06-2565 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00002565 _ Owner:
Property Address: 55293 RIVIERA ROD & BETTY MINKLER
F APN: 775-153-009- - 55-293 RIVIERA
Application description: REMODEL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Kl Application valuation: 89150
Contractor:
Applicant: Architect or Engineer: PR CONSTRUCTION INC
1995 BATAVIA
FULLERTON, CA 92835
(714)637-7848
Lic. No.: 673267
O
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 Professionals Code, and my License is in full force and effect.
License Class: B C33 LicenseNo.: 673267
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 asigned 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 ($500).:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
^I? as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
I—) I am exempt under Sec. , B.&P.C. for this reason
Date: .
Owner:
CON$jRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there iM construction lending agency for theperformanceof the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/22/06
AUG 2 21006
CITY OF LA QUINTA
• 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:
Carrier STATE FUND Policy Number 04-0006182-2006
g 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
6 700 of the Labor Code, I shI�forthwith comply ith those provisions.
Date: C' . /-Applicant:
h
WARNING: AILURE TO SECURE WORK S' 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 Director of Building and Safety 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 co my o enter upon the above-mentioned property for i pect�Rpurposes.
Date:, Signature (Applicant or Agent):
Application Number . . . . . 06-00002565
Permit
BUILDING PERMIT
Additional desc
"
Permit Fee . . . .
594.50 Plan Check
Fee
386.43
Issue -Date
Valuation
. . . .
89150
Expiration Date
2/18/07
rr Qty Unit Charge
Per
Extension
BASE FEE
414.50
40.00 4.5000
THOU BLDG.50,001-100,000
180.00
;1 ---------------.-------------------------------------------------
-----=------
Permit
ELECT - ADD/ALT/REM .
Additional desc .
Permit Fee . . . .'
17.38• Plan Check
Fee
4.35
Issue Date . .
- Valuation
. .
0
Expiration Date'.
2/18/0.7
Qty Unit Charge.
Per
Extension
BASE FEE.
15.00
25.00 .0350
ELEC NEW RES - 1 OR 2
FAMILY
..88
2.00 .7500
PER ELEC DEVICE/FIXTURE 1ST 20
1.50
Permit
MECHANICAL
Additional desc .
Permit Fee
24.00 Plan Check
Fee
6.00
Issue Date . . . .
Valuation
0
Expiration Date
2/18/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 9.0000
----------------------------------------------------------------------------
EA MECH APPL.REP/ALT/ADD
9.00
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
52.50 Plan Check
Fee
13.13
Issue Date . .
Valuation
. . . .
0
Expiration Date
2/18/07
Qty Unit Charge
Per
: Extension
BASE FEE
15.00
5.00 6.0000
EA PLB FIXTURE
30.00
1.00 7.5000
EA PLB WATER,HEATER/VENT
7.50
---------- - --------------------------------
- ---
Special
Special Notes and Comments
---------------
25 SQ. FT. ADDITION AND REMODEL.August.
LQPERMIT
Application Number
06-00002565
--------------------------
Special Notes and
Comments
----------
15, 2006 4:36:20 PM jjohnson
Other Fees . . .
. . . . . .
ENERGY REVIEW
FEE
38.64
STRONG MOTION
(SMI) - RES
8.91
Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
688.38
.00
.00
688.38
Plan Check Total
409.91
.00
.00
409.91
Other Fee Total
47.55
.00
.00
47.55
Grand Total
1145.84
.00
.00
1145.84
A1076, + /lvf-wfz.,l� ; 4 , _ R .lc rAq—
�A
City of La Quinta
Building U Safe Division
ox , 78-495 Calle Tampico / Cp
La Quinta, CA 92253 - (760) 777-7012 l/'
Building Permit Application and Tracking Sheet
Permit #
?S
Project Address:' S�.a93 t ✓l e► Owner's Name: T,,0 0 �� I l �A 1` IV/,
A. P. Number: Address: SS-Agr Z d l e Q,
Legal Description: City, ST, Zip: 9� IJIX
Contractor: bllSktx, 10 yL Telephone: —
Address: q - • � Project Description:
City, ST, Zip:
Telephone: 7 [{ �7 . -7
State Lic. #: City Lic. #:
Arch., Engr., Designer: Ll— �, �C.
Address:/4s
City, ST, Zip: Q n
Telephone: % . (P (a 67, NConstruction Type: Occupancy:
State Lic. #: Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
MSq.Ft.:p�# Stories: #Units:
Telephone # of Contact Person: — mafk slue of Project. gq 5'D
N lwv,'w5 1 4-46. -'9 PPLICANT:
DO NOT WRITE BELOW THIS LINE )VAN n
#
Submittal
Req'd
Rec'd
TRACKING .
F
Plan Sets
Plan Check submitted
Item
ount
Structural Calcs.
Reviewed, ready for corrections S
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs Fn
el v('M
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2"' Review, ready r corrections ue
Electrical
Subcontactor.List
Called Contact Per
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval °
Plans resubmitted 0 pL
Gp4ding
IN HOUSE:-
'"' Review, ready for correctio
job
Developer Impact Fee
Planning Approval
Called Contact Person 8
(S
b
A.I.P.P.
Pub. Wks. Appr
Date of permit issue 8'
School Fees
i
ry
%-I.
.1. .r-
Total Permit Fees
1 -W/ L / V l0 gz-) lCvty c' V"J`- ! / l I / LAD
��r�.A ?
CERTIFICATE OF COMPLIANCE4���FIEDy
Desert Sands Unified School District
47950 Dune Palms Road Q BERMUDA DUNES O
V] RANCHO MIRAGE d
Date 8/16/06 La Quinta, CA 92253 INDIAN WELLS
PALMDESERT
LAQUINTA y
No. 28845 (760) 771-8515 �'
�P IN 0
0
Owner Rod & Betty Minkler APN # 775-153-009
Address 55293 Riviera Jurisdiction La Quinta
City La Quinta Zip 92253 Permit #
Tract # Study Area
Type Residential Addition No. of Units 1
Lot # No. Street
Unit 1 55293 Riviera
Unit 2
Unit 3
Unit 4
Unit 5
Comments
S.F.
25 Unit 6
Unit 7
Unit 8
Unit 9
Unit 10
Lot # No. Street S.F.
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/Walkways, residential additions under 5
00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho
mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
Residential Addition 500 Sq Feet or Less
EXEMPT
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $0.00 X 25 S.F. or $0.00 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By Exempt - Betty Minkler Check No.
Name on the check Telephone 771.9507
Funding Exempt
By Dr. Doris Wilson
Superintendent
Fee collected /exe p -A by S ron
Payment Recd _ =" $0.00
'Over/Under
Signatu
NOTICE: Pursuant to Govemmen ode Section 66020(d)(1), this wil erve to notify you that the 90 -day approval period in which you may protest the fees o
r other payment identified above will gin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting