13-0657 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00000657
Property Address: 48745 FULL MOON WY
APN: 623-470-012- - -
Application description: REMODEL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 10000
Applicant: Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 License is in full force and effect.
License Class: B License No.: 884767
s
Date: �? Contractor: t Tr—
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).:
1 _ 1 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 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.).
(_ 1 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
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:
LQPERMIT
Owner:
RED TWELVE LLC
848 N. RAINBOW
LAS VEGAS, NV
LAS VEGAS, NV
BLVD #82
8910
Contractor:
ABARCA CONSTRUCTIO
79154 OLITE CT
BERMUDA DUNES, CA
(760)766-5088
Lic. No.: 884767
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/15/13
----------------------------------------7------
WORKER'S 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 issued. My workers' compensation
insurance carrier and policy number are:
Carrier EXEMPT Policy Number EXEMPT
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 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.
Date. -ell 7 — Applicant:
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.
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
ofthis county to enter upon the above-mentioned property
fs9 ii sspeection purposes. y�
Date. l Signature (Applicant or Agent):
Application Number . . . . . 13-00000657
Permit . . . REMODEL 2013
Additional desc .
Permit Fee
70.07
Plan Check
Fee
.00 __-
Issue Date . . . .
Valuation
0
Expiration Date
2/11/14
Qty Unit Charge
Per
Extension
1.00 48.6200
LS MISC
REMODEL, 1ST 100 SF
'48.62
1.00 21.4500
----------------------------------------------------------------------------
EA MISC
REMODEL, ADDL 500
SF
21.45
Permit . . .
PLUMBING 2013
Additional desc . .
Permit Fee . . . .
47.68.
Plan Check
Fee
.00
Issue_. Date
Valuation
0
Expiration Date
2/11/14
Qty Unit Charge
Per
Extension
3.00 11.9200
EA PLBG
FIXTURE/TRAP
35.76
1.00 11.9200
----------------------------------------------------------------------------
EA PLBG
WATER INST/ALT/REP
11.92
Permit . . . MECHANICAL
2013
Additional desc .
Permit Fee . . . .
23.84
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
2/11/14
Qty Unit Charge,
Per
Extension
1.00 11.9200
EA MECH
APPL REP/ALT
11.92
1.00 11.9200
----------- ----------------------------------------------------------------
EA MECH
VENT FAN
11.92
Permit . . .
ELECTRICAL
2013
Additional desc .
Permit Fee . . . .
23.83
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
2/11/14
Qty Unit Charge
Per
Extension
1.00 23.8300
LS ELEC
DEVICES, FIRST 20
23.83
-----------------------------------------'-----------------------------------
Special Notes and Comments
CONVERT 3 RD CAR GARAGE TO BATHROOM
128
SQ. FT. ADDITION. PER
2010 CALIF
BUILDING CODES.
August 1, 2013 1:24:51
PM jjohnson.
LQPERMIT
LQPERMIT
Application Number
.. . . . .
13-00000657
------------------------------------
Other Fees . .
. . . . . .
----------------------------------------
BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, REMODEL
150.15
STRONG MOTION (SMI) - RES
1.00
Fee summary
Charged
----------
Paid Credited
------------------------------
Due
-----------------
Permit Fee Total
165.42
.00 .00
165.42
Plan Check.Total
.00
..00 .00
.00
Other Fee Total
152.15
.00 .00
152.15
Grand Total
317.57
.00 .00
317.57.
Bra.
Cit}/ Of U. Quints
Banding 8L Safety Division
P.O. Box 1504,78-495 Carle Tampico
Ia.Qainta, CA 92253 -:(760) 777-7012
Building Penmit Application and Tracking Sheet
Permit#
Project Address: 7 J rt/LL/v o ^/ Wv
Owner's Name:. {Zt✓—D. `TW MWE Ll
A P. Number.
Address: S" N • PpygzW a"& * gZZ
Legal Description: L—O 1 3 4
contractorAgA492SA('
T126,r r 29 +,-2> L
city, sT, Zip. AN
Telephone:
Address: —7Q l
= . C --:T-
--:
Project Description:
City, ST, Zip:
bm VN OPC A ' 8,+rR)e00
Telephone• /�06�
State Lie. #:I
City Lic. #;
Arch., Engr., Designer A ,
Address: 4-1 O 3 2,N1> ST #
City., ST, Zip: ^j e W -
CA
Telephone: Z 3
State Lic. #:
Name of Contact Person: p
l� 1'Z
Construction Type:. Occupancy:
Project type (circle one): New d' Alter Repair Demo
Sq. FL: 7. ri # Stories:
# Unit,%
Telephone # of Contact Person:
Estimatcd Value of Project i
q Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS UNE
Reed TRAC ONG PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Strpcturai Calm
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
^
Plan Check Balance _
Tide 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted, .
Mecharilcal y -lift
Giad[ag plan
2'! Review, ready for correcti issue
Electrical
Subcontactor List
Called Contact Person
1
Plumbing
Grant Deed
Plans picked up
S NLl, !,
H.O.A. Approval
Plans resubmitted
Grading
IPI HOUSE:-
''' Review; ready for correetionslissae
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit
w`�p�+ w [ ss
� �.
>
. 1303.BARD
F
�J 1
MAY 2 4 2013
CITY CF I -A QQINTA
COMMUNITY DEVELOPMENT
rd
Date
8/12/13
No.
31771
Owner
Red Twelve LLC
Address
48-745 Full Moon Way
City
La Quinta Zip
Tract #
Type
Residential Addition
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515
Lot # No. Street
Unit 1 48745 Full Moon Way
Unit 2
Unit 3
Unit 4
Unit 5
APN #
Jurisdiction
Permit #
No. of Units
S.F. Lot # No.
128 Unit 6
Unit 7
Unit 8
Unit 9
Unit 10
Amv
Q BERMUDA DUNES
RANCHO MIRAGE
INDIAN WELLS
PALM DESERT y
LA QUINTA
'Q 0INO y�
O
623-470-012
La Quinta
1
Street S.F.
RECEIVED
AUG 112013
Comments Convert Garage to Bathroom CITY OF LA QUINTA
COMMUNITY DEVELOPMENT
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:
Residential Addition 500 Sq Feet or Less
EXEMPT
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $0.00 X 128 S.F. or $0.00 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy forthis square footage in this proposed project may now be issued.
Fees Paid By Exempt - Joe Landstrom Check No.
Bank Name/Recipient of Certificate Telephone
Funding Exempt
By Dr. Gary Rutherford
Superintendent
Fee collected /exem by h n Mc I rey Payment Recd
Zver/Udder
Signature
NOTICE: Pursuafit to Government Code Section 66020(d)(1), this Aill . rve 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 w Ich 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 without embossed seal
Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting
RECORDING REQUESTED BY:
AND WHEN RECORDED MAIL TO:
RED TWELVE LLC
848 N. Rainbow Blvd #822
Las Vegas, NV 89107
DOC # 2013-0185024
04/19/2013.10:01A Fee:18.00
Page 1 of 2
Recorded in Official Records
County of Riverside
Larry W. Ward
Assessor, County Clerk & Recorder
IIIII IIIIIII IN IIIIII IIIII III IIIIIII III IIIII illi IIII
S
R
I U
PAGE
SIZE
DA
MISC
LONG
RFD I COPY
M
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465
426
COR
NCOR
SMF
NCHG EXAM
_._ �0T:
UNI
CTY
GRANT DEED
THE UNDERSIGNED GRANTOR(S) DECLARE(S)
DOCUMENTARY TRANSFER TAX is $0.00
[X] computed on full value of property conveyed, or
[ ] computed on full value less value of liens or encumbrances remaining at time of sale.
[ ] Unincorporated area [X] City of La Quinta AND
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,` ,b/ERE/, 6
Joe Landstrom, a Married Man as His Sole and Separate Property ��
hereby GRANT(s) to:
RED TWELVE LLC
JUL 3 0 2013
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT
the real property in the City of La Quinta, County of Riverside, State of California, described as:
LEGAL DESCRIPTION ATTACHED HERETO AS EXHIBIT "A" AND MADE A PART HEREOF
Also Known as: 48745 Full Moon Way, La Quinta, CA 92253
APN#: 623-470-012
DATED
STATE OF CALIFORNIA
COUNTY OF p. ; �; a;f S),3 C
On Apr:�
before me, . a. V r� Z-iv e, Z
A Notary Public personally appeared
Tt,c_ L�noi��rorn -"
who proved to me on the basis of satisfactory evidence to be
the person(�)'whose names) is/are'subscribed to the within
instrument and acknowledged to me that he/she/they'
executed the same in his/her/their authorized capacity(ies),
and that by his/her/their signature(s)--on the instrument the
person); or the entity upon behalf of which the person(sy
acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State
of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
V40*7
Joe Landstrom
~ Commission # 1966763
z� = Notary Public - California z
Riverside County
Z
My Comm. Expires Jan 15, 2016
Signature /, (Seal)
MAIL TAX ..S - (A N,TS TO PARTY SHOWN BELOW; IF NO PARTY SHOWN, MAIL AS DIRECTED ABOVE:
EXHIBIT "A"
LOT 134 OF TRACT NO. 29436 IN THE CITY OF LA QUINTA, COUNTY OF RIVERSIDE, STATE OF
CALIFORNIA, AS SHOWN BY MAP ON FILE IN BOOK 342 PAGES 19 THROUGH 32 OF MAPS,
RECORDS OF RIVERSIDE COUNTY, CALIFORNIA;
EXCEPTING THEREFROM, ALL OIL, OIL RIGHTS, NATURAL GAS RIGHTS, MINERAL RIGHTS AND
OTHER HYDROCARBON SUBSTANCES BY WHATEVER NAME KNOWN, TOGETHER WITH
APPURTENANT RIGHTS THERETO, WITHOUT, HOWEVER, ANY RIGHT TO ENTER UPON THE
SURFACE OF SAID LAND NOR ANY PORTION OF THE SUBSURFACE LYING ABOVE A DEPTH OF 500
FEET, AS RESERVED BY A. RONALD BUTTON AND GLADYS BUTTON IN DEED RECORDED
DECEMBER 19, 1957 AS INSTRUMENT NO: 89870 OP -OFFICIAL RECORDS OF RIVERSIDE COUNTY,
CALIFORNIA.
***END OF LEGAL DESCRIPTION`
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04/11-4/2013 10:
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