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07-3221 (AR)P.O. BOX 1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number!Z�---—07 00003221_ Property Address: 79200 CAMINO AMARILLO APN: 604-192-018-54 -24517 - Application description: ADDITION - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 100000 Applicant: Architect or Engineer: 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: JEFFERS BRIAN S 79-200 CAMINO AMARILLO D LA QUINTA, CA 92253 Contractor: 1ST ATRIUM INC P.O. BOX 3882 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/14/08 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: LQPEPUNI 11' of La ouinta, 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 abninf is correct. I agree to Comply withall city and county ordinances and state laws relating to buildingnd hereby authorize representatives of thi u r upon t e above-mentioned propertytoposes. te: Si .lure (Applicant or Agent): UJNA- - DESERT, CA 92261 PALM Lic- No.: 836088 ------------------------------------------------------------------------------------------------- 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 fess ionals Code, and my License is in full force and effect. _ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: B C53 License No.: 836088 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ate: ntractor: 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 EXEMPT Policy Number EXEMPT following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to 1 certify that, in the performance of t ork 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 ecome su 'ect 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 be ubject o the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 f the L bar Code, I shy hwith mply with those provisions. 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).: ate: 1 1 plicant: (_ 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 WORK S' 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 f$1 00,000). 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.). APPLICANT ACKNOWLEDGEMENT (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, ( 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City 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: LQPEPUNI 11' of La ouinta, 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 abninf is correct. I agree to Comply withall city and county ordinances and state laws relating to buildingnd hereby authorize representatives of thi u r upon t e above-mentioned propertytoposes. te: Si .lure (Applicant or Agent): UJNA- - Application Number . . . 07-00003221 Permit . . . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 41.85 Plan Check Fee 10.46 Issue Date . . . . Valuation 0 Expiration Date . . 10/08/08 Qty Unit Charge Per Extension BASE FEE 15.00 767.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 26.85 ---------------------------------------------------------------------------- Permit . Additional desc Permit Fee Issue Date Expiration Date BUILDING PERMIT 639.50 10/08/08 Plan Check Fee . . 415.68 Valuation . . . . 100000 Qty Unit Charge Per Extension BASE FEE 414.50 50.00 -----------------------=----------------------------------------------------- 4.5000 THOU. BLDG 50,001-100,000 225.00 Permit . . . . . MECHANICAL PLB WATER HEATER/VENT 7.50 Additional desc . EA PLB WATER INST/ALT/REP 3.00 Permit Fee and Comments 52.50 Plan Check Fee 13.13 Issue Date 676 SQ. FT. Valuation . . . . 0 Expiration Date 10/08/08 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 Permit . Additional desc Permit Fee Issue Date Expiration Date PLUMBING 79.50 Plan Check Fee . . Valuation . . . . 10/08/08 19.88 0 Qty Unit Charge Per Extension BASE FEE 15.00 9.00 6.0000 EA PLB FIXTURE 54.00 1.00• 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ---------------------------------------------------------------------------- Special Notes and Comments REM / ADDITION 676 SQ. FT. ADDITION WITH LQPERINITT I Application Number 07-00003221 ---------------------------------------------------------------------------- Special Notes and Comments INTEROR REMODEL TWO BEDROOMS AND MASTER BEDROOM ADDITION. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 41.57 STRONG MOTION (SMI) - RES 10.00 Fee summary ----------------- Charged ---------- Paid Credited ------------------------------ Due 'Permit Fee Total 813.35 00 .00 813.35 Plan Check Total 459.15 .00 .00 459.15 Other Fee Total 51.57 .00 .00 51.57 Grand Total 1324.07 .00 .00 1324.07 LQPIiRD11T CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road Q BERMUDA DUNES r C40 RANCHO MIRAGE (� Date 4/15/08 La Quinta, CA 92253 NJ INDIAN WELLS Vi PALM DESERT ,y No. 29998 (760) 771-8515 v LA OUINTA QINDIO y� 0 Owner Jeffers APN # 604-192-018 Address 79200 Camino Amarillo Jurisdiction La Quinta City La Quinta Zip Permit # Tract # No. of Units 1 Type Residential Addition Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 79200 Camino Amarillo 767 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments (Corrected misspelling on city form from Amerillo to Amarillo) At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiost walkways, 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: 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 $2.97 X 767 S.F. or $2,277.99 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/Bank of America - Arnie Perthus Check No. 420904443 Name on the check Telephone Funding Residential By - Dr. Sharon P. McGehee Superintendent Fee collectec Signature e. - ' f Payment Recd =Overe- $2,277.99 � � ./Undr-- :v .i'+ NOTICE: Pursuant to Government Code Section 66020(d)(1), this 'll rve 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 ~ 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 colied them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID without embossed seal Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting Letter of Transmittal To: City of La Quinta Today's Date.gOf, Your Files ' ' 78-495 Calle Tampico City Due Date : Jog Checking La Quinta, Ca 92253 Project Address: ❑ Attn: Plan Check #: 07 - 37-2,1 Submittal: ❑ ist ❑ 4th ❑ 2nd ❑ 5th K 3`d ❑ Other: We are forwarding: _--e By Messenger ❑ By Mail (Fed Ex or UPS) ❑ Your Pickup Includes: # Of Descriptions: Includes: # Of Descriptions: Copies: Copies: ❑ Structural Plans ,� Revised Structural Plans ❑ Structural Calcs �- �_ Revised Structural Calcs ❑ Truss Calcs ❑ Revised Truss Calcs ❑ Soils Report ❑ Revised Soils Report ❑ Correction List ❑ Approved Structural Plans Redlined Structural Plans ❑ Approved Structural Calcs ,�- Redlined Structural Calcs ❑ Approved Truss Calcs ❑ Redlined Truss Calcs ❑ Approved Soils Report ❑ Redlined Soils Reports ❑ Other: Comments: "!:ArUCAlAT� PV.MC4., n", Thank vou! This Material Sent for: ❑ Your Files ❑ Your Review ❑ Checking Other: ❑ By: b_}m, m; f224 Palm Desert Office: ❑ # (760) 360-5770 Washington Office: ❑ # (760) 404-9556 ] Per Your Request /❑l Approval ❑ At the request of: