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09-0789 (AR)P.O. BOX 1504 78-495 CALLE TAMPICO LA.QUINTA, CALIFORNIA 92253 Application Number: 09-00000789 Property Address: 56150 BALTUSROL APN: 775-360-020- - - Application description: ADDITION - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 110000 Applicant: Architect o��rr� Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: BRUCE & ANNE STREBINGER 56150 BALTLUSROL LA QUINTA, CA 92253 Contractor: 0 LANG CONSTRUCTION 80590 CAMINO SAN GREGERI BERMUDA DUNES, CA 92203 (760)834-9020 Lic. No.: B VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/18/09 w J CITY QF I ,q c:931IN7A ------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION - - ----------------------------------------------— WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided ense Class: 748605 License No.: B _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is \\\//// Date: #// i 0 Contractor:AQ,lyt Ld_ XgEl 9 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1889409-2008 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or3700 of�he Labor Code, I shall forthwith comply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by �// �I any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date: �ly C' Applicant: n4Rlwai w XA�rsi _ 1 _ 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). (_ 1 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.). 1 1 1 am exempt under Sec. , BAP.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a constructibn lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPER1111T 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 hereby authorize representatives oL this cc nty�pon the above-mentioned property for inspection purposes. Date: 6/l&% Signature (Applicant or Agent): &!!V ff Application Number . . . . . 09-00000789 ------ Structure Information 729 SF ADDITION REMODEL; ----- Other struct info . . . . . CODE EDITION 2007 # BEDROOMS 2.00 FLOOD ZONE NO GARAGE SQ FTG .00 PATIO SQ FTG .00 1ST FLOOR SQUARE FOOTAGE 729.00 ---------------------------------------------------------------------------- 2ND FLOOR SQUARE FOOTAGE .00 Permit . . . BUILDING PERMIT Additional desc 729 SF 2 BDRM ADDTN Permit Fee 674.50 Plan Check Fee 438.43 Issue Date . . . . Valuation . . . . 110000 Expiration Date . . 2/14/10 Qty Unit Charge Per Extension BASE FEE 639.50 10.00 3.5000 -----------------------------------------------= THOU BLDG 100,001-500,000 ---------------------------- 35.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . . Permit Fee . . . . 47.27 Plan Check Fee 11.82 Issue Date . . . . Valuation 0 Expiration Date . . 2/14/10 Qty Unit Charge Per Extension BASE FEE 15.00 729.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 25.52 9.00 .7500 ---------------------------------------------------------------------------- PER ELEC DEVICE/FIXTURE 1ST 20 6.75 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 46.00 Plan Check Fee 11.50 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/14/10 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 2.00 6.5000 ---------------------------------------------------------------------------- EA MECH VENT FAN 13.00 Permit . . . . PLUMBING LQPERMIT t. Application Number . . . . . 09-00000789 Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 52.50 Plan Check Fee 13.13 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/14/10 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 6.0000 EA PLB FIXTURE 24.00 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 3.0000 ---------------------------------------------------------------------------- EA PLB FIXTURE DRAIN/VENT REP/ALT 3.00 Permit . . . GRADING PERMIT Additional desc . .. Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation 0 Expiration Date 2/14/10 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 729 SF 2 BEDROOM ADDITION & MASTER BATH / HALL REMODEL TO EXISTING RESIDENCE. TYPE VB CONSTRUCTION, R-3 OCCUPANCY. 2007 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 5.00 ENERGY REVIEW FEE 43.84 STRONG MOTION (SMI) - RES 11.00 Fee summary Charged ---------- Paid Credited ---------- Due ----------------- Permit Fee Total -------------------- 835.27 .00 .00 835.27 Plan Check Total 474.88 .00 .00 474.88 Other Fee Total 59.84 .00 .00 59.84 Grand Total 1369.99 .00 .00 1369.99 LQPERI7IT Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 Project Name: This Box For District Use Only DEVELOPER FEES PAID AREA AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MR7GATION AMOUNT: COMM/IND. AMOUNT: DATE: RECEIPT: CBECK #: INITIALS: CERTIFICATE OF COMPLIANCE (California Education Code 17620) Date: 08/18/09 Owner's Name: Bruce & Anne Strebinger Phone No. (760) Project Address: 56-150 Baltusrol, La Quinta, CA 92253 Project Description: Addition & Remodel of Existing Residence APN: 775-360-020 Tract #: Lot #'s: Type of Development: Residential XX! Commercial Industrial Total Square Feet of Building Area: 729 sq. ft. 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: 08/18/09 Signature: sssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssss 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 Total Square Footage 729 Sq. Ft. Amount per Sq.Ft. $ 2.97 Amount Collected $ 2,165.13 Building Permit Application Completed: Yes/No By: Jamie T. Brown, Asst. Supt., Business Services Certificate issued by: Leticia C. Torres, Facilities Analyst Signature: Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this'�ct 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. LT:c/mydocs/devfees/certificate of compliance form tablesTO USG.Ac 9/11/08 IN ! l A ,! `f ' 'S i TdS FAIRWAYS ASSOCIATION August 4, 2009 Bruce and Anne Strebinger 338 N. Dollarton Hwy. N. Vancouver, BC Canada V7G 1N1 Re: Architectural Application Approval for 56-150 Baltusrol, La Quinta, CA 92253 Dear Bruce and Anne Strebinger: The Architectural Committee has reviewed your plans submitted for construction of a single story casita addition to the existing dwelling. I am pleased to inform you the Architectural Committee has approved your application with the following condition: Pending receipt of City of La Quinta Building Permits. Please forward copies of the permits when received to the address below. Enclosed .is Exhibit C — Compliance Review Request form. Please complete that form after the construction project is completed and mail or fax to the address below. If you have any questions, please contact Joe Gibbs, Operations Manager at 760-776-5100 Ext. 345. Sincerely, For the Architectural Committee PGA WEST Fairways Association Jerry McDonald, PCAM Association Manager Encl: Compliance Review Request Form cc: Lot File Larry Lang- Lang Construction, Inc. Post Office Box 1690 • La Quinta, California 92247 • Phone (760) 776-5100 • Fax (760)) 7766-511 j I/ 0P C`.