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RER-14-781uia 3-495 CALLE TAMPICO D Q� VOICE (760) 777-7125 • FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 8/13/2014 Application Number: RER-14-781 Owner: Property Address: 79975 RANCHO LA QUINTA DR KEN ROBERTSON APN: 649740011 79975 RANCHO LA QUINTA DRIVE Application Description: CONVERT CASITA TO GARAGE LA QUINTA, CA 92253 Property Zoning: Application Valuation: $0.00 D Q 0 Applicant: �• AUG 13 2014 Contractor: RAWLINGS CUSTOM CONTRACTING' RAWLINGS CUSTOM CONTRACTING P.O. BOX 3216 L P.O. BOX 3216 PALM SPRINGS, CA 92263 \ CITY OF LA QUINTA PALM SPRINGS, CA 92263 ``/1 COMMUNITI' DEVELOPMENT DEPARTMENT (760)322-8788 Llc. No.: 746930 [ l LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am license der pr • visions of Chapter 9 (commencing with Section 7000) of Division 3 oft u ess and rofes " ns Code, and my License is in full force and effect. Lice se�Cilass: Bim] License No.: 746930 Date: ° —�P -// Contrac 'F 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).: (_) 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.). (_) 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 Lender's 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 isrl workers' compensation insurance carrier and policy number are: CarPolicy Number: �- ertifythat in the performance of the wo o hich this permit is issued, shall not employ any person in any manner so as eco a bject to the workers' compensation laws of California, and agree th , if I )��e h d b ome subject to the workers' compensation provisions of Sectio 700La r e hall forthwith comply with those provisions. Late: 9 -1:2 -/ `i 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 Building Official 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 i rm ion is orrect. I agree to comply with all city and county ordinances and stat ws re_ng to uilding construction, and hereby authorize representatives of this ci to en//pont a ov mentioned property for inspection purposes. fate: 9-/g-/ Z7) Signature (Applicant or Age DESCRIPTION FINANCIAL INFORMATION ACCOUNT QTY AMOUNT PAID PAID DATE' BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 8/13/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY RAWLINGS CUSTOM CONTRACTING CHECK R689 7307 AOR Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00 DESCRIPTION ACCOUNT - QTY AMOUNT PAID PAID DATE FIXTURES, FIRST 20 101-0000-42403 1 $23.83 $23.83 8/13/14 PAID BY METHOD RECEIPT # "` CHECK # CLTD BY RAWLINGS CUSTOM CONTRACTING CHECK R689„ 7307 AOR Total Paid for ELECTRICAL: $23.83 $23.83 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PLAN CHECK, ELECTRICAL 10160003428200 $23.83 $23.83 8/13/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY RAWLINGS CUSTOM CONTRACTING CHECK R689 7307 AOR Total Paid forPLAN CHECK, ELECTRICAL: $23.83 $23.83 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PLAN CHECK, REMODEL 10160003428200 $132.99 $132.99 8/13/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY RAWLINGS CUSTOM CONTRACTING CHECK R689 7307 AOR DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PLAN CHECK, REMODEL 10160003428200 $17.16 $17.16 8/13/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY RAWLINGS CUSTOM CONTRACTING CHECK ! R689 7307 AOR Total Paid forPLAN CHECK, REMODEL: $150.15 $150.15 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE REMODEL, EA ADDITIONAL 500 SF 101-0000-42400 0 $21.45 $21.45 8/13/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY RAWLINGS CUSTOM CONTRACTING CHECK R689 7307 AOR DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE REMODEL, FIRST 100 SF 101-0000-42400 0, $48.62 $48.62 8/13/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY RAWLINGS CUSTOM CONTRACTING CHECK R689 7307 AOR Total Paid for REMODEL: $70.07 $70.07 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.50 8/13/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY RAWLINGS CUSTOM CONTRACTING CHECK R689 7307 AOR Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.50 $0.50 TOTALS: Qin # (� City of La Quinta Building 8t Safety Division P.O. Box 1504, 78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: S �T•A �iZ . Owner's Name: tc3K IQGbSKJ%M A. P. Number: Z $70 -011-+ Address: -14191S R69MQ LA Legal Description: City, ST, Zip: LA 40014TA Contractor::`:':' 1W Telephone: «< >'•>s <:v %. Address: Project Description: City, ST, Zip: SI . -.Tb AA Go Telephone: An 2.8 8a lliii..::vi::j it}:'w:::.i'•: 4ii: is iii •'«'>: `#; <QSRAG�-. State Lie. # : 14L, jg City Lie. Arch., Engr., Designer: JONSMAN Address: '7: 50 VL ME012 VM- 10-7 City, ST, Zip:.JwApigr L14 'r Tele hone:. P 17 8 <?€;:<.:;:>:.:::.;>::•s :>::>;:l:>s .;<::>•s::: .i. i l' State Lic. #: C�`•»':?:>:<:>:: # :>:ys: G JA3 Construction Type: Occupancy: Project type (circle one): New Add, n Ite Repair Demo Name of Contact Person: Sq. Ft.: ��. # Stories: # Units: Telephone # of Contact Person: 8 Estimated Value of Project: Ott Q APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'.d TRACKING PERMIT FEES. Plan Sets Plan Check submitted Item Amount Structural Cates. Revicwed, ready for corrections Plan Check Deposit Truss Cala. Called Contact Person Plan Check Balance Title 24 Cala. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan god Review, ready for corrections/issue O Electrical Subcontactor List Called Contact Person PIumbi Grant Deed Plans picked up S. H.O.A. Approval Plans resubmitted Gradi IN HOUSE: '"' Review, ready for correctionstissue Develoier IF Planning Approval Called Contact Person A.I.P.P. u Pub. Wks. Appr Date of permit issue . 1 School Fees Total Permi s v v �vi7 - ' — CITY OF .LA QUINTA COMMUNITY DEVELOP C MENT CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road Date 8/13/14 La Quinta, CA 92253 No. 32244 (760) 771-8515 .Owner Ken Robertson Address 79975 Rancho La Quinta Dr City La Quinta Zip . Tract # Type Garage Addition BERMUDA DUNES Cn RANCHO MIRAGE INDIAN WELLS PALM DESERT y LAQUINTA „jam QINDIO y� 0 APN # 602-370-011-4 Jurisdiction La Quinta Permit # No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 79975 Rancho La Quinta Dr 114 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments Convert Casita to Golf Cart Garage 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: Convert Residential to Garage EXEMPT This certifies that school facility fees imposed pursuant•to in the amount of $0.00 X 114 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 - Patrick Rawlings Check No. Bank Name/Recipient of Certificate Telephone 760-275-8568 Funding Exempt By Dr. Gary Rutherford Superintendent t Fee collected /exem d bySh rop4cailvrey Payment Recd Ua;,FrlUnder r Signature NOTICE: Pursuant to Government Code Section 66n2, 0)(1), thisVill 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 without embossed seal Embossed Original Building Department Applicant Copy - Applicant/Receipt Copy - Accounting Cw Tihf 4 4 Q. am r10 COMMUNITY DEVELOPMENT DEPARTMENT 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 (760) 777-7012 FAX (760) 777-7011 CERTIFICATION OF BUILDING AREA STREET ADDRESS OF JOB: 79-975 RANCO LA QUINTA DR. APN: 602-370-011-4 DESCRIPTION OF WORK: CONVERT CASITA TO GOLF CART GARAGE SQUARE FOOTAGE: 114 SQ. FT. OWNER'S NAME: KEN ROBERTSON For questions regarding this letter, please call: City of La Quinta Permit Center (760) 777-7012 Coachella Valley Unified .School District 83-733 Avenue 55 P O Box 847 Thermal, CA 92274 (760) 398-5909.T. T. 0 ° � � � � � P� [DATE LDING & SAFE I `l DE APR�VED Desert Sands Unified School District FOR CON, CION 47-950 Dune Palms Road La Quinta, CA 92253 ` �o�l B (760) 771-8515 Please note: This letter verifies conditioned square footage. Please can your School District to verify school fees; requirement for cashier's check or money order and hours of operation.