07-1616 (AR)P.O. BOX 1504
78-495 CALLE TAMPICO
. LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
07 00001616
54840 SECRETARIAT DR
767-320-999-243 -32879
ADDITION- RESIDENTIAL
LOW DENSITY RESIDENTIAL
30000 —
T4ht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MCCOMIC GRIFFIN LLC
7979 IVANHOE AVE #550
LA JOLLA, CA 92037
Contractor:
or Engineer: TRANS WEST HOUSING, INC.
10721 TREENA STREET, #200
SAN DIEGO, CA 92131
(858)653-3003
Lic. No.: 701039
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 d Prof ssionals 9ode, and my License is in full force and effect.
License Class: B is nse No.: 701039
r
,,-6—ate: tractor:
O NER-BUI ER 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 _ 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, 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
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:
t on -
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/01/07
WORKER'S COMPENSATION. DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 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.
�+-1 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 US FIRE INS CO Policy Number 4086929772
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 subject to the workers' compensation provisions of Section
3700 of the Labor C41sforth" 'th comply with those provisions.
ate: lpplicant:WARNING: ILURE TO SECURE WOMPENSATION 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 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 thi ounty to enter upon a above-mentioned prope n nsp 'on purposes.
ate:L651gnawre (Applicant or Agentl: _
S�
Application Number . . . . •07-00001616
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee 284.50
Plan Check Fee
184.93
Issue Date . . . .
Valuation
30000
Expiration Date 11/28/07
Qty Unit Charge Per
Extension
BASE FEE
252.00
5.00 6.5000 THOU BLDG 25,001-50,000
------------------ -------------------------------------------------
32.50
Permit PLUMBING
Additional desc .
Permit Fee . . . . 18.00
Plan Check Fee
4.50
Issue Date . . . .
Valuation
0
Expiration Date 11/28/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 3.0000 EA PLB WATER
-----------------------------------------------------------------------------
INST/ALT/REP
3.00
Permit . . . ELECT - ADD/ALT/REM
Additional desc
Permit Fee 22.42
Plan Check Fee
5.61
Issue Date . .
Valuation . .
0
Expiration. Date 11/28/07'_
Qty Unit Charge Per
Extension
BASE FEE
15.00
212.00. .0350 ELEC NEW RES--
----------------------------------------------------------------------------
1 OR 2 FAMILY
7.42
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 1.9.50
Plan Check Fee
4.88
Issue'Date . . . .
Valuation
0
Expiration Date 11/28/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 4.5000 EA MECH VENT
INST/ DUCT ALT
4.50
7 ---------------------------------------------------------------------------
Special Notes and Comments
ADD 212 S.F. BEDROOM #2 SUITE FROM 3RD
CAR GARAGE; REVISION.WHILE UNDER
CONSTRUCTION.2001 CBC, CMC, CPC, 2004
LQPERMIT
LQPERMIT
Application Number
. . . . .
07-00001616
----------------------------------------------------------------------------
Special Notes and
Comments
CEC, 2005 ENERGY CODES
Other Fees . .
. . . .
ENERGY REVIEW
FEE
18.49
STRONG MOTION
(SMI) - RES
3.00
Fee.summary
Charged
Paid
Credited
Due
Permit Fee Total
344.42
.00
.00
344.42
Plan Check Total
199.92
.00
.00
199.92
Other Fee Total
21.49
.00
.00
21.49
Grand.Total
565.83
.00
.00
565.83
(_"34,vx /7,4 1 " .,
Bin #
City of La Quinta
Building& Safety Division
P.O. Box 1504, 78-495 Calle Tampico
LaQuinta, CA 92253 - (760) 777-7012_ '
Building Permit Application and Tracking Sheet
Permit #
Project Address:*
Owner's Na=25��'
A. P. Number:
Address:
Legal Description: /At"--J--43J-t�-328>7
Contractor:
City, ST, Zip:
Telephone:
Address:
Project Description:
City, ST, Zip:
Telephone:
--2 7
State Lie. #
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft::
# St6ries:
# Units:
Telephone # of Contact Person:' 1�2775
Estimated Value of Projec zl:2
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Reqld
Rec1d
TRACKM
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural CaIcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss CaIcs.
Called Contact Person
Plan Check Balance
Energy CaIcs.
Plans picked up
Construction
Floodplainplan.
Plans resubmitted
Mechanical'
Grading. plan
.2-d Review, ready for corrections/issue
Electrical
Subcontactor List.
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7rd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit
(o-./ - �Lf1.ac� -4 0-141 &4 - (o -(v
Coachella Valley Unified School District
83-733 Avenue 55,' Thermal, CA 92274
(760) 398-5909 — Fax (760) 398-1224
Project Name:
Owner's Name: Griffin Ranch LLC
This Box For District Use Only
DEVELOPER FEES PAID
AREA:
AMOUNT,
LEVEL ONE AMOUNT:
LEVEL TWO AMOUNT:
MITIGATION AMOUNT:
COMMAND. AMOUNT:
DATE:
RECEIPT:
CHECK #:
INITIALS:
CERTIFICATE OF COMPLIANCE
(California Education Code 17620)
Date: June 6, 2007'
Phone No. 777-4307
Project Address: 54-840 Secretariat Drive La Quinta, CA
Project Description: Add bedroom suite
APN: 767-320-999-243-32879 Tract #: Lot #'s:
Type of Development: Residential XX Commercial
212 sa. ft.
Industrial
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/developer.
Dated: June 6,2007 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
17620
Number of Sq.Ft.
Amount per Sq.Ft.
Amount Collected
Gov. Code
65995
212
$3.91
$828.92
Building Permit Application Completed: Yes/No
Project Agreement Existing Not Subject to Fee
Approval Prior to 1/1/87 Requirement
By: Carey M. Carlson, Asst. Supt., Business Services
Note
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.
MV:c/mydocs/devfees/certificate of compliance form updated 3-2007 3/9/07
fl °
M
QN&rC41J
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
To: Greg Butler, Building & Safety Manager To CDD: %
Prom: Planning
Building Permit Release
(This.is an approval to issue a Building Permit)
The Community Development Department has reviewed the following project:
.Description: ,31zd eA�<-'
Address or general location: T 3Z'9'7? ° 47 /0
APN and or legal description:
The Community Development Department finds that:
❑ ...issuance of this Building Permit does not require Community Development
Department approval.
I issuance of this Building Permit is approved by the Community Development
Department.
KAY'S GRN SHEET.doc
7/15/2004
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6 - <�-'4 - 0 --?
Date