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BRES2015-0436PO. BOX 1504 APPLICATION ONLY Building 81 18-495 CALLE TAMPICO Address LA QUINTA, CALIFORNIA 92253 Owner �1i � BUILDING: TYPE CONST. OCC. GRP. Mailing 4t A.P. Number Address S3 SdA� 1� CityZip Tel. Legal Description 6 1-0y, VL iJ93v1 w��. � Contractor Project Description •;,.wL = S+ Address— o tc � Il . Gp•14iaE >� 0 6 W--. city r Zip I. VN `i u.7o �y 78's-3 d State Lic. city Sq. Ft. No. No. Dw. & Classif. 7„58 c Lic. # Size 83gc Stories 1 Units Arch. ngt. New Add ❑ Alter ❑ Repair ❑ Demolition ❑ Design -I"•1r��►-- Address, Tel. 367 aw_ AA,,m City Zip State �C 61, Lic. # C.,53 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 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 toits issuance also requires the applicant for PERMIT AMOUNT 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 Plan Chk. Dep. r C56violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars (8500). Plan Chk. Bal. 01, 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 Proles- 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 that Mech. 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 Electrical not build or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the Plumbing project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply S. M. 1. 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 ❑ 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 ✓CONTACT INFORMATION �r✓� N/�.(L4 �?Rtj or less). I certify that in the performance of the work for which this permit is issued, I shall not employ V NAME: 30 �►a Q� 1 p.r any person in any manner so as to become subject to Workers' Compensation Laws of California. PHONE: � 3 �S 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. 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 for Rear Setback from Rear Prop. Line which this permit is issued. (Sec. 3097, Civil Code.) Lenders Name Side Street Setback from Center Line Lender's Address i This is a building permit when properly filled out, signed and validated, and is subject to Side Setback from Property Line expiration if work thereunder is suspended for 180 days. I certify that 1 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 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 This Box For District Use Only DEVELOPER FF.F.S PAID AREA: AMOUNT LEVELONEAMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMWIND. AMOUNT: DATE: RECEIPT: CHECK #: . INITIALS CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: Madison Glub Date: January 19, 2016 Owner's Name: Robert Brigham (Equestrian Life, LLC) Phone No. 714-785-3885 Project Address: 81-346 Amundson Avenue Project Description: New Single Family Dwelling APN: 767-690-017 Tract #: Lot #'s: Type of Development: Residential XX Commercial Industrial Total Square Feet of Building. Area: 8,390 Certification of Applicant/Owners: The person signinhertifies that the above informatio_n.is-correct and—&mitis statement under penalty of perjury and further represents that he/she is auth rized to sign on behalf • ""er ve oper. Dated: January 19, 2016 Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE� 0 PROJECT HAVE BEEN OR WILL BE SATISFIED INSCHOOL DISTRICT'S REQUIREMENTS FOR THE O PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (C LE ONE) Education Code Gov. Code Project Agreement Existing Not Subject to Fee 17620 65995 Approval Prior to 1/1/87 Requirement Number of Sq.Ft. 8390 Pursuant to AB 181 any room additions or enclosures of 500 Amount per Sq.Ft. $3.36 sq. ft. or less are exempt from developer fees. Any mobile homes being relocated within the same school district's Amount Collected $28190.40 jurisdiction are exempt from developer fees. Building Permit Application Completed: Yes/No By: Elsa F. Esqueda, Director of Facilities and Maintenance Certificate issued by: Laurie Howard, Secretary Signature: NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. MV:chnydoes!devf'ees/certikicate of compliance. toren upd<ued 3-2007 .11/2010 Documents provided by DataTme LLC via its proprietary imaging and delivery system. Copyright 2003, All rights reserved. Recording Requested by: FNTG Builder Services WHEN RECORDED MAIL TO:a�� Equestrian Life NV., LLC Attn: John McGraw/Deana Berquist 53 Soaring Bird Ct. Las Vedas, NV 89135 MAIL TAX STATEMENT TO: SAME AS ABOVE DOC # 2015-0314091 07/17/2015 08:00 AM Fees: $24.00 Page 1 of 4 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: ALGONZAL 7(07- x`10-017-� (This space for Recorder's use only) DOCUMENT TRANSFER TAX $ 1,870.00 XX Computed on the consideration or value of property conveyed; OR Computed on the consideration or value less liens or encumbrances remaining at the time of sale. The undersigned Grantor Signature of Declarant or Agent determining tax — Firm Name GRANT DEED FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, EAST OF MADISON, LLC, a Delaware limited liability company ("Grantor"), hereby GRANT(S) to Equestrian Life, NV LLC, a Nevada Limited Liability Company ("Grantee"), the real property located in the City of La Quinta, County of Riverside, State of California, described as: See Legal Description attached hereto and incorporated herein as Exhibit "A". SUBJECT TO all matters of record including, without limitation, the covenants and agreements described in Exhibit "A" attached hereto. June 18, 2015 Dated: EAST OF MADISON, LLC, a Delaware limited liability company By: 120 Acre Partners, LLC, a Delaware limited liability company Its: Managing Member By: Discovery La Quinta Investors, LLC, a Delaware limited liability company its Authorized Repres t e By Joseph L. Arenson Its: Authorized Representative RIGID JAN 1.2 2016 CITY OF LA OUINTA COMMUNITY DEVELOPMENT