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BRES2016-0215- 4v aw. 78 495.;CA11E•.TANIPICO 4TA LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRES2016-0215 Property Address: 51081 AVENIDA RAMIREZ APN: 773061015 Application Description: GARCIA/ 2,548 SF DWELLING/VB/RES-3/CLASS A-FR/13D Property Zoning: a Q w Application Valuation: $164,129.80 Applicant: MICAH COMBS 75-145 ST. CHARLES PLACE #4 PALM DESERT, CA 92211 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: B License No.: 818121 6-a Contractor: kopr f`-� 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).: (_) 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 improve for the purpose of sale.). (_) 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.). (_) I am exempt under Sec. B.&P.C. for this reason Date: Owner: 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 Lender's VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: GARCIA ARMANDO & STELLA 80876 DARTMOUTH AVE INDIO, CA 92201 Contractor: K P HUDSON CONSTRUCTIO 40905 AMADOR DR INDIO, CA 92203 (760)275-6137 Llc. No.: 818121 Date: 10/26/2016 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. &Lf 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: EXEMPT Policy Number: 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: to uO �� Applicantg,.W CcJ �S 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. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official 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 of this city to enter upon the abovee--mentioned property for inspection purposes. Dat l a`s—� Signature (Applicant or Agent). z CD a Q w 0 o z og �o INC CD z L� �I 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. &Lf 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: EXEMPT Policy Number: 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: to uO �� Applicantg,.W CcJ �S 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. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official 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 of this city to enter upon the abovee--mentioned property for inspection purposes. Dat l a`s—� Signature (Applicant or Agent). Application Number: BRES2016-0215 Property Address: 51081 AVENIDA RAMIREZ APN: 773061015 Application Description: GARCIA/ 2,548 SF DWELLING/VB/RES-3/CLASS A-FR/13D Property Zoning: Application Valuation: $164,129.80 Applicant: MICAH COMBS 75-145 ST. CHARLES PLACE #4 PALM DESERT, CA 92211 Date: 10/26/2016 Owner: GARCIA ARMANDO & STELLA 80876 DARTMOUTH AVE INDIO, CA 92201 Contractor: K P HUDSON CONSTRUCTION INC 40905 AMADOR DR INDIO, CA 92203 (760)275-6137 Llc. No.: 818121 Detail: GARCIA / 2,548SF SINGLE FAMILY DWELLING - [VB/RES-3/CLASS A-FR/13D] (2,028 SF MAIN HOUSE W/ 520 SF ATTACHED CASITA) THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2013 CALIFORNIA BUILDING CODES. DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $7.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $7.00 DESCRIPTION ACCOUNT CITY AMOUNT TEMP POWER SERVICE 101-0000-42403 0 $24.17 DESCRIPTION ACCOUNT CITY AMOUNT TEMP POWER SERVICE PC 101-0000-42600 0 $16.92 Total Paid for ELECTRICAL: $41.09 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $36.99 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF, PC 101-0000-42600 0 $15.24 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $145.03 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $47.86 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $245.12 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT >7KSF 101-0000-42408 0 $36.26 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT >7KSF PC 101-0000-42600 0 $181.29 Total Paid for GRADING: $217.55 DESCRIPTION ACCOUNT CITY AMOUNT CONDENSER/COMPRESSOR 101-0000-42402 0 $72.52 DESCRIPTION . . ACCOUNT CITY AMOUNT CONDENSER/COMPRESSOR PC 101-0000-42600 0 $48.34 DESCRIPTION ACCOUNT CITY AMOUNT EXHAUST HOOD 101-0000-42402 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD PC 101-0000-42600 0 $4.83 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE 101-0000-42402 0 $72.52 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE PC 101-0000-42600 0 $48.34 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN 101-0000-42402 0 $60.45 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN PC 101-0000-42600 0 $24.15 Total Paid for MECHANICAL: $343.24 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PERMIT 101-0000-424000 $552.79 . Total Paid for; NEW CONSTRUCTION -PERMIT: $552.79 DESCRIPTION s ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600. 0 $1,129.94 Total Paid.for NEW CONSTRUCTION PLAN CHECK: $1,129.94 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER 101-0000=42401 0 $12.09 DESCRIPTION ACCOUNT - QTY AMOUNT BUILDING SEWER PC 101-0000-42600 0 $12.09 DESCRIPTION ACCOUNT, QTY AMOUNT FIXTURE/TRAP 101=0000=42401: 0 $169.26 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP PC 101--000042600 - 0 $169.26 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 1-4 OUTLETS 10170000-42401 0 $12.09 DESCRIPTION ACCOUNT. QTY AMOUNT GAS SYSTEM, 174,OUTLETS PC '101-0000-42600. 0' $24.17 DESCRIPTION ACCOUNT. QTY AMOUNT WATER HEATER/VENT 101-0000-.42401', '0 $12.09 DESCRIPTION ACCOUNT, QTY AMOUNT WATER HEATER/VENT PC. .101=0000-42600 0 $7.25 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000=42401 0 $12.09 DESCRIPTION' ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP PC 101=0000-42600 0 $12.09 Total Paidfor.PLUMBING FEES: $442.48 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL: 101-0000-20308. 0 $21.34 •Total.Paid foc STRONG MOTION�INSTRUMENTATION SMI: $21.34 i ' 2111611 ',1.✓x -�K .. F" "'e c` t" a " ,& � t ;. � �" TQTALS« .-.��'.:�'� 1 3M0 ., I o Ll � TUT44a" P.O. BOX 1504 Building / / Q y n p� 78-495 CALLE TAMPICO Address ` �/ V I F""TuT�i % 1 (�-9PUINTA, CALIFORNIA 92253 Address WI V RMEM, ME Cor P for 1� . lv 0 L 1 �%�r' Ill J I'-) I City State Lie. City & Classif. 00 i % (Z I Lie. # Arch., Engr., Designer Address Tel. Lie. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) - of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contrac- tor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that he 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 Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such 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 did not build or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & PC. for this reason Date Owner WORKER'S COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑Copy is filed with the city. ❑Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less). 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 Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT., If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. 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 of this city to enter the above -mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip APPLICATION ONLY BUILDING: TYPE CONIST. P. OCC. GR A.P. Number ;ii-l 3 I - O l�— Legal Description ��"",,��ii Project Description _�L Sq. Ft. No. No. Dw. Size Stories Units NeW16_ Add ❑ Alter ❑ Repair ❑ Demolition ❑ �Ain 0 - 2Ig Estimated Valuation ODr CIO PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL CONTACT INFORMATION NAME: PHONE: ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE Bin ## City of La Q Uin to Building lT Safety Division _ 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #f Project Address: S�-05� Owner's Name: A�Qj)c,, C,�(zelA A. P. Number: Address: Legal Description: City, ST; Zip: 1l,4o ZZOt Contractor: N Z (Q Telephone: (x� ZS�oi :. ;>xz�r:•w•.ra;.:.:<.:;:�.:..:: Address: LA09 C) S Project Description: city, ST, Zip: ( N p I C Q_,A ZZv3 Telephone: Ph o . O-S -3 State Lic. # : tJ ( City Lie. #; Arch., Engr., Designer: S U� Address: _ U' ' S City, ST, Zip: SPA 91L I 1 Telephone: e P - L -(v O�D 1 BEEN= O ccu antY• Construction Type: pp Y State Lic. # • Repair Project CYP (circle ne) N Alterai r Demo Name of Contact Person: wi I C-A (4 Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 0- -7 q - 72-& Estimated Value of Project: APPLICANT; DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. J "940/ Called Contact Person Plan Check Balance. Title 24 Cafes. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval Plans resubmitted Grading IN HOUSE:- '`'. Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.1.P.P. Pub. \Vks. Appr Date of permit issue School Fees, Total Permit Fees Date:10/18/2016 No.: 16-00376-1 Owner: Armando & Stella Garcia Address: City: Type: Single Family Residential Lot # Street No. 51081 Comments: CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Qunita, CA 92253 (760)771-8515 Email: Jurisdiction: La Quinta Tract #: Street Name Sq. Feet APN Avenida Ramirez 2548 773-061-015 0O%F1ED S C 2 y00 11 BER4/UppAA DUNES RANCHO MIRAGE rd W1tMM OESERWELLS Y � NACCKELLA p a'4 LA m A y�i• Permit No. At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residen*i under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking eating, or sanitation) or rep:,, - 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: EXEMPTION NOT APPLICABLE This certifies that school facility fess imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $3.48 X 2548 S.F. or $8,867.04 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in the proposed project may now be issued. Fees Paid By: CC/1st Bank - Stella Garcia Check No.: 1371789 Bank Name/Recipient of Certificate Telephone: 760-625-5665 Funding: Residential By Dr. Gary Rutherford Superintendent Fee Collected/ Exempted by: Sharon P Amount Due: 8,86:% Original Payrrent(s) Rec'd: $0 Cs New Paymer.; Rec'd: $8,867.04 rover/Under: $0.''G NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify yol�tt%at the 90-day approval period in which you may protest 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 :i: _ 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 to Building Department: THIS DOCUMENT VALID ONLY IF IMPRINTED WITH EMBOSSED SEAL.