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04-6504 (SFD)f .- T-V.f 4 4Q" BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760);777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 Qty Unit Charge Per 8269.00 1255.00 1.00 BASE FEE .0350 ELEC NEW RES - 1 OR 2 FAMILY .0200 ELEC GARAGE OR NON-RESIDENTIAL 15.0000 EA ELEC TEMPORARY POWER POLE Extension 15.00 289.42 25.10 15.00 BUILDING PERMIT Application Number . . . . . 04-00006504 Date 1/28/05 Property Address . . . . . . 81070 CHANTICLEER DR APN: 762-370-042- - - Application description . . . DWELLING.- SINGLE FAMILY DETACHED Property Zoning . LOW DENSITY RESIDENTIAL . Application valuation . . . . 746292 Owner Contractor A a _ READ JOHN PAF92253 SOUTHERN HILLS DEVELOPMENT INC .81070 CHANTICLEER nEB 0 4 2005 81070 CHANTICLEER DR LA QUINTA AQUINTA CA 92.253 CITY OF LA QUINTA (760).7.71-3497 FINANCE DEPT. CC : EXEMPT WC: EXEMPT 05/31/05 CSLB: 838041 05/31/06 CCC:' B ------ Structure. Information 8269 SQ. FT. SFD ----.-_ Construction Type TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC # BEDROOMS 6.00 FIRE SPRINKLERS N0 GARAGE SQ FTG 1255.00 PATIO SQ FTG 4027.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 8269.00 ------------------------------------------------ Permit . . . . . . ---------------------------- BUILDING PERMIT Additional desc Permit Fee 2780.50 Plan Check Fee 1807.33 Issue Date . . . . Valuation . . . 746292 Qty Unit Charge Per Extension BASE FEE 2039'.50 247.00 3.0000 - THOU BLDG 500,001-1,000,000 - 741.00 ------------------------- Permit . . . . . . --------------------------------- ELEC-NEW RESIDENTIAL ---------------- Additional desc Permit Fee 344.52 Plan Check Fee 86.13 Issue Date Valuation 0 Qty Unit Charge Per 8269.00 1255.00 1.00 BASE FEE .0350 ELEC NEW RES - 1 OR 2 FAMILY .0200 ELEC GARAGE OR NON-RESIDENTIAL 15.0000 EA ELEC TEMPORARY POWER POLE Extension 15.00 289.42 25.10 15.00 P.O. Box 1504I4 CE VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: �—G O Date: 2 - Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 . full force and effect. � License Class License No. �>� / Date l� Contractor C Oati�(5A OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to selMnsure 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 Policy Number _ 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 sub'ect to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr is ns. Date �� 05 Applica WARNING: FAILURE TO SECURE KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRE HOUSAND 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. 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.). Lenders Name Lenders Address 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 perfonned 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 er upon the abov - entioned pro inspection purposes. Date �- �5 Signature (Applicant or Agent): Page 2 Application Number . . . . . 04-00006504 Date 1/28/05 ---------------------------------------------------------------------------- Permit . . . . . . GRADING PERMIT Additional desc Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Qty Unit.Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc . . Permit Fee . . . . 232.00 Plan Check Fee 58.00 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 7.00 9.0000 EA MECH FURNACE <=100K 63.00 7.00 9.0000 EA MECH B/C <=3HP/100K BTU 63.00 13.00 6.5000 EA MECH VENT FAN 84.50 1.00 6.5000 EA MECH EXHAUST HOOD 6.50 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc . . Permit Fee . . . . 390.00 Plan Check Fee 97.50 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 40.00 6.0000 EA PLB FIXTURE 240.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 11.00 6.0000 EA PLB ROOF DRAIN 66.00 2.00 7.5000 EA PLB WATER HEATER/VENT 15.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 16.00 .7500 EA PLB GAS PIPE >=5 12.00 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 8269 SQ. FT. SFD THIS PERMIT DOES NOT INCLUDE POOL & SPA BLOCK WALLS OR DRIVEWAY APPROACH. CASITA WAS MOVED FROM ANOTHER LOT AND REBUILT ON RAISED FLOOR ---------------------------------------------------------------------------- Other Fees . . . . . . . ART IN PUBLIC PLACES -RES 1365.73 DIF COMMUNITY CENTERS -RES 97.00 DIF CIVIC CENTER - RES 366.00 Page 3 Application Number . . . . . 04-00006504 Date 1/28/05 ------------=--------------------------------------------------------------- Other Fees . . . . . . . ENERGY REVIEW FEE 180.73 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 225.00 DIF.PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 74.62 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES 1098.00 Fee summary ----------------- Charged ---------- Paid Credited Due Permit Fee Total 3762.02 ------------------------------ .00 .00 3762.02 Plan Check Total 2048.96 k.00. .00 2048.96 Other Fee Total 4026.08 .00 .00 4026.08 Grand Total 9837.06 .00 .00 9837.06 Building (A i Address l Owner04W Mailing Address City ,�_ 4V \ Vv, Tq -z rz b Contracto�,� Address '(� �(,� l• its(jpU l N V V& Zlp State L?b. & Classif. Arch., Engr., Designer ..�� t TWT 4 4 a" P.O. BOX 1504 8-495 CALLE 9�fUJdAUINTA, CALIFORNIA 902253DOftIE— lel. City "V Lic. # Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affir t at I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divis' 3 of the Business and Professions Code, and my license is in full force and effect. I hereby affirm that I am exempt from the Contractor's License Lan for the following reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior :o its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant !or a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500) 01 , 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 Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or, im- provement is sold within one year of completion, the owner -builder will have the burden of proving that he 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 Cod(a: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKER'S COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company 0 Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less). 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 Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become subject to the Workers' Compensation Provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. 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 city to enter the above-mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip WHITE = BUILDING DEPARTMENT APPLICATION ONLY BUILDING: TYPE CONST. OCC. GRP. Vl A.P. Number -:6 / ,� co 1r �i— Legal Description ��:� yy��- Project Description K3 q 6f)E__ L Sq. Ft. 0 /'/� No. No. Dw. Size in? (j7 % Stories UnitSits Add Alter Repair ❑ Estimated Valuation r l&*A) Demolition ❑ PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I.' Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop.. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE_ Issued by: Validated by:— Validation: YELLOW = APPLICANT INSPECTOR Date Permit PINK = FINANCE 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 LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMM/MD. AMOUNT: DATF.- RF.CF.I➢T, (71MCK N• INITIALS' CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: Residence,ts at theSiimint Date: February 3, 2005 Owner's Name: John Read Phone No. Project Address: 81-070 Chanticleer La Quinta, CA Project Description: 1SFD APN: 762-370-014-6 Tract #: Lot #'s: Type of Development: Residential —X -X1 Commercial Industrial Total Square Feet of Building Area: 8,269 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/dgit*oper. Dated: February 3, 2005 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. 8,269 Amount per Sq.Ft. $ 2.68 Amount Collected $ 22,160.92 Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Business Services Certificate issued by: Elvira Mattson, Office Technician Signature: 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. At such time as this Certificate expires, if a building permit has not been issued for the project that is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. �fV:c mgdoc idcviees;`certiiicaue arcompliance. l'rrm ktblo'170 USf-doe 1/16/03 T G O,U VIS ENGINEERING • C A L I F :O R N 1 A• �e E-MAII: TO • SUPPOR7@GOUVISGROUP.COM . SALES6-GOUVISGROUP.COM September 11, 2003 John Reed Southern Hills Devclopmer.t, Inc. 81070.Chanticleer La Quinta, CA 92253 Re: Casa Moderna (cwjom Home) G.E.C. 21148 Dear Mr. Reed, 'l'hts letter advises that w,:', have observed the structural requirements that are visible during construction at the time of .:►ur site visit. Gouvis Engineering believes that the as -built construction at the time of our visit is iu general conformance with our stru:tural plans and relevant correspondence issued by our office relating to the above referenced dW.:lting. We observed the building in its framed condition prior to installation of drywall and stucco, We observed the visual and ac,'4ssible structural requircutcias. (.Exclusions are items such as: size of footings, reinforced steel.'in the foundations, roof and top plate splice connections and roof sheathing). This report is understood -;o be an expression of professional opinion by this engineer, which is based on his best knowl6tge, information and beliefs: As suu:h it consists of a report for only structwal elements (as ab ave outlined) and is neither:a guarantee nor a warranty, expressed or implied for other trades or iequiremcnts of subject dwe.11ing. Respectfully Submitted: Got+V' Engi g C tnia seed '`%� ='.�� jgofE~;_— �N� Vino President ��Q ���9 B� t Manager SJB:SV;cb No. 00276 m 091103a Exp.3/31/OS Ea a. (103 -� CIV% OFC GOUVIS ENGINEERING GROUP OF ,OMPAiVJES WITH OFFICES IN:; WEB SITE: vrfp//www c o: ivicnnrniv. enm 4400 C.AMPUSDRIV.F. SUITF. ANEWPORTREACH, CALIFORNIA 92660 (949) 752-1612 • FAX(949) 752-5321 ?150 EA ST TAHQUI77 CANYON, SU17:s 9 P.4LMSPRINGS. CALIF6RNIA.92262 •. (160)32.9-5090 • FAX(760)325-2863 --....__.r..,,..,.'...�../-....-.......Y%�onk1'ATrn%r 4I tlCrf/'r• 11YV'rhTAAI TO 39tid SIJ1f1DJ tZE9Z9L6b6 Lb:60 E00Z/ii/60