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Home My WebLink About0212-057 (SFD)LICENSED CONTRACTOR 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 is in full force and effect. License # Lic. Class Exp. Date 183503 B1 C10 HIC 8/31104 Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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 & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). () I am exempt under Section B&P.C. for this reason Date Signature of Owner WORKER'S 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 issued. My workers' compensation insurance carrier & policy no. are: Carrier EXEMPT Policy No. (This section need not be completed if the permit valuation is for $100.00 or less). ( ) 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 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: Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $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. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his 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 applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 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 State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) Date 1 1 BUILDING PERMIT PERMIT# 0212-057 DATE VALUATION $397,380.90 LOT 27 TRACT 29147-1 JOB SITE ADDRESS 57-630 BALLYBUM014 APN 761-850-002 OWNER CONTRACTOR / DESIGNER / EN (NEER WEISKOPF PARTNERS, LLC KAHUILLA CONSTRUCTION INC 80-070 CHANTICLEER 78-070 CADIZ LAQUINTA CA 92253 LAQUINTA CA 92253 (760)564-4832 CBL# 3237 USE OF PERMIT SINGLE FAA/IIL.Y DWELLING SFD - LOT 27, PLAN 2B. PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH CUSTOM CONSTRUCTION 4,732.00 SF PORCHIPATIO 1,113.00 SF GARAGEICARPORT 712,00 SF ESTIMATED COST OF CONSTRUCTION 397,380.90 PERMIT FEE SUMMARY CONSTRUCTION FEE 101-000-418-000 $1,682,50 PLAN CHECK FEE 101-000-439-318 $1,353.71 MECHANICAL FEE 101-000-421-000 $137.00 ELECTRICAL FEE 101-000-420-000 $232.36 PLUMBI140 FEE 101-000-419.000 $233,75 STRONO MOTION FEE - RESID 101-000-241-000 $39.74 GRADING FEE 101.000-423-000 $15,00 DEVELOPER IMPACT FEE $2,405.00 ART IN PUBLIC PLACES - RESIE 270-000.445-000 $493,45 SUB -TOTAL CONSTRUCTION AND PLAN CHECK $6,592.57 LESS PRE -PAID FEES $0.00 TOTAL PERMIT FEES DUE NOW $6,592.37 RECEIPT DATE BY DATE FINALED INSPECTOR SPECIAL INSPECTION SERVICE REGISTERED INSPECTOR'S WEEKLY REPORT JON TANDY 37630 Medjool Ave. Palm Desert, CA 92211 Office (760) 772-7192 Fax (760) 772-7193 Pager (760) 776-3338 TYPE OF INSPECTION PERFORMED ❑ REINFORCED CONCRETE TRUCT. STEEL ASSEMBLY ❑ ❑ POST TENSIONED CONCRETE ❑ ASPHALT "BOTHERr, L/!( ❑ REINFORCED MASONRY ❑ FIRE PROOFING JOB LOCATION QULA�iY'i REPORT SEQUENCE N0. TVP STgl1C•TrURJE$s� �l ��1`• PERMIT NO. � DAV OF WEEK MATERIAL DESCRIPTIONX-3 - _ ^ (� o Pr ARCHITECT INS �OT R _ HRS. CHARGED T -IT G-rAA 'a ,I , ENGINEER ASSrISTAhTS HRS. CHARGED INSPEDATE CTION GENERAL SUB CpNTRACTOCJV `C'O i "l ij CONTRACTOR 03 6) 9; SL12Lkn Sk ; 6.," WuoN 8AS EL -O 13 CoLs -gAoP Lj e Qv� K 60 L,-- 0 6--ta • u-i421L. J1�1, (ems c• 6:5". COPY SENT TO CLIENT ❑ CONTINUED ON NEXT PAGE O PAGE OF CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MV KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS, AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. l� SON TUBE OF REGISTERE SPECT R 7_�� 1 o ATE OF REPORT REGISTER NUMBER Coachella Valley Unified S Nol District P.O. Box 847, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 Project Name: _ Owner's Name: Weikko Project Address: 57-660 Project Description: Two This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMM/MD. kNOUNT: DATE: RECEIPT, CHECK #, [NiTIALS. CERTIFICATE OF COMPLIANCE (California Education Code 17620) C Bally Bunion, 57-630 Bal Sinqle Family Dwellings APN: 761 850 002 761 850 003 Type of Development: Residential _ nylon Tract #• 29147-1 XX Commercial Total Square Feet of Building Area: 9096 Date: December 10, 2002 Phone No. 485-0497 inta, PGA The Summi Lot #'s: 27 & 28 Industrial Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized to sign on behalf of the owner/developer. Dated: U Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code Project Agreement Existing Not Subject to Fee 17620 65995 Approval Prior to 1/1/87 Requirement Note: Number of Sq.Ft. 909fi Amount per Sq.Ft. $ 9 - 16 Amount Collected $ 19,647.36 Building Permit Application Completed: Yes/No By: Carey M. Carlson Asst. Supt., Business Serv. Marcela Valdez Certificate issued by: Facilities Clerk Signature: Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90-day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90-day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. At such time as this Certificate expires, if a building permit has not been issued for the project that is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. MV:c/mydocs/devfees/certificate of compliance 09/30/02 Date: December 9, 2002 Owner: Weiskopf Partners 1,LLC 80-070 Chanticleer La Quinta, Ca 92253 PERMIT FEE SUMMARY Builder: Kahuilla Construction P.O. Box 366 La Quinta, Ca 92253 1?, 2$ Project: eg SFD, The Summit @ PGA West, Tract 29147-1, Lots-24-2.9; 4 Lot Plan Sq. Ft. Address APN Permit # Fees 27 2B 4,732 57-630 BALLY BUNION 761-850-002 ogja-05'7 6,592.57 28 1 B 4,364 57-660 BALLY BUNION 761-850-003 0,A1;-0.58 6,277.27 Total area: 9,096 Total permit fees: $12,869.84