10-0572 (AR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUI.NTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
•
Applicant:
10 -00000572
46248 ROUDEL LN
600-041-026- - -
ADDITION - RESIDENTIAL
MEDIUM DENSITY RES
7.591?
Architect or Engineer:
04��
41'
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT.
Owner:
MARK BRADSHAW
46248 ROUDEL LANE
LA QUINTA, CA 92253
.(
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 Class: " License No.:
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 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 contractingwith 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 contractors) licensed
pursuant to the Contractors' State License Law.).
( 1 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: -
LQPERM3T
Contractor:
Owner
a"n
`0 0LJ 2010
--- PiT-111 F
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/23/10
-------- - - - - -—
TION
I.herebyaffirm under penalty of perjury one of the follow
—1n `as:
_ I have and will maintain a certificate of consent to self -insure ' 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 P y Number
I certify that, in the performance of a work for which this permit is issued,. I shall not employ any
person in any manner so as to come subject to the workers' compensation laws of California,
and agree that, if I should b me subject to the workers' compensation provisions of Section
Q 3700 of
the Labor Code, all forthwith comply with those provisions.
✓Date %" ^% 114pplicant:
WARNING: FAILURE TO SECURE RKERS'.COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI NAL -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 applicationis 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 p4nd void if work is not commenced
within 180 days from date of issuance of such permit, c ssation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the abov of mation is correct. I agree to comply with all
city and county ordinances and state laws relating to building ns uction, and hereby authorize representatives
/Iate:
hisLicoun`tytoenter up n the above-mentioned property f i pection purposes.
ignature (Applicant or Agent):
Application Number
10-00000572
------ -Structure Information
-260: SF CASITA - GARAGE CONV
-=---
Other struct info . .
. . . CODE EDITION
2"007/08 energy
# BEDROOMS
1.00
FLOOD ZONE
no
GARAGE SQ FTG
260.00
PATIO SQ FTG
.00 .
1ST FLOOR SQUARE FOOTAGE
260.00-
60.002ND
2NDFLOOR SQUARE FOOTAGE
.00
Permit
BUILDING PERMIT
Additional desc
260 SF CASITA
Permit Fee . . . .
171.00 Plan Check Fee
111.15
Issue Date
Valuation . . .
. 15912
Expiration Date
1/19/11
Qty Unit Charge
Per
Extension
BASE FEE
45.00
14.00 9.0000
------------------------------------------------------------------------------
THOU BLDG 2,001-25,000
126.00
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
' Permit Fee . . . .
24.10 Plan Check Pee
6.0.3
Issue Date
Valuation
0
Expiration Date
1/19/11
Qty Unit Charge
Per
Extension
BASE FEE.
15.00
260.00' .0350
ELEC NEW RES - 1 OR 2 FAMILY
9.10
Permit . . .
MECHANICAL
Additional desc .
Permit Fee
30.50 Plan.Check Fee
7.63
Issue Date
Valuation'
0
Expiration Date
1/19/11
Qty Unit Charge.
Per
Extension
BASE FEE
15.00
1.00 9.0000
EA MECH B/C <=3HP/100K BTU
9.00
1'.00' ..6.5000
EA MECH AH,<=10K CFM
6.50
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
36.00 Plan Check Fee
9.00
' LQPERDIIT
LQPERMIT
Application Number . . . . 10-00000572
Permit . . . . . PLUMBING
-
Issue Date . . . . Valuation . . .
. 0
Expiration Date 1/19/.11
Qty Unit Charge Per
Extension
BASE FEE
15.00
3.00 6.0000 EA PLB FIXTURE
18.00
1.00 3.0000 EA PLB WATER INST/ALT/REP
3..00
--'---------------------------------------------------------------------------
Special Notes and Comments
260 SF CONVERSION OF SINGLE CAR AARAAR
1110 CASITA. TYPE V -B CONSTR. R-3
OCCUPANCY. 2007 CODES 2008 ENERGY.
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
_ ENERGY REVIEW FEE
11.12 -
STRONG MOTION (SMI) - RES
1.59
Fee summary Charged Paid Credited
Due
Permit Fee Total 261.60 .0,0 .00
261.60
Plan Check Total 133.81 .00 .00
133.81
Other Fee Total 13.71 .00 .00
13.71
Grand Total 409.12 .00 .00
409.12
LQPERMIT
CERTIFICATE OF COMPLIANCE N
Desert Sands Unified School District Z�� M
47950 Dune Palms Road ¢ BERMUDA DUNES r
rn RANCHO MIRAGE
Date 8/9/10 La Quinta, CA 92253 N INDIAN WELLS
No. 30791 (760) 771-8515 d PALM DESERT
LA QUINTA
1 P1 N0 O L�
Owner
Mark Bradshaw
APN # 600-041-026
Address
46248 Roudel Lane
Jurisdiction La Quinta
City
La Quinta Zip
Permit #
Tract #
No. of Units 1
Type
Residential Addition
Lot # No. Street
S.F.
Lot # No. Street S.F.
Unit 1
46248 Roudel Lane
260 Unit 6
Unit 2
Unit 7
Unit 3
Unit 8
Unit 4
Unit 9
Unit 5
Unit 10
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiosrwalkways, 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:
Residential Addition 500 Sq Feet or Less
EXEMPT
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et.Seq.
in the amount of $0.00 X 260 , 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 - Mark Bradshaw Check No.
Name on the check Telephone 7660-275-6891
Funding Exempt
By Dr. Sharon P. McGehee
Superintendent
Fee collected /exemp by Sharo cGilr/rey Payment Recd
'r Aver/Under,..,
Signature
NOTICE: Pursuant to Government Code Section 66020(d)(1), this w II se a to notify you that the 90 -day approval perioc. in which you may protest the fees
or other payment identified above will begin to run from the date on hi the building or installation permit for this project is issued, or from the date on
which those amounts are paid to the Districts) or to another public e i 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