05-0107 (SFD)P..O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253'
T-iht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: �05-00000107
Property Address: 5253'0—DEL GATO DR
APN: 77.0-299-003- - -
Application description: DWELLING SINGLE FAMILY DETACHED
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 69957.0
Applicant: Architect or Engineer:
------------- ---- - ----- -- - -- ---
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that) am licensed under provisions of Chapter 9 Ycommencingwith
Section '7000) of Division 1of;:the Business and Professionals Code, and my,Ucense,is in fullfforee and effect.
License Class: 1 Lloense No::. 818121
Date:- Contractor:
OWNER -BUILDER DECLARATION
m
I hereby affirm under penalty of perjury that I•eexempt from the Contractor's State License.Law, for the
following reason (Sec: 70314, Business and Professions Code:. Any city or that requires s,permit to
construct; alter, improve, demolish, or repair anystructure, prior.to'its.issuance, also requires the applicant for the
permit to file a:slgned statement that he or she is licensed pursuantto'the provisions'of the Contractor's'State
Uoense.Law (Chapter, 9 -(commencing with Section 7000) of: Division 3 of the Business and�Professlons Code) or
that he orshe,is exempt' therefrom and the oasis for the,alleged exemption. Any'violation of Section 7O31.6:by
any applicant for a.parmlt subjects the applicant to s civil penalty of not more than five hundred dollars` 18500).:
1 _) I, as ownerof the property, or my employees with wages ;aatheir 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, Low 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 emPloyaes,;provided that -the
improvements aremot intended or offered for sale.. If, however, the building or improvement is sold within
one year of completion; the owner -builder will have the,burdsn of proving that.he or she did not build or
improve for the purpose of,sale.).
1 _ 1 I, as owner of the property,am exclusively contracting with' licensed contractois 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.).
1 _) I am -exempt under Sec. , B:&P.C..for this reason
Data:
Owner:
CONSTRLICTION LENDING AGENCY
T hereby affirm under penalty of perjury that,thereis a construction lending agency for the performance -of the
work for whichahis.permit is issued (Sec: 3097; Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (160) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/18/05
Owner:
Kristine & Earl Morley
Contractor:
HUDSON CONSTRUCTION, INC.,.K.P
77622 COUNTRY CLUB DR, STE M
PALM DESERT, CA 92211
(760)345-5154
Lic. No.:- 818121
--------------- ------------
WORKER'S COMPENSATION. DECLARATION
I hereby affirm'underpenaky of perjury one of the:fallowing declarations:
_ I have and will maintain a certificate of consent toAdtfinsure 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 havwand will maintain workers' compensation insurance, as:required' by Sectiom3700 of the Labor
Code, for'the:performance of the work4orwhich .this,pamiit'is issued. My workers' compensation
insurance carrier and policy number are:
Carrier EXEMPT' Policy Number EXEMPT.
_ I certify that,'in the performanoe 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,agres that, if Lshould become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions:
,Data: Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE ISIUNLAWFUL, AND;.SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE'HUNDRED THOUSAND
DOLLARS (8100,000). IN. ADDITION TO•THE COST OF COMPENSATION, DAMAGES_ AS PRO_ VIDED'FOIi IN
SECTION 3708 OF THE LABOR'GODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWIEDGEMENT
IMPORTANT Application is hereby made to the Director of'Budding ;and : Safety for a,permit subject to the,
conditions and restrictions set.forth onthis=application.
1. Each person upon whose behalfithis application (s.made, each person at whose request and for
whose benefit work is.performed under or pursuant to any'permlt 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 Quints; its officers, agents and employees for any actoromission related to the work being
performed under orfollowing Issuance of this permit.
2: Any permit issued as a result of this application becomes null and void if work is not commenced
within 1.80 days from date of issuance of such permit; or cessation of work for 180 days will subject
permit to cancellation.
1 certify. that I have,read this application and. state that the above information is correct. I agreeto comply" all
city and county ordinances and'state laws relating to building construction, and hereby 'author ze. represenetives
of thiscountyto enter upon the above-mentioned property for inspection. purposes.
Date: Signature (Appiicant;orAgent):
Application Number . . . 05-00000107
------ Structure Information 8179 SQ. FT. SFD
-----
Construction Type. . .
. . . TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/CONG <=10
Flood Zone.
NON -AO FLOOD ZONE
Other, struct info . .
CODE EDITION_• 2001 CBC
# BEDROOMS
4.00
FIRE SPRINKLERS NO
GARAGE SQ FTG
1147.00
PATIO SQ FTG
1220.00
NUMBER OF UNITS
1.00
1ST FLOOR SQUARE FOOTAGE
8179.00
Permit.
BUILDING PERMIT
Additionaldesc ..
Permit Fee . . . .
2639.50 Plan Check.Fee
1115.68
Issue Date . . . .
3/24/05 Valuation . . . .
699570
Expiration Date..
10/16%05
Qty Unit Charge
Per
Extension
BASE FEE
2039.50
200:..00 3.0000
THOU BLDG 500,001-1,000,000
6'00.00
Permit. . . . .MECHANICAL
Addi.tionaldesc
Permit Fee
201.00 Plan Check Fee-..
50.25'
Issue Date . . .
3/24/05 Valuation . . . .
0
Expiration Date
10/16/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
6.00 9.0000
EA MECH FURNACE <=100K
54.00
6.0.0 9.0000
EA MECH B/C <=3HP/100K BTU
54.00
11..00 6.5000
EA MECH VENT FAN
71.50
1,00 6.5000
"EA MECH EXHAUST HOOD
.6.50
Permit. . . . ELEC-NEW RESIDENTIAL
Additional desc . .
Permit Fee ..
339.21 Plan Check.Fee
84.80
Issue Date
3/24/05 Valuation . .
0
.Expiration Date ..
10%16/05
Qty Unit Charge
Per
Extension
BASE FEE
15.00
8179.00 .0350
ELEC NEW RES - '1 OR 2 FAMILY
286.27
1147.00 .0200
ELEC GARAGE OR NON. -,RESIDENTIAL
22.94
1.00 15.0000
EA ELEC TEMPORARY POWER POLE
15.00
LQPERMIT
Application Number .. . . . 05-00000.107
Permit .
Additional desc
Permit Fee
Issue Date
Expiration -Date
. . PLUMBING
282.75 Plan Check Fee 70..6:9
3/24/05 Valuation 0
10/16/05
Qty Unit
Charge Per
EXtension
BASE FEE
15..00
2.8.00
6.000,0 EA PLB FIXTURE
168.00
1.00
15.0000 EA PLB BUILDING SEWER
151.00
5.00
6.0000 EA PLB ROOF DRAIN
30.00
2.00
7.5000 EA PLB WATER HEATER/VENT
15..00
1.100
3.0000 EA PLB WATER INST/ALT/REP
3.0.0
1.00
9.0000 EA PLB LAWN SPRINKLER SYSTEM
9.00
17.00
.7500 EA PLB GAS PIPE >=5
12.75
1:00
15.000.0EA PLB GAS .METER
15:00
Permit
. . . GRADING PERMIT
Additional desc
.
Permit Fee
15'.00 Plan Check Fee
.00
Issue Date
3/24/05 Valuation
0
Expiration Date
10/16,/'Q5
Qty Unit
Charge Per
Extension
BASE "FEE
'15.00
-------------------------------
Special Notes
----------------------------------------------------
and Comments
8179SQ. FT. SFD.
THIS PERMIT DOES NOT
INCLUDE POOL '&
SPA BLOCK ,WALLS OR
DRIVEWAY APPROACH. 2/3/05 11:01:,52 AM
JJOHNSON
------------------_------------.-.------------,--------------------------
Other Fees
ART IN PUBLIC PLACES -RES
-
1248:,92
DIF COMMUNITY CENTERS=RES_
97.00.
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
171.57
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
69.95
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION -.RES
1098.00
Fee summary
Charged Paid Credited
Due
Application Number
. . . . .
05-00000`107
Permit Fee Total
3477.46
3477.46
.00
.00
Plan Check Total
1921.42
1921.42
.00
.00
Other Fee Total
3895.44
3895.44
QO
.00
Grand Total
.9294.32
9294..32.
.00
.00
LQPE MT
T .0d
BUILDING & SAFETY DEPARTMENT
.0. Box 1504 (760),777-7012
-495 CALLS TAMPICO FAX (760) 777-7.011
1011 A UINTA,, CALIF . ORNIA 9227,53 INSPECTION REQUESTS (760) 777-71,53,
BUILDING PERMIT
ation Number . . .
rty Address . . . . . .
Akllv
Application description . . .
Property Zoning . . . . . . .
Application valuation . . . .
Date 3/15,/05
522,30 DEL GATO DR
770
DWELLING - SINGLE FAMILY DETACHED
LOW DENSITY RESIDENTIAL
699'570
Owner'
Contractor
------_-------------------
Kristine &.Earl Morley
-------------
HUDSON CONSTRUCTION,
INC.'. 'K. P
.
PALM DESERT ..CA
52211
(760)_345-5:154
WCC: EXEMPT
WC: EXEMPT
07/'31../0:5
CSLB: 818121
03/31/05
CCC:
Structure Information
8179 SQ,. FT'. SFD
Construction Type . • .
. . TYPE V - NON RATED
Occupancy Type . . . .
. . DWELLG/LODGING/CONO <=10
-Flood Zone.. . . . . .
. . NON -AO FLOOD ZONE
Other struct inf o
CODE EDITION 2001
CBC
# BEDROOMS'
4.00.
FIRE -SPRINKLERS NO
GARAGE SQ FTG
1147.00
PATIO SQ FTG
122"0.00.
NUMBER OF UNITS
1ST FLOOR SQUARE FOOTAGE
8179.00
------------------------------------------------ --------------------
Permit . . . ... . BUILDING PERMIT
Additional desc
Permit Fee-
2639..50 Plan Check Fee
171.5.68
Issue'Date-
Valuation . . . .
69'9570
Expiration Date
9/15/05
Qty 'Unit Charge
Per
Extension
BASE FEE
2039.50
200.00 3.0000 THOU BLDG 5010,001-1,000,000
600.00
---------------------- ------------- I -------------- -----------------
Permit ELEC-NEW RESIDENTIAL
Additional de8,c,.
Permit Fee
339.21 Plan -Check Fee'.
8-4.80
'Issue Date . . . .
Valuation
0
Expiration Date
-9/15/05
,Qty Uhit Charge 'Per
Extension
BASE FEE
15.00
81.79..00 .0350
ELEC.NEW RES 1 OR 2 FAMILY
286-.27
X - 4
P O BOX 1504 VOICE (760) 777-701.2.
78-495 CALLE TAMPIco FAX (760) 777-701.1
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760)'777-715,3.
BUILDING & SAFETY DEPARTMENT
-
Application, Number: O J — �� Date '3 Z�%-
Applicant: Architect or Engineer: ,
Applicanfs Mailing Ad ess: Architect or 'Engineer's Address:
r `
Lic. No::
BUILDING PERMIT DECLARATIONS.
LICENSED CONTRACTOR'S DECLARATION
Code a affirmm L Lice �rnttfuofor rjur d at I a . 'licensed under provisions of Cho pter (commencing withZection,7000) of Division 3 of the Business and Professionals
I hereby
ns3 rseNe--B/8�2�..
OWNER43UILDER DECLARATION
I hereby atfimi underpenaityof perjury that l am exempt from the Contntctors' State ,License Lawfor:the following reason (Sec. 7031:5, Business and Professions Code: Any
city or county # atrequires a peimklo`construck alter, improve, demolish, or, repair any structure; prior to its issuance, also:requires'the applcant for the pennM to file a signed
statement that he or she is licensed pursuant to:the. provislons.of the. Contractors' State License law (Chapter 9 (commencing w th Section 7000) of Division 3 of the Business
and Professions Cods) or.that.he orshe1s exempt therefrom and the basis for the alleged exemption. Any violation of Section 7,031.6 by any applicant for a penTA-subjects
the applicantto a civil. penalty of not more than five hundred:dollars ($500).):
(, I, as owner of proPerty,,or my employees wifh wages as their sole compensation, will do the'work, and the structure is.not intended or o((ered,for sale (Sec. 7044,
Business and Professions Code: The Contractors' State Lioense.Law does not applyto.an owner of property who builds or improves thereon, and who does the work
himself, or herselfor ltuough his or her own employees„provided that the'improVeinents.ate not Intended or offered for sale. If; however, the building orimprovement is
sold wlthin;one year of completion, the owner-builder'Will havethe burden of proving that he or she did not build or improve for_the purpose of sale;).
U I, as owner the proparty,. am excluslvely.contractlng with licensed contradorwto conslrud`thepmject (Sec. 7644;:Businesstand Professions Code:. Tho Contractors''
State License Lew does not apply'to an owner of property who bu(Ids or improves thereon, and who contracts for the projects with a contractor(s)licensed purauantto
the Contractors'. State License Law.).
V I am exempt under Sec. ,,BA P.C. for this reason
Date Owner
WORKERS' COMPENSATIONDECLARATION
I hereby affirm=deripenaltyof,perjury one of the followingAeclarations:
l have and will malntatna certificate of consentto,selfnsure for workers' compensation, as provided for by Section 3700 of the Labor Code; for.the'perfomrance
of the work for which this permitts:tssued.
_ I have and will maintain workers' compensation Insurance, as required by Section 3700, of the Labor Cade, for the peftrmance of themork for which this: pem►R is
issued: My workers' compensation insurance carrier and policy number are:
Carrier Policy Number
_ 1 certMythat, in tWpeifonnance-of the woilc:for which this perrnitis-issued„ f sheMmot employ anyperson,in any manner so are'
eto become subject to the worke
compensation laws of California, arid agme;that,'f`GshcW become subject to the workers' compensation provisions of 6ectiom3700 of the'Labor Code, [shall
k ttiwMh ooftWwith those provision I.`
WARNING: FAILURE -TO SECURE WORKERS' COMPENSATION COVERAGE I&UNLAWFUL, AND'SHALL.SUBJECT AN EMPLOYER TO:CRIMINAL PENALTIES AND
CIVIL -FINES UP 70'.ONE HUNDRED THOUSAND DOLLARS:(E100,000), IN ADDITION TO THE: OPCOMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION,3706 OF THE LABOR CODE; INTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
1 herebyaffirrn under penatty,of perjury that there is a construction lending;egency for the'performance of the work'fcr winch this permit Is issued (Sec..3097, Civ. C).
Lenders Name
Lenders Address
APPLICANTACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of. Building and Safety for a permM:subjed to the conditions and restrictions set forth on this application..
1. Each person upon whose behalf this application is made, each person at whose requestand for whose benefit work is perfoinred under or pursuant:to any permit
issued as; a reauM`of this application, the ,owner, andthe appticaK each agrees to, and shall, defend, indemnify and hold hamdess the City of La Orririta, its
officers, agents and employees for any ad, oromission related, to.themork being performed.under or following issuance of this permIL
2. Any permit issued,as a resultof this application becomes null and void Ifwork is notcommenced within 180 days from date of issuenee of such:peffrK or
cessation of work for 180 days will subject permit to cancellation:
I oartifytheft have:read this.application and state that the aboveinfomiati ' is corrert,:.l,agree to comply.wMh all;city and countyordinanoes.and,state'raws relating to building
construction_ and'tiereby authorize representatives of thisoounty:to ant9 pon)he above -mart ioned,propertys:
forinspection purpose
j�
a
Appl.ic_at^ion Number 05-00000107`
`Page 2.
Dat& 3/15/05
Qty Unit Charge.
Per
Extension
1141.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
2°2.94
1.00
1.5.000'0
EA ELEC.TEMPORARY
POWER POLE
15.00
Permit .
. . . . . .GRADING PERMIT
Additional
desc .
Permit Fee
1,5.00
Plan.Check Fee_.
.:00
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
9/1:5/0,5
Qty Unit,Charge
Per.
Extension
BASE
FEE
15.00
Permit .
. . . 'MECH_ANICAL
Additional
des'c .
Permit Fee
. . . .
201.0.0'
Plan Check Fee
50.25
Issue Date
Valuation
0.
Expiration
Date
9/151/45
Qty Unit Charge
:Per
Extension.
BASE
FEE
15.00
6.00
9.0000
EA MECH
FURNACE <=10OK
54.00
6.00
9.'0000
EA MECH
B/C <=3HP/100,K BTU
54.00
11.00
6.5000
EA MECH
VENT FAN
71.50
1.00
6.5000
EA MECH
EXHAUST HOOD
6.50'.
Permit .
. . . . . PLUMBING:
------------
Additional
desc .
Permit Fee
. . . .
282.75
Plan Check_ Fee
70.69
I<ssue Date,
Valuation
0;
Expiration
Date
9/15/05
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
28:00
6.0'000
EA PLB
FIXTURE
168.00
1.0'0
'15.0.000
EA PLB
BUILDING SEWER
15..00
5.00
6.0000
EA PLB
ROOF DRAIN.
30..00
2.00
7:5000
EA PLB
WATER HEATER/VENT
15.00
1..00
3.01000
EA PLB
WATER INST/ALT/REP
3..00
1.00
9.0,0:00
EA PLB
LAWN SPRINKLER SYSTEM
9.00
17.00
.7500
EA PLB
GAS PIPE >=5
.1.2:75
1.00
115. 0'0:0 0
EA PLB'
GAS METER
1:5.00
Special Notes and Comments
8179 SQ. FT. SFD. THIS PERMIT DOES NOT
Page 3
Application Number
05-00'0,00107 Date
3/15/05
Special Notes and
Comments
INCLUDE POOL & SPA
BLOCK WALLS
OR
DRIVEWAY APPROACH.
2/3/05 11:01:52
AM
JJOHNSON
--------.-.-----------
Other Fees . . ..
-------------.=-----------------------------
. . . . . . ART IN PUBLIC PLACES -RES
------- -
1248.9'2.
DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER,- RES
366.0.0
ENERGY 'REVIEW FEE
171.57
DI:F FIRE PROTECTION -RES
97.0.0
GRADING PLAN CHECK .FEE
.'&0
DIF LIBRARIES - RES
225..00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION ( SMI) - RES
6`9.95
DIF .STREET MAINT FAC -RES
15,.,00
DIF TRANSPORTATION - RES
1098.0-0
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
3477.46
.00, .0'0
3477.46
Plan Check. Total
1921.42
100`0.00 .010
921.42
Other Fee Total
3895.,44
.00 .00
3895.44
Grand Total
9294.32
1000.00 .0.0
8294.32
. 0jtt,,\�1�1
Q
Q
•
V
y
P:0. BOX 1 504
BUILDING &. SAFETY DEPARTMENT
C�
OF'
F
78-495 CALLE TAMPICO
(760) 777-701"2
LA QUINTA, CALIFORNIA 92253
FAX 760. 777-7011
May 18, 2005,
Ms. Esther Sanchez
Riverside County Assessor's Office
'3255 E Tahquitz Canyon Way, Ste 114
Palm Springs, CA 92262-6962
Dear Ms. Sanchez,
Please be advised of an address change for -the following single family dwelling.
The house was incorrectly issued to .52-230 Del Gato Drive, permit # 05-107.
The correctaddress is: 52-530 Del Gato Drive, APN # 770-290-003
Please. note this change and contact me directly at (760) 777-7084 if I may be of
further assistance.
Sincerely,
Kay Hensel
Office Assistant
a
: , . CertIrica to of Occupancy
Bulding & Safe# Department
y p
'
i
1 `
This Certificate is issued pursuant to the requirements of Section 909 of the California Building
Code, certifying that, at the time- of issuance, this structurewas in compliance with the
.provisions of the Building Code and the various ordinances of' the City .regulating building
construction and (or use.
BUILDING ADDRESS:, 52-530 DEL. GATO-DRIVE
Use classification: SINGLE FAMILY DWELLING Building Permit No.: 05-10.7
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC.
Owner of Building: KRISTINE & EARL MORLEY Address:
(arm By: STEVE WILLETT
Date;: SEPTEMBER 13, 2006
i
1
j
Building Official
f
1
POST IN A_CONSP.IC000S PLACE
MITek Industries, Inc.
7777 Greenbackiane
Suite 109
Citrus Heights; CA,.95610
Telephone,916/6761900
Re: MORLEY Fax 916/676-1909
MORLEY RESIDENCE
The truss drawing(s) referenced below have been ,prepared by'MiTek Industries, Inc. under my direct supervision,
based on -the parameters provided by J M W Truss.
Pages or sheets covered by this -seal: R15353761 thru R15353865
My license renewal date for the state of California is September 30, 2006.
February 23;2005
Yu, .Ray
The seal on these drawings indicate acceptance of professional engineering responsibility solely for the
truss ,components shown. The suitability and use: of this component for.any particular building is the
responsibility of the building designer, per ANSI/TPI-2002 Chapter 2.
Mc GEE SUR VEYING, INC.
79-301 Country Club Dr., Ste. 102 — Bermuda Dunes, CA 92201.
Phone (760) 345-3828 - Fax (760) 772-5705
April 13, 2005
City of La Quinta
78A95 Calle Tampico
La Q.uinta, CA 92253
Re: Pad Certification — Lot 3, Tr. 28470-2
Pursuant to your request a field survey was conducted on the above referenced project to
determine the vertical location_ of the building pad. The above mentioned was found as
follows:
LOT ADDRESS PAD (DES) PAD (FIELD)
`=3 52-530 Del Gato Dr. 67.0'
'Sin a ely
Wayne, A. McGee
L.S. 5479
67.0'
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road BERMUDA DUNES O
CC RANCHO MIRAGE, C7
Date 3/23/�(760) 771-8515
0f5 La Quinta, CA 92253 r INDIAN WELLS
PALM OESEFrr
No. 2701E d%, LAQUINTA y
Q INDIG y2
Owner
Kristine 81 Eaft Modey
APN,# 770=280-012
Address
Jurisdiction La Quinta
City
Zip
Permit #
Tract #
Study Area
Type
Single Family Residence
No. of Units 1
Lot # No. Street S.F.
Unit 1 52530 Del Gato Dr Unit 6
UnW2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
Lot # No. Street S.F.
At the present time, the Desert Sands Unified School District does not collect fees on garagesicarports, covered patlos/walkways, residential additions under 5
00 square feet, detached accessory,structures (spaces that do not contain facilities for living, sleeping, cooldng, eating or sanitation) or replacement mobile ho
mes. it has, been determined that the above4amed owner is exempt from paying school: fees it this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et.Seq.
in the amount of $2.24 X 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 CC/Valley Independent Bank - Ken Hudson Check No. 332887
Name on the check Telephone
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sharon M Gilvrey Payment Recd
Over/Under
Signature
NOTICE: Pursuant to Govemment Code Section 6M(d)(1), this will serve to notify you that the 90 -day approval period in which: you may protest the fees o
r 6thOpsyment identified above will begin to nm from the date on which the building orinstalietlon, 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 DistrtctCs) behalf, whichever Is earlier.
NOTICE:. This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting
P.O. BOX 1504
Building78-495 CALLS TAMPICO
Address SZ S30 int _ (&vt� DiZ . LA.QUINTA, CALIFORNIA 92253
JR
aUing
ddress,
City Zip" TeL
" I
AL� , 10ril--a7
8 Classif. I Lic. p
Arch., Engr.,
Designer YWILYI\i1S'oN )SIC►
Address Tel.
-TZ--\V5 "4H FIZS YWT 1'?Ita I
City Zip State.
PRAM bFSflRT 9ZZ-40 Lic. a
LICENSED:CONTRACTOOS DECLARATION
I herebyy,affirm that'l am licensed under envisions of Chapter 9 (commencing with Section
7000) of Dlvision.3 of the Business and Professions Code,,and'my license 16 in full force'and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following:
reason:. (Sec. 7031.5;13usbass and Protesslons Code: Any city or county, whkh requires a
permfi"to construct, after, improve, demolish, or repair any structure; prior fo `fts Issuance also
repliirea the applicant for such permit to ft signed statement that he b licensed pursuant to
the provisions of the for
License Law; Chapter 9" (commencing with Section 7000) of
Division 3 of line Business and Professions Code, Or thathe Is exempt therefrom, and the basis
for the 411aged exemption. Any violation of Section 7031.5 by any applicant for a permit
sutyecta the applicant.to a civil;penalty of not more than five hundred dollars ($500).
1': I,. as owner of the property, or my employees with wages as their sole compensation, will.
do the work, and the structure isnot'intended or offered•for, sale. (Sec. 7041, Buisness and
Professions Code: The Contractor's license law doesnot 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. _B, however, the building
or improvementis sold within one year of completion, the owner -builder will have the burden
of proving that he did not buifd or improve for the purpose of sale.)
I 1 I, as owner of the property, am exclusively_ contracting withAlcensed,contractore to con-
struct the project. (Sec. 7011, Business and Professions Code: 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 contractorts) licensed pursuant to. the Contractor's Ucenso Law.)
I1 I am exempt under Sec. B. fi P.C. forthis reason
Date Owner
WORKERS' COMPENSATION DECLARATION`
I hereby affirm that I have a certificate of consent to self -Insure, or a certificate of
Worker's Compensation Insurance, ora certified copy -thereof. (Sec. 3800, Labor Code.)
Policy No. Company
f I Copyis 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 thg work for which this permit is issued, I shall not
employ any pparson in any manner so. as to becormsubject1o,lhe Workers' Compensation
laws o ,Cali on..
Dale Owner
NOTICETO APPLICANT: f, after making this Certificate of Exemption you should become
subject to the 1Norkers' Compensation provisions of the Labor Code, you must forthwith
.comply with such provisions or this permit shift be deemed revoked.
CONSTRUCTION LENDING AGENCY
I'.hereby°affirm that there, Is a construction lending agency for the performance of the
workdor which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This-isa building permit, when properly filled out, signed and validated, and is subject to
expiratlon,'lf 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,sta_te laws relating to building
construction, and hereby authorize representatives 'sof this city to enter the above.
mentioned property for inspection purposes.
Signature of a0plicant Date
Mailing Address
City, State, Zip
L�) J- o/ 197
APPLICATION ONLY
Y N1z
BUILDING: 'TYPE'C.O�NSST� OCC. GRP.
A.P. Number T`yv cl-
Legal Description, % 3 Zed 7,9 V a0 ' Z
Project'Descriptlon
Set 6 n� Stories I Units, I.
New ❑ Add ❑ Alter O Repair ❑ Demolition ❑ \
PERMIT AMOUNT
Plan Chk. Dep. - 19
Plan Chk. Bal.
Const.
Mech..
Electrical
Plumbing
S.M.I.
Grading
Driveway'Enc.
infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front .Setbac 0 Ce^��r� r
Rear Setback ro Reaf' g..
Side Street tb n
Side Setbac from,P tQE
FINAL DATE INSPECTOR�
Issued by: Date Permit
Validated by:
Validation:
WHITE = BUILDING, DEPARTMENT YELLOW = APPLICANT PINK = FINANCE