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
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