 ` k Plan -ck-Fee 1227.85 Issue Date ." . Val ion G=,1 456224 Expiration, Date 9/29//05 Qty Unit Charge :Per'` 6:. MAR 2.9 2005 tension ,BASE FEE 639.50 357.00 3.5000 THOU BLDG -100, 001-50 , 00ITY.OF LA QUINTA 1249.50 ----------------- FINANCE DE - gL----_--= ". ----- Permit . . . .• ELEC-NEW RESIDENTIAL s Additional_desc y Permit Fee 229.97 yPlan.Check Fee 57.49: Issue Date Valuation, 0 ` Expiration Date, 9/29-/05 Y,. Qty Unit:Ch'arge. Per x�• Extension BASE` FEE 15 00 r P �^4 P.Q. BOX 1504 • �I�I�II� 1 '1 7$-495 CALLE TAMPICO VOICE (760) 777-7012760 777-701 I LA QuINrA, CALIFORNIA 92253 FAX INSPECTIONS (760) 777-7153 BUILDING $ SAFETY DEPARTMENT Application Number: O ��- 7 g g Date: Applicant: (9 Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: Lic. No.: CSUILUINU PhRMIT 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 m Lice is in full force and effect. Uce la s=l�f ��icense N^o�%1,5 77,5' 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 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 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 reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: a � 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 , 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 i sued. �X workers' compensation.insurancecarrier and polic number are: Carrier l'Z. �1 Policy Nu'm�er ��_y_ yD , !r_ I certify that, in the performance of the 70' f, o� 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. 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 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 construction, and hereby authorize representatives of this county to enter upon the above -men oned property for inspection purposes. .. .%9 r ` Page 2 Application Number ry. X04-00007.998 Date 3/29/05 - Qt)- Unit Charge Per. Extension 5354.00 0350 •ELEC NEW RES - 1 OR 2 FAMILY 187.39 629,00 0200 ELEC.GARAGE OR NON=RESIDENTIAL 12.58 1:00'. 15-0000 EA ELEC TEMPORARY POWER'POLE 15.00, Permit GRADING PERMIT . Additional desc " - Permit Fee .. .. 15.00 t Plan Check Fee .00 - Issue Date - Valuation 0 Expiration' Date 9./29/05 .. Qty. t Unit Charge .,.P 6'r rt Extension 1 BASE- FEE" .. _ 15.00 -; ---------.--------- Permit --------------------------.------------------- :' °MECHANICAL ----------- Additional desc Permit Fee139.00 r , `Plan Check.Fee 12.75 Issue Date Valuation 0 Expiration Date `9/29/05 ri Qty." Unit -Charge Per Extension - BASE FEE t 15.00 4.00 `9.0000•EA MECH=FURNACE <=100K 36.00 4.00 \' 9. 0000 ;- "MECH- B/C,<=3HP/100K BTU 36.00 .7.00 6.5000 EA,-- MECH VENT -'FAN t 45.50 1.00 .6.5000 EA MECH'EXHAUST HOOD 6.50 Permit PLUMBING' v` Additional desc , Permit`lFee Plan Check Fee 61.31 Issue Date" " �' "� Valuation 0 Expiration Date 9/29/05 - Qty Unit.Charge'- Per, Extension - s BASE FEE .,PLB 15.00 -25.00: 6".0000 EA FIXTURE' 150.00 ' 11.00 15.0000 EA PLB BUILDING'SEWER 15.00 2•.00'• 6.0000 EA PLB ROOF DRAIN 12.00- r 2..0'0. 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 15.00 ..7500 EA PLB GAS PIPE >=5 11.25 l.•00 15.0000 EA ' PLB GAS METER 15.'00 "."Special,Notes and. Comments - 5354 SQ. FT,. SFD . THIS. PERMIT DOES NOT _ . Page 3 Application Number 04-00007998 Date 3/29/05. Special Notes and. Comments - INCLUDE POOL & SPA, BLOCK WALLS -OR DRIVEWAY APPROACH. 1/19/05-2:11:53 PM, JJOHNSON Other Fees ART IN -PUBLIC PLACES -RES 640.56 DIF COMMUNITY CENTERS -RES 97.00 DIF"CIVIC CENTER - RES 366.00 ENERGY,REVIEW FEE 122:79 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 45.62 ' DIF STREET`MAINT FAC. -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary Charged Paid Credited Due - ------ - - - - -- - - -- Permit Fee Total ----- --- - -- 2518.22 ---- - - - - ------ - - - ----- ".00' .00 -- - - - - -- 2518.22 Plan Check Total 1359..40 -'10100.00. 00 359.40 Other Fee"Total 3213.97. .00 .00 3213.97 Grand Total r. 7091.5'9 .. 1000.00 .00 -6091.59 Ail I� P.O. BOX 1504 o Building Q 78-495 CALLE TAMPICO Address LA QUINTA, CALIFORNIA 92253 A) (_�`IM l°acGL Mailing Address _ L City Zip Tel. 4"7 7 9y9 -yy8 9395' r "NN, State Lic. City I & Classif. ---) "'7 --v-- I Lic. # Designery�nt,im- 6,„r 4 /-3 6".AArC %Jca+s err —% 20 7o 1?� %��P4Rf�El4tri I / 0 ILic. # 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). ❑ 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) O 1 am exempt under Sec. B. & P.C. for this reason DatZ% " Owner WORKER'S CO ENSATION 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. 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 eny 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 WHITE = BUILDING DEPARTMENT APPLICATION ONLY BUILDING: TYPE CONST. OCC. GRP. A.P. Numbed -1 �— SOO D1 l — ^^(, Q 1' Legal DescriptionLf7'T l LT Ia c9 t o r• aq 8-I 4 Project Description 5� Sq. Ft. `'�?�� No. No. Dw. Size J./y Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. 4r/ cop ° Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure In 4 TOTAL r.^ REMARKS ULA+ OF SPT, 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: Validation: Date Permit YELLOW = APPLICANT PINK = FINANCE 03/28/2005 16:12 FAX FIDELITY `ATIONAL TITLE Z002 FIDELITY NATIONAL TITNE COMkFANY " r SUBDIVISION DEPARTMENT'_--- DOC 17/;a/z003 88:01M Foe:19," POO* 1 of S DOC r Tex Paid 'Recorded in Offlotal Records WHEN RECORDED MAIL TO: county of Riverside }�. Assessor CQrY L. Orso I r Oun�y Clerk g Recorder Mr. b RMrsafael Darr,in Campbell llllll��ll111 L4San %inaNiguel, CA 92677- 61 A .. jf to+l 1till1111111111,11,1�Hill111,111 MAIL TAX STATEMENT TO: 7 M s PAC!tE. PBQN hoCaQ mob. SAME AS ABOVE I Cuvr •ION. Prs=uu0 � wCMG �• DOCUMENT TRANSFER TAX$ 5 E('• vS %?X Computed on the consideration or value of property conveyed; OR Computed on the consideration or value less liens or encumbrances gp lkJ remaining at the tune of sale. Signature of Declarant or Agent determining tax - Firm Name GRANT DEED FOR A VALUABLE CONSIDERATION, receipt of'which is hereby acknowledged, ND LA QUINTA PARTNERS, LLC, a Delaware limited liability company ("Grantor's, hereby GRANT(S) to Darrin Campbell, Sr., aiid Lisa Campbell, Trustees of THE CAMPBELL FAMILY TRUST Dated November; 1, 2000 ~ {"Graotee"), thc.real propeny'located,in the City of La Quinta�County of Riverside, State of California, described as: See Legal Description attached hereto and incorporated herein as Exhibit "A". SUBJECT TO all matters of record including, without limitation, the covenants and agrcements described in Exhibit "A" attached hereto. • , ` _a ;, ` Dated: f l j l t a 3 MND LA QUINTA PARTNERS, LLC, a Delaware limited liability company .By: Nationwide Realty Investors, Ltd. = an Ohio limited liability company itWor embcr w " c B, Y: u enson . A Authorized Representative Description: Riverside, CA Document- Year DOCZ 2003,998081 Page: 1 of5 . Order., 44 Comment: _ - EXHIBIT "A" Lezal Description Parcel_No. 1: Lot 169 (the "Lot") of Amended TraetNo, 29894-2 as shown on Subdivision Map (the "Map") recorded on December 12, 2002, in Book 327, Pages 56 to 88, inclusive, of Maps, in the Office of the Riverside County Recorder. EXCEPTING AND RESERVING THEREFROM TO GRANTOR, and its successors, assigns, invitees, licensees and employees, together with the right to grant and transfer all or a portion of the same, all easements and rights for access, ingress, egress, encroachment, maintenance, drainage, support, and for other purposes over the Association Maintenance Areas and other portion of the hot, reserved to Grantor in the following instruments: i . The Amended and Restated Declaration of Covenants, Conditions and Restrictions and Reservation of Basements for The Hideaway Owners Association (as amended or supplemented, the "Deelaration'�, recorded on December 13, 2002, as Instrument No. 2002- 745939, of Official Records of Riverside County, California (the."®fficial Records'); 2. The Supplementary Declaration of Annexation of Property, recorded on March 21, 2003, as lnstnunent No. 2003-201647, of Off dial Records of Riverside Country, California FURTHER RESERVING THEREFROM, the right to eater the Lot for a term of twelve (12) months following the recordation of this Grant Deed, to complete and repair any i.rnprpvernents or landscaping located thereon as determined necessary by Grantor, in its sole discretion, in order to comply, with requirements for the recordation of the final Tract Map, the grading of said Tract and/or in compliance with the requirements of applicable governmental agencies. Such entry by Grantor shall be preceded by reasonable notice to Grantee before such entry. If this reservation of ri&t of entry isnot complied with by Grantee, Grantor may enforce this right of entry in a court of law. Grantee shall be responsible for all damages arising out of said breach including attorneys' fees and court costs. This reservation of right of entry shall automatically expire twelve (12) months from the recordation of this Grant Deed. FURTHER RESERVING THEREFROM, an easemctit for landscaping purposes over the Southerly 11,5' feet, thereof. Parcel No. 2; Nonexclusive easements for access, ingress, egress, drainage, maintenance, repairs and for other purposes, all as described in the Declaration. Description: Riverside, CA Document- Year.DoclD 2003.998081 page: 3 of Order: 44 Comment: 03!28/2005 16:13 FAX FIDELITY NATIONAL TITLE z oo5 SUBJECT TO: I. Non delinquent general, spCCial and supplemental real property taxes and ' assessments. 2, All other covenants, conditions; restrictions, reser" ations, easements, rights and fights -of --way of record including, wit'iout irritation, the Declaration and the Map for Tract No. 29894-2. - Grantee, by acceptance and recordation of this Grant Deed, hereby (a) accepts and approves all of the foregoing in this Grant Deed, (b) grants to Grantor, and The Hideaway Owners Association such powers and rights as are set forth in the Declatntion, and (c) accepts, covenants and agrees to be bound by and assume performance of all of the applicable provisions and requirements set forth in the Declaration, including Section 1115 establishing the procedure for resolving disputes with Grantor, and the notice, which provisions and requirements are acknowledged to be reasonable and incorporated herein by this reference thereto. This grant is conditioned upon the performance of such provisions and requirerrierts as are to be performed by Grantee under the Declaration. The restrictions on use and occupancy of the Lot are set forth in the Declaration to which this Gant Deed is specifically and expressly made subject. GRANTEE HEREBY ACCEPTS AND APPROVES TIME FOREGOING, granting unto Grantor and The Hideaway Owners Associa ion such powers and rights which are set forth in the Declaration defined above, on 2003. Damn Campbell, Sr., Trustee 'Lisa Campbell, Trusted STATE OF COUNTY OF On 2003, bef r i o e me, the ur-dersigied, a notary public in and for said State, personally appeared Darri>a Campbell, Sr. and Lisa Campbell, personally known to me (or proved to me on the basis of satisfactory evidence) to be the persons whose names are subscribed to the within instrument and acknowledged to me that they executed the saint in their authorized capacities, and that by their signature on the instrument the persons, or the entity upon behalf of which the persons acted, executed the instrument. WITNESS MY HAND AND OFFICIAL SEAL. +` l- JSEAL} Signature tL10 FV 04, ; SEL" My commission expires: �J (3.01 _ Description: Riverside, CA Document -Year D.600 2003.998081 Page: 4 of 5 Order., 44 Comment: