04-5347 (SFD)► ,i!/� �.
BUILDING & SAFETY DEPARTMENT
P.O. Box 1504.
cwt 9T$=49- 5 G�LE TAM PICO (760) 777-7012
. FAX (760) 777-7011
L��JL-1Q1U11N1'1CALIFORNIA 92253 INSPECTION REQUESTS (760).777.-7153
JUL 0 9BUILDING PERMIT
r F ..QLi4rITA
`Appli'ga 's(anoEMT mbe . . 04-0.0005347 Date. 7%07/04
Property Address . . . . . . 78505 BOTTLE BRUSH DR
APN-:646-312-•056- - -
Application description DWELLING.- SINGLE FAMILY DETACHED
Property Zoning MEDIUM DENSITY RE -S
Applacation- valuation . 119569
Owner Contractor
POWER FINANCE CORONEL CONSTRUCTION
P..0... BOX: 134 P.O. BOX:389
LA QUINTA CA 92.2,53 LA QUINTA '. CA:'92253
(760) 564_-4604.
WCC: STATE FUND.
WC: 1744453 01/'01/05
• .. CSLB:. .. 634981 :,01/31/06
CCC: B=C13
-------- --------=------ Structure Information -------------=----7.-----
Construction Type TYPE.V - NON:RATED
Occupancy.Type . . . . DWELLG/LODGING/CONG <=10
Flood Zone NON -AO FLOOD ZONE
Other struct info.. CODE EDITION 2001 CBC
# BEDROOMS 3:00
FIRE SPRINKLERS N.0
GARAGE SQ FTG 480:00.
PATIO SQ FTG 34.00..
NUMBER. OF: UNITS.. i •0�
FIRST FLOOR -SQ FTG 1918..00.'
Permit BUILDING PERMIT
Additional:desc
Permit Fee .709.50 Plan Check. Fee 461:18
Issue Date Valuation 119569
:Qty Unit,Charge Pere Extension
BASE FEE 639.50
20.00 3.5000 THOU BLDG 100,001-5001000 70.00
Permit MECHANICAL
Additional. desc: .
Permit Fee 5`9.00 Plan Check Fee 14.75
Issue Date Valuation 0
Qty Unit Change Per Extension
P.O. Box 1504 VOICE -(7G0) 777=701-2
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUiNTA, CALIFORNIA 922.53 INSPECTIONS (760)'777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: O AI 53-417 Date: ?, ?• 0*9(
Applicant:
Applicant's Mailing Address:
Architect or Engineer::
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS"
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions f'C apter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my a is in full force and a //'�� m -
License Class Lij arse No.
Date --2-c
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors` State License Law for the following reason (Sea 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 Coetractors' State License Law (Chapter 9 (commendng 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 fora permit subjects
the applicent,to a dw'I penalty of not more than five hundred dollars ($500).):
U 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 Piofessions Code: The contractors' State License Law does not apply to an owner of properly who builds or improves thereon, and who does time 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 1, as owner of the property, am exclusively contracting with licensed contractors to constrict 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. ..8A P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION'
hereby affirm under penalty of perjury one of the following declarations:,
_ 1 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. ems compensation insurance carie and policy n are:
Carrier _ Vic_ C _, Policy Number k-7 4'A
_ I certify that, In the performance of the work for which ttmis pe Issued, I shall not employ, any person In any manner so as to become subject to the workers'
compensation laws of Cal' la; and agree that 'rf I shout me subject to the workerstcompensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with tho p ons.
Date —�-d� Applicant
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.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there Is a construction lending agency for the.perfommance 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 beingperfo 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 ce ced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit cancellation.
I certify that 1 have read this application and state that the ab v information is coFeet I agree comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this ccto en r upon a above menti property for inspection purposes.
Date `b` i Signature (Applicant or Agent):
Application Number . . . . . 04-00005347
Page 2
Date 7/07/04
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
3.00
6.5000
EA
MECH
VENT FAN
19.50
1.00
6.5000
EA
MECH
EXHAUST HOOD
6.50
----------------------------------------------------------------------------
Permit .
. . . . .
ELEC-NEW RESIDENTIAL
Additional
desc
Permit Fee
. . . .
106.73
Plan Check Fee
26.68
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per.
Extension
BASE
FEE
15.00
1918.00
.0350
ELEC
NEW RES.- 1 OR 2 FAMILY
67.13
480.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
9.60
1.00
15.0000
EA
ELEC
TEMPORARY POWER POLE
15.00
----------------------------------------------------------------------------
Permit .
. . . . .
PLUMBING
Additional
desc
Permit Fee
. . . .
147.00
Plan Check Fee
36.75
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
13.00
6.0000
EA
PLB
FIXTURE
78.00
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
----------------------------------------------------------------------------
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
----------------------------------------------------------------------------
Special Notes
and Comments
1918 S:F.
SFD PERMIT
DOES
NOT INCLUDE
Page 3
Application Number
. . . . .
04-00005347 Date
7/07/04
----------------------------------------------------------------------------
Special Notes and
Comments
BLOCK WAAL, POOL/SPA
OR DRIVEWAY
APPROACH
----------------------------------------------------------------------------
Other Fees . . .
. . . .
ART IN PUBLIC PLACES -RES
.00
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
46.12
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
STRONG MOTION (SMI) - RES
11.95
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary
-----------------
Charged
----------
Paid Credited
--------------------
Due
Permit Fee Total
1037.23
----------
.00 .00
1037.23
Plan Check Total
539.36
250.00 .00
289.36
Other Fee Total
2463.07
.00 .00
2463.07
Grand Total
4039.66
250.00 .00
3789.66
k9`,J
3�14
P.O. BOX 1504 APPLICATION ONLY
Building r _\ 5�\ ^\^ _�� 78-495 CALLE O
Address Q _ 1 \7C?�1 1� ?� LA QUINTA, CALIFORNIAORNIA 92253
Address m - �<�
CityZip. - � Tel
C � c�V(2 lcka�y-y6oy
ContLactor i 4 —k \
qty
Lrx C
Zip
r
Tel.
0%(
State Lic.
& Classif. i
City
Lic. #
Arch., En
Des ignertc)Lj\�,,�
Address
Tel.
City IZip n IState \
Lic. #
LICEN ED � RACTO�i'S DECLARATION '
that I arlice ed u�fd r provisions of Chapter 9 (commencing with Sect
3�tha si ess d rofessions Code, an my license is In full force i
OWNER•BUILOER DECLARATION
I hereby a ifm th I am exempt from the Contractors License Law for the following
reason: (Sec. 37. ,Business and Professions Code: Any city or county which requires a
permit to constru Iter, improve, demolish, or repair any structure, prior to is issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor'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 thealleged 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 (8500).
C1 1, 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, Buisness and
Professions 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.)
111, as owner of the property, am exclusively contracting with licensed contractors to con•
struct 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.)
I'! I am exempt under Sec. B. 8 P.C. for this reason
Date Owner
WORKERS' 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
(7 Copy is filed with the city. 0 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 (E700) valuation
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.
Date Owner
NOTICE TO APPLICANT: It, 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.
1 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 a0plicant Date
Mailing Address
City, State, Zip
WHITE = BUILDING DEPARTMENT
BUILDING: TYPE'C�OjNST. OCC. GRRPP,
A.P. NumberI
Legal DescriptionLCSyA
Project Description
Sq. Ft. , n i C, No.
No. Dw. 1
Units `
NewX Add ❑ Alter ❑ Repair ❑ Demolition ❑
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
RE
AMOUNT
ZONE: BY:-
Minimum
Y: 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 bv:
Validation:
YELLOW = APPLICANT
PINK = FINANCE
Date 7/9/04
No. 26155
Owner Coronel Enterprises
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515
APN #
Q BERMUDA DUNES
Cn RANCHO MIRAGE t7
�. INDIAN WELLS 'r
PALM DESERT ,y
�LA QUINTA
VQ INDIO^�
O J
646-312-056
Address 78505 Bottlebrush Jurisdiction La Quinta
City La Quinta Zip 92253 Permit #
Tract # Study Area
Type Single Family Residence No. of Units 1
Lot # No. Street
Unit 1 78505 Bottlebrush
Unit 2
Unit 3
Unit 4
Unit 5
Comments
S.F.
1918 Unit 6
Unit 7
Unit 8
Unit 9
Unit 10
Lot # No. Street S.F.
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, 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 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 $2.24X 1,918 S.F. or $4,296.32 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 CC -Valley Independent Bank-Ish Coronel Check No. 305700
Name on the check Telephone
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Beth Schieferstine
Signature A!�s
Funding Residential
Payment Recd $0.00
$4,296.32 Over/Under
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you 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 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
- Certificate. of Occupancy0
Lrwaouhn �4� 4
G�OF'TLBuilding & Safety Department
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: 78-505 BOTTLEBRUSH
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 04-5347
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RM
CORONEL ENTERPRISE. Address: 51-105 AVENIDA VILLA
City, ST, ZIP: LA QUINTA, CA 92253
^�
By: GARY SHOWALTER
Date: FEBRUARY 22, 2005
Building Official
POST IN A CONSPICUOUS PLACE
joili