BRES2015-040578-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
HUGO CERVANTES
51825 AVENIDA VELASCO
LA QUINTA, CA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BRES2015-0405
53389 ROSS
767680008
ASHER / MADISON CLUB/ 11,081 SINGLE FAMILY
$963,250.30
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
Date: �' % ' Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
3 of the Business and Professions Code) or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(_J I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that
he or she did not build or improve for the purpose of sale.).
(� 1, 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
Lender's
66
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:. 2/4/2016
Owner:
WINDSOR SPORT
9460 WILSHIRE BLV STE 600
BEVERLY HILLS, CA 0
Contractor:
DISCOVERYI —
80955 AVEN
LA QUINTA, 9 253`H 04 2010
(760)393-52 6 CRICIFLAQUINTA
LIc. No.: AEC 6QMMUNITYDEVELOPMENTOER
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 foe by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by .
Section 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and -policy number are:
Carrier: _ Polity 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. ,1
Date: �' / Applicant:IV
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the 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:Z�yl� Signature (Applicant or Agent)•
i/ e
i
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PAID
mi, "PAID�DATE,
ART IN PUBLIC PLACES - RESIDENTIAL 270-0000-43201y
.'s`E'd'`f"a'SK,�:
-0 $1,908.12 $1,908.12 2/4/16
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DISCOVERY. BUILDERS CHECK
R12598 1010 RSE
Total'Paid for ART -IN PUBLIC PLACES'- AIPP: $1,908.12: ` $1,908.12
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2/4/16
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Total.Paid for BUILDING STANDARDS ADMINISTRATION BSA: $39.00 $39:00
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$129.00
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2/4/16
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257-0000-43200
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2/4/16"
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253-0000-43200
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$344.00.
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2/4/16
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DIF - PARK MAINTENANCE
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$40A0
2/4/16
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251-0000-432000
$2,048.00
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2/4/16
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$116.00
$116.00
2/4/16 "
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250.0000-43200.
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$2,842:00 ' .
.$2,842.00
2/4/16
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1112598
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Total Paid fot-DIF -.SINGLE FAMILY DWELLING: $6,894.00, - $6,894.00
*,rr ., -y Y j e:>�-k t`Pi KY'?ism_'. ,y✓a, {fCit,�nt+%"i.Y E$
DESCRIPTION' $t
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rdxo:i
TEMP POWER SERVICE
-10170000-42403
0
_$24.17
$24.17•
2/4/16
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PAID`DATE•E
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TEMP POWER SERVICE PC
101-0000-42600
0 ,
` : $16.92
$16.92.
2/4/16
"K',�p r>,3 -:
' PAID BYE''` d€ F
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DISCOVERY BUILDERS
CHECK
R12598
1010
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Total Paid for ELECTRICAL:• $41.09 '$41:09! "
d '. x R : :--.i..�ifr?.,S,q '. > XY?• 'i e?ffi -' 9'i'C'
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RESIDENTIAL, EA ADDITION 1,000SF
'.101-000042403
;0:
$147.96
-$147.96
2/4/16
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1112598:
•:3030
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RESIDENTIAL, EA ADDITION.1,000SF, PC
101=0000-42600.
0
$60.96
$60.96
:2/4/16
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•1112598
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RESIDENTIAL, FIRST.11000SF
'301-0000-42403'
$145:03
$145:03 `
2/4/16,
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RESIDENTIAL, -FIRST 1,000SF, PC;
101-0000-42600
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"$47.86 !
'
2/4/16
. ! 'X .Y'. 2U - P ^Y : 4 £rX>P i` Yy 42 4 is;F .yt',$,jr
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-
,101-0000-42408
0 "
$36.26*,, -
2/4/16
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101-0000 42600
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$181.29
$181.'29-'2/4/16
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-$290:08-
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2/4/16
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$193.36
2/4/16 "
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$12:09 _
$12.09
2/4/16 °.
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$4.831
$4.83
2/4/16
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$290.08
$290.08
2/4/ifi
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101-0000-42600, j
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1014000-42402
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$205:53 '
$205.53
'2/4/16
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R12598,.
1010
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R12598
1010
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Total Paid for MECHANICAL`: $1,271.44' $1;271:44
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101=0000=42400 ,..
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$1,009:41.
$1,009.41
.2/4/16
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1112598
1010
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Total Paid for NEW"CONSTRUCTION`PERMIV
J
- : • $1,009.41, $1,009.41°
'
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101-0000-42600
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- $1,200:00
$1,200.00
10/19/15.'
= �[ i r # ✓' - rr �" . ..F�'i, v: ms''''s.-- ``?,
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R101162486
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'iZ ..b„.„,'..»?`” ••v'ryFe„)'>M ... `�..:(v.$=-.<6..Y,.:bn,Fai�'. ,r.s. •. '�'E.,
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= 101-0000-42600
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$1,008.12
$1,008:12
2/4/16
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'Rl2598,,,,
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Total Paid for NEW CONSTRUCTION PLAN CHECK: $2,208.12. $2,204.12
NO 011
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101-0000-42401
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$1L09
$12;"09
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$4.83
.$4.83
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$12.09�
2 4/16
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$12.09
:'$12.09,
2/4/16
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$423.15
-2/4/16
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1010
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:�•$413'.15_'_
$423.15
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A01-0000-'42401.
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$36.26'
$16.26,
2/4/16
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R12598'
1010
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301-0000-42600
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$24'17
$214.17
,2/4/16,.
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R125-98.
1010,
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101-0000,42401
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$126' 3,,
$326.43
2/4/16
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$�26.43
$326.43
-2/4/16
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1010
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DATE..
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101-0000-42401.
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$12.09
$12.09
2/4/16
j ,.� 4.i .
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mRECEIPT#,
=
�Y,.e�
"AAS
42€n - i
CHECK=#�CLTU
BYy
t„I
yMETHOD�
P�xR ... ,,✓, ._..i <>-. l ��`.
dr
.Wz”'2.,'.�tF�4'
x `�'."w;?F'Y'y;•'!W01
DISCOVERY BUILDERS
`CHECK
R12598
1010
RSE .
k DESCRIPTION: ? k=
s� � ACCOUNT; � gm
Ar
QTYga
b AMOUNT
PAID;:DATE
wan.3�e?i'�..iC#ii��.
?'.x.2!{ s:E ii.? _.. :E•.� da, x •r
Fv"z'.n;+b: Pav-'xw*u:�''h'..rn,�,�,"'=w"-.$.h`,r„-:i...
zPAID�
WATER HEATER/VENT PC
101-0000-42600'
0
$7.25,
$7.25
2/4/16
f ..:ti. -i } ,y ti. -d+• i,{ 1.� "9�:h3*fe�....,
i'.`.uF&YGia§a P'i'..%•ti �+6.W?y3h"st°�.
RECEIPT[#�
CMECK #
[LTD BY
r S. ,'ee ....DISCOVERY
gMETFIOD?�w _
BUILDERS BUILDERS
CHECK
R12598 .
1010
RSE
< �• C,'' :i4:'. .' f 4S,T ?'4" Lh +`•:
f DESCRIPTION & �
-
�.4 '
"M AC000NyT�
tel.
rwQTY
t..
AMOUNT Ii
_'Y:'A'" ei'F'.`"'
� z PAID
PAID DATE
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
$12:09%
$12:09
2/4/16
-tS.:b. q.�"
igs
<yL PAID:BY'�?rn
' METHOD����
RECEIPT# T° 5
;. CHECK#[LTD
BYE;
DISCOVERY BUILDERS .
CHECK
R12598
1010
RSE.
. �;.v,S^"&, C93�*S .�s .��gT
pESCRIPTION�r
Zi -§`XxY i T:F �
i
�� ". A
� �i� T" ,"SYS
OwlOs
PAID„DATE
.?lY.
7ACCOUNT�QTXAMOUNT�
WATER SYSTEM •INST/ALT/REP.PC
lol-o000-42600.
0
$12.09.
.$12. 09•
"2/4/16
T. Y ,. a':E.'.✓ '. 3.i.XY.L&�.`
3 RAIDS,n �� ?
41
n,"CFEY.fJ,Cp,�^Lit �,YH
it �r d
METHOD
S{,Y...-$"•:'geL±iS'�..' 4
RECEIPT #Oft
"l" ��..idf•i :,£.:YX - '.�.4 K
ECK�#
,
” .R'.. Y:wf Ri
[LTD Y
g
M
BCH
.,,9 .�£.. zt'.'fis.:, ..3&evn_R
s?'�SFA:$!v 3'alu.`...�",
DISCOVERY BUILDERS
CHECK_
R12598.•
1010
RSE
Total Paid for PLUMBING FEES: $1,644.21 $1,644.21 .
,.i.yE Y "S^"
x 4 kDESCRIPTION } z'�r
igr
�� :ACCOUNT
1i4.�i-.^SGi h+ 'i t�k,, : �: 'i
AMOUNT�PAID
g "x -0,c
"
ti.. ! .�
PAIp DATE"
I , . S.-: .a. ! ,:.,r ..:: ,_M'tv i.,, els.. 't 34;_,` 4,yY +;�,?« „-.'
srx ky lsF „E;anv..y :rStn-.,s..;. .3 .,� ,.:
t4�.r�->'�3
x�t-.4 .: Y...:: L,? >'•cs.a.=-+` ,
>> A
.(.�
SMI.- RESIDENTIAL
101-0000-20308
0
$125.22
$125.22.,
.2/4/16OR .
%PAID BY=
p F
%.1�?'&+'�af FiC.•,a C7'3- S.
ks;CHECK#
i i:::'Fi'
27CLTMBYh;
., k:..METHOD�eRECEIPT#
Uzz
DISCOVERY BUILDERS'
CHECK
R12598
1010.
RSE
Total Paid for STRONG`MOTI IN INSTRUMENTATION SMI: $125.22 '. $325.22
t.�:s' x i`' "Rf i•4x Vie, a°'
�`" +`t Rf_-Sa iw i w.z.. . •>a�
CtTY�
nq, 1O %3�.s�.n.
+,s.: a.ySt., L .tF
K "
PAID,:DATE_
:..A000UNT� _
.'i"A
.AMOUNTS
� „� _ :• ... a...: :_�
PA,I�' �
,
SINGLE FAMILY DETACHED
:224-0000-20320
0
$1,837:44
$1,837.44
.2/4/16 ,
. 'C f ✓ . n: a A .:.,:, ? 3,�??- • { (,i>- .e
C
PAID;BY;�.,.
+w�i' T 3;
- ti ...»,x
METHODx.
q,. 5� d ¢ PF'� %, 'cYtA S 'it,
nmly
Shu #�
�'i�.�,'�;ti Y,
i w"'C y3y
CHECK # gNCITD
�„''z�naca!:;,-n
- ¢*','% '•g
BYE
..
ti e ..E,RECEIPT
3=i'`aT, i
�f �:e:..;v
z1•;Sr.
DISCOVERY BUILDERS
CHECK
R12598
1010
RSE
Total Paid for TUMF - RESIDENTIAL: ' /. .$1;837.44 $1,837.44
•
Permit Details PERMIT NUMBER
City of La Quinta BRES20115`0405
Description: ASHER / MADISON CLUB / 11,081 SINGLE FAMILY
Type: BUILDING, RESIDENTIAL Subtype: DWELLING -SINGLE Status: APPROVED
Applied: 10/19/2015 SKH
FAMILY DETACHED
Approved: 1/8/2016 JJO
Parcel No: 767680008 Site Address: 53389 ROSS LA QUINTA,CA 92253
Subdivision: TR 33076-1 Block:- Lot: 31
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $963,250.30 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0.
Details: NEW 11081 SQ. FT. ST. SFD THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS, DRIVEWAY APPROACH, FIRE PIT, BBQ OR
WATER FEATURE. HOME IS FIRE SPRINKLED PER 2013 CRC CODES.
Printed: Thursday, February 04, 2016 2:49:52 PM 1 of 7 CR
SYS7Eiv1S
CHRONOLOGY
CHRONOLOGY TYPE
STAFF NAME
ACTION DATE
COMPLETION DATE
NOTES
NOTE
JIM JOHNSON
11/5/2015
11/9/2015
PLAN CHECK COMMENTS
FROM CONSULTANT
KAY HENSEL
11/6/2015
11/6/2015
STRUC READY FOR CORRECTIONS 11/6/2015
RECEIVED
PLAN CHECK COMMENTS
FROM CONSULTANT
RAMSES SEVILLA
1/6/2016
1/6/2016
STRUC APPROVAL 1/5/16
RECEIVED
PLAN CHECK PICKED UP
STEPHANIE GUMPERT
11/10/2015
11/10/2015
PLAN CHECK SENT TO
STEPHANIE GUMPERT
10/19/2015
10/19/2015
OUTSIDE PC
PLAN CHECK SENT TO
STEPHANIE GUMPERT
12/22/2015
12/22/2015
OUTSIDE PC
•
Printed: Thursday, February 04, 2016 2:49:52 PM 1 of 7 CR
SYS7Eiv1S
PLAN CHECK SUBMITTAL
STEPHANIE GUMPERT
10/19/2015
10/19/2015
PLAN CHECK SENT TO YOUNG. DUE BACK 11-09-15.
RECEIVED
PLAN CHECK SUBMITTAL
'RECEIVED
STEPHANIE GUMPERT
12/22/2015
12/22/2015
TELEPHONE CALL
JIM JOHNSON
11/9/2015
11/9/2015
CALLED HUGO TO INFORM HIM PLANS ARE READY FOR
CORRETIONS
TELEPHONE CALL
JIM JOHNSON
1/8/2016
1/8/2016
CALLED HUGO TO INFORM HIM THE PLANS ARE READY TO
ISSUE.
CONDITIONS
CONDITION
DATE
'DATE-
DATE
CONTACT
STATUS
REMARKS
NOTES
TYPE
ADDED
REQUIRED
-SATISFIED,
GRADING PLANS NEED TO BE SIGNED BY
ENGINEER AND SOILS REPORT REQUIRED.
READY TO ISSUE
JIM JOHNSON
1/7/2016.
1/7/2016
1/7/2016
COMPLETE
GRADING PLANS SIGNED
CHECKLIST
GEO. TECH RECEIVED JOHN AT YOUNG
APPROVED
CONTACTS
..NAME TYPE...,=
NAME.;, „ ,
ADDRESSI
CITY STATE`
ZIP :'
- `' PHONE
FAX ':
EMAIL..
APPLICANT
HUGO CERVANTES
51825 AVENIDA
LA QUINTA
CA
92253
VELASCO
CONTRACTOR
DISCOVERY
BUILDERS
80955 AVENUE 52
LA QUINTA
CA
92253
zhanan@discoverybuil
derslic.com
OWNER
WINDSOR SPORT
9460 WILSHIRE BLV STE
BEVERLY HILLS
CA
0
600
Printed: Thursday, February 04, 2016 2:49:52 PM 2 of 7
CRWYSTEM9
Printed: Thursday, February 04, 2016 2:49:52 PM 3 of 7
SYSTEMS
CLTD.
DESCRIPTION
ACCOUNT
CITY .
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$39.00
$39.00
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION
$39.00 $39.00
BSA:
DIF - CIVIC CENTER
252-0000-43200
0
$942.00
$942.00
2/4/16
1112598
1010
CHECK
DISCOVERY BUILDERS
RSE
DIF - COMMUNITY
254-0000-43200
0
$129.00
$129.00
2/4/16
R12598.
1010
CHECK
DISCOVERY BUILDERS
RSE
CENTERS
DIF - FIRE PROTECTION
257-0000-43200
0
$433.00
$433.00
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
DIF - LIBRARIES
253-0000-43200
0
$344.00
$344.00
2/4/16
.1112598
1010
CHECK
DISCOVERY BUILDERS
RSE
DIF -PARK
256-0000-43200
0
$40.00
$40.00
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
MAINTENANCE
DIF - PARKS/REC
251-0000-43200
0.
$2,048.00
$2,048.00
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE,
DIF - STREET
255-0000-43200
0
$116.00
$116.00
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
MAINTENANCE
DIF - TRANSPORTATION
250-0000-43200
0
$2,842.00
$2;842.00
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 $6,894.00
TEMP POWER SERVICE
101-0000-42403
0
$24.17
$24.17
2/4/16
1112598
1010
CHECK
DISCOVERY BUILDERS
RSE
TEMP POWER SERVICE
101-0000-42600
0
$16.92
$16.92
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
PC
Total Paid for ELECTRICAL: $41.09 $41.09
RESIDENTIAL, EA
101-0000-42403
0
$147.96
$147.96
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
ADDITION 1,000SF
RESIDENTIAL, EA
101-0000-42600
0
$60.96
$60.96
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
ADDITION 1,000SF, PC
RESIDENTIAL, FIRST
101-0000-42403
0
$145.03
$145.03
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
1,0005 F
.
Printed: Thursday, February 04, 2016 2:49:52 PM 3 of 7
SYSTEMS
Printed: Thursday, February 04, 2016 2:49:52 PM 4 of 7
SYSTEMS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT .
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID.BYe
BY
RESIDENTIAL, FIRST
101-0000-42600
0
$47.86
$47.86
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
1,000SF, PC
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $401.81 $401.81
RESIDENTIAL PRECISE
GRADING - CUSTOM
101-0000-42408
0
$36.26
$36.26
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
HOME LOT >7KSF
RESIDENTIAL PRECISE
GRADING - CUSTOM
101-0000-42600
0
$181.29
$181.29
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
HOME LOT >7KSF PC
Total Paid for GRADING:. $217.55 $217.55
CONDENSER/COMPRES
101-0000-42402
0
$290.08
$290.08
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
SOR
CONDENSER/COMPRES
101-0000-42600
0
$193.36
$193.36
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
SOR PC
EXHAUST HOOD
101-0000-42402
0
$12.09
$12.09
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
EXHAUST HOOD PC
101-0000-42600
0
$4.83
$4.83
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
FURNACE
101-0000-42402
0
$290.08
$290.08
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
FURNACE PC
101-0000-42600
0
$193.36
$193.36
.2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
VENT FAN
101-0000-42402
0.
$205.53
$205.53
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE-
SE-VENT
VENTFAN PC
101-0000-42600
0
$82.11
$82.11
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
Total Paid for MECHANICAL: $1,271.44 $1,271.44
NEW CONSTRUCTION
101-0000-424000
$1,009.41
$1,009.41
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
PERMIT
'Total Paid for NEW CONSTRUCTION PERMIT: $1,009.41 $1,009.41
NEW CONSTRUCTION
101-0000-426000
$1,200.00
$1,200.00
10/19/15
R10116
2486
CHECK
DISCOVERY BUILDERS
SKH
PLAN CHECK
Printed: Thursday, February 04, 2016 2:49:52 PM 4 of 7
SYSTEMS
Printed: Thursday, February 04, 2016 2:49:52 PM 5 of 7
SYSTEMS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
NEW CONSTRUCTION
101-0000-42600
0
$1,008.12
$1,008.12
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
PLAN CHECK -
Total Paid for NEW CONSTRUCTION PLAN CHECK: $2,208.12 $2,208.12
BACKFLOW DEVICE
101-0000-42401
.0
$12.09
$12.09
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
BACKFLOW DEVICE PC
101-0000-42600
0
$4.83
$4.83
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
BUILDING SEWER
101-0000-42401
0
$12.09
$12.09
2/4/16
R12S98
1010
CHECK
DISCOVERY BUILDERS
RSE
BUILDING SEWER. PC
101-0000-42600
0
$12.09
$12.09
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
FIXTURE/TRAP
101-0000-42401
0
$423.15
$423.15
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
FIXTURE/TRAP PC
101-0000-42600
0
$423.15
$423.15
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
GAS SYSTEM, 5+
101-0000-42401
0
$36.26
$36.26
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
OUTLETS
GAS SYSTEM, 5+
101-0000-42600
0
$24.17
$24.17
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
OUTLETS PC
ROOF DRAIN
101-0000-42401
0
$326.43
$326.43
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
ROOF DRAIN PC
101-0000-42600
0
$326.43.
$326.43
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
WATER HEATER/VENT
101-0000-42401
0
$12.09
$12.09
•2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
WATER HEATER/VENT
101-0000-42600
0
$7.25
$7.2S
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
PC
WATER SYSTEM
INST%ALT/REP
101-0000-42401
0
$12.09
$12.09
2/4/16
R12598 .
1010
CHECK
DISCOVERY BUILDERS
RSE
WATER SYSTEM .
INST/ALT/REP PC
101-0000-42600
0
$12.09
$12.09
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
Total Paid for PLUMBING FEES: $1,644.21 $1,644.21
SMI'-; RESIDENTIAL
101-0000-20308
0
$125.22
$125.22
2/4/16
R12598
1010
CHECK
DISCOVERY BUILDERS
RSE
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $125.22 $125.22
Printed: Thursday, February 04, 2016 2:49:52 PM 5 of 7
SYSTEMS
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD
BY
SINGLE FAMILY 224-0000-20320 0 $1,837.44 $1,837.44 2/4/16 R32598 1010 CHECK DISCOVERY BUILDERS RSE
DETACHED
Total Paid for TUMF - RESIDENTIAL: $1,837.44 $1;837.44
INSPECTIONS
BOND INFORMATION
Printed: Thursday, February 04, 2016 2:49:52 PM 6 of 7 rp sysTrms
PARENTPROJECTS
REVIEWS
RETURNED
STATUS
REMARKS
REVIEW TYPE
REVIEWER
SENT DATE
DUE DATE
NOTES
DATE
1ST BLDG NS (3 WK)
JIM JOHNSON
10/19/2015
11/9/2015
11/5/2015
REVISIONS REQUIRED
1ST BLDG STR (3
YOUNG
10/19/2015
11/9/2015
11/6/2015
REVISIONS REQUIRED
WK)
ENGINEERING
1ST PW GREEN
AMY YU
12/1/2015
12/8/2015
12/1/2015
READY FOR APPROVAL
SHEET
2ND BLDG NS (2
JIM JOHNSON
12/22/2015
1/11/2016
1/8/2016
APPROVED
WK)
SOILS REPORT NOT INCLUDED IN RESUBMITTAL.
SOILS REPORT INFO NOTED ON STRUCTURAL
PLANS, AND CONCRETE STRENGTH SPEC -D FOR
SULFATE CONDITIONS.
2ND BLDG STR (2
JOHN
12/22/2015
1/11/2016
1/5/2016
READY FOR APPROVAL
WK)
THOMPSON
JT 1-5-2015
soils update letter provided and approved.
JT 1-8-2016
BOND INFORMATION
Printed: Thursday, February 04, 2016 2:49:52 PM 6 of 7 rp sysTrms
Printed: Thursday, February 04, 2016 2:49:52 PM 7 of 7 CRUll
SYSTEMS
ATTACHMENTS
Attachment Type
CREATED
OWNER
DESCRIPTION
PATHNAME
SUBDIR
ETRAKIT ENABLED
BRES2015-0405 -
DOC
12/22/2015
AJ ORTEGA
SCHOOL FEE
SCHOOL FEE
0
CERTIFICATION
CERTIFICATION. pdf
DOC
11/5/2015
JIM JOHNSON
53-389 ROSS AVE..docx
53-389 ROSS AVE..docx
0
2ND REVIEW -
2ND REVIEW -
DOC
1/5/2016
JOHN THOMPSON
STRUCTURAL
STRUCTURAL
0
TRANSMITTAL.pdf
TRANSMITTAL.pdf
1ST REVIEW -
DOC
11/6/2015
KATHRYN SAMUELS
STRUCTURAL
BRES 2015-0405 KS
0
(lst).doc
COMMENTS
1ST REVIEW -
NEW CITY
DOC
11/6/2015
KATHRYN SAMUELS
STRUCTURAL
TRANSMITTAL BRES
0
TRANSMITTAL
2015-0405 (ist).pdf
DOC
1/8/2016
STEPHANIE KHATAMI
GEO TECH 1-7-16.pdf
GEO TECH 1-7-16.pdf
0
Printed: Thursday, February 04, 2016 2:49:52 PM 7 of 7 CRUll
SYSTEMS
POAADISdAJ
Building
Address . J
Mailing
Address
'-f 5?2,e520 5 --o40S
C&tT 4 4 Cl/
PO. BOX 1504 APPLICATION ONLY
78-495 CALLE TAMPICO
js J '4' Vt1.�j LA QUINTA, CALIFORNIA 92253
City l Zip I Tel.
& Classif. I Lic. #
Hrcn., tngM �� /�)� , : I
Designer ; ff�� 4/
Lic. #
• /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 Contrac-
tor'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 penalty of
not more than five hundred dollars ($500).
OI, 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).
O1, 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.)
111 am exempt under Sec. B. & P.C. for this reason
Date _ Owner
WORKER'S COMPENSATION DECLARATION
1 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
O Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(rhis section need not be completed if the permit is for one hundred dollars ($100) valuation
or fess).
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
BUILDING: TYPE CONST. ADCC. GGRP.
A.P. Number
Legal Description h /
Project Description
Sq. Ft. ' %,/il!/ll�de/ No.
Newy Add ❑
t / ✓l�� //,
Estimated Valuation
No. DIN.
Alter ❑ _ Repair ❑ Demolition ❑
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
CONTACT WFORMATION
—/ //—
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 'roperty Line —
FINAL DATE—
Issued by:
Validated by: —
Validation:
YELLOW = APPLICANT
INSPECTOR
Date
PINK = FINANCE
1A
RECORDING REQUESTED BY
First American Tide Company
AND WHEN RECORDED MAIL DOCUMENT TO:
The Asher -Glass Community Pty Trust
1071 Laurel Way
Beverly Hills, CA 90210
A.P.N.: 767-680-008-4
DOC # 2015-0206367
05/18/2015 01:19 PM Fees: $21.00
Page 1 of 3
Recorded in Official Records
County of Riverside
Peter Aldana
Assessor -County Clerk -Recorder
"This document was electronically submitted
to the County of Riverside for recording"
Receipted by: MARUIZ
Space Above This Line for Recorder's Use Onty
GRANT DEED
T.R.A. No.020-205
The Undersigned Grantor(s) Dedare(s): DOCUMENTARY TRANSFER TAX $2365.00; CrTY TRANSFER TAX $0.00;
X computed on the consideration or full value of property conveyed, OR
computed on the consideration or full value less value of pens and/or encumbrances remaining at time of sale,
urgnmrporated area; [ X ] CM of to Quinta, and
File No.: RIW-4895866 (SE)
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Madison 31A, LLC, a California
limited liability company
hereby GRANTS to Gal Asher and Ginger Glass, as Trustees of The Asher -Glass Community Property
Trust dated March 16, 2015
the following described property in the City of La Quinta, County of Riverside, State of California:
PARCEL NO. 1:
LOT 31 (THE "LOT") OF TRACT NO. 33076-1 AS SHOWN ON SUBDIVISION MAP (THE "MAP")
RECORDED ON SEPTEMBER 7, 2005, IN BOOK 388, PAGES 57 TO 79, 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 OF
COVENANTS, CONDITIONS AND RESTRICTIONS AND RESERVATION OF EASEMENTS FOR
THE MADISON CLUB OWNERS ASSOCIATION, RECORDED ON SEPTEMBER 13, 2005 AS
INSTRUMENT NO. 05-754387, OF OFFICIAL RECORDS OF RIVERSIDE COUNTY,
CALIFORNIA. '
Mail Tax Statements To: SAME AS ABOVE
r, DOC #2015-0206367 Page 2 of 3
Grant Deed - continued
Dated: April 28, 201S
Madison 31A, LLC, a California limited
liability company
By: Tom,Chang, Managing ember
S.
notary public or other officer completing this
rtiflcate verifies only the identity of the
ndMdual Who signed the document to which this
rtificate Is attached, and not the truthfulness,
ccuracy, or validity of that document.
STATE OF . CAU froPM-A )SS
Date: 04/28/2015
COUNTY OF LDS - AtjGEtE5_ )
On MAj II , 2015 before me, MiltiAm %.Ni?f.SrfNA Rc%,ft , Notary
Public, pertonally appeared 1 ori S. CAAtC
.who proved to me on the basis of satisfactory evidence to he the person(s)
whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/sh0they executed
the same in his/her/their authorized capadty(les), 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. •
MIRIAM CHRISTINA Rf)BI:fS•
Commission 11892571'
4 wury.Puilft - C80011111I.-
= lett Arpsta Cosnhr
•!� comma Ins 8s '29, bt6
This area for oftial notarial seal
Page 2 of 2