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12-0341 (AR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 application _Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 12-00000341 80370 CAMARILLO WY 777-330-043- - - ADDITION - RESIDENTIAL LOW DENSITY RESIDENTIAL 7493 Architect or Engineer: iia BUILDING & SAFETY DEPARTMENT . BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION 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 _ License No.: 810010 Date:/. -5//Z Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt 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).: 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.). (_) 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: LQPERMIT Owner: HANSEN MICHAEL B/K A 80370 CAMARILLO WY LA QUINTA, CA 92253 Contractor: CALIFORNIA TECHNOLOGY 83750 CITRUS STREET, INDIO, CA 92201 (760)238-6854 Lic. No.: 810010 VOICE (760) 777-7012 'FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/03/12 TRUST WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty cf 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 EXEMPT Policy Number EXEMPT 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 agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code forthwith comply with those prov ns. Date: Applicant-l� D 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. 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. I certify that I have read this application and state that the above information 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 to enter upon the above-mentioned property for ' ction purposes. Date4Jhz- Signature (Applicant or Agent): Application Number . . . . . 12-00000341 ------ Structure Information 111SF PATIO ENCLOSURE/VB/RES-3/CLASS A ----- Other struct info . . . . . CODE EDITION 2010 FLOOD ZONE NO 1ST FLOOR SQUARE FOOTAGE 111.00 ---------------------------------------------------------------------------- Permit . . . BUILDING PERMIT Additional desc . . Permit Fee 99.00 Plan Check Fee 64.35 Issue Date . . . . Valuation . . . . 7493 Expiration Date . . 10/30/12 Qty Unit Charge Per Extension BASE FEE 45.00 6.00 9.0000 THOU BLDG 2,001-25,000 54.00 ---------------------------------------------------------------------------- Permit . . . ELECT ADD/ALT/REM Additional desc . Permit Fee 18.89 Plan Check Fee 4.72 Issue Date . . . . Valuation 0 Expiration Date 10/30/12 Qty Unit Charge -Per Extension . BASE FEE 15.00 111.00 .0350 ELEC NEW RES - 1 OR'2 FAMILY 3.89 ---------------------------------------------------------------------------- Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 19.50 Plan Check Fee 4.88 Issue Date . . . . Valuation . . . 0 Expiration Date 10/30/12 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 111SF PATIO ENCLOSURE TO INCREASE SIZE OF MASTER BEDROOM/VB/RES-3/CLASS A -FR [CONVENTIONAL] THIS PERMIT DOES NOT INCLUDE PLUMBING ALTERATIONS. 2010 CALIFORNIA BUILDING CODES. April 19, 2012 3:12:10 PM AORTEGA ---------------------------------------------------------------------------- Other Fees BLDG STDS ADMIN (SB1473) 1.00 LQPERMIT Application Number . . . . . 12-00000341 --------------------7------------------------------------------------------- Other Fees . . . . . . ENERGY REVIEW FEE 6.44 STRONG MOTION (SMI) - RES .75 Fee summary Charged Permit Fee Total 137.39 Plan Check Total 73.95 Other Fee Total 8.19 Grand Total 219.53 LQPERMIT Paid Credited Due .00 .00 137.39 .00 .00 73.95 .00 .00 8.19 .00 .00 219.53 CITY OF LA QUINTA'SUB-CONTRACTOR LIST JOB ADDRESS. R370 CA*-lajc.to war, . PERMIT NUMBER OWNER IA'tl+le NA"vssn/ BUILDER C%�-( 0�^++1► Knows By+ice This o C . Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by aDDlicant. "On File" is not an acceptable response. :. . Trade Classi(ie r "' ::.:;:.:.-_ , Cit,lBusi a Lice se' .'. anon Contractor .. ........:.:::.:r:::::;;>raStat�.Contrgctor .Ucerise."�"><::::.°.<;::.i>. ;. .:;,.< : � :.W.orlceis.C.om ensadon:Insurance:"s:' .,;»;:::'>::.:..' .> Company Name Classification License Number Exp. Date Carrier Name (e.g. A, B. C-8) (xxxxxx) (xx/xx/xx) (e.g. State Fund, CalComp) Policy Number (Format Varies) . Exp. Date License Number Ixx/xx/xx) (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12) , CONCRETE (C-8)" FRAMING :(C-5) ' .., STRUCT: STEEL ( 51) MASONRY (C-29) PLUMBING (C-36) LATH; PLASTER (636) DRYWALL (C-9) HVAC. (C-20) ELECTRICAL. (C-10)' . ROOFING SHEET METAL (C43)' ? FLO RING l¢:=:15); GLAZING'IC-17);." VA MASS C'� lL Dslos sNs. Co. 6ZDr_Z 1 (011-7112, 16G 2-9 1 30l INSULATION(C-2). SEWAGE DISP; (C -A2) ' PAINTING (C=33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13) LANDSCAPING (C;27) POOL (C-53) `Coaehella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMM/IND. AMOUNT: DATE: RECEIPT: CHECK#: F.N1ALS CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name:Mouritain View Country Club, Owner's Name: Michael Hansen Project Address: 80-370 Camarillo Way, LaQuinta, CA Project Description: Patio Enclosure/Addition APN: 777-330-043 Tract #: Type of Development: Residential X Total Square Feet of Building Area: Commercial 111 Certification of Applicant/Owners: The person signing certifies that the above ii penalty of perjury and further represents that he/she is authorized t sign behalf Dated: April 25, 2012 Signature: Date: April 25, 2012 Phone No. Lot #'s: Industrial tion is correct and makes this statement under owner/developer. SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code 17620 65995 Number of Sq.Ft. 111 Amount per Sq.Ft. $.00 Amount Collected $.00 Project Agreement Existing Not Subject to Fee Approval Prior to 1/1/87 Requirement Building Permit Application Completed: Yes/No By: Elsa F. Esqueda, Director of Facilities and Maintenance Note: Pursuant to AB 181 any room additions or enclosures of 500 sq. ft. or less are exempt from developer fees. Any mobile homes being relocated within the same school district's jurisdiction are exempt from developer fees. Certificate issued by: Laurie Howard, Secretary Signature: (�L�t.L.t.� .442i c--,- `�— NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. i\1V:c/nlydocs/devfee,�/certificate ofaunpliance Form updated 3-2007 11/2010 The Management Trust MONARCH GROUP DIVISION April 06, 2012 MICHAEL B HANSEN RE: Architectural Submittal for 80-370 CAMARILLO WAY Account#401417 Dear Homeowner: The Architectural Review Committee for MOUNTAIN VIEW HOA has reviewed and APPROVED your architectural submittal for the installation of Enclosing the covered patio off the master bedroom and Repainting in scheme # 1 per the plans submitted. All construction must commence within 365 days of this approval letter. If construction has not been commenced within the 365 days, such approval shall be deemed withdrawn. ARC approval of plans shall not constitute a representation, warranty, or guarantee that such plans and specifications comply with engineering design practices or zoning and building ordinances, or other governmental agency regulations or restrictions. The ARC shall not be responsible for reviewing, nor shall its approval of any plans or design, be deemed approved from the standpoint of structural safety or conformance with building or other codes. By approving such: plans and specifications, neither the ARC, the Members thereof, the Association, any Member thereof, their Board .of Directors, any Members thereof, or the Declarant assumes any liability or responsibility therefore or for any defect in the construction or improvement from such plans or specifications. As provided in the CC&R's neither the ARC, the Association, the Board of Directors or the Association or any Members thereof, not the Declarant or Developer shall be liable to any Member, Owner, Occupant, or other person or entity for any damage, loss or prejudice s uffered or claimed on account of (1) the approval or disapproval of any plans, drawings, or specifications, whether or not defective, or (2) the construction or performance of any work whether or not pursuant to the approved plans, drawings, or specifications. Your patience and cooperation with the architectural review process is appreciated. If you have any questions, please contact the association at (760) 776-5100, Extension 333. Sincerely, On behalf of the MOUNTAIN VIEW HOA Architectural Review Committee Heather Yslas I Association Assistant Manager Jamie Hansen The Management Trust - Monarch Group Division Enclosures (1) cc: Board of Directors .. .. Unit File 39755 Berkey Drive, Suite A, Palm Desert, CA 92211 CONNECTING PEOPLETOTHE PROMISE PH: 760.776.5100 FAX: 760.776.5111 www.managementtrust.com Bin.# � Crty of b Quo : ta Building a Safety Division . P.O. Box 1504,78-495 Cai(e Tampico, La.Qltinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # F !� 3 Project Address:. 3"�� W&IOwner's Name:.MAM A. P. Number Address-. *)blo Legal Description:. Contractor. t .AL i Fe Q o t O City, ST, Zip: l9oum6, 6A Tele hone: p Address: S-0 i -MUS AVV, `IAS Project Description: City, ST, Zip: :�-T-U_b 10 e.A - Telephone: Ch, 0) 23$ -b 'v .��>. ' State Lia # : eoo l o City Lie'. #, Arch., Engr., Designcr: Address: City, ST, Zip: to 122W Telephone: 2 ' ' '° Construction Type: - Occupancy: State Lic. #: Project type (circle one): New dd' Alter Repair Demo Name of Contact Person:�j Sq. Ft : # Stories: SI411g#Units: Telephone # of Contact Person: O 4j Estimated Value of Project ©pp •- �q3 tftQ. APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACICYIVG PERMIT FEES Plan Sets 3 Plan Check submitted 1317 Item Amount Structural Calm Reviewed, ready for corrections Plan Check Deposit. Trawn talcs. Called Contact Person Plan Check Balance Title 24 Cales.a Pians piclad ap Construction,1 Flood plain plan I Plans resubmitted Mecharilcal �1•� Grading plan 2' Review, ready for correctionsrissue `�' .i1� Electrical Subcostactor List Called Contact Person Plumbing �.. Grant Deed Plans picked up SILL H.O.A. Approval i resubmitted Grading IN HOUSE:- Review; ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue 1i0 School Fees Total Permit im1q .