11-0575 (AR)f
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: ------11-00000575 ` f
Property Address: _54250 rCANANERO CIR
APN: 767-780-072- -
Application description: ADDITION - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 35714
Applicant:
c&ty,,, 4 4v -Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ERIC MARKELL/ELLEN AHEARN
14125 SE 90TH STREET
NEWCASTLE, WA 98059
Contractor:
DESERT BAY CONSTRUCTION
PO BOX 2623
PALM DESERT, CA 92261
INI� (760)34
Lic. No..:: 543 543201
-----------------------------------------------------------------------------
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 CJass:1 B 10N A cen o.: 543201
ate:�111 '(ntr.ctor'.
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).:
(_ 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.).
I—) 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:
T
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/16/11
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 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
s 7700 of the Lab e, shall forth}p rth comp th th provisions.
ate: o licant:
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 t ilding construction, and hereby authorize representatives .
of this co tpy�to nter upon the bove-mention ro y for insp tion purp es.
aa3 te: ! v /( Si ture (Applicant or Agent):
Application Number . . . . . 11-00000575
Structure Information
Construction Type . .
. . . TYPE V, UNPROTECTED
Occupancy Type . .
. . . DWELLG/LODGING/LONG <=10
Other struct info . .
. . . CODE EDITION 2010
# BEDROOMS
1.00
FLOOD ZONE no
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
442.00
Permit . . . BUILDING PERMIT
Additional desc . .
Permit Fee
323.50 Plan Check Fee
210.28
Issue Date . . . .
Valuation . . . .
35714
Expiration Date
2/08/12
Qty Unit Charge
Per
Extension
BASE FEE
252.00
11.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
71.50
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
30.47 Plan Check Fee
7.62
Issue Date . . . .
Valuation . . . .
0
Expiration Date . .
2/08/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
442.00 .0350
----------------------------------------------------------------------------
ELEC NEW RES - 1 OR 2 FAMILY
15.47
Permit . . . GRADING PERMIT
Additional desc . .
Permit Fee . . . . 15.00
Issue Date . . . .
Expiration Date . . 2/08/12
Plan Check Fee . . .00
Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15.00
----------------------------------------------------------------------------
Permit . . MECHANICAL
Additional desc . .
Permit Fee . . 33.00
Issue Date . . . .
Expiration Date . . 2/08/12
Qty Unit Charge Per
LQPERMIT
Plan Check Fee . . 8.25
Valuation . . . . 0
Extension
Application Number .
. . . . 11-00000575
Permit . . . . . .
MECHANICAL
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
Permit . . .
PLUMBING
Additional desc . .
Permit Fee . . . .
49.50 Plan Check Fee
12.38
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
2/08/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
4.00 6.0000
EA PLB FIXTURE
24.00
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
442 sf DETACHED CASITA. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . .
. . . . BLDG STDS ADMIN (SB1473)
2.00
ENERGY REVIEW FEE
21.03
STRONG MOTION (SMI) - RES
3.57
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
Permit Fee Total
451.47 .00 .00
451.47
Plan Check Total
238.53 .00 .00
238.53
Other Fee Total
26.60 .00 .00
26.60
Grand Total
716.60 .00 .00
716.60
LQPERMIT
tih�n2� C/ CITY OF LA QU.INTA SUB-CONTRACTPR LI T
JOB ADDRESS 6-4 Z � PERMIT NUMBER OWNER ` "4§- �l BUILDER
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. 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 applicant. "On File" is not an acceptable response.
Trade / Classification
Contractor
State Contractor's License : W.g&ers Compensation Insurance Cit Business License
Company Name
Classification
(e.g. A, B, C-8)
License Number
(/xxxxxx)
Exp. Date Carrier Name
(xxlxx/xx) (e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date License Number
(xx/xx/xx)
Exp. Date
(xx/xx/xx)
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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 ii'
Project Address: S4 2-5'Q Lit/' aM64rD IC/r,Cle
Owner's Name: Mark -411 4hearel
A. P. Number: -76 % — % k6 — O 7 z
Address:
Legal Description:
City, ST, Zip:
Contractor: 4Je5 �a �it�
e Cons
Address:"d B/q
Telephone:
Project Description: Cp►S : hd '1111 YJ
City, ST, Zip: MIA, 0
TelephonerXp 00 —% 0?0
7
:: > t ::' :,>> :: a: rvi ; <.
State Lie. # : 157-4-3Z0 t
City Lie. #;
Arch„ Engr., Designer: 7%te MG k/ k
Address:
'
City, ST, Zip:
�•:::;.,{�isL:v>:::':5:,;-;'•."i}'<i:}i:•}Ji. ..ry,}:,}•-}}••
w:>::{:. �w{'•m<>;' :xrµe:>•;:->
Telephone: ... k:;:>:
State Lic. #: ... %" > : % h <'
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:i*G' i�n1
!�7%0-
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: ZR7'(p ��
Estimated Value of Project-Tar.X
APPLICANT: DO NOT WRITE BELOW THIS LINE
q
Submittal
Req'd Rec'd
TRACKING
PERMIT FEES
Plan Sets
3
Plan Check submitted
b
Item Amount
Structural Calcs.
J
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Persona
Plan Check Balance.
Tide 24 Calcs.
Plans picked up
1
Construction
in Ian
Plans resubmitted 1 la1
Mechanical
Grading plan -
of
2`' Review, ready for corrections ue
g (
Electrical
Subeontactor List
Called Contact Person
t
Plumbing TV
Grant Deed
Plans picked up
S.M.1.
Approval
7
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for correcdons/issu
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
•
Total Permit Fees
k
"Coachella 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
LEVELONEAMOUNT:
LEVELTWOAMOUNT:
MITIGATION AMOUNT:
COMMAND. AMOUNT:
DATE:
RECEIPT:/'
CHECK#:
INITIALS:
CERTIFICATE OF COMPLIANCE
(California Education Code 17620)
Project Name: Griffin�Ranch Date: August 15, 2011
Owner's Name: Markell/Ahearn Phone No. 760-200-6200
Project Address: 54-250 Cananero Circle, LaQuinta, CA 92253
Project Description: Casita Addition (attached to garage)
APN: 757-780-072 Tract #: Lot #'s:
Type of Development: Residential XX Commercial Industrial
Total Square Feet of Building Area: 442 sq. ft.
Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under
penalty of perjury and further represents that he/she is authorized to sign on behalf of the owner/developer.
Dated: August 15, 2011 Signature:
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 Project Agreement Existing Not Subject to Fee
17620 65995 Approval Prior to 1/1/87 Requirement
Note:
Number of Sq.Ft. 442 sq. ft.
Amount per Sq.Ft. $ 0.00
Amount Collected $ 0.00
Building Permit Application Completed: Yes/No
By: Jamie T. Brown, Asst. Supt., Business Services
Certificate issued by: Laurie Howard, Secretary HI Signature: d—,O--L� ac tt
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.
M V:c, nlvdocs/decfecs/ccrti 19catc of compliance form tables fO USE.doc 1/16/03 T
JOB ADDRESS
�� Z � G�h aflery Glome CITY OF LA QUINTA
PERMIT NUMBER
SUB-CONT=7fz
LI$T (��`,,,� _
OWNER ��"l BUILDER V"�''I s�r �G
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. 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 applicant. "On File" is not an acceptable response.
Trade / Classification Contractor
State Contractor's License Workers Compensation Insurance.
City Business License
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date Carrier Name
(xx/xx/xx) (e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
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May 16, 2011
Eric Markell and Ellen Ahearn
54-250 Cananero Circle
La Quinta, CA, 92253
.Personalized Property Management
68950 Adelina Road
Cathedral City, CA 92234
(760)325-9500
(760) 325-9300 fax
c'Iani�n
Your application to' install a Casita Addition has been approved by the
~Architectural Committee as per the plans submitted.
.-For.;the .Board of Directors
Dayton Dickey
Community Manager
. _ ...rt Zµ"�"j 1 Y M��l*F y R� �• "-'yrs . • • • • • • • • • • • • •
ComM"U004;ivq at'its Fenest