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08-1002 (RER)
P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 08-00001002 Property Address: 79200 CAMINO AMARILLO APN: 604-192-018-54 -24517 - Application description: REMODEL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4576 T4ht 4 4 Q" Applicant: - ) Architect or Engineer: alp ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I 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/ B C53 License No.: 836088 Date: D.� ontractor: rMl WNER- ILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt rom the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Cade: 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 1, 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 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 fSec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT Owner: JEFFERS BRIAN S 79-200 CAMINO AMAILLO LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/05/08 D q Contractor: r� 1ST ATRIUM INC J/ P.O. BOX 3882 A n PALM DESERT, CA 9 26 " cuUj (760) 880-6606 Lic. No.: 836088 PINAE��./lypA ------------------ 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. 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 STATE FUND Policy Number 2290040182 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 beca b'ect to the workers' compensation laws of California, and agree that, if I should beco s ject t the workers' compensation provisions of Section //3700 he Labor Code, I all ith co y with those provisions. Date: iJ� pplicant: 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 1$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 relatedto 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 a infor ation is correct. I agree to comply with all city and county ordinances and state laws relating to building onstru , and hereby authorize representatives of this /c�ouInty to enter upon the above-mentioned pr party for spe r oses. Date: V�/ P o gnature (Applicant or Agent): Application Number . . . . . 08-00001002 Permit . . . . .BUILDING PERMIT Additional desc . . Permit Fee . . . . 72.00 Plan Check Fee 46.80 Issue Date . . . . Valuation . . . . 4576 Expiration Date . . 1/31/09 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 ---------------------------------------------------------------------------- 9.0000 THOU BLDG 2,001-25,000 27.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 17.80 Plan Check Fee 4.45 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/31/09 Qty Unit Charge Per Extension BASE FEE 15.00 80.00 ---------------------------------------------------------------------------- .0350 ELEC NEW RES - 1 OR 2 FAMILY 2.80 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 30.50 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/31/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH APPL REP/ALT/ADD 9.00 1.00 ---------------------------------------------------------------------------- 6.5000 EA MECH VENT FAN 6.50 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 30.00 Plan Check Fee 6.75 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/31/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 2.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 6.00 ---------------------------------------------------------------------------- Special Notes and Comments ADD NEW LAUNDRY ROOM IN GARAGE AND LQPER,N11T 0 LQPERINUT Application Number . . . . . 08-00001002 ---------------------------------------------------------------------------- Special Notes and Comments FIREPLACE IN MASTER BEDROOM. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 4.68 STRONG MOTION (SMI) - RES .50 Fee summary Charged Paid Credited Due --------------------------- Permi t Fee Total 150.30 -------------------- .00 ---------- .00 150.30 Plan Check Total 64.00 .00 .00 64.00 Other Fee Total 5.18 .00 .00 5.18 Grand Total 219.48 .00 .00 219.48 0 LQPERINUT Bin #2 City of La Quinta Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # lcop Project Address: Zoo k,,,. 4o 1 Cto Owner's Name: /1 e S A. P. Number: 60 Z _ —3 Address: 792ooz�a- Legal Description:2 2, City, ST, Zip: z- // Contractor: � %7 YYLvI(W G Telephone: Address: _ l�, p Project Description: City, ST, Zip: ! / Telephone: 70 d 6G� I State Lic. # : City Lic.#: �(� C'�ti �iYe �� kpL•kj Arch., Engr., Designer: ,?p©et�, /4 i�a Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: �y�, L Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 7r/pQ 880 6 p(o Estimated Value of Project: APPLICANT: DO DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACIUNG I PERMIT FEES Plan Sets Plan Check submitted Z/ Item Amount Structural Calc .;IT Reviewed, ready f r corrections rt2goPlan Check Deposit Truss Calcs. WevCalled Contact Pelson Plan Check Balance Energy Cal Plans picked up 141"10-1y V. Construction Flood plain plan Plans resubmitted Mechanical Grading plan 20° Review, ready 16rcorrectionshss�i Z Electrical Subcontactor List Called Contact Pers Plumbing Grant Deed Plans picked up % S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review, ready for correctio issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Pe ' F % f,bg 7/ l % WA// 'P6Rrai nM+ 1'� ass ubo R-�� 7l �' �Go`''� . sctIoo( res Date 8/4/08 No. 30154 Owner Jeffers Address 79-200 Camino Amarillo City La Quinta Zip 95523 Tract # Type Residential Addition CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 APN # Jurisdiction Permit # No. of Units Q BERMUDA DUNES h rn RANCHO MIRAGE 0 INDIAN WELLS 'ter �.� PALM DESERT .y LA QUINTA 4 QINDIO y� O 604-192-018-54 La Quinta 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 79200 Camino Amarillo 80 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 patios/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: Residential Addition 500 Sq Feet or Less EXEMPT This certifies that school facility fees imposed pursuant to in the amount of $0.00 X 80 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 Arne Perthus Check No. 0.00 Name on the check Telephone Funding Residential BY Dr. Sharon P. McGehee Superintendent . Fee collected /exempted by Es a Lara Payment Recd 80.00 Over/UhdO,, Signature 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 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 Districtfs) 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: (12.Z -OR 78-495 Calle Tampico -3 City Due Date La Quinta, Ca 92253 Project Address: 23.&p CAP{tl l0 AtAhe-liM Attn: Submittal: We are forwarding: JK By Messenger Includes: # Of Descriptions: Copies:' Plan Check #: Og- 1002- 0 0020 1 St ❑ 4d' ❑ 2nd ❑ 5th ❑ 3`d ❑ Other. ❑ By Mail (Fed Ex or UPS) ❑ Your Pickup Includes: # Of Copies: ❑ Structural Plans ❑ ❑ Structural Calcs ❑ Other: Truss Calcs ❑ ❑ Soils Report ❑ . ❑ Correction List B ❑ Redlined Structural Plans. t ❑ Redlined Structural Calcs ❑ ❑ Redlined Truss Calcs ❑ ❑ Redlined Soils Reports ❑ Comments: SaAh-SMARA 3—AR-PS Mg - Thank you! This Material Sent for: ❑ Your Files ❑ Your Review ❑ Checking Other: ❑ Palm Desert Office: ❑ # (760) 360-5770 Washington Office: ❑ # (760) 404-9556 Descriptions: Revised Structural Plans Revised Structural Calcs Revised Truss Calcs Revised Soils Report Approved Structural Plans Approved Structural Calcs Approved Truss Calcs Approved_Soils Report Other: Per Your Request ❑ Approval ❑ At the request of: