04-8262 (SFD)Property Address. 53875 AVENIDA RUBIO
APN: 774-152-020-8 _000000 -
Application description . . . DWELLING - SINGLE FAMILY DETACHED
Property Zoning COVE RESIDENTIAL
Application valuation . . . . 130495
)5
Owner
Contractor
- --- - - - - - - --- - - - - - - - - - -
BIRDSELL
- - - -----------------------=
BIRDSELL BUILDERS, JOSEPH
P.O. BOX 630
P.O. BOX 680
LA QUINTA
CA 92253 LA QUINTA' ..CA
92247
-(7-60) -3-60=2301
WCC: ROSTEN INS
WC: 2292649105
.11/22/05
CSLB: 811293
08/31/05
CCC:* B
------- Structure Information
1970 SQ. FT. SFD & 220 LN.FT. BLOCK WALL -----
Construction Type
TYPE V -.NON RATED.
Occupancy Type . . .
. . . DWELLG/LODGING/CONG <=10
Flood Zone .. . . . .
. . . NON -AO FLOOD ZONE
Other struct info
-CODE EDITION 2001
# BEDROOMS
3.00.
FIRE SPRINKLERS NO
GARAGE SQ FTG
470.00
PATIO.SQ FTG
233.00 -
NUMBER OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
1970.00
------------------------------------
Permit
----------------------------------------
BUILDING PERMIT
Additional desc
Permit Fee
748.00 Plan Check Fee'
222.55
Issue Date . . . . ..
Valuation
130495
Qty Unit Charge
Per
Extension
BASE FEE
639.50
31.00 3.5000
THOU- BLDG 100,001-500,000
108.50
------------------------------------------
Permit . . . . . .
-------------------------7
ELEC-NEW RESIDENTIAL
---------
Additional desc-.
Permit Fee . . . .
108.35 Plan Check Fee
27.09
Issue Date . . . .
Valuation . . . .
0
Qty Unit Charge
Per
Extension
BASE FEE
15.*00
1970.00 0350
ELEC NEW RES 1 OR 2 FAMILY
68.95
470.00 0200
ELEC GARAGE OR NON-RESIDENTIAL
9.40
1.00
EA ELEC.TEMPORARY POWER POLE
15.00
P.O. Box 1504 Tdf
78-495 CALLE TAMPtCO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number: b 82 6 z
Applicant:
Applicant's Mailing7Cddress:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under peialty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Piaee and my Licen is in full force and effect.
License Class k r-ense No.�/
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 requirss 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).):
(__) 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 Prcfessions 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. BA rC. for hid reason
Date -3 A-- T C7z=—
I 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 wait for which this permit is issued.
v 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�ps rance carrier n policy number are:
Carrier /JL5 Ts-�rV licy Number
�i G
_ 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 Califomia, d a9 gpe that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with tho4 provisi ns.1\ i
3-21
WARNING: FAILURE TO SECURE WORK0kS' COMPENSATION COVERAGE IS UNLA&A% L, 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.
I certify that I have read :his applicaI o n'd state that the above info tiorr's correct. I agree to comply with all city and county ordinances and state laws relating to building
;Dat
nstruction, and hereby authoriz presentatives of this cou o nt r upo the above-mentioned property for inspection purposes.
�� n'- G Signature (Applicant or Agent
Page
2
Application Number
. . . . . 04-00008262 Date
3/08/05
-----'-----------------------------------------------------------------------
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
65.50 Plan Check Fee
16.38
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 B/C <=3HP/100K BTU
9.00
4.00
6.5000'EA MECH VENT FAN.
26.00
1.00
6.5000 EA MECH EXHAUST HOOD
6.50
----------------------=-----------------------------------------------------
Permit . ...
. . . PLUMBING
Additional desc
Permit Fee .
. . . 141.00 Plan Check Fee
36.75
Issue Date .
. . . Valuation . . . .
0
Qty Unit
Charge Per
Extension
BASE FEE
15.00
12.00
6.0000 EA PLB FIXTURE
72.00
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
------------------7----------------------------------------------------------
Special Notes
and Comments
1970 SQ. FT. SFD.
THIS PERMIT DOES NOT
INCLUDE POOL,SPA
OR DRIVEWAY
APPROACH.
3/8/05 7:28:08
AM jjohnson this permit
reflects $250
deposite paid Aug. 31,
2004. ALSO 220
LN. FT. BLOCK WALLS ORCO
SPECS.
----------------------------------------------------------------------------
Other Fees ...
. . . . . . . ART IN PUBLIC PLACES-RES
.00
Page 3
Application Number
. . . . .
04-00008262 Date
3/08/05
----------------------------------------------------------------------------
Other Fees . .
. . . . .
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
22.26
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
12.49
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
Paid Credited
Due
Permit Fee Total
----------
1077.85
------------------------------
.00 .00
1077.85
Plan Check Total
302.77
.00 .00
302.77
Other Fee Total
2539.75
.00 .00
2539.75
Grand Total
3920.37
.00 .00
3920.37
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, 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 1,970 S.F. or $4,412.80 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 Commerce Title Company - Joe Birdsell Check No. 5111008871
Name on the check Telephone
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sharon cGllvrey Payment Recd 1$0.00
$4,412.80 Over/Under
Signature �4 ,
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will seR-'F'fo 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
Embossed Original -Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
��. Ce'rtificate of Occupancy
0OF1�Building Y p & Safet .De artm'ent
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: 53875 AVENIDA RUBIO
Use classification: SFD Building Permit No.. 05-259
Occupancy Group: R3U1 Type of Construction- VN Land Use Zone: RC
Owner of Building:. MR BIRDSELL Add ress:'78073 JALOUSIE
City, ST, ZIP- PALM DESERT CA 92211
By: KIRK KIRKLAND
Date: 1-20-2006
Building Off ici I
POST IN A CONSPICUOUS PLACE