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
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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