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05-0461 (RER)79768 Arnold Palmer I IIIIIII VIII III VIII IIII 34 ot. U BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 FTt 9 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . 0, -0-010.74768 Date 2/07/05 Property Address . . . . . . 79768 ARNOLD PALMER APN: 775-241-068- - Application description . . . REMODEL - RESIDENTIAL Property Zoning . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . 8000 Owner Contractor ------------------------ ------------------------ PGA WEST RESIDENTIAL HOA OWNER 54320 SOUTHERN HILLS LA QUINTA CA 92253 ------ Structure Information VOLUNTARY SEISMIC RETROFIT ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . DWELLG/LODGING/CONG <=10 Other struct info . . . CODE EDITION 2001 ---------------------------------------------------------------------------- Permit BUILDING PERMIT Additional desc Permit Fee 99 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 8000 Qty Unit Charge Per Extension BASE FEE 45 . 00 6 . 00 9 . 0000 THOU BLDG 2 , 001-25, 000 54 . 00 ----------------.------------------------------------------------------------ Special Notes and Comments D n Phase 1 Fairways Units Voluntary Seismic 1 Retrofit . Voluntary seismic upgrade & selected construction defect repairs FEB 16 2005 constructed to the 1985 UBC allowable design values, applided loads conform to CI!TY OF LA EQUINTA the 1997 UBC. ---------------------------------------------------------------------------- Other Fees . . . . . . . STRONG MOTION (SMI) - RES . 80 Fee summary Charged Paid Credited Due ----------------- ------"---- ---------- ---------- ---------- Permit Fee Total 99 . 00 . 00 . 00 99 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total . 80 . 00 . 00 . 80 Grand Total 99 . 80 . 00 . 00 99 . 80 P.O. Box 1504 • �G/ VOICE (760) 777-7012 78-495 CALLS TAMPICO ^I FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: O S' eco Date: o?•/S-Of Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 License No. Date Contractor OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors'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 Contractors'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).): U 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 or 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.). U I am exempt under Sec. ,B.&P. or this reason / �te ' 061 mer WORKERS'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 Policy Number edify 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 provision ate L c "� plicant 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. 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 J MA 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 construc tion, (annd hereby authorizf sentatives of this county to ent pon the above-mentioned property for inspection purposes. Date ° v ignrS Applicant or Agent): IIIIIIIIIIIIIIIIIIIIIIIII 35 l 4 IE j No. x.5295 P.O.BOX 1504 Building 79-768 -Arnold Palmer Dr. 78 495 CALLE TAMPICO Address LA QUINTA,CALIFORNIA 92253 Owner Mailing Allen & �:ioki Merchant BUILDING: TYPE CONST-.00C.GRP. Address SaM A.P:Number City ip Tel. La .Quint a.p CAT .92253 773.-6701 Legal Description Contractor Project Description* Rom: Addition Integrity Construction Address 54-y705 Ave. Co.ranza. TS Qn rata 7CAZ'P92256 Te�. 64-1274 State Lic. City &Classif. 627.156 Lic.# 2966 Sq.Ft. 163 No. No. Dw. Size- Stories Units Arch., Engr., Designer DeCost-er & Associates New 0 Add X Alter 0 Repair.0 Demolition 0 Address Tel. . 73725- El Paseo 346-1418 C'ty Zip State aim. Desert 92260 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 DECLARATIONEstimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following $13,.©87.0v 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 PERMIT AMOUNT 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 for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Plan Chk. Dep. - subjects the applicant to a civil penalty of not more than five hundred dollars($500). - p I,as owner of the property,or my employees with wages as their.sole compensation,will Plan Chk. Bal. q Ain do the work,and the structure is not intended or offered for sale.(Sec. 7044,Buisness and Const.Professions Code: The Contractor's License Law does not apply to an owner of property who t) r builds or improves thereon and who does such work himself or through his own employees, Mech. provided that such improvements are not intended or offered for sale. If, however, the building15-00 i or improvement is sold within one year of completion, the owner-builder will have the burden Electrical - of proving that he did not build or Improve for the purpose or sale.) 7 0 I,as owner of the property,am exclusively contracting with licensed contractors to con- Plumbing struct 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 S.M.I. 1 such projects with a contractor(s)#caned 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 WORKERS'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 0 Copy is filed with the city. 0 Certified copy is hereby furnished. TOTAL Q_ CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS'COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that In the performance of thg work for which this permit is issued,I shall not employ anyperson in any manner so as to become subject to the Workers'Compensation Laws of California Date Owner NOTICE TO APPLICANT., d, after making this Certificate of Exemption you should become ZONE: BY' subject to the Workers' Compensation provisions of the Labor Code, you must forthwith - comply with such provisions or this permit shah be deemed revoked. Minimum Setback Distances: tj Front Setback from>Center Line } Rear Setback from Rear,Prop.Line (l WARNING:FAILURE TO SECURE WORKERS'COMPENSATIONCOVERAGE ISUNLAWFUL.AND' Side Street Setback from,Center Line SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES,UP TO ONE HUNDRED THOUSAND DOLLARS($IDo,000),IN ADDITION TO THE COST OF COMPENSATION, - Side Setbackfrom Property Line. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND. � ATTORNEY'S FEES. ..­ TM J�/If Tti,s is a building permit when properly filled out,signed and validated,and is subject to FINAL DATE INSPECTOR/ yyy expiration it work thereunder is suspended for 180 days./ �` I certify that I have read this application and-state that the above information is correct. Issued by: Date Permit / 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. Validated by,: Signature of applicant Date- Mailing ate Mailing Address Validation: City, State, Zip Y` - `✓ . ' CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING;FEES IST FL. SO.FT.® $ UNITS 2ND FL. SO.FT.@ YARD SPKLR SYSTEM POR. SO.FT.® MOBILEHOME SVC. BAR SINK GAR. SO.FT.® POWER OUTLET ROOF DRAINS DRAINAGE PIPING CAR P. SO.FT. WALL SO.FT. DRINKING FOUNTAIN SO FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE:Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE,TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO.FT.®c BATH TUB SO.FT.®c WATER HEATER MAX.HEATER OUTPUT,B.T.U. SO.FT.RESID®114 c SEWAGE DISPOSAL SO.FT.GAR®3/4c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST.FEE ELECT.FEE SMI FEE PLUMB.FEE STRUCTURE PLUMBING ELECTRICAL HEATING&AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C.UNIT COLL.AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING(ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE AOUND.REINF. GAS(ROUGH) METER LOOP HEATING(FINAL) OTHER APPJEOUIP. REINF.STEEL GAS(FINAL) TEMP.POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING LUMBER GR. AL INS l� cu.yd. FRAMING �n^ FINAL INSP. $ plus x$ _$ R OFING y �[ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL - INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT I IIIIIII VIII III VIII IIII 36 82-879 Highway 111 iE NOTICE: Indio, CA 92201 Document Cannot Be.Duplicated 619-775-3500 Date 11/9/95 Type of Permit I La Quinta No. 113854 Permit # Log Owner Name Allen & Vicki Merchant No. 79768 Street Arnold Palmer Dr. City La Quinta Zip 92253 Study Area 106 APN# Tract# Lot#0 Square Footage 1168 Type of Development Residential Addition No.of units 0 Comments Room Addition At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined 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 EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 0.00 X 168 or $ 0.00 have been paid to D.S.U.S.D. 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 N/A Telephone Name on the check _ By Dolores A. Ballesteros + Superintendent 1s Fee collected/exempted by Pauline Pearson �l Signature `� g \ ,n�.rA Q,�,, n� PJAUAV " �0':(iO,Chtaak No. N/A Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original-Building Dept./Applicant Copy-Applicant/Receipt Copy-Accounting