06-0668 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
Application Number:
Property Address:
APN:' .
Application description
Property Zoning:
Application valuation:
Applicant:
--06-00000668 -- •-
78320 --VIA PAVION___ _
604 -032 -999 -44 -305212 -
REMODEL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
11460
Architect or Engineer:
BUILDING PERMIT
Owner:
M/M BARBOSA
78-320 VIA PAVION
LA QUINTA, CA
LA QUINTA, CA 9225
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011.
INSPECTIONS (7.60) 777-7153
Date: 6/05/06
LQPERMIT
1
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LICENSED CONTRACTOR'S DECLARATION
------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
1 hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers'. compensation, as provided
License Class: License No.:
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: Contractor:
_ 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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier _ — 20 01 / 2 0 0 5 Policy Number - - - - - - - - - - - - - - -
. • following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
certify that, in the performance of wo or which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to o subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if c subject to the workers' pensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
, 3700 f the Labor Code forthwith compl t' hose provisions.
II
that he or she is. exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
-' �-- - —
any .Pplfcant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
j DateV Applicant:
(_ 1, 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
-- WARNING: FAILURE TO SE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of. property who builds or improves thereon,
SUBJECT AN EMPLOYEW CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND -.
- and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000) ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. .
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 Bare.).
APPLICANT ACKNOWLEDGEMENT
as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
-
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person atwhoserequest and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. &P.C. for this re
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 -
--- -�-
(-Dater
performed under or following issuance of this permit.
Owner:
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
STRUCTION LENDING -AGENCY
permit to cancellation.
I hereby affirm under penalty of perjury there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above inform is corre agree to comply with all '
work for which this permit is issued (Sec. 3097, Civ. C.).
and state laws relating to bu' cons ion, an eby authorize representatives
city and county ordinZature
n
of this my to entn the above-mentioned property for ' pectio rposes.
Lender's Name:
_
__
Dat (Applicant or Agent):
Lender's Address:
LQPERMIT
LQPERMIT
Qty Unit Charge Per.
Extension
BASE FEE
90.00
.10.00 18.0000 THOU BLDG 2,001-25,000
180.00
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Permit Fee 19.50 Plan Check Fee
4.88
Issue,Date . . . . Valuation . . .
. 0
Expiration Date 12/02/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
6.00 .7500 PER ELEC DEVICE/FIXTURE.IST 20
4.50
r Permit PLUMBING
"
Additional desc.
Permit Fee . . . . 21.00 Plan Check Fee
5.25
Issue Date Valuation . . .
. 0
' Expiration Date 12/02/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 3.00.00 EA PLB WATER INST/ALT/REP
3.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
-
3.00
-- - -------------------------------------------------------
Special Notes and Comments
--------------
65 LF BLOCK WALLS, FOUNTAIN AND 138
TRELLIS ONLY.FIREPLACE OR OTHER
STRUCTURES BY SEPERATE
PERMIT.INVESTIGATION FEE
ASSESSED PER 1997 UNIFORM
ADMINISTRATIVE CODE §304.5.FOR WORK
BEGUN WITHOUT BUILDING PERMIT.
-------------------------------------------------=---------------
Other. Fees . . . . . . . ENERGY REVIEW FEE
-----------
20.48
HOURLY PLAN CHECK
225.00
STRONG MOTION (SMI) - RES
1.67
Fee summary Charged Paid Credited
Due
LQPERMIT
Application Number
06 -00000668
----------
Permit Fee Total
310.50
------.---- ----------"
.00`
-------
.00
310:50
Plan Check Total
97.88
.00
.00
97:88
Other Fee Total
247.15
.00
.00 -
247.15
Grand Total
655.53
.00
.00
655.53 "
LQPERMIT
-
- -
-
Dojue Fee I'Jamc, ST
Bin #
City of LaQuinta. /v -07--c- %t /-&-o f -W
Building u Safety Division 19f A,
Box 1504, 78-405 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Buil 'lig Permit..Application, and Tracking ' Sheet
Permit, # QP.O.
6 �U
Project Address: 9L 0
Owner's
A. P. Number:
Address: 7�--120
Legal Description:
Contractor: (2.
City, ST, Zip:
Telephone:G)ze
Address: 0 00 &A—
Project Description
City, ST, Zip:
)01
Telephone-
Vo 11,4 (Y.C_YLt CIL L Y -e a
State Lic. # :@itY'c. #:
Arch., Engr., Designer: At
-F0 -t iu` a
Address: rt Y
(o
Jr
City, ST, Zip: VII&V
Telephone:
Construction Type: Occupancy:
State Lic. #:
Projecttype circle one): New Add'n Alter Repair Demo
Name of Contact Person -e
Sq. I t.tU f A-1
(1
# Stories- s
Telephone # of Contact Person: `7 Z
Estimated Value of Project:
776 1� .376
q -7 1 —7 APPLICANT: DO NOT WRITE BELOW THIS LINE
;I
Submittal
Req'd
Rec.'d
TRACKING
LP 1,RYr/!EE'S
Plan Sets
Plan Check submitted
Item
Plan Check L!,-pf-,(j
mount
Structural CaIcs.
Reviewed, ready r corrections
Truss Calcs.
Called Contact
PlanCheck Balance
Energy CaIcs.
�tans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for /Correctio /issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.T.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
6
School Fees
Total Permit Fees
w lu vte F-9 IV
c
glob Ljo -s
9,�,r A9,0
f
S
?b tA, 7t -
co o . 4PPP-ou
4q
.
6
4 _
4q
DOC t 2005-0684088 .
08/19/2005 08:00A Fee:25.00
Paged of 7 Doc T Tax Paid
NORTH AMERICAN TITLE COMPANY Recorded in official Records
County of Riverside
Order No. 75-08444-24 Larry W. Ward
Escrow No. 67609 -SA Assessor, County Clerk .& Recorder
Loan No.
MAILTAXSTATEMEN`SAND IIIIIIIIIIIIIIIIIIIIII
N IIIIIIIIIIIIIIIIIIII
IIIIIilllllll
WHEN RECORDED MAIL TO: ,
;HEi!IRY S . = BARjBOSA.. .
ANA YOLANDA BARBOSA.:.
2592 NIXON WAY
• FULLERTON, CA '92;835
DOCUMENTARY TRANSFER TAX s —.51T.-OO.'
.:51,7:-:00 t'
X Computed on the consideration or value of property conveyed, OR
THE UNDERSIGNED GRANTOR
Computed on the consideration or value less liens or encumbrances Siguature.of Declarant or Agent determining tax — Firm N
remaining it time of sale.
APN: 604=600-034-9
TRA: '020-044 .
CORPORATION GRANT DEED
For valuable consideration; receipt of which is hereby acknowledged, LENNAR HOMES OF CALIFORNIA, '
INC., a California corporation, and LENNAR SALES CORP., a California corporation (collectively, "Grantor's..
hereby grants to i
HENRY.S.,.BARBOSA AND -ANA YOLANDA BARBOSA,,TRUSTEES OF THE BARBOSA
FAMILY 1992 REVOCABLE TRUST, DATED SEPTEMBER 23, 1992
(hereinafter jointly referred to as ("Grantee') the real property in the County of Riverside, State of California,.
described as follows:
SEE EXHIBIT "A" ATTACHED HERETO
This grant is subject to the covenants and agreements described in attached Exhibit "A."
Dated: February 16 12005 .'Dated: February 16 , 2005
LENNAR HOMES OF CALIFORNIA, INC., LENNAR SALES CORP.,
a California corporation a California corporation
• By: By:'
Name: Brad Crouse t Name: Phil Freebern
Title: Vice President Title: Vice Predident
Grantor Grantor
Lennar Sales Corp. has executed. this Grant Deed in order to convey its' interest in the real property, which Lennar
Sales Corp. acquired pursuant to an unrecorded Grant Deed from Lennar Homes of California, Inc., a California
corporation, dated February 16 2005
1 •. 1
snen�ae Quin10 Del Oroiwreh Deeax
03-31.04
a ACKNOWLEDGEMENT
.,STATE OF CALIFORNIA
y a
4; ) SS.
COUNTY OF RIVERSIDE
On March -1, 2005, before me, Lindy Balatoni, Notary Public; personally appeared }. Y
Brad Crouse, personally; known to me to be the'- .whose name is subscribed to the within N -
..
-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.
F . Witnes's my hand and official seal.
LINDY BAIATONI -
�.
'Commission # 1415042
` -� . Notary Public - Confornip
Riverside County +
MY Comm. Ex of Pub 60-325-4289
Pees May
STATE OF CALIFORNIA
) SS.
COUNTY OF RIVERSIDE
On March 1, 2005, before me, Lindy Balatoni, Notary Public, personally appeared ,
Phil Freebern, 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. JM
LINDY WU ATONI
Commission #'1415042 + '
-� Notary Public*-. California
" Riverside county Notary P is -�
My Comm. Expires May 2, 2007
2' �• ;.,�, .• - , r._ r �f s r _� �� `! ,,, �,,. �Y
. .
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder, of the property
improvements specified.
c
For your protection you should be aware that as ``Owner/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless. they are personally performing their
own work. If your work is being performed by someone: other than yourself, you may protect yourself from possible ,
liability if that person applies for the proper permit in his- or her name..
Contractors are required by law to be -licensed and bonded by the State of California and to have a business license
from the City or County. They are also ;required by law to put their license number on all permits for which they
apply
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the, following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then.you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions..
There maybe financial risks -for you if you do not carry out these obligations', and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division.of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contracts are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "'Owner/Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are. not required to be signed by property owners unless they are performing their own work
personally. .
Information about licensed contractors may be obtained by contacting the Contractors' :State License Board in your
community,or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed.owner-builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very. truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Qyinta, CA 92253
(766) 777-7012
F : (460) 777-7011
O ER'S`SIGN RE ATE J
V �-
PROPERTY DRESS
PERMIT NUMBER(S)
> ;( CITY OF LA QUINTA SUB -CONT CTO LIST:
JOB ADDRESS l
' C(_ 0 PERMIT NUMBER f06 -l6 g , OWNER Z? • BUILDER
This form shall be posted on the job with th Building Inspection Card at all times in a conspicuous place. Only pe sons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of Work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade/ Classification
---------------
Contractor
. ..:......:
:::;;>::'::;:: ;:: _..: ::>>..:
::...:.:.:., State..Contractor s. License... ....: <::::.
..............::.:....:.....:.:. .:.....:.. .
Worke�sCom er)sation;Insurance:°.:" : ;:
Cit'. Business
Y
License::> .
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(kx/xx/xx)
License Number
(xxxx)
Exp: Date
(xx/xx/xx)
EARTHWORK 1C -12i :::.
�►% ' 1
_
CONCRETE (C-8) t
_ 5 C��i
J p
�►
13-L 0Q �b I'� j
FRAMING .(C-5) .:::;'
t(,3a
OO a o/
L(
\
STRUCT�:STEEL (C-51)
MASONRY (C-29)
S0 OA PP J
�1 �(�tof
; O ..3 3a
5h Q
PLUMBING (C-36),
LATH; PLASTER (C-35)
DRYWALL (C-9) . ,:,
�--
HVAC. (C -20Y
ELECTRICAL.(CAo)":..`
n-A
3
C
ROOFINGIC 39)::. ; <:`` `: ..
(A—
SHEET METAL (C-43)
q—
FLOORING (C=:15):.`-'.-...:-*..
AJ
GLAZING (C7.17)` ` ` ?>.:;:
/Vi
iNSULATION'(C-2):
14.
SEWAGE DISI: (6-42) . `
PAINTING (C=33)�
'�
)
n
1a�G
1 �
(�
/
I
CERAMIC TILE (C-54)
CABINETS IC -6)
FENCING (C-13)
LANDSCAPING (C=271 ":
POOL (C-53)