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05-2152 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 .4 u�rtiGv BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: coo-=: 666_2f52 T_) Property Address: 56605 VILLAGE DR: APN: 764-050-015- - Application description: DWELLING,- SINGLE FAMILY DETACHED Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 244473 Applicant: Architect or Engineer' Lic. No.: OOR SQUARE FOOT Owner: BUTENSHON 682 34TH STREET ASTOSRIA, OR 97103 Contractor: 13OVENZI HOMES P.O. BOX 1714 TRUCKEE, CA 96160 (530)613-1173 Lic. No.: 710230 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/02/05 SEP 0 6 2005 - 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 of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Co , 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: 13 Licen a No.: 710230 - _ for by Section -3700 of the Labor Code, for the performance of the work for which this permit is issued. Date:f�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: hereby affirm under penalty of perjury that I am exempt from the Contractor's State Lipense Law for the _ Carrier EXEMPT Policy Number EXEMPT 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 became 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 s uld become subject to the w�ersceompensatnion provisions of'Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of theLaborIshallforthmplywrovisos. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by �- ----- _ o any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: -- --Date: Q -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 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 _ 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 application, (_) I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and -shall defend, indemnify and hold harmless the City 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. 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. certify that I have read this application and state that he above information is correct. I agree to comply with all city and county ordinances and state laws relating to b '(ding const , and her y authorize representatives of this county toenterupon the above-mentioned prop for ins ction rposeS. OM Date �I l•lJL Signature (Applicant -or Agent):' Application Number' 05-00002152 Permit BUILDING PERMIT Additional desc.. 0 ' Permit Fee . . . i147.00 Plan Check Fee-. 745.55 Issue Date -Valuation 244473 = Expiration Date 3/01/0.6 Qty Unit Charge Per Extension BASE FEE 639.50 145.00 3.5000 THOU -BLDG 100,001=.500,000 � 507.50 Permit ELEC-NEW: RESIDENTIAL Additional desc . Permit. Fee . . . . 111.79 Plan Check Fee 27.95 Issue Date Valuation �.. .0 Expiration Date 3/01/06" Qty Unit Charge Per Extension BASE FEE 15.00 2737.00 0300 ELEC NEW RES - MULTI FAMILY 82.11• 734.00 .0200 --------------------------------------------------- ELEC'GARAGE OR NON-RESIDENTIAL 14.68 Permit . . . GRADING PERMIT Additional desc . Permit Fee . . . 15.00 Plan Check Fee .00 Issue Date . . . Valuation . . 0 Expiration Date 3/01/06 Qty. Unit Charge Per Extension BASE FEE 15.00 Permit. . . . MECHANICAL Additional desc . Permit Fee 96.50 Plan Check Fee 24.13 Issue Date . . Valuation 0' - Expiration Date 3/01/06 Qty. Unit Charge Per - "Extension BASE FEE 15.00, 2..00. 9.0000 EA MECH FURNACE <=100K 18.00 .2.00 9.0000 EA MECH B/C <=3HP/100K BTU._ 18:00 _ - - - 6.00 6.5000 EA MECH VENT FAN 39.00.' 1.00 6.5000 -------------------------------- EA MECH EXHAUST HOOD 6.50. Permit . . . . . PLUMBING. LQPERMIT Application Number . . . 05-00002152 Permit PLUMBING. Additional desc . Permit -Fee .. 154.50 Plan Check Fee 38.63 Issue Date Valuation '0 Expiration Date.. 3/01/06 Qty Unit Charge Per Extension BASE FEE .15.00.: 14.00 6.0000 EA PLB FIXTURE 84.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 .EA PLB WATER HEATER/VENT 7.50 . 1.00 3.00.00 EA PLB WATER INST/ALT/REP 3.00 1.00.. 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 8:00 .7500 EA PLB GAS PIPE.> -5 6.00 1.00 15.0000 EA PLB.GAS METER 15.00 Special Notes and Comments 2737 SF SFD. This permit• does not include pool & spa,.block walls. or driveway approach. -----------------------".----------------- Other Fees . . . . .. . • ART IN PUBLIC PLACES -RES. 111.18 DIF COMMUNITY CENTERS -RES. 97.00 DIF CIVIC CENTER'- RES 366..00` ENERGY REVIEW FEE 74:56 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 24'.44 DIF STREET MAINT FAC -RES 15'.00 DIF TRANSPORTATION .- RES 1098.00 Fee summary Charged Paid Credited Due Permit Fee Total 1524..79 .00 .00 1524.79 Plan Check Total 836.26 500.00 ..00 336.26 • Other Fee Total 2615.18 .00 .00 2615.18 . Grand Total 4976.23 500.00 .00 4476:23 _ s LQPERMIT. _ _ - ,�, • �5 ? P.O. BOX 1504 APPLICATION ONLY ildingS� _�� 1 18-495 CALLE TAMPICO Address U, LLA D/L, LA QUINTA, CALIFORNIA 92253 Owner (� YL: I T/4 &wt:V)te.— l7 400, 14A) BUILDING: TYPE CONST. 1,0004 OCC. GRP. Mailing Address (�gZ 3 ST A.P. Number 70q-050 �/SZ City Zip Tel.Legal Description 'TRAM a g 98� 4s4vM, i' A oaEGa) 7 / ' S - 338 -9S / Contractor Project Description S,"L6j11i �f 12Cs' DL�✓L� S o✓e n12'► Al c e, - M A&k l3oV& p Address s-& 7 p Lw1 S 0/t City Zip 922- S Tel. I-A 64A JA+ e A . c Sao) X013 -1) 7 State Lic. d a City Sq. Ft. D No. No. Dw. & Classif. -71 Lic. # g Size vd� Stories Units Arch., Engr., New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Designer r. 14AM,�S � Address Tel. Cyd /j . Pa lt., c4A), City Zip State A- 1 Lic.# it 99/ LICENSED CONTR 'S DECLARATION I hereby affirm that I am licensed n pro 'ions of Chapter 9 (commencing with Section 7000) of Division 3 of Busin P essions Code, and my license is in full farce and effect. „ SIGNATURE DATE OVKER.RamLDER DECLARATION Estimated Valuation 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 PERMIT AMOUNT 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 Plan Chk. Dep. L/v 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). Plan Chk, Bal, ❑ 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- Const. 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 Mech. 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 o/ Electrical proving that he did not build or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct Plumbing the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does S. M. 1. 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.) Grading 0 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date owner Infrastructure 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 TOTAL WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation REMARKS C;ITYOF 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' Compensa:ion Provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. ZONE: BY: Minimum Setback Distances: CONSTRUCTION LENDING AGENCY Front Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the work Rear Setback from Rear Prop. Line for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Side Street Setback from Center Line Lender's Address Side Setback from Property Line 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. FINAL DATE INSPECTOR 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. Issued by: Date Permit Signature of applicant Date Mailing Address Validated by: City, State, Zip Validation: WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE Coachella Valley Unified School District This 'Box yFor District Use Only - '83-733 Avenue 55 Thermal, CA 92274 DEVELOPER FEES PAID (760) 398-5909 — Fax (760) 398-1224 - - AREA. - AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT:• COMMAND. AMOUNT: DATF. RF.CF.IPT- CFrFCK 8& INITIAI.O _ " CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: $esldence is atThe Pal%ns Date: September 2, 2005 Owner's Name: Butenshon Phone No. - t Project Address: 56-605 Village Drive La Quinta, CA Project Description: 1 SFD APN: 764-050-015-02 Tract #: Lot #'s: Type of Development: Residential XX -X Commercial Industrial Total Square Feet of Building Area: 2,806 sq. ft. " Certification of Applicant/Owners: -The person signing ce •fies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is autho ' ed to sign %alf the owner/developer. Dated: Spetember 2, 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 Agreement Existing Not Subject to Fee 17620 65995 Approval Prior to 1/1/87 Requirement Note: Number of Sq.Ft. 2,806 Amount per Sq.Ft. $ 2.88 Amount Collected " $ 8,081.28 Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst.Supt., Business Services 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 latteri 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. 1�':c:'In de cs .ievtcesrcertiiieatc offcompliance i*,rm U-Lbles O Uslii.doc ' 1/16/03 T ORANGE COAST TITLE CO. 1 RECORDING REQUESTED BY ®®C Is 2003-597952 08/06/2003 08;00A Fee:10.00 r AND W'ifEN RECORDED MAIL TO: Page 1 of 2 Doc T Tax Paid ' Recorded in Official Records Keith D. Butenshon County of Riverside Genevieve A. -Butenshon Gary L. Orso Assessor, 682 - 34th St. County Clerk 8 Recorder Astoria, OR 97103IIIlillllllllllllilllllillllllllllll IIIIIi 111111 111111 A.P.N.: 764-050-015-2 ,TRA #: 020-147 Order No.: R. GRANT'. M $ U PAGE SIZE DA PCOR NOCOR SMF MISC. n A R L COPY LONG REFUND NCHG I EXAM THE UNDERSIGNED GRANTOR(s) DECLARE(s) THAT DOCUMENTARY TRANSFER TAX IS: COUNTY $225.50 [ 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 Ouinta , and 11 FOR A VALUABLE CONSIDERATION, Receipt of which is hereby acknowledged, �G Mark A. Niemela and Cynder Niemela, Husband and Wife. cJ hereby GRANT(S) to F Keith D. Butenshon and Genevieve A. Butenshon, husband and wife, as joint tenants the following described property in the City of La Quinia, County of Riverside State of California; Lot 56 of Tract 28983, in the City of La'Quinta, County of Riverside, as per map recorded in Book 285, Page(s). 76 - 82, of Maps, in the Office -,of the County Recorder of said County. M k A. Nie la Cyd r Niemela Document Date: July 19, 2003 STATE OF CALIF qIA )SS COUNTYOF�d�6id� ) � �!��;UTf1i�1 �- �'/oUl�C1a , ,�0� •. On jjtLf ao`j, 02 3 , f before me,-' "7 personally appeared #44 Al 4 NICifQ�i /106 eVAMal N/c/m" A 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 a fficial seal. Signature. }' This area for official notarial seal. CYNTHIA L. NIOZtNGO J !i Coto...#1312866 M Notary Public_Cal�ifornia 0 W , RIVERSIDE C0*J.NTY -' ' Idly comm. Exp. July 14, 2005 Mail Tax Statements to: SAME AS ABOVE or Address Noted Below f j � G.kR L. ORtiO Recurdcr COUNTY- OF RIVERSIDE. Rncrs,ce CA. 92502-0751 R ASSESSOR -COUNTY CLERK. RECO-)DER r900,11,�6-7000 NOTARY CLARITY Under the provisions of Government Code 27361.7; 1 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: C Y" �; 0\ L 1 t0 Commission Place f �2�51(��2 ' . e o Execution ^ . �, � Date Commission Expires- _ t+-0 S. Date: Signature: l-obert Tho1>>pson 7=ori range Coast Title Company ACR 186?- S4RE0 (Est. 05/2003) i I VIII IIII VIII IIIIII III VIII IIII IIII 0 8/0 c'CA 03 C8L00R IIIIIIIIIIIIIIIIIIof ;4