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04-7843 (SFD)�F�Q�rw O. Box 1504. OF 9 8-495 CALLS TAMPICO O� QUINTA, CALIFORNIA 92253 L �P��' `NtP BUILDING PERMIT _ o� �. BUILDING & SAFETY DEPARTMENT (760),777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 u - G = cation Number . . . . .0MUOOa�7?8�3`r Date 3/09/05 \ �foperty Address . . . . . . 80715 VIA PORTOFINO ✓ APN: 772-490-017- - Application description . . . DWELLING - SINGLE FAMILY DETACHED Property Zoning . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 402460 Owner Contractor ANDY WILLIAMS DOLAN CONSTRUCTION, J.A. 2500 W'HWY 76 74040 HIGHWAY 111, STE #L-207 BRANSON MD 65616 PALM DESERT CA 92260 -- --- - (760) 340-0905 WCC: STATE FUND WC: 0020047-2005 01/01/06 CSLB: 645369 05/31/06 CCC: $ =----- Structure Information 4423 SQ. FT. SFD ----- Construction Type . . . . . TYPE V - NON RATED Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC #. BEDROOMS 4.00 FIRE SPRINKLERS NO GARAGE.SQ FTG 892.00 PATIO SQ FTG 2075.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 4423.00 ---------------------------------------------------------------------------- Permit . . . . . .. BUILDING PERMIT Additional desc Permit Fee . . . 1700.00 Plan Check Fee 1105.00 Issue Date Valuation . . . . 402460 Expiration Date 9/09/05 Qty Unit Charge Per Extension BASE FEE 639.50 303.00 3.5000 -----------= THOU BLDG 100,001-500,OOD = 1060.50 ------------------------------ Permit . . . . . . --------------------------------- ELEC-NEW RESIDENTIAL Additional desc Permit Fee . . . . 169.81 Plan Check Fee 50.26 Issue Date . . . . Valuaticn . . . . 0 Expiration Date 9/09/05 Qty Unit Charge Per Extension BASE FEE 15..00 4423.00 .0350 ---------------------------------------------------------------------------- ELEC NEW RES - 1 OR 2 FAMILY 154.81 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: i9y- % 9 Y 3 Date:.! Applicant: rD--7 All -c To Applicant's Mailing Address: 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 Lice res i full force and effect. ` L�feense°Class t1 Ltcens_`_ o1loy-��% -3)05_ 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 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.). U I am exempt under Sec. BA P.C. for this reason 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 i sued. My wo rscompensation insurance carrier and policy number are: , tette'---�`7� 14'TF- vy D !P`oolTc Number 670`2- 6b(/'7 - 7_ 5__ 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 a e that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pyo vli 'sis� C)5- WARNING: s WARNING: FAILURE TO SECURE WO RS' 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 Lenders 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 pernit 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. 1 certify that I have read this application and state that the above info is co ect. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this count ente upon th above-mentioned property for inspection purposes. a 2� 0`atord"(zrppl'rcant�r"4 \j Page 2 Application Number . . . . . 04-00007843 Date 3/09/05 Permit . . . . . . GRADING PERMIT Additional desc . . Permit Fee 15.00 Plan Check Fee .00' Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/09/05 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 163.50 Plan Check Fee 40.88 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/09/05 Qty Unit Charge Per Extension BASE FEE 15.00 5.00 9.0000 EA MECH FURNACE <=100K 45.00 5.00 9.0000 EA MECH B/C <=3HP/100K 3TU 45.00 8.00 6.5000 EA MECH VENT FAN 52.00 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------- ----------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc . . Permit Fee . . . . 235.50 Plan Check Fee 58.88 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/09/05 Qty Unit Charge Per. Extension BASE FEE 15.00 27.00 6.0000 EA PLB FIXTURE 162.00 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 12.00 .7500 EA PLB GAS PIPE >=5 9.00 1.00 15.0000 ---------------------------------------------------------------------------- EA PLB GAS METER 15.00 Special Notes and Comments 4423 SQ. FT.. SFD THIS PERMIT DOES NOT INCLUDE POOL & SPA , BLOCK WALLS OR DRIVEWAY APPROACH. 1/10/05 7:28:49 AM jjohnson ----------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 506.15 DIF COMMUNITY CENTERS -RES 97.00 Page 3 Application Number . . . . . 04-00007843 Date 3/09/05 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 110.50 DIF FIRE PROTECTION -RES 9'7.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAQ - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 40.24 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATIO=N - RES 1098.00 Fee summary Charged Permit Fee Total 2283.81 Plan Check Total 1255.02 Other Fee Total 3061.89 Grand Total 6600.72 Paid Credited Due ---------- ---------- ---------- .00 .00 2283.81 750.00 .00 505.02 .00 .00 3061.89 750.00 .00 5850.72 . A Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 Project Name: Owner's Name: J. A. Dolan This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMMAND. AMOUNT: DATE: RECEIPT: CHECK M INITIALS: CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Address: 80-715 Via Portofino, La Quinta, CA 92253 Project Description: Single Family Dwelling Date: 3/•� /1 /,os Phone No. 340-0905 APN: 772 490 042-5 Tract #: Lot #'s: Type of Development: Residential XX Commercial Industrial r� Total Square Feet of Building Area: 4423 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 ownerldeveloper. Dated: �l`�/QS Signature: �(.� (�/� (AA � ********************************************** ***4e******************* SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN DR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code 17620 Number of Sq.Ft. Amount per Sq.Ft. Amount Collected Gov. Code Project Agreement Existi:lg Not Subject to Fee 65995 Approval Prior to 1/1/87 Requirement 4423 $2.68 $11,853.64 Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Business Services N�-ote•-7 Certificate issued by: Marcela Valdez, Facilities Secretary Signature: NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that -his District provide (1) a writt tice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 9•) -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 pa: ment 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 no/ 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. M V:UInydocs/devfees/Ccn titicatc of compliance form tablesTO USE'doe 1/16/03 T RECORDING REQUESTED BY: City of La Quinta —,.City Clerk's Office PO Box 1504 La Quinta, CA 92247-1504 WHEN RECORDED PLEASE MAIL TO: Kristi Hanson, Inc. 72-185 Painters Path, Ste. A Palm Desert, CA 92260 DOC a 2005-0162190 03/01/2005 MON Fee:NC, Page 1 of 4 Recorded in Official Records County of Riverside Larry W. Ward Assessor, County Clerk & Recorder ,' r.' 1 ' IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII �IIIIIIIIIIIIIIIIII M $ U PAGE SIZE OA PCOR NOCOR SMF misc. A I R L COPY I LONG I REFUND NCHG EXAM COVENANT AND AGREEMENT RESTRICTING THE USE OF THE RESIDENCE AT 80-715 VIA PORTOFINO, LA QUINTA, CALIFORNIA SP This covenant and agreement are made and executed this 27" day of December, 2004_by Andy 'Williams, as the record owner(s) of the property described herein. The City of La Quinta, a Municipal Corporation, is hereby made a party to this agreement for the purposes set forth below. The undersigned hereby certifies that he/she is the property owner of the following described real property in the City 'of La Quinta, County of Riverside, State of California: Lot 144, Bk. 772, PG. 49 of Tract 29894 as. per record map on file with the Recorder of Riverside County In consideration of the City of La Quinta issuing a building permit for certain improvements which will be constructed on said property, the undersigned does hereby covenant and agree to and with said City to restrict the use of said property as follows: 1. The guest house may not be rented nor sold independent of the main single family residence (Minor Use Permit No. 2004-575); 2. `No kitchen or cooking facilities shall be constructed in the guest house per the provisions of Chapter 9.30.030 (RL Zone District). and 9.60.110 (Guest Houses) of the La Quinta Municipal Code; 3. All on-site facilities are intended for the sole occupancy of the property owner(s), guests, and caretakers (i.e., a maid and/or housekeeper, etc.); and, 4. The guest house shall be used primarily as a sleeping facility, and shall I ti be maintained in accordance with all zoning and other codes as set forth in the La Quinta Municipal Code, as may be amended from time to time, This covenant and agreement shall run, vvitl� the land and shall be binding upon future owners, their successors, heirs v ::or.: -assigns, and ourselves, and shall continue in effect while said accessory .building remains on the real property or unless otherwise released by the authority of -the City of La Quinta. All leases of said dwelling and/or property shall be subject to this restriction. This agreement shall be entitled to the remedy of injunctive relief in addition of any remedy in law or equity. This. covenant and agreement and the provisions hereof are irrevocable, except by the written consent of all parties to the agreement, including the City of La Quinta, a municipal corporation. The City shall have the right. to enforce each and every provision hereof and the parties agree that the agreement shall not be rescinded, revoked, modified, or otherwise amended or changed, without the expressed written consent of the City first being obtained. In the event that the owners, their heirs, assigns or successors in interest, shall fail to perform any obligation hereunder, they hereby agree to pay all costs and expenses incurred by the City of La Quinta in securing performance of such obligation, including attorney's fees. By: 1. 2. 3. 04 Signature(s) Dated:Aq _ Printed Name of all owner(s) //f -/O9, Thomas P. Genovese Date City Manager/Interim Community Development Director City of La Quinta ALL PURPOSE NOTARY ACKNOWLEDGMENT(S) MUST BE ATTACHED IN ' 8 1/2 X 11 " FORMAT, FOR EACH SIGNATURE. STATE OF -CALIFORNIA ) `. COUNTY OF RIVERSIDE ) ss. ` `? CITY OF LA QUINTA ) On 'December 28, 2004 before me, Regenia Hensley, Notary Public, personally appeared - THOMAS P. GENOVESE personally known. to meto be the person yvhose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by. his signature on the instrument the person or the entity upon behalf of which the person acted, executed the instrument. WITNESS my hand and official seal. (Seal) i 4IREA HENSLEY Public Commission # 1521423 Expiration: October 23, 2008 W State of Missouri County of Taney) ss. City of Branson ) On Januga 21, 2005, before me, Dawn K., Cleveringa, Notary Public, personally appeared Andy Williams, personally known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity; and that .by his signature on the instrument the person or the entity upon behalf of which the person acted, executed the instrument. WITNESS my -hand and official seal. (Seal) w , _iZ'" DAWN K. CLEVERINGA Tane Dawn K. Cleveringa My Commisssion Expires DAWN K. CLEVERINGA pJanuary 21, 2006 Notary Public - State of Missouri Taney County My Commission Expires: January 21, 2006