10-1392 (AR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00001392
Property Address: 54985 AVENIDA CARRANZA
APN: 774-294-024-12 -000000-
Application description: ADDITION - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 4000
T4 -ht 4 4 Q"
Applicant: Architect or Engineer:
aJA
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
1 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 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 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
Ilit 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.).
(_ 1 I am exempt under Sec. , BAP.C. for this reason
ate:
Owner:
CONSTRUCTION LENDING
I hereby affirm under penalty of perjury that there, is a construction lending
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: Q'
Lender's Address: ! 1
LQPERMIT
the performance of the
Owner:
SHARON RUMSEY
54985 AVENIDA
LA QUINTA, CA
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/07/11
--------------- - - -
WORKER'S COMPENSATION DECLARATION
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
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 he workers' compensation provisions of Section
r� 3700 of the Labor C;deI shall forthwith ply with those pr visions.
/bate: �+ �� plicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVEaE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,0001. 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 here4 authorize representatives
ofthis coou tt/y T enter upon the above-mentioned property fo i pection purpose /
aD te: gnf� (Applicant or Agent): _
Application Number . . . 10-00001392
------ Structure Information 25SF ADDITION WITH REMODEL/VB/RES-3/CL A -----
Other struct info . . . . . CODE EDITION 2007/2008
# BEDROOMS 2.00
FLOOD ZONE NO
1ST FLOOR SQUARE FOOTAGE 25.00
-------------------------------------------------------- ---------------------
Permit . . . ELECT - ADD/ALT/REM INV FEE
Additional desc .
Permit Fee . . 120.30 Plan Check Fee 15.04
Issue Date . . . Valuation . . . . 0
Expiration Date . . 9/03/11
Qty Unit Charge Per Extension
BASE FEE 30.00
20.00 1.5000 PER ELEC DEVICE/FIXTURE 1ST 20 30.00
67.00 .9000 EA ELEC DEVICE/FIXTURE >20 60.30
----------------------------------------------------------------------------
Permit . . . BUILDING PERMIT INV FEE
Additional desc .
Permit Fee . . . . 126.00 Plan Check Fee 40.95
Issue Date . . . . Valuation . . . . 4000
Expiration Date 9/03/11
Qty Unit Charge Per Extension
BASE FEE 90.00
2.00 18.0000 THOU BLDG 2,001-25,000 36.00
----------------------------------------------------------------------------
Permit . . .
Additional desc .
Permit Fee
Issue Date . . . .
Expiration Date . .
MECHANICAL INV FEE
48.00
9/03/11
Plan Check Fee*. . 6.00
Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 30.00
1.00 18.0000 EA MECH APPL REP/ALT/ADD 18.00
----------------------------------------------------------------------------
Permit . . . PLUMBING INV FEE
Additional desc . .
Permit Fee . . . . 87.00
Issue Date . . . .
Expiration Date . . 9/03/11
Qty Unit Charge Per
LQPERMIT
Plan Check Fee 10.88
Valuation 0
Extension
Application Number . . . . . 10-00001392
Permit . . . . . . PLUMBING INV FEE
Qty Unit Charge Per
Extension
BASE FEE
30.00
3.00 12.0000 EA PLB FIXTURE
36.00
1.00 15.0000 EA PLB WATER HEATER/VENT
15.00
1.00 6.0000 EA PLB WATER INST/ALT/REP
6.00
----------------------------------------------------------------------------
Special Notes and Comments
25SF CLOSET ADDITION AT MASTER BEDROOM
WITH ENTIRE DWELLING REMODEL/UB/RES-3/CL
A -FR [ENGINEERED] THIS PERMIT DOES NOT
.INCLUDE ALTERATION TO BUILDING ENVELOPE,
MECHANICAL DUCTS OR BATHROOM PLUMBING.
MINOR ADJUSTMENT.NUMBER 2010-622 TO
REDUCE INTERIOR SIDE YARD SETBACK
APPROVED NOVEMBER 8, 2010 BY ERIC CEJA.
***INVESTIGATION FEE ASSESSED PER 2007
CALIFORNIA BUILDING CODE APPENDIX
CHAPTER 1 §108.6 FOR WORK COMMENCING
BEFORE PERMIT ISSUANCE*** 2007/2008.
CALIFORNIA BUILDING CODES.
March 7, 2011 2:48:56 PM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
4.10
STRONG MOTION (SMI) - RES
.50
Fee summary Charged Paid Credited
---------------------------
Due
------------------------------
Permit Fee Total 381.30 .00 .00
381.30
Plan Check Total 72.87 .00 .00
72.87
Other Fee Total 15.60 .00 .00
5.60
Grand Total 459.77 .00 .00
459.77
LQPERMIT
iwT
P.O. BOX 1504
LA -0 UINTA, CALIFORNIA 92247-1504 BUILDING & SAFETY DEPARTMENT
78-495 CALLS TAMPICO (760) 777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
PROPERTY OWNER'S PACKAGE
Disclosures & Forms for Owner -Builders Applying for Construction Permits
VWM Afff NOTICE TO PROPERTY OWNER
Dear Property Owner.
An application for a building =been1!7.pWin your if as the builder of the property
improvanents specified at 9d2dZ�
We are providing you with an Owner -Budder Acknowledgment and l6formattei Verification Form to make you aware of your
respoesrbilities and possible risk you may incur by having this permit issued in your name as the
Owner -Builder. We gill not issue a building permit until you have read, inked your understanding of each prOvidon,
signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute dais notice
unless you, the property owner, obtain the prior approval of the permitting authority.
OMR'S A�CKKOWLEDGM=ql AND WERMCATION OF UVORNAMON
DfREMONS- Read and initial each statement below to signify you understand or verify this information.
9
. I understand a fi�equeret practice of unlicensed persons is to have the property owner obtain an "Owner -Budder"
building permit that erroneously implies that the property owner is providing his or her own labor and material persore&k. 1. 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 my property.
4t—/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.
3. I understand as an "Owner -Builder" I am the responsible party of record on the permit_ I understand that I may protect
yself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
Aj4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employee'
under state and federal law.
�/6. I understand if I am considered an "employee' under state and federal law, I must register with the state and federa
government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemploymen
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious fhumia
risk.
7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residenti:
structures cannot legally build them with the intent to offer them for sale, unless all work is performed by license
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is perform,
under contract with a licensed general building Contractor.
I understand as an Owner -Builder if I sell the property for which this permit is issued, 1 may be held IiaMe for any
financial or personal Wjwies sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
9. I understand I may obtain more information regarding my obligations as an "employee' from the Iatered Revenue
Service, the United -States Small Business Administration, the -California Department of Benefit Payments; and -the California
Division of Industrial Accidents. I also understand 1 may contact the California Contractors' State License Board (CSLB) at 1-
800-321-CSLB (2752) or www.csth.ca.gov for more information about licensed contractors.
k0. I 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 financially responsible for proposed construction activity at the following address:
At, I. I agree that, as the party legally and ftaancially responsible for this proposed conswAction activity, 1 will abide by all
app 'cable laws and requirements that govern Owner-Btrilders m well as employers.
12. I agree to notify the issuer of this form immediately of any additions, deletions, or cha6>6-sby ofthe infannatioa 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, am Centruwrs' 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 toundmstaad that if an unlicensed Contractor or employee of the individual or f cm is injured while wmtdng
on your property, you may be Add [fable for damages. If you obtain a permit as Owner -Builder and wish to hie CQGU*c6ors,
You wdl be responsible for verifying whether or not those Contractors are property lieemed and the status of their workers'
Compensation iastuanoe ooverago.
Before a building permit can be issued, this form must be completed and signed by the property owner sed returned to
the agency responsible for isud" tis permit. Nota: A copy of tis property *woe's driw.r's I&M959, fwm ""n'480"% Or
oilier verification acceptable to the sgerney is requbvd to be presr4w4 when flee peendt is in"d to reify die propeM
owner's signature.
Signature of property owner Due:
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 BEHaF
Excluding the Notice to Property Owner, the execution of which 1 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:
Address of Authorized Agent:
Tel No
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:
CITY OF LA QUINTA SUB -CONTRACTOR_ LIST
JOB A1)DRESS Ae. r4?11227Za PERMIT NUMBER OWNER( .BUILDER
This form shall be posted on the job with the Building Inspection Card at all times'in a conspicuous place. Only persons appearir(9 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 tb 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 completed by applicant. "On File" is not an acceptable response.
on :
Trade /C.IassifieaU.........
Cofitrac or . ;:.
.:. ......... t..........
State :C�ritractor s...i!�RI)se::;:.... -:.. ,
Workers Cotrr..nset?ott insurance .
l:it . Busme$s Uce11e
t
V:
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 (C-12).'::.
CONCRETE (0-8)
FRAMING YC -5) ..:
��?S>�l!'fa
V 11/�7
'
G( e/�di
c, 3 OoL 7 �il%
a1 1 lI
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81311
STRUCT.`STEEL- (C
MASONRY (C-29)..,,:;
PLUMBING. (C-36,):
LATH, PLASTER (C=351. ;:
DRYWALL (C-9)
dylS GY1 TYiIC
HVAC (C-20) .
ELECTRICAL::(C-1OY..;:;
C9 L / /
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Afd
ROOFING :(C-39)
SHE€T METAL (C-43).
FLOORING (C-1-5):::,`: ...
GLAZING IC -17):
IN.SUkAT10N (C-:21.
.SEWAGEDISP.:.(G2}.
:PAINTING (C-33)..
CERAMIC TILE.(C-54)...
CABINETS (C-6).
!
FENCING (0-1:3) .. .
LANDSCAPING (C=27)
POOL (C-53)
Bin
City of La Quinta
Building a Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Qulnta, CA 92253 - (760) 777-7012
/� Building Permit Application and Tracking Sheet
Project Address: s ff rra,o Owner's Name: h e
A. P. Number:'7799tlOAV,,' Address: zw/s"20 Q a�
Legal Dcsaiption: yG_ LQ G�l�inl� nib .2S1 JarL tty. T, Zip: //2
Contractor:
Address:
Telephone:
Project Description:
=ez--4
City, ST, Zip:
• ulldenw ha -11
Telephone:h
State Lic. # :
.......... .......... 41,5e .Wnef
City Lic. #; lw
ee esWgnev : me . woe
�' De.�gAer a/d ae4o a4611IVU2l
Address: CZQ SCh Rr
ours .f.
• �Ct� �l�!lI9Cl� CCOtwxjh
h
City, ST, Zip:
Telephone: 1,60- %r% _
State Lic. #:
93 Construction Type: V Occupancy: u
Project type (circle one): Now Add' ter Repair
Demo
Name of Contact Person:B
Sq. Ft :a-7
# Stories: # Uniu:
Telephone # of Contact Person:
FS r%- 6-8-'913 Estimated Value of Project: 10 DOO.
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal Req'd
Rec'd TRACIQNG PERMIT FEES
Plan Sets
Plan Check submitted �� Item
Amount
Structural Cala.
Reviewed, ready for corrections 1 W Plan Cheek Deposit
Truss Cala.
Called Contact Person t M Plan Check Balance.
Tide 24 Cala.
Plana picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2' Review, ready [or corrcctio ue 3 l Electrical
Subcoataetor List
Called Contact Person :SMAW Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
''' Review, ready for correctioasAssue Developer Impact Fee
Planning Approval
Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fee
T
CMAo
3�Z �9or,t - 1JSlSiR AF�t,G
y� usT
V'.
Total Permit Fees
0
P.O._Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO (760) 777-7000
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7101
November 8, 2010
Ms. Sharon Rumsey
P.O. Box 4216
Newport Beach, CA 92661-4216
SUBJECT: MINOR ADJUSTMENT 2010-622, AMENDMENT 1
54-985 AVENIDA CARRANZA
REDUCED INTERIOR SIDE YARD SETBACK — EXTENDED CLOSET
Dear Ms. Rumsey:
This letter is to report that the Planning Department has reviewed your amendment
application to the originally approved Minor Adjustment (MA 2010-622), dated July 6,
2010, pursuant to Section 9.210.040 of the City of La Quinta Zoning Code,. for the
residence at 54-985 Avenida Carranza.
Request:
A request has been made to decrease the interior side yard 'setback, to accommodate
an extended master bedroom closet. The interior side yard setback in the Residential
Cove (RC) zoning district is five (5) feet. Therefore, the request is to'decrease the
interior side yard setback from five (5) feet to four feet six inches (4'6").
This request for a decrease in the interior side yard setbacks voids the originally
approved Minor Adjustment request for a decrease in the exterior side yard setback.
The exterior side yard setback for this lot is ten (10) feet.
Decision:
Approval is granted for the requested decrease in the interior side yard setback, based
on the following Findings:
• Minor Adjustment 2010-622, Amendment 1 is consistent with the La Quinta
General Plan, in that the decreased interior side yard setback proposed does not
alter the approved land use for the property, or affect land use on surrounding
similar properties.
a
• . Minor Adjustment 2010-622, Amendment 1 is consistent with the intent of the
La Quinta Zoning Code, in that the requested adjustments will retain adequate
side yard separations as required under said Zoning Code.
• Processing and approval. of Minor Adjustment 2010-622, Amendment 1 is in
compliance with the California Environmental Quality Act. The adjustments
requested fall under CEQA Guidelines Section 15305, which includes .minor
alterations in land use limitations as Categorically Exempt under this Section.
• Approval of Minor Adjustment 2010-622, Amendment 1 is not detrimental to
the public health, safety and general welfare, nor injurious or incompatible with
other properties and land. use in the vicinity. The adjustment has no impact on
health or safety issues, and will not affect physical land, use characteristics in
the vicinity.
Based on the. noted findings, your Minor Adjustment application is subject to the
following Conditions:
1. A building permit shall be.obtained from the Building & Safety 'Department prior
to construction of the verandah or any building additions.
2. You are. limited to one minor adjustment per lot; therefore, future requests for
minor adjustments cannot be approved for'this property.
Please be advised that this approval relates. only to allowance of the decrease as. -stated
above, and does not imply any entitlement or approval of a building permit for any
structures shown on the ,plans on file. All other setback provisions, including the ten
(10) foot exterior side yard setback, and development' stand-ards of .the La Quinta
Zoning Code are applicable and shall be adhered to in preparing plans for building plan
check.
If you have any additional questions, please contact me at (760) 777-7125.
Respectfully yours,
ERIC CE
Assistant Planner
C: Building & Safety. Department
Comments
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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. 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 - sharon Rumsey Check No.
Name on the check Telephone
Funding Exempt
By Dr. Sharon P. McGehee
Superintendent `
Fee collected /exempted by S IF cGilvrey Payment Recd
CS'ver/Und'e�r :�'
C J/ r
Signature 'i
r
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
or 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 without embossed seal
Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting