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04-4370 (AR)BUILDING & SAFETY DEPARTMENT P.O. Box 1504. - (760),777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number' '. . . . r04-00004370 Property Address .. . . . . 6755 HIGHLAND PA APN:. 643-191-013-13 - Application description ADDITION - RESIDE Property Zoning LOW DENSITY RESIE Application valuation 54031 Owner ------------------------ DONNA RICKETSON 46755 HIGHLAND PALMS LA QUINTA CA 92253 t `Date 7 07 04 DR p buff— IAIJUL 211004 CITY OF LA QUINTA Contractor FINANCEDEP4 ------------------ ------- EDWARDS.CONSTRUCTION, BOB... 79920 FIESTA DR LA QUINTA .CA 92253 WCC: PREF INS WC: WKN1090403 01/01/05 CSLB: 684857 03/31/06. CCC': B. ------ Structure Information. REM / ADD Construction Type TYPE V - NON RATED Occupancy Type . ... . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . . . NON -Ab FLOOD ZONE Other struct info CODE EDITION 2001 CBC BEDROOMS 2.00 FLOOD ZONE NO GARAGE SQ FTG 462.00 PATIO SQ FTG ,101.00 FIRST FLOOR `SQ ,FTG 588.00 ` ----------------------- -------------------------------------------------------- Permit BUILDING.PERMIT Additional desc Permit Fee . . . . 437.00 Plan Check Fee 284.05 Issue Date Valuation 54031 Qty Unit Charge Per Extension BASE FEE 414..50 5.00 4.5000 THOU BLDG 50,001-100,000 ,22.50 ---------------------------------.------------------------------------------- Permit ELECT ADD/ALT/REM F Additional desc ; Permit Fee 44.82 Plan Check Fee 11.21 Issue Date Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 P.O. Box 1504 •/�/ VOICE (760) 777-7012 78-495 CALLE TAMPICO ~ FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760)'777-7153 BUILDING & SAFETY DEPARTMENT Application Number:%C7 Date: 0 Applicant: Architect or Engif��r: Applicant's Mailing Address: ft/ IR Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION hereby affirm un^ 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 Li a is in full force and effect. Le / r �T License CI License No. ` - Date ` U D�Contractor OWNER43UILDER 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 pen -nit 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 oontractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. BA P.C. for this reason Date Owner, 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. he and wil . Lain workers' compensation insurance, as required by Section 3700 of the labor Code, for the performance of the work for which this permit is o pensation insurance Brie{ andgel'y�y n�rQ,@ Cartier Policy Number �l J]_Cl_ �V 1 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 Califo and a ree that, if I should become subject tA the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with tho prosioAs. I /J n // Date I1 L1U Xr Applicant 7 v 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 beco null and void if work is not commenced within 100 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to can ellation. I certify that I have read this application and state that the aboi rm ion i ct. I to comply with all city and county ordinances and state laws relating to building constructi , an hereby authorize representatives of this co hty o e er p eintioned property r inspection purposes. -' �. L/ Date Signature (Applicant or Agent . Page 2 Application Number 04-00004370 Date 7/07/04 / Qty Unit Charge Per Extension 588.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 20.58 462.00 ---------------------------------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL 9.24 Permit . . . . . . MECHANICAL Additional desc Permit Fee *. . . . 61.50 Plan Check Fee 15.38 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 APPL REP/ALT/ADD 9.00 1.00 9.0000,EA MECH B/C <=3HP/100K BTU 9.00 2.00 6.5000 EA MECH VENT FAN 13.00 1.00 ---------------------------------------------------------------7------------ 6.5000 EA MECH EXHAUST HOOD 6.50 Permit . . . . . . PLUMBING Additional desc Permit Fee . . . . 66.00 Plan Check Fee 16.50 Issue Date . . . . Valuation . . . . 0 Q-ty _Unit Charge Per Extension BASE FEE 15.00 6.00 6.0000 EA PLB FIXTURE 36.00 1.00 6.0000 EA PLB ROOF DRAIN 6.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 2.00 -------.--------------------------------------------------------------------- 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 6.00 Special Notes and Comments GARAGE, PATIO -AND MASTER BEDROOM ADDITION ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 28.41 STRONG MOTION (SMI) - RES 5.40 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total ---------- ---------- 609.32 -------------------- .00 .00 609.32 Plan Check Total 327.14 .00 .00 327.14 Other Fee Total 33.81 .00 .00 33.81 r t Application Number 04-00004370 Grand Total 970.27 .00 0 Page 3 Date 7/07/04 00 970.27 Date 7/20/04 No. 26200 Owner Donna Ricketson Address 46755 Highland Palms Dr.. City La Quinta Zip Tract # Type Single Family Residence CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 .� c�SSSUU� o Q BERMUDA DUNES (/)RANCHO MIRAGE �J INDIAN WELLS V^ PALM DESERT ,y t}� LA QUINTA �QIN010 y� O APN # 643191-013-13 Jurisdiction La Quinta Permit # Study Area No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 46755 Highland Palms Dr 588 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 v Unit 4 Unit 9 Unit 5 Unit 10 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: P EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to in the amount of $2.24 X 588 S.F. or $1,317.12 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/Downey Savings -Donna Ricketson Check No. 03610108991 Name on the check Telephone Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Espe Lara Payment Recd 1$0.00 $1,317.12 Over/Under Signature dk 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(§) or to another public entity authorized to collect them on the DistrictCs) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting