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05-3133 (AR)�j• 4 P.O. BOX 1504 w a 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number:, 05-00003133 Owner: Property Address: 79045 CALLE BRISA AMY MOGLIA APN: 649-450-033- - - 79045 CALLE BRISA Application description: ADDITION - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 32239 Contractor: Applicant: Architect or Engineer: HOWARD CONSTR DON DBA CHE 4 OUTSIDE CITY LIMITS D LA QUINTA, CA 92253 (760)341-0920 Lic. No:: 706794 I --------------------� LIC I ; I hereby affirm under penalty of perjury tha am Section 7000) of Division 3 of the Busine and I License Clals: Date: V (1_/uy Contractor: TRACTOR'S DECLARATION under provisions of Chapter 9 (commencing with rials Code, and my License is in full force and effect. Licans No.: 706794 r N;- BUILDER DECLARATION I hereby affirm under penalty of perjury that I a exe t 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).: (_ 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 ' 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.). (_ 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 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 Name: Lender's Address: LQPERMrT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date SEP 0 0 2005 CITY OF LA QUINTA WORKER'S COMPENSATION DECLARATION 9/06/05 I hereby affirm under penalty of perjury one of the following declarations: 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 whic this per yt is issued. My workers' compensation insurance carrier and policber y n cy Carrier STATE FUND P91 umber 31276 certify that, in the perf/de, ce o fie wo k for hich is Permit is issued, I shall not employ any ffqff��rson in any mannes to come bje tot a workers' compensation laws of California, 1d agree that, if I sbee sub) ct to a orke s' compensation provisions of Section 7QJ,�bf the Labor CI s forthw, th co p)� with hose provisions. Date: /IV/V/ Applicant: WARNING: FAILURE TO SECURE WO ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN L 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 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 rel/rize rk being performed under or following issuance of this permit. 2. Any permit issued as a result of this applicationpe o es nu vo/iworkmenced ithin 180 days from date of issuance of suc per it,o cess tions will subject permit to cancellation.I certify th I h ve read this application and state that he abov �ormati n is cmply with all city and c nt ordi99�aaces and state laws relating to wlding cooy�structio , and ereby esentatives of sco (nty ;e rt(er upon the above-mentioned p perty f �hs�pectio purp es. Date: v � Signature (Applicant or Agent): / t� Application Number . . . . . 05-00003133 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 304.00 Plan Check Fee 197.60 Issue Date . . . . - Valuation 32239 Expiration Date 3/05/06 Qty Unit Charge Per Extension BASE FEE 252.00 8.00 6.5000 THOU BLDG 25,001-50,000 ------------------------------------------------------- ------- 52.00 -------------- Permit . . . ELECT - ADD/ALT/REM Additional desc . . Permit'Fee 28.97 Plan Check Fee 7.24 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/05/06 Qty Unit Charge Per Extension BASE FEE 15.00 399.00 .0350 ELEC NEW RES - 1 OR 2 ----------------------------------------=-------------------- FAMILY --------------- 13.97 Permit . . . MECHANICAL Additional desc - Permit Fee . . . . 19.50 Plan Check Fee 4.88 Issue Date . . . . Valuation 0 Expiration Date.. . 3/05/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 --------------=------------------------------------------------------------- Special Notes and Comments RESIDENTIAL - 399 SQ.FT. ADDITION TO DETACHED CASITA. R-3 OCC. TYPE V -N CONSTRUCTION, 2001 CODES. **PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL OR SPA.** --------------------=-------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 19.76 STRONG MOTION (SMI) - RES 3.22 Fee summary Charged Paid Credited ---------- Due --------------------------- Permit Fee Total 352.47 ---------- .00 ---------- .00 352.47 Plan Check Total 209.72 .00 .00 209.72 Other Fee Total 22.98 .00 .00 22.98 LQPERMIT t I LQPERMIT Application Number Grand Total . . . . . 05-00003133 585.17 .00 .00 585.17 Date 9/6/05 No. 27627 Owner Amy Moglia Address 79045 Calle Brisa City La Quinta Zip 92253 CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 �AV, EDsc zc. o BERMUDA DUNES r RANCHO MIRAGE d INDIAN WELLS �.� PALM DESERT y LA OUINTA � OIN DIO N� 4 APN # 649-450-033 Jurisdiction La Quinta Permit # Tract # Study Area Type Residential Addition No. of Units Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 79045 Calle Brisa 399 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, residential additions under 5 00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: Residential Addition 500 Sq Feet or Less EXEMPT This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.00 X 399 S.F. or $0.00 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 Exempt -Dave Howard Check No. Name on the check Telephone Funding Exempt Supenmefl em , ti Fee collected /exem ted b Y $0.00 Y Patri Barbuzza Payment .00 =� `F Over/uncfe`�: ry Signature V NOTICE: Pursuant to Government Code Section (d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees o r 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 DistrictCs) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy - Accounting