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BRES2015-0391LICENSED 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 Professions Code, and my License is in full force and effect. License Class:,_ License No.: AEC252 Q� Date: cT'f 81 ontractor: OWNER -BUILDER DF9EARATION 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).: () 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.). (� 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 contractor(s) 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: (760)393-5286 " Llc. No.: AEC252 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 woork f_or�hich this permit is issued. Lr and will maintain workers' compensation insurance, as required by . SqRion 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: _ Policy Number: _ 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 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: Applicant: WARNING: FAILURE TO SECURE WORKERS' CONSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL 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 Building Official 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 of this city to enter upon the above-mentioned property for inspection purposes. Date: _nature (Applicant or Agent): C� 18 78-495 CALLE TAMPICO 0 U VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 FAX COMMUNITY DEVELOPMENT DEPARTMENT (760) 777-7153 BUILDING PERMIT ate,.3, 0/2016 Application Number: BRES2015-0391 Owner: Property Address: 81382 AMUNDSON AVE T STAR III LLC APN: 767690015 2030 E FLAMING TE 90 Application Description: T -STAR RESIDENCE / NEW SFD MADISON CLUB LAS VEGAS, NV 89 r Property Zoning:��1 Application Valuation: $694,822.70 � 1 Applicant: Contractor: �z DISCOVERY BUILDERS DISCOVERY BUILD 80955 AVENUE 52 80955 AVENUE 5� LA QUINTA, CA 92253 LA QUINTA, CA 9 3 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 Professions Code, and my License is in full force and effect. License Class:,_ License No.: AEC252 Q� Date: cT'f 81 ontractor: OWNER -BUILDER DF9EARATION 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).: () 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.). (� 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 contractor(s) 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: (760)393-5286 " Llc. No.: AEC252 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 woork f_or�hich this permit is issued. Lr and will maintain workers' compensation insurance, as required by . SqRion 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: _ Policy Number: _ 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 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: Applicant: WARNING: FAILURE TO SECURE WORKERS' CONSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL 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 Building Official 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 of this city to enter upon the above-mentioned property for inspection purposes. Date: _nature (Applicant or Agent): FINANCIAL •• • DESCRIPTION = ACCOUNT QTY AMOUNT PAID PAID DATE ART IN PUBLIC PLACES - RESIDENTIAL 270-0000-43201 0 $1,237.05 $1,237.05 3/30/16 PAID BY METHOD RECEIPT #. CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH Total Paid for ART IN PUBLIC.PLACES - Al PP: $1,237.05. $1,237.05 DESCRIPTION ACCOUNT QTY AMOUNT. PAID PAID.DATE BSAS 561473 FEE 101-0000-20306 0 $28.00 $28.00 3/30/16 PAID BY METHOD RECEIPT # CHECK #" CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $28.00 $28.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - CIVIC CENTER 252-0000-43200 0 • $942.00 $942.00 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 $129.00 3/30/16 PAID BY METHOD RECEIPT # : CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION = ACCOUNT QTY AMOUNT 'PAID PAID DATE DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 $433.00 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF -'LIBRARIES 253-0000-43200 0 $344.00 $344.00 3/30/16 PAID BY METHOD RECEIPT #. CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - PARK MAINTENANCE 256-0000-43200 0' $40.00 $40.00 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - PARKS/REC 251-0000-43200 0 $2,048.00 $2,048.00 3/30/16 PAID BY METHOD RECEIPT #. CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 $116.00 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY. . DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 $2,842.00 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 $6,894.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE TEMP POWER SERVICE 101-0000-42403 0 $24.17 $24.17 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE TEMP POWER SERVICE PC 101-0000-42600 0 $16.92 $16.92 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH Total Paid for ELECTRICAL: $41.09 $41.09 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL, EA ADDITION 1,OOOSF 101-0000-42403 0 $110.97 $110.97 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT. QTY AMOUNT PAID PAID DATE RESIDENTIAL, EA ADDITION 1,OOOSF, PC 101-0000-42600 0 $45.72 $45.72 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY11' AMOUNT PAID PAID DATE RESIDENTIAL, FIRST 1,000SF 101-0000-02403 0 $145.03 $145.03 3/30/16 PAID BY METHOD RECEIPT# CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 ' 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID GATE RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $47.86 $47.86 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH Total Paid for ELECTRICAL - NEW CONSTRUCTION: $349.58 $349.58 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT >71(SF 101-0000-42408 0 $36.26 $36.26 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD'BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT >7KSF PC 101-0000-42600 0 $181.29 $181.29 3/30/16 PAID BY METHOD RECEIPT # CHECK # . CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH Total Paid for GRADING: $217.55 $217.55 DESCRIPTION ACCOUNT - QTY AMOUNT PAID PAID DATE CONDENSER/COMPRESSOR 101-0000-42402 0 $217.56 $217.56 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R143S9 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE CONDENSER/COMPRESSOR PC 101-0000-42600 0 $145.02 $145.02 3/30/16 PAID BY METHOD RECEIPT # CHECK '# : CLTD BY .. DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE EXHAUST HOOD 101-0000-42402 0 $12.09 $12.09 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE EXHAUST HOOD PC 101-0000-42600 0 $4.83 $4.83 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT : QTY AMOUNT PAID PAID DATE FURNACE 101-0000-42402 0 $217.56 $217.56 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FURNACE PC 101-0000-42600 0 $145.02 $145.02 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLm BY DISCOVERY BUILDERS CHECK R143S9 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE VENT FAN 101-0000-42402 0 $169.26 $169.26 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE VENT FAN PC 101-0000-42600 0 $67.62 $67.62 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNTQTY AMOUNT PAID PAID DATE WALL HEATER 101-0000-42402 0 $74.13 $74.13 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY - AMOUNT PAID PAID DATE WALL HEATER PC 101-0000-42600 0 $36.27 $36.27 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH Total Paid for MECHANICAL: $1,089.36 $1,089.36 DESCRIPTION • ACCOUNT QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PERMIT 101-0000-42400 0 $858.77 $858.77 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH Total Paid for NEW CONSTRUCTION PERMIT: $858.77 $858.77 DESCRIPTION ACCOUNT • QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $1,200.00 $1,200.00 10/9/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS' CHECK ' R9908 2469 MFA DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $666.36 $666.36 3/30/16 PAID BY METHOD . RECEIPT #, CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,866.36 $1,866.36 DESCRIPTION ACCOUNT QTY. AMOUNT PAID PAID DATE BACKFLOW DEVICE 101-0000-42401 0 $12.09 $12.09 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT • QTY AMOUNT PAID PAID DATE BACKFLOW DEVICE PC 101-0000-42600 0 $4.83 $4.83 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BUILDING SEWER 101-0000-42401 0 $12.09 $12.09 3/30/16 PAID BY. METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BUILDING SEWER PC 101-0000-42600 0 $12.09 $12.09 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP 101-0000-42401 0 $459.42 $459.42 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP PC 101-0000-42600 0 $459.42 $459.42 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $36.26 $36.26 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 5+ OUTLETS PC 101-0000-42600 0 $24.17 $24.17 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE ROOF DRAIN 101-0000-42401 0 $132.99 $132.99 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 1686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE ROOF DRAIN PC 101-0000-42600 0 $132.99 $132.99 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER HEATER/VENT 101-0000-42401 0 $24.18 $24.18 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT. QTY AMOUNT PAID PAID DATE WATER HEATER/VENT PC 101-0000-42600 0 $14.50 $14.50 •3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09' $12.09 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R143S9 2686 SKH DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.09 $12.09 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH Total Paid for PLUMBING FEES: $1,349.21 $1,349.21 DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $90.33 $90.33 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH Total Paid for STRONG MOTION INSTRUMENTATION SMI: $90.33 $90.33 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 $1,837.44 3/30/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY DISCOVERY BUILDERS CHECK R14359 2686 SKH Total Paid for TUMF - RESIDENTIAL: $1,837.44 $1;837.44 Description: T -STAR RESIDENCE / NEW SFD MADISON CLUB Type: BUILDING, RESIDENTIAL Subtype: DWELLING -SINGLE Status: APPROVED Applied: 10/9/2015 MFA FAMILY DETACHED Approved: 3/30/2016 SKH Parcel No: 767690015 Site Address: 81382 AMUNDSON AVE LA QUINTA,CA 92253 Subdivision: TR 33076-2 Block: Lot: 23 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $694,822.70 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: NEW SFD @ 7797 SQ. FT. THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS, DRIVEWAY APPROACH, FIRE PITS, WATER FEATURE OR BBQ. THIS HOME IS FIRE SPRINKLED PER 2013 CRC CODES. ADDITIONAL SITES CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES NOTE JIM JOHNSON 2/16/2016 2/18/2016 PLAN CHECK COMMENTS FROM CONSULTANT JIM JOHNSON 2/17/2016 2/17/2016 RECEIVED PLAN CHECK PICKED UP STEPHANIE GUMPERT 10/27/2015 10/27/2015 PLANS PICKED UP BY DANIKA PLAN CHECK SENT TO KAY HENSEL 10/9/2015 10/9/2015 1ST STRUCTURAL P/C TO ESGIL - YOUNG DID THE CALCS. DUE OUTSIDE PC BACK 10/30/2015 PLAN CHECK SENT TO RAMSES SEVILLA 2/8/2016 2/8/2016 OUTSIDE PC PLAN CHECK SUBMITTAL KAY HENSEL 10/9/2015 10/9/2015 PLANS & DOCS SUBMITTED AT FRONT COUNTER. DEPOSIT RECEIVED INPUT BY MARY PLAN CHECK SUBMITTAL RAMSES SEVILLA 2/8/2016 2/8/2016 RECEIVED Printed: Wednesday, March 30, 2016 2:32:47, PM 1 of 6 CR ' SYSTfIvfS a u� OS �0 V � > OF'f�iF'��`' TELEPHONE CALL JIM JOHNSON 10/27/2015 10/27/2015 CALLED KRISTY TO INFORM HER THE PLANS ARE READ.Y.FOR CORRECTIONS TELEPHONE CALL JIM JOHNSON 2/18/2016 2/18/2016 CALLED DISCOVERY BUILDERS TO INFORM THEM THE PLANS ARE READY TO ISSUE. CONDITIONS CONDITION DATE DATE DATE TYPE CONTACT. ADDED REQUIRED SATISFIED STATUS REMARKS NOTES READY TO ISSUE JIM JOHNSON 2/18/2016 2/18/2016 3/30/2016 COMPLETE CHECKLIST CONTACTS NAMETYPE NAME ADDRESSI, CITY STATE 21P PHONE FAX EMAIL, APPLICANT DISCOVERY BUILDERS 80955 AVENUE 52 LA QUINTA CA 92253 zhanan@discoverybuil dersllc.com CONTRACTOR DISCOVERY BUILDERS 80955 AVENUE 52 LA QUINTA CA 92253 zhanan@discoverybuil dersllc.com . OWNER T STAR III LLC 2030 E FLAMINGO RD LAS VEGAS NV 89119 STE 290 FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT. PAID PAID DATE RECEIPT # CHECK # CLTD METHOD PAID BY BY. ART IN PUBLIC PLACES - 270-0000-43201 0. $1,237.05 $1,237.05 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH RESIDENTIAL Total Paid for ART IN PUBLIC PLACES - AIPP: $1,237.05 $1,237.05 BSAS SB1473 FEE 101-0000-20306 0 $28.00 $28.00 3/30/16 R14359 , . 2686 CHECK DISCOVERY BUILDERS SKH Total Paid for BUILDING STANDARDS ADMINISTRATION $28.00 $28.00 BSA: DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $942.00 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH DIF -.COMMUNITY 254-0000-43200 0 $129.00 $129.00 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH CENTERS Printed: Wednesday, March 30, 2016 2:32:47 PM 2 of 6 CJ sysrFMs DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 $433.00 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH DIF - LIBRARIES 253-0000-43200 0 $344.00 $344.00 3/30/16 R14359 .2686 CHECK DISCOVERY BUILDERS SKH DIF - PARK'. 256-0000-43200 0 $40.00 $40.00 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH MAINTENANCE DIF - PARKS/REC 251-0000-43200 0 $2,048.00 $2,048.00 3/30/16 R14359 . 2686 CHECK DISCOVERY BUILDERS SKH DIF - STREET 255-0000-43200 0 '$116.00 $116.00 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH MAINTENANCE DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 $2,842.00 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 $6,894.00 TEMP POWER SERVICE 101-0000-42403 0 $24.17 $24.17 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH TEMP POWER SERVICE 101-0000-42600 0 $16.92 $16.92 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH PC Total Paid for ELECTRICAL: $41.09 $41.09 RESIDENTIAL, EA 101-0000-42403 0 '$110.97 $110.97 3/30/16 'R14359 2686 CHECK DISCOVERY BUILDERS SKH ADDITION 1,000SF RESIDENTIAL, EA 101-0000-42600 0 $45.72 $45.72 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH ADDITION 1,000SF, PC RESIDENTIAL, FIRST 101-0000-42403 0 $145.03 $145.03 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH 1,00MF RESIDENTIAL, FIRST 101-0000-42600 0 $47.86 $47.863/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH 1,000SF, PC Total Paid for ELECTRICAL - NEW CONSTRUCTION: $349.58 $349.58 RESIDENTIAL PRECISE GRADING - CUSTOM 101-0000-42408 0 • $36.26 $36.26 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS 'SKH HOME LOT >7KSF RESIDENTIAL PRECISE GRADING - CUSTOM 101-0000-42600 0 $181.29 $181.29 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH HOME LOT >7KSF PC Total Paid for GRADING: $217.55 $217.55 Printed: Wednesday, March 30, 2016 2:32:47 PM 3 of 6 C SYS7EAAS DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # : METHOD` PAID BY - CLTD BY CONDENSER/COMPRES SOR 101-0000-42402 0 $217.56 $217.56 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH CONDENSER/COMPRES SOR PC 101-0000-42600 0 $145.02 $145.02 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH EXHAUST HOOD 101-0000-42402 .0 $12.09 $12.09 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH EXHAUST HOOD PC 101-0000-42600 0. $4.83 $4.83 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH FURNACE 101-0000-42402 0 $217.56 $217.56 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH FURNACE PC 101-0000-42600 0 $145.02 $145.02 3/30/16 R14359 2686 CHECK DISCOVER'i BUILDERS SKH VENT FAN 101-0000-42402 0 $169.26 $169.26 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH VENT FAN PC 101-0000-42600 0 $67.62 $67.62 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH WALL HEATER 101=0000-42402 0 $74.13 $74.13 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH WALL HEATER PC 101-0000-42600 0 $36.27 $36.27 3/30/16 R14359 • 2686 CHECK DISCOVERY BUILDERS SKH Total Paid for MECHANICAL: $1,089.36 $1,089.36 NEW CONSTRUCTION PERMIT 101-0000-424000 $858.77 $858.77 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH Total Paid for NEW CONSTRUCTION PERMIT: $858.77 $858.77 NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0. $1,200.00 $1,200.00 10/9/15 R9908 2469 CHECK DISCOVERY BUILDERS MFA, NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $666.36 $666.36 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,866.36 $1,866.36 BACKFLOW DEVICE 101-0000-42401 0 $12.09 $12.09 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS 'SKH BACKFLOW DEVICE PC 101-0000-42600 0 $4.83 $4.83 3/30/16 • R14359 2686 CHECK DISCOVERY BUILDERS SKH BUILDING SEWER 101-0000-42401 0 $12.09 $12.09 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH BUILDING SEWER PC 101-0000-42600 0 $12.09 $12.09 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH FIXTURE/TRAP 101-0000-42401 0 $459.42 $459.42 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH WW SYSTEMS DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT# CHECK# METHOD PAID BY CLTD BY FIXTURE/TRAP PC 101-0000-42600 0 $459.42 $459.42 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH GAS SYSTEM, 5+ 101-0000-42401 0 $36.26 $36.26 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS • SKH OUTLETS GAS SYSTEM, 5+ 101-0000-42600 0 $24.17 $24.17 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH OUTLETS PC ROOF DRAIN 101-0000-42401 0 $132.99 $132.99 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH ROOF DRAIN PC 101-0000-42600 0 $132.99 $132.99 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH WATER HEATER/VENT 101-0000-42401 0 $24.18 $24.18 3/30/16 R14350 2686 CHECK DISCOVERY BUILDERS SKH WATER HEATER/VENT 101-0000-42600 0 $14.50 $14.50 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH PC WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 $12.09 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0. $12.09 $12.09 3/30/16 R14359 2686 , CHECK DISCOVERY BUILDERS SKH Total Paid for PLUMBING FEES: $1,349.21 $1,349.21 SMI - RESIDENTIAL 1 101-0000-20308 0 $90.33 $90.33 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERS SKH Total Paid for STRONG MOTION INSTRUMENTATION SMI: $90.33 $90.33 SINGLE FAMILY 224-0000-20320 0 $1,837.44 $1,837.44 3/30/16 R14359 2686 CHECK DISCOVERY BUILDERSFSK DETACHED Total Paid for TUMF - RESIDENTIAL: $1,837.44 $1,837.44 TOTALS: $15,858.74 $15,8S8.74 PARENT PROJErTS Printed: Wednesday, March 30, 2016 2:32:47 PM 5 of 6. SYSTEMS IST BLDG NS (3 WK) JIM JOHNSON 10/9/2015 30/30/2035 10/27/2015 REVISIONS REQUIRED 1ST BLDG STR (3 WK) KURT CULVER 10/9/2015 10/30/2015 10/23/2015 REVISIONS REQUIRED SUBDIR ETRAKIT ENABLED IST PW GREEN AMY YU 11/25/2015 12/4/2015 11/25/2015 READY FOR APPROVAL DOC SHEET AJ ORTEGA STRUCTURAL FEE SHEET REVIEW STRUCTURAL 0 2ND BLDG NS (2 WK) JIM JOHNSON 2/8/2016 2/23/2016 2/16/2016 APPROVED 2ND BLDG STR (2 WK) KURT CULVER 2/8/2016 2/23/2016 2/12/2016 READY FOR APPROVALSEND AJ ORTEGA FOR STRUC DUE BACK 2/23/16 BOND INFORMATION ATTACHMENTS Attachment Type -CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED 1ST REVIEW BRES2015-0391- 1ST DOC 2/16/2016 AJ ORTEGA STRUCTURAL FEE SHEET REVIEW STRUCTURAL 0 (ESGIL) FEE SHEET (ESGIL).pdf 2ND REVIEW BRES2015-0391- 2ND DOC 2/16/2016. AJ ORTEGA STRUCTURAL REVIEW STRUCTURAL 0 - TRANSMITTAL TRANSMITTAL (APPROVED) (APPROVED).pdf 1ST REVIEW BRES2015-0391- 1ST DOC .2/16/2016 AJ ORTEGA STRUCTURAL REVIEW STRUCTURAL 0 CORRECTIONS (ESGIL) CORRECTIONS (ESGIL).pdf DOC 10/27/2015 JIM JOHNSON 81-382 AMUNDSON 81-382 AMUNDSON 0 AVE.docx AVE.docx DOC 2/18/2016 JIM JOHNSON SCHOOL FEES BRES2015- SCHOOL FEES BRES2015- 0 0391.pdf 0391.pdf DOC 12/1/2015 STEPHANIE KHATAMI PM10 APPROVAL 12-1- PM10 APPROVAL 12-1- 0 15.pdf 15.pdf Printed: Wednesday, March 30, 2016 2:32:47 PM 6 of 6 CJ SYSTEAAS -s TAT 4 a" 81-16?_ Ar^Vr4Soh Ave,P.O. BOX 1504 78-495 CALLE TAMPICO /1 ..:. -r r o 4 -7 -7 c 2 LA QUINTA, CALIFORNIA 92253 T- Mailing Address Dlscpve$vi lde Co,l��'orv��c. Address 90-955' Ave SZ City Zip Tel. L f VIII -0-22 S 3 7Go - 3q - S2 86 State Lic. City & Classif. Lic. # Arcn., tngr, Designer k"'5T, C4�:Tec-rS Address Tel. U187. PoJI.%Tges ?ATh#A 7Go-776-1q06$ City Zip State Po. Vet eer 9 22 6 o Lic. # G 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: Ankily 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 Contrac- s License Law, Chapter 9 (commencing with Section 7000) o1 Division 3 of the Business and fessions Code, or that he is exempt therefrom, and the basis for the alleged exemption. Any ot", ation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty o1 more than five hundred dollars ($500). ❑ 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 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 improvement 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 contractors) licensed pursuant to the Contractor's License Law) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date—Owner— WORKER'S ate Owner WORKER'S COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to sett -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 piratI n if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. gree to comply with all city and county ordinances and state laws relating to building onstruction, and hereby authorize representatives of this city to enter the above-mentioned property for inspection purposes. Signature of applicant Data Mailing Address City, State, Zip WHITE = BUILDING DEPARTMENT APPLICATION ONLY BUILDING: TYPE CONST. %1/ 15 OCC. GRP. keS-,aeviI I o. A.P. Number 116 7 6 Q 0o I S Legal Description Lot :23(6 T<-o.cT : 330 -7(o -2 - Project 3076-ZProject Description C u STow% Novae ZONE: BY: Minimum Setback Distances: SO' Front Setback from Center Line — Sq. Ft. No. Size 9 r2 Stories Z No. Dw. Units IJr► New'X Add ❑ Alter ❑ Repair ❑ Demolition ❑ 1Jr Floor Ma: % Lwrvw� 2y►d Floor Ma:v, L:nirw Si- I.S7o SF INSPECTOR 41veST t VJ*.%e L:1I.-, Icy 13 SF ToT �, 9� 7 yF olataaj ToCO.Se Aeck&_.,ac_I 1,14B gF 18, SF Tor -_1 Icy�l gF CwTpoocL;v i ' ovTboar U-ji n f,- Lt�2l� 779 yF 716 SF 9,z $�I Sr ToT.wl Lor A=tgo 31� 5'7 3 5: .91 A c.Cei t O Estimated aluation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL CONTACT INFORMATION NAME: PHONE: ZONE: BY: Minimum Setback Distances: SO' Front Setback from Center Line — 1 o t Rear Setback from Rear Prop. Line _ IJr► Side Street Setback from Center Line 1 G Side Setback from Property Line — FINAL DATE INSPECTOR Issued by: Validated by: Validation: YELLOW = APPLICANT Date Permit PINK = FINANCE Coache'tit 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 FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMMAND. AMOUNT: DATE: RECEIPT: CHECK #: INITIALS CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: IT-StarIII _ (Madison Club) Owner's Name: T -Star III Project Address: 81-382 Amundson Ave, La Quinta, CA 92253 Project Description: APN: 767-690-015 Type of Development: 1 Single Family Dwelling Unit Tract #: Residential IXX Date: March 30, 2016 Phone No. Lot #'s: 52&2 Commercial Industrial Total Square Feet of Building Area: 7,797 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. Dated: 3 — 3d -Z JL Signature: l 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 17620 Number of Sq.Ft. Amount per Sq.Ft. Amount Collected Gov. Code Project Agreement Existing Not Subject to Fee 65995 Approval Prior to 1/1/87 Requirement 7,797 $3.36 $26,197.92 Building Permit Application Completed: Yes/No By: Elsa F. Esqueda, Director of Facilities and Maintenance Certificate issued by: Leticia C. Torres, Facilities Analyst NOTICE OF 90 DAY PERIOD FOR PROTEST OF PEGS AND STATIEME'NT 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 requiremen i . i V,9,ra[nM 0 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in p ia Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Complianc s ate of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions mayle M V:c/Inydoes/dcvfec;'oci,t ic• tc if g%iance form updated 3-2007 CITY OF LA QUINTA COMMUNITY DEVELOPMENT 1 1/201 0 DOC # 2015-0070860 02/23/2015 03:37 PM Fees: $21.00 !f ` Page 1 of 3 Doc T Tax Paid Recorded in Official Records County of Riverside Peter Aldana RECORDING REQUESTED BY Assessor, County Clerk & Recorder First American Title Company AND WHEN RECORDED MAIL DOCUMENT TO: **This document was electronically submitted T -Star III, LLC to the County of Riverside for recording - 2030 East Flamingo, Suite 290 Receipted by: CTOLOSSA Las Vegas NV 89119 Space Above This Line for Recorder's Use Only A.P.N.: 767-690-015-1 GRANT DEED T.R.A. No.020-172 The Undersigned Grantor(s) Dedare(s): DOCUMENTARY TRANSFER TAX $1,100.00; CITY TRANSFER TAX $; X computed on the consideration or full value of property conveyed, OR computed on the consideration or full value less value of liens and/or encumbrances remaining at time of sale, unincorporated area; [ X ] City of La Quinti, and File No.: RIW-4816605 (SE) FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, David T. Delia Penta and Karen Della Penta, husband and wife as joint tenants hereby GRANTS to T -Star III, LLC, a Nevada limited liability company the following described property in the City of La Quinta, County of Riverside, State of California: PARCEL NO. 1: LOT 23 (THE "LOT") OF TRACT NO. 33076-2 AS SHOWN ON SUBDIVISION MAP (THE "MAP") RECORDED ON NOVEMBER 29, 2005, IN BOOK 393, PAGES 61 TO 80, INCLUSIVE, OF MAPS, IN THE OFFICE OF THE RIVERSIDE COUNTY RECORDER. PARCEL NO. 2: NONEXCLUSIVE EASEMENTS FOR ACCESS, INGRESS, EGRESS, DRAINAGE, MAINTENANCE, REPAIRS AND FOR OTHER PURPOSES, ALL AS DESCRIBED IN THE DECLARATION. FEB C 8 2016 CITY 0I -F LA QUAN TA COMMUNITY DEVEl-ORMIE:NT Mail Tax Statements To: SAME AS ABOVE Dated: January 28, 2015 I David T. Della Penta notary public or other officer completing this certificate verifies only he identity of the individual who signed ;the document to which this certificate is attached,,and not the truthfulness, ' accuracy, or validity of that document. DOC.#2015-0070860 Page 2 of 3.02/23/2015 03:37 PM ' t Grant Deed - continued Date: 01/28/2015 I Karen Dela Penta r STATE OF )SS r COUNTY OF ;�t�n ) On �) before Notary Public, personally ap eared who 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. 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. Signature This area for official notarial seal n NAY ado , pn Egkss Jan.15, ZQ19 Page 2 of 2 f DOC #2015-0070860 Page 3 of 3 02/23/2015 03:37 .PM Notary Seal Under the provisions -of Government Code 27361.7, I certify under the penalty of perjury that the Notary Seal on the document to which this statement is attached'reads as follows: Name of Notary: Commission # . Date Commission Expires: _ , Cn 10 � V I County where Bond is filed: Vendor : Place of Execution: San Bernardino Date:'=b214 .. _.- ... . Signature: &Salters October 12, 2015 T -Star III RECEIVED 2030 E. Flamingo, Suite 290 Las Vegas, NV 89119 FEB RE: Lot 23B at 81382 Amundson Avenue Preliminary Submittal #1/Construction Document Submittal #1Nariance Request Dear T -Star III: Ci y This correspondence shall serve as notification from The Madison Club Design Review Committee ("DRC") that your preliminary/final working drawing submittal was reviewed at the October 8, 2015 meeting. The project was approved as both a preliminary submittal and a construction document submittal subject to the following conditions which must be resolved prior to the start of framing. 1. A Variance Request was received for a ridge that peaks at 26'-5" at the Bath and 26'-9" above the Master Bedroom. The total roof area for the portion of the roof that extends above the allowable 26' is 144 square feet. The DRC is recommending approval of the request as submitted as there is no impact to the neighboring lots or the community. The request has been forwarded to the Board of Directors for final review and consideration. 2. All yard walls should have a terminus design and/or must incorporate an appropriate thickness at the wall ends. 3. Please provide a detail for the illuminated address numbers rather than a standard, illuminated address box. 4. The roof plan indicates metal on the pitched roof and the vent details and notes indicate the vents are to match a "slate/shake" roof. Please clarify and update the plans as necessary. As a reminder, field review of all color and material selections is also required during construction. 5. There are walls located in the front yard which extend to 6' high. These walls must be reduced to 5' which is approximately 10' high as viewed from the street. Please update the site, landscape and grading plans. 6. Please provide all details and material call -outs in reference to the site plan. 7. There was no light.fixture information provided; however, the fixture specifications and details are required for review of all lighting. 8. There are 22 uplights proposed which exceeds the guideline allowance; however, the DRC would be inclined to support approval of a Variance if submitted. 9. Sego palms are proposed in the rear yard view corridors which must be replaced with plant material that does not exceed 3' in height. With a neighbor's written approval plants over 3' high may be utilized in the view corridors; however, the committee recommends the Sego's be relocated given they will not do well in full sunlight. Additionally, the installation of plants that require shade cloths in the summer is discouraged in areas that are highly visible to the golf course or neighboring lots. Please contact Brook Marshall at 760-219-8057 or by email at DRCFacilitator@gmail.com with any questions or to schedule your Pre -Construction Meeting once a Building Permit has been obtained. Sincerely, MADISON CLUB DESIGN REVIEW COMMITTEE By: Title: cc: Kristi Hanson Dave McFarland Tammy Jenkins DRC File Date: Pursuant to Cal. Civil Code, any rejection by the DRC may be appealed to the Board of Directors for the Association. ff you wish to pursue an appeal, please contact the Association's property manager so that you maybe put on the next meeting axenda. Building Permit Number. Project Description: SFR Exempt: O (Materials may contain hazardous wastes and are not subject to recycling provisions) Construction Debris. Management Plan Pian Submittal Datel 9/2212015 Jab Site Addressl 81382 Aamundsen Owner's Name Number, Street, or PO Box City, State, Postal Code Owner's Phone Number Owners E -Mail Address Project Managers Name Project Managers Phone Number Project Managers E-mail Address Builder / Contr. .umber, Street or PO City, State, Postal C Waiters, William & Susan Tammy Jenkins 760-393-5286 tienkinsg)discover►buildersllc.com Discovery Builders California, Inc. 80955 Avenue 52 La Quinta, CA 92253 Project Square Footase 7,797 City Approval By Date of City Approval To Be Discarded: Product Trash Asphalt Brick/Block Cardboard Commingled Concrete Drywall Donated / Reuse 'Describe Items Tons 14.811 Not recyclable 0.00 Recyclable Recyclable Product Masonry (broken) Plaster Scrap Metal Tile (floor) Tile (roof) Wood Landscape Debris Tons 1.56 Recyclable 0.00 Recyclable 1.33 Recyclable 0.00 Recyclable Totals: Recycle Trash Projected Diversion: 26.011 14.8 1 1 F 63.7% 1 understand It Is the property owners responsibility to submit copies of weight tickets or receipts to the District Environmental Coordinator as these hauls occur. I hereby certify that completion, Implementation and adherence of the Debris Management Plan (DMP) for the above named project shall guarantee that at least 50% of the jobsite waste is diverted from landfilling. The remaining material will be recycled or reused. I will divert, for recycling or re -use, remaining materials generated from the first day of the project through the completion of the project in accordance with. this plan. This DMP is issued in the name of the property owner(s) and shall remain their property throughout the coand/or demolition project. A contractor serving as agent of the owner may obtain a DMP for the owner. Ho TARED issued in the name of the property owner(s) and the owner retains legal responsibility for ensuring th Giv DMP are adhered to. The roe owner(s) and general contractor shall be kept informed of the divers on pr ogressrough property rtY bi-monthly reports. If self -hauling, all refuse material from this project site must be taken to an appr ve recyr ��2016 Owner/ Developer/ Project Manager/ SuperintendentDat CITY OF LA QUINTA COMMUNITY DEVELOPMENT Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 Project Name: _ Owner's Name: Project Address: This Box For District Use Only DEVF.T.0PER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMM/IND. AMOUNT: DATE: - RECEIPT: CHECK #: INITIALS CERTIFICATE OF COMPLIANCE (California Education Code 17620) East of Madison . (Madison Club) Discovery Builders California, Inc. / T -Star 111 81-382 Amundson Way, La Quinta, CA 92253 Project Description: 1 Room Addition While Under Construction APN: 767-690-015 Tract #: Type of Development: Residential Commercial XX Total Square Feet of Building Area: 247 SQ. FT. Date: September 26, 2016 Phone No. Lot #'s: Industrial 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. Dated:r24V( Signature: * * * * * W.* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *Y* * * * * * * * * * * * * * *-41 * * * * 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 17620 Number of Sq.Ft. Amount per Sq.Ft. Amount Collected Gov. Code Project 65995 Approval. 247 $3.36 PRE -PAID Building Permit Application Completed: Yes/No By: Elsa F. Esqueda, Director of Facilities and Maintenance Agreement Existing Not Subject to Fee Prior to 1/1/87 . Requirement . Note: CERTIFICATE OF PREPAID SQUARE FOOTAGE Previous Sq.Ft. balance 3,863 Less Sq.Ft. this certificate '-247 New Sq.Ft. balance 3,616 Certificate issued by: Leticia Torres, Facilities Analyst Signature: 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 (gees"), 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 Goverpment 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. \1V:_h1tydocs/dccfee skc:r6 icar:^ ot'comp@.uLcc form npdarz;d 3-2007 11/2010 0 RE S 0 50I 1 R > EsGil Corporation In (Partnership with Government for Building Safety 'DATE: April 19, 2016 i JURISDICTION: La Quinta ` PLAWCHECK NO.: BRES2015-0391 Rev PROJECT ADDRESS: 81-382 Amundson Ave PROJECT NAME: SFR for T -Star III- Lot 23B SET: I ❑ APPLICANT L-JlJRIS. ❑ PLAN REVIEWER - ❑ FILE The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. ❑ The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by.building department staff. ❑ The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. ❑ The check list transmitted herewith is for your information. The plans are being held at EsGil q Corporation until corrected plans are submitted for recheck. ❑ The applicant's copy of the check list is enclosed,for the jurisdiction to forward to the applicant contact person.` ❑ The applicant's copy of the check list has been sent to: ® EsGil Corporation staff did not advise the applicant that the plan check has been completed. EsGil Corporation staff did advise the applicant that the plan check has been completed. Person contacted:,-- Telephone #: ' - ' v Date contacted: J (b ) Email: Mail Telephone Fax In Person ® REMARKS: Original approved plans were not received by EsGil.. By: Abe Doliente Enclosures: EsGil Corporation ❑ GA ❑ EJ ❑ MB ❑ PC 4/13/16 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 *'(858)560-1468 ♦ Fax(858)560-1576 H Bin # City of La Quinta Building a Safety Division Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #78-495 Project Address: LPG wl� Owner's Name: A. P. Number: Address: Legal Description: A Dut City, ST, Zip: Contractor: Telephone: Address: Project Description: ..,...,..•.. 4 1 f I/f City, ST, Zip: s �nrt� (GOl2. e: p. Telephone: Z U v N •6 r gra State Lic. # : City Lic. Arch., Engr., Designer: Address: City., ST, Zip: Telephone: Construction T Y P e• Occupancy: to Ste Lic. # ProJe Ater eP air Demo tYPa circle one): New A d'n R Name of Contact Person: Sq. Ft.:17 1 # Stories: #U -its: Telephone # of Contact Person: a 3 1 S 2 8 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance. Title 24 Calcs: Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"" Review, ready for correctionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3'� Review, ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. WV s. Appr Date of permit issue . School Fees, Total Permit Fees