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05-1531 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT ` BUILDING PERMIT. Application Number: 05.:-0-0-0.0-1-53 1-----'-^'� Property Address: Q'tYEf06'VIA DONA APN: 772-410-999-7. -.298944- Application description: DWELLING.:- SINGLE FAMILY DETACHED Property Zoning: LOW DENSITY RESIDENTIAL Application valuation:, 550275 Applicant: Architect or Engineer: Lic. No.: OOR.SQUARE FOOT Owner: Zig. /APC OX 3420 DESERT, CA 92261 SFP 31005 n' F Lq ��i9A1W, . QilafA P ERCE CORPORATION, ANDREW P.O. BOX 3420 PALM DESERT, CA 92261 (760)346-3228. Lic. No.: 6712.03 VOICE (760) 7717-7012 FAX (760) 7717-7011 INSPECTIONS (760) 777-7153 Date: 9/09/05 - - 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 I hereby affirm under penalty ofperjury -one of the following declarations: Section 7000) of Division 3 of the Business and Professional. 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 provide License lass: B cense No.: 671203 . for by Section 3700 of the Labor Code, for the performance of the work for which this permit is �--^ issued. fflate:_ fil,Cod mra_ctor. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labo Code, for the performance of the work for which this permit is issued. My workers' compensatii 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 STATE FUND Policy Number 0014314-2005 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to_ I certify that, in the performance of the work for 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 become 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 I should become subject to #he workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code) or 3700 of the Labo Code, I hal` forth" th co ply with those provisions. ' 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).: Date.. : Applicant: (_ I 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 WARNING: FAILURE TO SECURE 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 EMPLOYER TO 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). IN 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 sale.). APPLICANT ACKNOWLEDGEMENT (_ 1 I, 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 at whose request 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 applicatic (_ 1 I.am exempt under Sec. , BAP.C. for this reason 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 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 _ 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 186 days from date of issuance of such permit, or cessation of work for 180 days will subjr permit to cancellation. I certify that 1 have read, this application and state that the above information is correct. I agree to comply with city and county ordinances and state laws relating to building construction, and herebykuthorize representatives cor -of this county to enter above-mentioned prckerty for inspe(3ion purpOes. , ' S_Signature-(Applicant or-Agent):knw% 4 ; 4V Application Number 05-00001531-, Permit- BUILDING PERMIT Additional desc Permit Fee 219.2.50 Plan Check Fee 1425.13 Issue Date Valuation 550275 Expiration Date .: 3/08/06 Qty Unit Charge Per Extension BASE FEE 2039.50 51.00 3.00.00:THOU BLDG 500,001-1;000,000. -153.00 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee 275.40 Plan Check Fee 68.85 - Issue Date Valuation 0 Expiration Date.. 3/08/06 Qty Unit Charge Per Extension BASE FEE 15.00 6424.00 .0350 ELEC NEW RES -'1 OR.2 FAMILY 224.84 1028.00 .0200 ELEC GARAGE -OR NON-RESIDENTIAL 20.56 . - 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 Permit GRADING PERMIT .. Additional desc Permit Fee 15.00 Plan Check Fee .00 -Issue Date, Valuation 0 Expiration Date ., 3/08/06 Qty Unit" Charge Per. i Extension BASE FEE 15.00 Permit MECHANICAL Additional desc - Permit Fee 194.50 Plan" Check Fee 48.63 Issue Date . . . . Valuation_ 0 Expiration Date 3/08/06 Qty Unit Charge Per Extension BASE FEE 15.00 6.00 9.0000 EA MECH FURNACE <=100K 54.00 6.00 9.0000 EA MECH B/C <=3HP/100K BTU .54.00 10.00 6.5000 EA MECH VENT FAN 65.00 1.006.5000 -- -------------- - EA ' MECH --------- EXHAUST HOOD ----------------- ---------------- 6.50 - LQPERMIT Application Number . . . . 05-00001531 Permit PLUMBING Additional desc . Permit Fee 261.75, Plan Check Fee 65.44" Issue Date . . Valuation. .. 0 Expiration Date 3/08/06 Qty Unit Charge Per' Extension -BASE FEE 15.00 - 28.00 6'.0000 EA PLB FIXTURE 168.00 1.0.0. 15.0000 -.EA PLB BUILDING SEWER 15.00 3.00 7.5000 EA PLB..WATER HEATER/VENT 1 '22.50: - 1.00 3.0000 EA PLB'WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN.SPRINKLER SYSTEM 9.00 . 19.00 ,.7500 EA PLB GAS PIPE.>=5 14.25 .1.00 15.0000 EA PLB.GAS METER - 15.00 ------------------------------------------- special Notes'--- p and` Comments . .. ----------- 6424 sq„ ft. sfd. THIS PERMIT DOES..NOT, INCLUDE POOL & SPA BLOCK WALLS OR DRIVEWAY APPROACH.July.13, 2005 8:49:54 AM JJohnson ---------------------------------------- Other Fees . . .. ART IN"PUBLIC PLACES -RES 875:-68 DIF•.COMMUNITY CENTERS -RES:." 97.00." D,IF-CIVIC CENTER.-- RES ._ 366.00 - ENERGY -REVIEW FEE 142.51 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 55.02 DIF STREET MAINT FAC -RES . 15.00 DIF TRANSPORTATION. - RES 10.98.00 . Fee summary Charged.. Paid Credited Due Permit -Fee Total --- - --- ----- --------- 2939.15 - .00 .00 - ---- 29.39.15 Plan Check Total 1.608.05 1000.00 .00 .608.05 Other Fee Total 3478.21 0 .00 3478.21 Grand Total 8025.41 1000.00 .00' '7025.41 • LQPERMIT - .. .... - Building 54-00b q1Ab #2v1 / Xre- i TUT 014 a" P.O. BOX 1504 78-495 CALLE TAMPICO doIJA LA QUINTA, CALIFORNIA 92253 Address t?0. Ifox ;+Z0 Cit F" tit-J'ipJ1tZ61 J'§*10_5Jr4_421_& Address t?0. oc% 3�Zo City 'AW Vf54V - JZip 92�) .Tel. State Lic. Cl y & Classif. 90 4�tLf Lic. # 00 Ott Arch., Engr., Designer 01A AwAffG+'S Address Tel. %0311 W -41 0f *ilk., Q1A4 Vol -1 if - X34- 2506 �AiJkA �a k14A)6J �r911o� ��: # oa 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 penally 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). O 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.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKER'S COMPENSATION 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 any 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 JS -f-3 APPLICATION ONLY BUILDING: TYPE CONST V-4 P. OCC. GRu' A.P. Number 11%-410 —Qqq' Legal Description Lo, * 14 firuk -4 Project Description amµ Ofd TOTAL REMARKS 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: YELLOW = APPLICANT Date Permit PINK = FINANCE Sq. Ft. . Size No. No. Dw. Stories 1✓ Units New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation ` PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS 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: YELLOW = APPLICANT Date Permit PINK = FINANCE r A . Coachella Valley Unified School District 83-733 Avenue 55, 'Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 This Box For District Use Only DEVELOPER FFFS PATI) AREA: AMOUNT LEVEL ONE AMOUNT: _ LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMMAND. AMOUNT: DATE, RFr.F.IPT- CHECK B- INITIAIS- ' CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: TheResdenceis at the'H�deaway - Date: September 13, 2005 Owner's Name: Rich/APC Phone No. 346-3228 Project Address: 52-806 Via Dona La Quinta, CA Project Description: 1 SFD APN: 772-410-999-7 Type of Development: Tract #: Residential XX Lot #'s: IF y Commercial Industrial Total Square Feet of Building Area: 6,424 sq. ft. 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 owner/developer. n Dated: September 13, 2005 Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code Project 17620 65995 Approval Note: Number of Sq.Ft. 6,424 Amount per Sq.Ft. $ 2.88 Amount Collected $ 18,501.12 Building Permit Application'Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Business Services Agreement Existing Prior to 1/1/87 Not Subject to Fee Requirement Certificate issued by: Elvira Mattson, Office Technician 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 this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -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 payment 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 not 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. iF1':c;rtydoc idevlccs e rtiiicate u.f compli;tnce term ublesTO US' -d' oo 1/16/03 T t •t5 F aii lITY 'NA7'I01�'AY,.1.11 LE" ®14�tt'AI°t d , SUBDIVISION DEPARTMENT. ENT. MHEN RECORDED MAIL TO: Itr. and Mrs Jolla Rich 20 outrider :-Road` Rolling Hills CA 90274 MAIL TAX STATEMENT TO: SAME AS ABOVE 'bib, e RE 4?9 W S :. U,.:- . -PAGE._,,, SIZE ., DA .POOR NOGOR , . SMF MISG. L'1 A I copy LONG I REFUND NGHG. EXAM DOCUMENT TRANSFER TAX $ 544.50 -- XX Computed on the consideration or value of property conveyed; OR Computed on the consideration or value less liens or encumbrances remaining at the time of sale. re'A, Ego 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"), hereby GRANT(S) to Jobn::Ri.ch and Joann Rich, Husband and Wife as Joint Tenants ("Grantee"), the real property 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 agreements- described in.Exhibit "A" attached hereto. Dated: 0 " ND LA QUINTA PARTNERS, LLC, a Delaware limited liability company By: Nationwide Realty Investors, Ltd. an Ohio limited liability company its managing member By: e L. Arenson Authorized Representative STATE'OF 'California: } COUNTY' OF Riverside On. March 29-2004 before. me, K Larby. Notary Public' (Nane,'Title of Officer) personally appeared Joseph L. Arenson personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) 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(s),. or the entity upon behalf of -which the "person(s) acted, executed the instrument. WITNESS my hand,and official seal. crdo.caes OFFICIAL SEAL (Signatur of No r Publ c) Q �• K.;tARBr COMM 01268797 Notwy Public . California ' 0 RIVERSIDE COUNTY My Commission-ERpi- 1UNE 24,-2004.-... (This area for notarial seal) Parcel No. 1: Lot T(the "Lot") of Tract No: 29894-4, in the City of La Quints, as showi by map on file in Book 351, Pages 49 to 57, inclusive, of Maps, in the Office of the County Recorder of Riverside County; California. EXCEPTING AND RESERVING THEREFROM TO GRANTOR, and its successors, assigns, invitees, icensees and employees, together with the rightto 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 Lot, reserved to Grantor in the' following instruments: 1. The Amended and Restated Declaration of Covenants, Conditions and. Restrictions and Reservation of Easements for The. Hideaway Owners Association '(as amended or supplemented, the '.'Declaration")) recorded on December 13, "Offi Instrument No. 2002- 745938,6f Official Records of Riverside County, California (the "Official Records"); 2. The Supplementary Declaration of Annexation of Property, recorded on March 4, 2004, as Instrument No. 2004-0151981, of Official Records of Riverside Country, California. , FURTHER RESERVING THEREFROM, the right to enter the Lot for a term of twelve (12) months following the recordation of this Grant Deed, to complete and repair any improvements 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 right of entry is not 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' feesand court costs. This reservation of right of entry shall automatically expire twelve (12) months from the recordation of this Grant; Deed. Parcel No. 2: Nonexclusive easements for access, ingress, egress, drainage, maintenance, repairs and for other purposes, all as described in the Declaration. SUBJECT TO: 1. Non delinquent general, special and supplemental real property taxes and assessments. Lk - ... w, .,. .`" .;- J tifi..+r t •S rF e,'` k-�.C.�M Yr)t•+� 1f ,a le �i 4.='�Y.. 'I i 2 All .other covenants, conditions, restriction's, reservations, easements, rights*, and o e - w ' nglits=of way of record includ><ng; without imitati`on;.the. Declaration and the;Map,:for Tract No: 29894-4. 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'suchgowers and.rights as areaet forih inane Declaration, and (c) accepts,, . �. r 4 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 13:15 establishing theprocedure for resolving disputes with Grantor, and the notice, which provisions and requirements are acknowledged to be reasonable and incorporated herein•.b y this reference thereto: This grant is conditioned upon the performance of such provisions and requirements 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 Grant Deed is specifically and expressly made subject. GRANTEE HEREBY ACCEPTS AND APPROVES THE FOREGOING, granting unto Grantor and The Hideaway Owners Association such powers and rights which are set forth in the .. Declaration defined above, on 2004. Y t . Jo ch - Jo Rich STATE OF+ - s ) ss. COUNTY OFj.��.P�-.mac ) On g. 2004, before me, the undersigned, a notary public in and for said State, personally appeared John Rich and Joann Rich personally known. to me (or p •roved 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 same in their authorized capacities, and that by their signature on the instrunient the persons, or the entity upon behalf of which the persons acted, executed -the instrument. = '` WITNESS MY HAND AND OFFICIAL SEAL. R [SEAL] ignature My commission expires: , CONNIE CONCETfO V3 COMM. #1417229 b U NOTARY PUBLIC CALIFORNIA y RNERSIDE COUNTY My, Commission Expires May 11, 2007 { 0