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04-7619 (AR)a, r BUILDING & SAFETY' DEPARTMENT ,(76U) .777-7012 787495 C'ALLE TAMPI,CO , FAX (760) 77.7-701 1 -LA QUINTA;. CAiiFORNIn 922.53. INSPECTION REQUESTS (760) 777-7153 BUILDING'PERMIT Application Number 04 00007619 Date 12/13/04 Property Address 64483`0, CALLE.-SANTA `BARBARA 604-'3,91-0:06 •6, 25953 Application; descripty ori a ADDITION •- ,RESIDENTIAL Property Zoning LOW•DENSITY.RESIDENTIAL Application `valuation .... 8085. Owner Contractor _ ___________ - - -__ KELLY BRENDAN OWNER 44-8.30 CALLE SANTA.. BARBARA �� .1 3 2004 LA QUINTA CA 9,2251 % Cffr/ F_.La ,.p Ayg.CA Structure..Informati'on CONVERT GARAGE TO' OFFICE I FINANCE DEM-7 Type ... TYPE V,` .NON RP,TED:. Occupancy ,'Typ.e DWEtL;d/LODGING/GONG <=10 Flood' Zone NON AO FLOOD, ZONE Other• struct,-info- } °COD'E EDITION' 2001 CBC' FLOOD - ZONE NO " 1ST FIJOOR;'SQUARE FOOTAGE 215.0;0 o ----------------------.-------------------s:---------.-- ---- ---- ----- --------------- Permit . . . BUILDING PERMIT`,. Additional desc Permit, -Fee °108:00 Plan Chec'k;'.Fee 70.20 Issue Datela•luo,i'on 8085 Expiration Date .6./07./05 Qty Unit• -Charge Per Extension'' BASE FEE 45.00 7.00 9.00-00 THOU BLDG 2 -,'-'0 01-j2;5 , 0':0'0 F '.Al 63.00 Permit. ELECT - ADD/.ALT/REM' Additional desc Permit Fee '23.80': Plan Check Fee 5.95 Issue Date, : Valuation . . . . 0 Expiration. Date -,,....6/07/05 Qty Unit :;Charge Per, 1,4 Extension BASE FEE'.; . 15.00 215.00 02:O,OI: .. ELEC GARAGE OR.:NON=RESIDENTIAL 4.30 6.00 : 7'50'0 0'&,'PER ELEC DEVICE%?FIX'TURE 1ST .20' 4.50 ----- �- ------ - ---------- .------------------- Permit--.-.- .-.----MECHANICAL Additional desc Permit Fee ,-33':°'0'.0 Plan "Check Fee . 8.25 Issue Date .'t Valuation 0 Expiration Date, 6/07%05; ;. - A' Qty Unit Chargee Per, Extension P.O. Box 1504 • 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: -7� r / Date: 1 Z- l?- o�- 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 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 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 fora 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 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.). L) I am exempt under Sec. B.& P.C. for this reason _& V r —Owner WORKS' COMPENSATION DECLARATION I hereby affirm unLr penalty of perjury one of the following eclaration _ I have and will maintain a certificate of conse to self -ins re 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, 1 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 3700 of the Labor Code, I shall forthwith comply with those proyL-4W . WARNING: FAILURE TO SECURE WORKERS' COMP N9ATION C ERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DO RS ($100, 0), 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.). Lender's Name Lender's 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 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 Ouinta, its officers, agents and employeesfor 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. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the a Tentioned property for inspection purposes. (-Date- _bt sionature-(ApplicantorAgent): i Page 2 " Application Number'. . . . ' .:04'=000.0:76,19 Date 12/13/04 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:/.0 <=3H°P/10OK BTU 9.00 Special Notes and Comments. convert garage to office space, 215: sq ft. 12/7/04 9 20:.41 AM jjohn'son Other Fees ENERGY REVIEW. FEE, 7.,.02 STRONG MOTT:ON;> ( SMI) '--RES : 8.0 Fee summary Charged Paid. 'Credited Due Permit Fee- Total 164..8.0 00. .00 164.80, Plan Check. Total 84:40 ..60 00 84.40 Other Fee Total 7.82 .00 Joo 7.82 Grand Total 2'5.7.02. 0'0 00 257.02 CERTIFICATEtOF COMPLIANCE cNF'EDs Desert'Sandsl Unified School; District 47950. Dune': Palms Road BERMUDA DUNES r V RANCHO MIRAGE Date 12/13/04 d La'Quinta;�CA�_92253 � INDIAN WELLS C% PALM DESERT No. 26694 (760) 771-8515 LAINDIOTA r:V� Owner James Kelly APN # 604391-006 Address 44830 Calle Santa Barbara Jurisdiction La Quinta City LaQuinta Zip 92253 Permit # Tract # Study Area Type Residential Addition No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 44830 Calle Santa Barbara 215 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 ,a Unit 5 Unit 10 Comments At the present time, the Desert Sands Unified School District -does not collect fees on.garagestcarports, .covered patiostwalkways, residential additions under 5 00 square feet, detached accessory structures.(spaces4hat do not contain Wilities for;•hving; sleeping„ cooking; eating or sanitation) or replacement mobile ho mes. It has been determined that the above-named owner is exempt from paying'khoolfees-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 1.7620 and Government Code 659,95 Et Seq. in the amount of $0.00 X 215 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 - Brenden Kelly. check No. Name on the check Telephone Funding Exempt By Dr. Doris Wilson Superintendent Fee collected /exempted by Sh' Mc.Gilvrey Payment Reed So.00 Over/Under Signature C' NOTICE: Pursuant to Goverment Code Section 66020(d)(1.), this will serve to notify you,that the 90 -day approval period in which you may protest the fees o r other payment identified above will begin to'run from the date omwhich the buildingpt' installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect'them on the District(s) behalf, whichever is earlier. NOTICE: This Document NOTVALID if Duplicated Embossed Original -Building DepartmenUApplicant Copy -Applicant/Receipt Copy -Accounting OWNERBUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work.. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City or County. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the State and Federal Government as an employer and you are subject to several obligations include State and Federal income tax withholding, federal social security taxes, worker's compensation insurance, disability insurance costs and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law,. contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more. specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contracts are allowed to perform their Work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 (760)777-7012 n FAX: (76Gr 77011 OWNER'�SIGN T %LST < PROPERTY ADDRESS PERMIT NUMBER(S)