04-5026 (AR)BUILDING '&, SAFETY DEPARTMENT
P.O. Box.. 1'504. = ': (760),777-7012
78-495 CALLE-TAMPIC.O FAX (760) 777-7011
LA QUINTA, CALIFORNIA,;92253 INSPECTION REQUESTS .(760) 777.-71:53
BUILDING PERMIT
Application' Number
04-0.0_ 005026 Date
6/24/04
Property Address
o52190 AVENIDA RAMIREZ
APN:,7737222=010-13
: '000Q0.0-
Application description ". ADDITI.ON'_,PRESIDENTIAL
Property Zoning . . .
. COVE RESIDENTIAL
•Applicat,ion valuation:
4'-3129
Owner
Contractor
LEON.SAUL.
,.OWNER:
.52190,.AVENIDA RAMIREZ:
r
LA :.QUI NTA . "'
CA: 9.2 2 53 :..
- - - _ - - Structure '.Informat
ion• :FAMILY ADD, ". RELOCATE KITCHEN' : ; :
- - - - -
Construct on ;Type
;TYPE ,V.° NON
"O.ccupan'cy Type'.
DWELLG/LODGIN(VCONG <=1.0.
Flood Zone
NON P,Q', FLOOD" ZONE
Other •struct. info"
CODE 'EDITION,.- '2001
CBC .
FLOOD ZONE.., NO
FIRST •FLOOR SQ FTG
754.0.0
,.
" ---------=--------------------------_-
---- -------------1,-`-------------------------
Permit . . . . .
BUILDING .PERMIT . ,
Additional desc
Permit Fee--.:
375`:50 Plan' Check ,Fe.e
244.08
Issue Date
Valuations
43129
Qty Unit, Charge
Per.•
Extension
�. BASE"FEE `;:'.
. ,252.00
.19..00 6.5000
THOU` " BLDG 2.5,.001-5'0",.000,
123.50
Permit"
ELECT - ADD/ALT/REM '
6
Addittonal desc
Permit Fee
59 54 Plan•Cheek Fee
14.89
Issue Date . . .
Valuation;
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
754.00 :03.50
ELEC NEW RES'-.1.OR 2 FAMILY
26.39
20.00 -750'0
.PER ELEC. DEVI;QE/"FIXTURE " 1ST 20
15.00
•7.,00 4500.
EA ELEC DEVICE%FIXTURE '>20
3.15
Permit
Add i.t i
Permit
CITY OF LA QUINTA
I'CAL
4:00 Plan 'Cheek Fee 6.00
✓ , I
P.O. Box 15044�� VOICE -(760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760)'777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: O .$-0,2 Date:
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Address:
pv/74
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
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 Class License No.
Date Contractor
OWNER -BUILDER DECLARATION
I hereby affirn 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 perrhit 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
' 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 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 contractors) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. BA P. .for this mason
Z
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.
_ 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:
Cartier 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 agreecome subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
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 3708 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.
certify that I have read this application and state that the above inform
nfor maI' n 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 county toe er u n the above-mentioned property for inspection purposes.
/Date ! Signature (Applicant or Agent):
I
Page
2
Application Number
04-.00005026 1 Date
6/24/04
Issue Date
Valuation'
0
Qty Unit Charge
Per
Extension
BASE FEE- �
.15.00
1.00 9.0000
EA MECH`eAPPL
REP/ALT/ADD
9.00
Permit . .
PLUMBING
Additional desc
Permit -Fee
•27.00
Plan Check Fee
6.75
Issue Date
Valuation,
0
Qty Unit Charge
Per:
Extension
BASE -FEE
15.00
1.00 6.0000
EA PLB,,FIXTURE
6.00
1.00 3.000.0
EA PLB`•WATER'IN8T/ALT/REP
3.00-
1.00 3:0'00:0
EA PLB GAS PIPE 1-4 OUTLETS
3.00
Special Notes and,Comments
FAMILY ROOM ADDITION
AND RELOCATE
KITCHEN
Other FeesENERGY
REVIEW -FEE
24.41
STRONG'
MOTION; ( SMI ).. - RES
4..31
Fee summary Charged.
Paid Credited
Due
Permit Fee,Total
486.0.4
:00 ..00
486.0,4
Plan Check Total
271_'-72..'-
00 `.00
271.72
.Other Fee Total
28.72
.00 .00
28.72
Grand Total
786.418
.00 0,0
786.48
I
CERTIFICATE OF COMPLIANCE
Desert„Sands Unified School District
47950 -Dune Palms Road, ¢ gERMUDADUNES r
Date 7/22/04 La QUI.n Af CA 92263; Cn RANCHO MIRAGE
- N INDIAN WELLS
760 771-8515 PALM DESERT
No. 26213 ( ) `�� LA QUINTA
11 w1 l0 L�
0
Owner Saul Leon APN # 773-222-010
Address 52190 Avenida Ramirez Jurisdiction La Quinta
City La Quinta Zip 92253 Permit #
Tract # Study Area
Type. Residential Addition No: of Units 1
Lot # No. Street S.F. tot # No'. Street S.F.
Unit 1 52190 Avenida Ramirez 754 Unit 6
Unit 2 Unitj7
Unit 3 Unit8
Unit 4 Unrt'9
Unit 5 Unit 10
Comments
At the present time, the Desert Sands Unified School -District. does not collect fees on garagestcarports, covered patiosANalkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for.1iving, 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 thistime due to the following reason:
Y
EXEMPTION NOT'APPLICABLE .
This certifies that school facility fees imposed pursuant to.
Education Code Section 17620 and Government Code 65995,EtSeq..
p.
in the amount of $2.24 X 754. S.F.. or $1;688.96 haVeitIpen paid for thb 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 Cash -Saul Leon: Check No.
Name on the check Telephone< 771-3697
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Beth Schleferstine Payment Recd $0.00
$1,688.96 Over/Under
Signature AaV
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify, -y6u 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 Districts) onto another public entity.auttionzed to collect them on the Districtrs) behalf; whichever is earlier.
NOTICE: ThisDocutnent NOT. VALID; if-DuPliGated
Embossed Original - Building Department/Applicant Copyi= Applicant/ Receipt Copy - Accounting
r / 1
'Bin
3 City of La QWnta
Bwlding at Safety Division
Permit # P.0- Box 1504,78-495 Calle Tampico
. S0 La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
J< Project Address: —Z ( of d Owner's Name:
A P. Number
7 –7:!) .Z2z d I DAddress:
2_1 0z -
Legal Description:
Contractor Cary, ST, Zip: a
X r. 2 _
iC i F Tcicphonc: 7 7 `– 36 GL 7
x Address:All) s -
ject Dcscr•ipti n-
J� City, ST, Zip: -
dC Telephone:
C .001
State Lie. M City Lie d:� (_O
Arch., Engr., DCSISncr: � � 142)O (]f /•�
�, ®C
Addresr. ctVl. U�.t.
Io,
Cit)•. ST, Zip: L.o �
Telephone:
:. Construction Type
is: `` • ; panty:
State Lie.
P!0ject type (circle one): New Add'n Alta Repair Demo
X Name of Contact Person:
Sq'. FL:
r Stories: r Units:
Telephone d of Contact Person;
. Value of Project: `7 /000-1
APPLICANT: DO NOT WRITE BELOW THIS UNE
tt Submittal Req•d Reed TRACKING
• PERMIT FEES
Plan Sets Plan Check submitted.
6 /% Item Amount
Structural talcs. Reviewed, ready for corrections
246 Plan Cbeck Deposit.
Truss Gla. Called Contact Person
• 0 Plan Check Balance 1
Energy Gla. Plans oieked up -7/Z,
Construction
Flood plain plan Plans resubmitted
ktechaoical
Grading pian Y' Review, ready for eorrectio usu , 6
Electrical
Subcontactor List Glkd Contact Person�' L
�1 Plum,
Grant Decd Plans picked up
SALT.
N-O.A. Approval Plans resubmitted
Grading
IN HOUSE:- a"' Review, ready for eorrccNons�ivae Developer Impact Fee
Planning Approval Called Contact Person
A.I.P.P.
Pub. Wks. Appr ate of permit sm., School Fees ism
cal Permit Fees