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SFD (04-5871)Tedf 4.44" 1504 ELLE TAMPICO A, CALIFORNIA 92253 BUILDING PERMIT APN: Application description Property Zoning . . . . . . Application valuation . . . Owner ------------------------ ENENEL MERVILUS 51-955 AVE. RUBIO LA QUINTA CA 92253 BUILDING & SAFETY DEPARTMENT (760) .777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 _.04-00005871 Date 10/05/04 -51545 AVENIDA MENDOZA 773-142-015-3 _000000- DWELLING.- 000000- DWELLING- SINGLE FAMILY DETACHED COVE RESIDENTIAL 103544 Contractor ------------- t. DESERT HOME CONSTRUCTION, INC. 231 E. ALESSANDRO BLVD, #348 RIVERSIDE CA 92508 (909) 641-3269 WCC: STATE FUND WC: 00261312004 04/01/05 CSLB: 824985 09/30/05 CCC: B ------ Structure -Information 1640 SQ. FT. SFD. ----- Construction Type . . . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . . . . . NON -AO -FLOOD ZONE Other struct info . . . . . CODE.EDITION 2001 CBC # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE,SQ FTG -, .475.00 PATIO SQ FTG ' 32.00 NUMBER OF UNITS 1.00 -----------------------------------------------_-=-=------------------------- FIRST FLOOR SQ FTG 1640.00 Permit . . . . . . BUILDING PERMIT Additional desc Permit'Fee . . . . 653.50 Plan Check Fee 424.78 Issue Date . . Valuation . . . . 103544 Qty Unit Charge Per Extension BASE FEE 639.50 4.00 3.5000 ---------------------------------------------------------- THOU BLDG.100,001-500,000 14.00 Permit . . . . . . ------------------- ELEC-NEW RESIDENTIAL Additional desc Permit Fee 96.90 Plan Check Fee 24.23 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension ir P.O. Box 1504 78-495 CALLS TAMPICO VOICE (760) 777-7012FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: d y— 15797/. I Date: ,2 —A O S 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 . in full force and effect. �� C� QS License Class r3 License No. O Date 2-%S Contractor 14,41 d ,06 / 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.). U 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.). U I am exempt under Sec. , B.& P.C. for this reason Date 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 issue My wo�rs' co ensation insurance carrier arm of r}uM44 ale2 �n Carrier C lr''�_- R _ rr Policy Number _ C761 , ! �S / LW �( Zcerti y 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 provisions. Date r�— % ��� Applicant/JL 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 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. 1 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 county to enter upon the above-mentioned property for inspection purposes. Date -2- Signature (Applicant or Agent): �� a f: Application Number . . . . 04-00005871 o Page 2 Date 10/05/04 Qty Unit Charge Per Extension BASE FEE 15.00 1640.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 57.40 475.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.50 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 ------------------------------------------ Permit . . . . GRADING --------------------------------- PERMIT' Additional desc Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 59..00 Plan Check Fee 14.75 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 3.00 6.5000 EA MECH VENT FAN 19.50 1.00 ---------------------------- 6.5000 EA MECH EXHAUST HOOD 6.50 Permit ---------------------------------------------- PLUMBING -- Additional desc Permit Fee . . . . 117.00 Plan Check Fee 29.25 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE J 15.00 8.00 6.0000 EA PLB FIXTURE 48.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000, EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 6.00 .7500 EA PLB GAS PIPE >=5 4.50 1.00 ---------------------------------------------------------------------------- 15.0000 EA PLB GAS METER 15.00 Special Notes and Comments 1640 sq. ft. sfd.THIS PERMIT DOES NOT 0 Fee summary ----------------- Permit Fee Total Plan Check Total Other Fee Total Grand Total Charged Paid 941.40 Page 3 Application Number . . . . . 04-00005871 Date 10/05/04 -------------------------------------=----------------------7--------------- Special Notes and Comments INCLUDE POOL & SPA , BLOCK WALLS OR DRIVEWAY APPROACH. CONTRACTORS INFORMATION NOT IN HTE. ---------------------------------------------------------------------------- Other Fees . . . . . . . . ART IN PUBLIC PLACES -RES .00 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 42.48 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK.FEE .00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 COVE PRECISE PLAN FEE 100.00 STRONG MOTION (SMI) - RES 10.35 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Permit Fee Total Plan Check Total Other Fee Total Grand Total Charged Paid 941.40 .00 493.01 250.00 2557.83 .00 3992.24 250.00 Credited Due .00 941.40 .00 243.01 .00 2557.83 .00 3742.24 CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road < BERMUDA DUNES O MIRAGE Date 2RANCHO INDIAN /1/05 La Quinta, CA 92253 RAN AN WELLS �. PALM ALA Q No. 26846 (760) 771-8515 INDIOo ,, L Owner Evenel Mervilus APN # 773-142-015 Address Jurisdiction La Quinta City Zip Permit # Tract # Study Area Type Single Family Residence No. of Units 1 Lot # NO'---- ^ Street S.F. Mf Unit 1 <�545—Aveni-d`a-1PieQza 1640 Unit 6 Unit 2 "OftUnit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments Lot # No. Street S.F. At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiosANalkways, 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: 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 1,640 S.F. or $3,673.60 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 CC/Union Bank of Calif - Harlin Borcherding Check No. 0618000883 Name on the check Telephone 909-641-3269 By Ar. Doris Wilson Superintendent Fee collect Funding Residential. Payment Recd $3,673.60 Over/Under Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will 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 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 I Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy - Accounting ��. Certificate of Occupancy = s �GV �7 OF�9w_ Building & Safety Department This Certificate is issued pursuant to the requirements of Section 109 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 51-545 AVENIDA MENDOZA Use classification: SFD Building Permit No.: 04-5871 Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC Owner of Building: EVENEL MARVILUS Address: 51-955 AVE. RUBIO City, ST, ZIP: LA QUINTA CA 92253 By: KIRK KIRKLAND Date: 11-1-05 Building Officia POST IN A CONSPICUOUS PLACE r