BPLB2019-011878-495 CALLE TAMPICO C� 0 D 4v�N[ACU
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: PLUMBING/
Application Number: BPLB2019-0118
Property Address: 55610 ROYAL ST GEORGE
APN: 767522005
Application Description: REIFF / (2) FIRE PITS (1) STUB FOR FUTURE BBQ
Property Zoning:
Application Valuation: $8,000.00
Applicant: D
Q0 D
BONNIE REIFF
5707 LYON CT AUG 2 2019
CALABASAS, CA 91302
CITY OF LA QUINTA
DESIGN & DEVELOPMENT DEPARTMENT
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.:
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
aIIe ed exemption, Any violation of Section 7031.5 by any applicant for a permit
Ml
the applicant to a civil penalty of not more than five hundred dollars ($500).:
s 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
2struct
r4at build or improve for the purpose of sale_].
jownerof the property, am exclusively contracting with licensed contractors to
the project. (See. 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: —'II ! 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 Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/22/2019
Owner:
BONNIE & JERRY REIFF
55610 ROYAL ST GEORGE
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
LIc. No.:
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 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:
Carri _ Policy Number:_
ertify 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 th se provisions.
Date: Applicant:
WARNING: AILURE TO SECURE WORKERS' COMPENSATION CO ERAGE 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 ofthis 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 iprppefty for inspection purposes.
Date: Signature (Applicant o 4
Date:' 8/22/2019
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
BONNIE REIFF
5707 LYON CT
CALABASAS,CA 91302
BPLB2019-0118
55610 ROYAL ST GEORGE
767522005
REIFF / (2) FIRE PITS (1) STUB FOR FUTURE BBQ
$8,000.00
Owner:
BONNIE & JERRY REIFF
55610 ROYAL ST GEORGE
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
Llc. No.:
Detail: NEW GAS LINE FOR (2) FIRE PITS AND (1) STUB OUT FOR FUTURE BBQ AT REAR YARD. THIS PERMIT DOES NOT INCLUDE WORK OUTSIDE OF THIS
SCOPE. PER 2016 CALIFORNIA PLUMBING CODES.
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.40
Total Paid for PERMIT ISSUANCE: $101.40
DESCRIPTION
ACCOUNT
CITY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$13.34
DESCRIPTION
ACCOUNT
CITY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$26.68
Total Paid for PLUMBING FEES: $40.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
ta 0 ra
cAL11:0KNIA
PERMIT #
PLAN LOCATION:
oject Description:
lh C�i O.nG
Project Address: tb
APN #:
I1rVi, o
Applicant Name:
Address: 5 7v 7 Loh
3=�/ vvtr-
City, ST, Zip: a b4SQS(A.l302-
Telephone:
Email:
bs' G•�I C�
Project Valuation $__ - - -
..
Contractor r A
New SFD Construction:
�Nam,:
Address: )Jb h o k �
Conditioned Space SF
City, St, Zip
Garage SF
Telephone: 742) .2%b
Patio/Porch SF
Email: V MghdScA I'm(,, Iwoli; . com
Fire Sprinklers SF
State Lic: /0 31111 City Bus Lic:
Architect/Engineer Name:
Construction Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms:
Stories:
# Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name: �h r
w Commercial / Tenant Improvements:
Address: gyhp its J �� ' w
Total Building SF
City, ST,'Xtp
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal `
Required
Received
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
CVWD Fire Flow Letter
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
I
Public Works approval
Fire approval
City Business License
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(760)777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submitt d in your name listing yourself as t e builder of the property
improvements specified at 16 Q6
q2z 53
We are providing you with an Owner -Builder Acknv ledgment and InformaUn V 'Gcation Farm to make you aware of your
responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision,
signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice
unless you, the property owner, obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
L41-11-
I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those
injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
on Amy property.
/� 2. I understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
4A3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
_4Z4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
o my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer"
under state and federal law.
L-6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
risk.
I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
U/ 8- I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
� I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
Service, the United States Small Business Administration, the California Department of Benefit Payments, and .the California
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-
800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
&10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party legally and finarkpially responsible for proposed, construction activity at the following address:
f J 7
11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
ajl 1, 'cable laws and requirements that govern Owner -Builders as well as employers.
2. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also
important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working
on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors,
you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or
other verification acceptable to the agency is required to be presented when the permit is issued to verify the property
owner's signature.
Signature of property owner _ ADate: i
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize
the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work)- _
Project Location or Address:
Name of Authorized Agent: _ _ Tel No
Address of Authorized Agent:
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification
acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature.
Property Owner's Signature: __^ _ -Date: _.
r.EGCRDING REQUESTED BY:
Equity Title
AND WHEN RECORDED MAIL TO:
Jerry Rent and Bonnie Goldstein
5707 Lyon Court
Calabasas, CA 91302
Order No.: OR1950414
Escrow Ho.: FS2761
A.P.H.: 767.522.005-2 TRA: 020-059
`.ir'Aut: 0-%b
GRANT DEED
tt) r.ET YIFtr Y�I�f THIS IIS ATRUE
,A14D CORRECT COPY OFTHE ORIGINAL
AEREOP �tJ
FOUR SEASONS ESCR . INC.
t.tNE IS FOR RECORDER'S USE
THE UNDERSIGNED GRANTOR(S) DECLARE(S)
DOCUMENTARY TRANSFER TAXIS $ 1 375, 00
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 J x ] City of La Quinta
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged.
John B. Evans, A Married Man as his Sole and Separate Property and Pete D. Papilfon, A Married Man as his
Sole and Separate Property and Milton C. Karavites, An Unmarried Man and James H. Watson Jr., A Married Man
as his Sole and Separate Property and Bradley R. Parker, A Married Man as his Sole and Separate Property all
as joint tenants
hereby GRANT(S) to Jerry N. Reiff and Bonnie S. Reiff AKA Bonnie-S. Goldstein,
as Trustees of The Reiff Trust Agreement dated November 17, 2004
the following described real property in the County of Riverside, State of California
See Exhibit "A" attached hereto and made a part hereof.
Commonly known as: 55610 Royal St. George, La Quinta, CI
Dated: February 13, 2019
A notary public or other officer completing this certificate
verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the
truth rullies s, accuracy. or validity of t#tat oer� ent.
STATE
OF
`7 , _ (,.I _ before me,
who proved to j;e—o'nI ho basis of satisfactory Evidence tLy be the
person(s) whose name(s) is/are subscribed to the within
instrument and acknowledged to me that he/sha/they executed
the same in his/her/their authorized capecity(ies), and that by
hisiherAheir 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 f f 7
NU I F%Kll wUM-lt,.
STATE OF COLORADO
NOTARY ID ','-00 34018!- 30 v
MY COMMISION M JUNE 5, zo1u
n
(seal)
E3 Q
O
3
(This area for official notary seal) � �
TAX STATEMENTS AS DIRECTED ABOVE H5 'N
M
A
A
y,�<_ SPIT►t ��ro `CITY OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESS SSCQLO t-P- Qs) ,m PERMIT NUMBER] Lf�0[gt-6#b0WNER I tIONJM Je. re-cE- L F F ^_ BUILDER. OwNia- �Jt�.7��t'�
This for►7� shallIse asted on a 'ob with the Buildin In ee i❑ C rd at all times in a cons icuousplace. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be comp':eted by applicant. "On File" is not an acceptable response.
Tra:cle./: C.lass..fic..a:fi;ori; :
Contractor
State.EontC ctgr'S.License...
Workers Compensation Irisusance
G'rty Susines ,License
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp, Date
(xx/xx/xx)
EARTHWORK (0-4:2
CONCRETE (C-8)
FRAMING (C-5)
STRU.CT. STEEL (C:611
MASONRY (C 291
PLUMBING (C-36)
LATH, PLASTER.. (C=35)
DRYWALL (C-9),
HVAC (:C-20):
ELECTRICAL (G=10)
ROOFING (C=39)::
SHEET :METAL (G.43)°
FLOORING (C•1-5.)
GLAZING; 01:7)
IN.SU:.L:.ATIOI�I::(_C 21
SEWAGE DISP. (C-42)
PAINTING. (C-33)
1_
CERAMIC TILE (-C-54)
_
CABINETS (C•6);
FENCING (C-13)
LANDSCAPING (.C-27)
1'`oRtOXF-LOr
C- 2.'`j
lCJ3l1 I
POOL (C-53)
�_
SUNKEN FIRE PIT @18" BELOW GRADE LEVEL
SEAT WALL ON TWO SIDES AT +18" HIGH
STUCCO & PAINTED CONCRETE
FIRE PIT AT -0- LEVEL WITH CONCRETE CAP
WHITE STONE VENEER TO MATCH INTERIOR FIREPLACE
NOT ON THIS PERMIT
NOT ON THIS PERMIT
w.
REIFF RESIDENCE
55610 ROYAL SAINT GEORGE
LA QUINTA, CA. 92253 n
2" POLYPYPE GAS LINE
2" GAS STUB FOR FUTURE BBQ
-� NOT ON THIS PERMIT
CITY OF LA QUIi,ETA
NOT ON THIS PERMIT BUILDING & SAFETY DEPT.
APPR V ED
FOR CONSTRUCTION
DAT6�I�BY
FIRE PIT A
CONCRETE CAP WITH STUCCO & PAINTED VENEER
GAS SAFETY VALVE ON BACK SIDE
"T" CONNECTION