05-0219 (AR)i
dw.
•
P.O. BOX 1504
78-495 CALLE TAMPICO.
LA QUINTA, CALIFORNIA 92253
Application Number.0
Property Address:
APN:
Application description:
Proprty Zoning,-
Application
oning;Application validation:
51184 A E1 I A HERRE RA
773-064-010-14 -000000-
ADDITION
-000000-
ADDITI N - RESIDENTIAL
COTE RESID
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
.
------ ..�=--- __-------------
MORGAN HILL
.
4
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
Architect or Engin __________ ___________ ____
i I I S EN CONSTRUCTION L L C
-8560 VINEYARD AVENUE #409
RANCHO CUCAM NGA, CA 91730
L . No.: __ ________ Lic. No.: 171.9404
CITY OF LA QUINTA I
FINANCE DEPT.
LICENSED CONTRACTOR'S DECLARATION
•f hereby affirm under penalty of perjury that I am licensed under provisions of Chapter S (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Mass: 823546 License o.: 1719404
Dater W Contractor
- OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that i am exempt from the Contractor's State License Lawn for the
following reason (Sec. 7031. 5, Business and Professions Code: Any city or county that requires a permit to
construct, alter irprove, 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 Laws (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).o.
I+ as owner of the property, or illy employees with wages as their sole compensation, will Bio the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' Mate License Lawn 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 sola 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.).
IR 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
i pursuant to the Contractors' Mate 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. 309 7,, Diu, C.).
Lenders Name:
Lender's Address:
LRM IT
�z7
Date: 6/01/05
WORKER'S ER' O PEI SATION 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
i 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 6 0 4 2 Policy Number STATE FUND
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 theworkers' compensation laws of California,
+ and agree that. if I should become subject to the workers' compensation provisions of Section
5740 of the Labor code, i shall forthwith comply with those provisions.
Date. Ap
WARNING: : FAILURE TO SECURE w RI ERS' SATI N COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES ISP TO ONE HUNDRED THOUSAND
DOLLARS 01 00,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 5706 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.
. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days f rom date of issuance of such permit, or cessation of work for 180 days w i I I subject
permit to cancellation.
certify that I have read this application and state that thb above information is correct. I agree to comply with all
city and county ordinances and state lawns relating to building construction, and hereby authorize representatives
of this cony#ta enter upon the above-mentioned property far inspection purposes.
Date' j
Si
icar
_�A
i
IS P R I IT
Application Number . i # i i
OS- 000002 19
Permit #
. . .
# .
BUILDING PERMIT
Additional.
desc
. a
Permit Fee
590.00
Plan Check Fee #
383.50
Issue Date
i
Valuation
88891
Expiration
Date
#
11/28%05
Qty Unit
Charge
Per
Extension'-
BASE
FEE
414.58
39-00
----------------------
4# 5800
THOU BLDG8,
081-1+80, 000
- - - - - - - -
175.50
- - - - - - - -
Permit
ELECT - ADD/ALT/REPS
Additional
desc#
i
Permit Fee
55-11
Play Check Fee 0 0
1 *78
Issue Date
Valuation !0
'Expiration
Date
.-#
11/28/85
h
Qty Unit
Charge
Per
Extension
BASE
FEE
15#00
1106-00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
38.71
-70.00
.0200
L C
GARAGE OR NON-RESIDENTIAL
---------------------------------
1.40
Permit #
. # .
#
MECHANICAL
Additional
desc
Permit
65-50
Plan Check Fee i .
16-38
+ Issue Date
Valuation # # * #
V
iExpiration
Date
!
11/28/05
Qty Uni t
Charge
Per.
Extension
BASE
FEE
15-00
1l
9. 0000
M CH
FURNACE 1. - 8K
9.80.
1.00 F +
9. 0000
EA MECH
B/C <=3HP/100K BTT
9.00
4.00
6 #5000
EA MECHVENT
FAN t
26-o00
1.00
-----------------------
------------------------------
i CIS
EXHAUST HOOD
--------------
6.50
Perri t
!
#
PLUMBING
Additional
desc
!
Permit Fee
102-00
Plan Check Fee
25-50
Issue Date
Valuation
0
Expiration
Date
11/28/05
Qty Unit
Charge
Per
Extension
BASE
FEE
15-00
8.00
6. 0000
EA PLB
FIXTURE
48-00
4.00
6. 0000
EA PLB
1F DRAW
2#88
M
a
I
4
}�
Application Number 05 - 00000219
Permit PLUMBING
f
Qtr Unit Charge Per Extension
1.0 o EA PLrB NATER EATER/ ENT 7. 50
1.00 3. 000o EA PLB NATER I TST/ALT/F EP 3.00
6.00 ;7800 EA PLB GAS PIPE >=5 4.80 w
----------------------------------------------------
Special Notes and Comment s
replace roof , addition to living xoom, t
bedroom master bedroom.june 1, 2005
1:47: if 8 PM j j ohn s ori
i Other Fees ENERGY REVIEW FEE 38-35
STRONG MOTION (SMI) - E S .50
Fee summary Charged Paid t Credi tech Due i
Permit Fee Total 812.61 . 00 � 812-61
Plan Check Total 439-16 .o t • 0 439-16
Other Fee Total 38-85 . 0 .00 38-85
t Grran Total 1290-62 .00 .00 1290-62
h
- h
t #
4
L P RMI'T t
r
t
78-495 CABLE TAMPICO
LA QUiNTA, CALIFORNIA
92253
(760) 7T7-7012
STRUCTURAL OBSERVATION REPOICIF FORM
STRUCTURAL OBSERVATION means the visual observation of the structural system, forgeneraf c+onfomnance to the approved
plans and specifications, at significant constrvciUan stags and at completion of the structural system. Structural observation does
not include or waive the ra awsihfli for the ins ectfons required bKSecfion 10a 1701 or over secr ons of rrre code.
Report No. 2005-167
Cw SERVED aTRUCTURAL E MD TwC0E=C"
OBSERVED DEFICIENCIES:
G t.00-qw't
I
DECLARE T14AT THE FOLLOW NG STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE:
I THE ENGINEER OR ARCHITECT RETAMED BY THE OWNER TO BE IN RESPONSIBLE
C A S OR THE STRUCTURAL OBSERVAMN IN ACCORDANCE WiTH THE REQUIREMENTS
OF THE CITY OF LA QUINTAL
OR ANOTHERGINE OR ARCHITECT WHO I HAVE IGNATED A13OVE AND IS UDDER
MY RESPONSIBLE CHARGE, HAS PERFORMED THE E UIRED SITE VISITS AT EAC"
SIGMFICANT CONSTRUCMON STAGE TO VERIFY IF THE STRUCTURE IS IN GENERAL
C iti F CE W" APPROVED FlJkNS AND SP SATM 3;
3 ALL DEFICIENCIES VItN1CHTO 0
A I aEcomMEwa THAAc rNCTE of
LA QJiNTA BE 1MTHHEL UNTiL ALL 08
T Od
SIGNATURE
}
RRECTED HAVE BEEN INDICATED ABOVE,
1E STRUCTURAL SYSTEMS BY THE CITY F
RILED DEFICIENCIES ARE CORRECTED,
98ZB-ZES (OTC)
/D
zatezuos
%w-
Q�ESSIO/� F
amp
dea=90
SO 61 100
FOUNDATION
WALL
FRANfES
FLOOR PORTION OBSERVED, IF NOT WHOLE
❑
Footing, Stem Wafts.
❑ Concrete
❑ Steel Alloment Frame
❑
Concrete
❑
Mat Foundation
❑Masonry
❑Steel Braced Frame
❑Steel
C1
Caisson, Piles, Grade Beams
Woad
❑Concrete Moment Frame
i81
Wood
❑
Retaining Foundation
Hillside Special Anchors
� Other:
❑Masonry WaJI Frame
❑
Others:
❑
Others:
❑ Others:
OBSERVED DEFICIENCIES:
G t.00-qw't
I
DECLARE T14AT THE FOLLOW NG STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE:
I THE ENGINEER OR ARCHITECT RETAMED BY THE OWNER TO BE IN RESPONSIBLE
C A S OR THE STRUCTURAL OBSERVAMN IN ACCORDANCE WiTH THE REQUIREMENTS
OF THE CITY OF LA QUINTAL
OR ANOTHERGINE OR ARCHITECT WHO I HAVE IGNATED A13OVE AND IS UDDER
MY RESPONSIBLE CHARGE, HAS PERFORMED THE E UIRED SITE VISITS AT EAC"
SIGMFICANT CONSTRUCMON STAGE TO VERIFY IF THE STRUCTURE IS IN GENERAL
C iti F CE W" APPROVED FlJkNS AND SP SATM 3;
3 ALL DEFICIENCIES VItN1CHTO 0
A I aEcomMEwa THAAc rNCTE of
LA QJiNTA BE 1MTHHEL UNTiL ALL 08
T Od
SIGNATURE
}
RRECTED HAVE BEEN INDICATED ABOVE,
1E STRUCTURAL SYSTEMS BY THE CITY F
RILED DEFICIENCIES ARE CORRECTED,
98ZB-ZES (OTC)
/D
zatezuos
%w-
Q�ESSIO/� F
amp
dea=90
SO 61 100
r
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District 4�.0n"-?0
47950 Dune Palms Road BERMUDA DUNES
�
v= RANCHO MIRAGE
Date 6/11/05 La Quints, CA 92253 Y INDIAN WELLS -
PALM
No,. LA QUINT
2725s (760) 771-8515 �,No,o
L
Owner Morgan Hill
Address 51-184 Ave
City
Tract #
La Quints
-1
APN #
12 nida Herrera Jurisdiction
Zip 92253 Permit #
Study Area
Type Residential Addition No. of Units
Lot # No. Street
Unit 1 51184 Avenida Herrera
Unit 2
Unit 3
Unit 4
Unit 5
Comments
S.F.
1174
Unit
6
Unit
7
Unit
8
Unit
9
Unit
10
773-064-010
La
Quinta
Lot # No. Street
0
J
S.F.
At the present time, the Desert Sands Unified School District does not collect fees on garagestcarports, covered patiosANalkways, residential additions under 5
OQ square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ha
nus. It has been determined ftrat the above-named owner is exempt from paying school fees at this time due to the following reason:
e
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.24 X 19174 S.F. or $2,629.76 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 c/c Bank of America, David Jones Check No. 411763145
Name on the check Telephone
Funding Residential
By [)r, Doris Wilson
Supedntendent
Fee collected /exempted by Ptricia Barbu a
Signature
Payment Recd
$2,629.76
Fso.o-,o
Over/Under
NOTICE: Pursuant to Government Code Sect0S 55020(d)(1), this wrEll serve to notify you that the 90 -day approval period in which you may protest the fees o
r other payment identified above will begin 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 Districts) or to another public entity authorized to coiled them on the District(s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applica nt Copy -Applicant/Receipt Copy -Accounting
{