13-0473 (AR)P.O. BOX 1504 Tihf
,
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
13-00000473
58047 CARMONA
764-480-004- - -
ADDITION - RESIDENTIAL
LOW DENSITY RESIDENTIAL
65000
j6fltj ojrtl
Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that Ia licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business a rofessionals Code, and my License is in full force and effect.
License Class: B C10 License No.: 746198
Date �' 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).:
(_ 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 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
1 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:
M/M BROADWELL
58047 CARMONA DRIVE
LA QUINTA, CA 92253
(760)777-1060
Contractor:
A & M CONSTRUCTION
P.O. BOX 366
LA QUINTA, CA 92247
(760)564-4832
Lic. No.: 746198
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/01/13
----------------------------------------------—
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 497854
_ 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 o become subject to the workers' compensation laws of California,
and agree that, if I should come subject to the workers' compensation provisions of Section
3700 of the Labor Code shall forthwit a provisions.
ate:'` I Applicant:
WARNING: FAILURE TO SECURE W KERS' 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' ermit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the bove information is correct. I agree to comply with all
city and county ordinances and state laws relating to buil g construction, and hereby authorize representatives
of his county to enter upon the above-mentioned prope for inspection purposes.
Oatr r 1 Signature (Applicant or Agent):
Application Number . . . . . 13-00000473
LQPERMIT
Structure Information
Construction Type . .
. . . TYPE V, UNPROTECTED
Occupancy Type .
. . . DWELLG/LODGING/CONG <=10
Other struct info '. .
. . . CODE EDITION
20101
# BEDROOMS
1.00
--------------------------------
.1ST FLOOR SQUARE FOOTAGE
-----------------------------------
492.00
---------
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
482.00 Plan Check Fee
313.30
Issue Date . . . .
Valuation . . .
. 65000
Expiration Date
10/28/13
Qty Unit Charge
Per
Extension
BASE FEE
414.50
15.00 4.5000
---------------------------------------------------------------
THOU BLDG 50,001-100,000
67.50
-------------
Permit ..
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
32.22 Plan Check Fee
8.06
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
10/28/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
492.00 .0350
-------------=--------------------------------------------------------------
ELEC NEW RES - 1 OR 2 FAMILY
17.22
Permit . . .
MECHANICAL
Additional desc .
Permit -Fee . . . .
46.00 Plan Check Fee
11.50
Issue Date . . . .
Valuation
0
Expiration Date . .
10/28/13
_
Qty Unit Charge
Per
Extension
BASE FEE
.15.00
1.00 11.0000
EA MECH FURNACE >100K
11.00
.1.00 4.5000
EA MECH VENT INST/ DUCT ALT
4.50
1.00 9.0000
EA MECH B/C <=3HP/100K BTU
9.00
1.00 6.5000
--------------------------
EA MECH VENT FAN
-----------------------------------
6.50
---------------
Permit . .
PLUMBING
Additional desc .
Permit Fee . . . .
64.50 Plan Check Fee
16.13
LQPERMIT
Application Number . . . . . 13-00000473
Permit . . . . . . PLUMBING
Issue Date . . . . Valuation . . .
. 0
Expiration Date 10/28/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
4.00 6.0000 EA PLB FIXTURE
24.00
1.00 15.0000 EA PLB BUILDING SEWER
15.00
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
492 S.F. DETACHED CASITA. 201000DES.
ENGINEER:BRIAN GOTTLIEB C33047
------------------------- ---------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
3.00
ENERGY REVIEW FEE
31.33
STRONG MOTION (SMI) - RES
6.50
Fee summary Charged Paid Credited
-----------------
Due
----------------------------------------
Permit Fee Total 624.72 .00 .00.•
624.72
Plan Check Total 348.99 .00 .00
348..99
Other Fee Total 40.83 .00 .00
40.83
Grand Total 1014.54 .00 .00
1014.54
a,
LQPERMIT _
Bin. #
Crty, 0f Ld Qu%nta 0,9
BuAding ar Safety Division C� 11 ?01
P.O. Box 1504,78-495 Calle Tampico CONN ,'QF 3
ra.Quinta, CA 92253 -:(760) 777-7012 UIV17 ,D Q�jNl-
Build' 'n e q
Building Permit Application, and Tracking Sheet F� .
Permit #
�j �
Project Address: -, ' o 117
Owner's Nwn�.:.
A P. Number. -7(..V-0 _ 00 _ I
Address:
Legal Description: Q f f " 34CA
(Eft-
Contractor:/ , 1 W h S- -I-,
City, ST, Zip: `( v q 2 zS 3
Telephone: 760 777 �0 0 n
Address:
Project Description: Mew cleiRckwd
City, ST, Zip:
Caf dw, aoe
Telephone: "76o 0 2-06-
1p
•T Q". SF
State Lic. #: Lic. #:
�yCity
Arch., Engr., Designer C(/A(1 A v
Address:
Cfty, ST, zip: %1 awt Qq. q z?-(0 0
Telephone: -76D 3 X607 3 S Construction Type:. V Ng Ocxnpancy:
State Lic. #: / Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: L!/l l--f7{�A V Sq. Ft : a-' # Stories: # Unitg:
Telephone # of Contact Person: 766WO T O 3 S Estimated Value of Project "q,11000.0,9
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Pian Sets
Req'd
Recd
TRACKING PERMfI FEES
Plan Cheek submitted / Item Amount
Structural Calm
Reviewed, ready for corrections Plan Check Deposit. .
Truss Calcs.
. Called Contact Person Plan Cheek Balance.
Title 24 Cates.
-Plains picked up Construction
Hood plain plan
Plans resubmitted Mechanical
Grading plan
Z' Review, ready for correctiouslissue Electrical
Subeoutactor List
Called Contact Person Plumblag
Grant Deed
Plans picked up ` ML
H.O.A. Approval
Plans resubmitted GGrra,.dllug
IN ROUSE;-
'IkYL—' ready for corrections/issue : e per Impact Fee
Planning Approval
Called Contact Person P.
Pub. Wks. Appr
School Fees
Date of permit issue
Av A,
Total Permit Fee$
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: Bromadwweel Date: May 1, 2013
Owner's Name: Phone No.
Project Address: 58-047 Carmona, La Quinta, CA
Project Description: Detached Casita
APN: 764-480-004
Tract #:
Type of Development: Residential MR
Total Square Feet of Building Area:
Certification of Applicant/Owners: The person signing certifies t
penalty of perjury and further represents that he/she is authorized to
Dated: �5- `<
Signature:
Lot #'s:
Commercial
492
Industrial
ie above information is correct and makes this statement under
on behalf of the 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
17620
Number of Sq.Ft.
Amount per Sq.Ft.
Amount Collected
Gov. Code
65995
492
$3.20
$1,574.40
Building Permit Application Completed: Yes/No
By:
Project Agreement Eidsting Not Subject to Fee
Approval Prior to 1/1/87 Requirement
Elsa F. Esqueda, Director of Facilities and Maintenance
Certificate issued by: Leticia Torres, Facilities Analyst
Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that tthk_ r>' trict 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.
MV:c/mydocs'dcvlces/certilicatc ofcolnpliancc form updated 3-2007 112010
Andalusia at Coral Mountain Association
April 12, 2013
Broadwell Residence
58-047 Carmona
La Quinta, CA 92253
RE: 58-047, Tract 31681-1, Lot 4
The Design Review Committee has previously approved the Architectural Improvement Request for
the construction of your casitas in accordance with the submitted drawings and paperwork.
A copy of your plan is kept for our files. Please bear in mind that you are responsible for obtaining
any building permits and/or inspections that may be required by the City of La Quinta.
Please remember that this approval does not permit you to alter any property that is not within the
boundaries of your residential lot. Also, it is important that you understand that you, as the homeowner, are
responsible for maintaining and insuring any betterments and improvements to your home.
All work is to be commenced within thirty days of final written approval and completed within
ninety days of commencement, unless written consent for a longer period is received.
Hours of construction from October 1 through April 30 annually:
Monday — Friday 7:00 a.m. — 5:30 p.m.
Saturday 8:00 a.m. — 5:00 p.m.
Sunday & Holidays No work
Regarding construction debris, the site must be cleaned up daily, including the driveway, street and
gutter. No dumping of dirt or other construction debris is permitted anywhere on the property.
In accordance with the Master Design Guidelines, any variations from the original application and
drawings must be approved in writing by the Architectural Committee prior to commencement of work.
When all work on these improvements is complete, please notify this office so that the Design
Review Committee may inspect the work; sign off on the file, and refund your construction deposit. Please
contact me if you have any questions about your application.
Sincerely,
ANDALUSIA AT QQRAL MOUNTAIN ASSOCIATION
Dennis Byerly
Association Manager