10-1156 (AR)1
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
GvNTrt�GG614.
10-00001156
49265 AVENIDA EL NIDO
658-290-009- - -
ADDITION - RESIDENTIAL
LOW DENSITY RESIDENTIAL
8807
Tdtt °F 4Qumrw
Architect or Engineer-
LICENSED
nginee� : �
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Cie s: B Li ense No.: 688068
V Date: (✓Contractor: /
WNER-BUILD 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 (5500).:
(_) 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 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.).
1 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:
LQPFWN11T
Owner:
STADNICK, STEVEN J
Contractor:
SOUTHERN CALIFORNIA C L
81162 FRED WARING DR, #1
INDIO, CA 92201
(760)342-1558
Lic. No.: 688068
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/17/11
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I 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.
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 STATE FUND Policy Number 496004872
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 became subject to the workers' compensation laws of California,
and agree that, if I should come subject to the workers' compensation provisions of Section
3700 of the Lab Ot1E� all forthwith comply ith those provisions.
Date:✓Applica
WARNING: FAILURE TO SEC w0 ERS' OMPENSATION COVEFOE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 Quints, 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 be information is correct. I agree to comply with all
city and county ordinances and state laws relating buil construction, and hereby authorize representatives
of this c unty to enter upon the above-mentio prop inspec/t�ca,p�Jurp ses
Oat 91 ignature (Applicant orgent): �J
7' -1 �>
Application Number . . . . . 10-00001156
Structure Information
Construction Type . . . . .. TYPE V, UNPROTECTED
Occupancy Type . . . . . DWELLG/LODGING/LONG <=10
Other struct info . . . . . 1ST FLOOR SQUARE FOOTAGE 109.25
----------------------------------------------------------------------------
Permit . . . BUILDING PERMIT.
Additional desc . . ADDTN TO EXIST. MSTR BEDRM
Permit Fee . . . 108.00 Plan Check Fee 70.20
Issue Date . . . . Valuation 8807
Expiration Date 8/16/11
Qty Unit Charge Per Extension
BASE FEE 45.00
7.00 9.0000 THOU BLDG 2,001-.25,000 63.00
"-----'-----------------------------------------------------------------------
Permit . .
Additional desc .
Permit Fee
Issue Date . . .
Expiration -Date .
ELEC-MISCELLANEOUS
23.25 Plan Check Fee . . 5.81
Valuation . . . . 0
8/16/11
Qty Unit Charge Per Extension
BASE FEE 15.00
11.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 8.25.
----------------------------------------------------------------------------
Permit . .
Additional desc .
Permit Fee . . .
Issue Date . . .
Expiration Date .
MECHANICAL
24.00 Plan Check Fee .
Valuation.
8/16/11
6.00
0
Qty Unit Charge Per Extension
BASE FEE 15.00
2.00 4.5000 EA MECH VENT INST/ DUCT ALT 9.00
----------------------------------------------------------------------------
Special Notes and Comments
109.25 SF ADDITION TO EXISTING MASTER
BEDROOM AT REAR ELEVATION PER ENGINEERED
PLANS.
2007 CODES 2008 ENERGY.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00
ENERGY REVIEW FEE 7.02
HOURLY PLAN CHECK 52.50
LQPERMIT
.- �r
Application Number
. . . . .
10-00001156
-----------------------------------------------------
Other Fees .
. . ...
STRONG MOTION
-----------------------
(SMI) - RES
.88
Fee summary
-----------------
Charged
----------
Paid
--------------------
Credited
----------
Due
Permit Fee Total
155.25
.00
.00
.155.25
Plan Check Total
82.01.
..00
.00
82.01
Other Fee Total
61.40
.00
.00
61.40
Grand. Total
298.66
.00
.00
298.66
LQPERMIT
CERTIFICATE OF COMPLIANCE vN�t�sc
Desert Sands Unified School District
47950 Dune Palms Road Q BERMUDA DUNES °
RANCHO MIRAGE Cf
Date 2/22/11 La Quinta, CA 92253INDIAN WELLS
PLA DESERT y
No. 30937 (760) 771-8515 `�J o INDDIO
Owner
Steven Stadnick
APN # 658-290-009
Address
22871 Pine Lake Ln
Jurisdiction La Quinta
City
Lake Forest Zip 92630
Permit #
Tract #
No. of Units 1
Type
Residential Addition
Lot # No. Street
S.F.
Lot # No. Street S.F.
Unit 1
49265 Avenida Elnido
110 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 patiostwalkways, 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 110 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 - Gary Ferguson Check No.
Name on the check Telephone
Funding Exempt
BY Dr. Sharon P. McGehee
Superintendent
Recd
Fee collected /exempt d by ar MC llv Payment �-
°' Over/Undei;
J'
Signature
NOTICE: Pursuant to Government Code Section 66020(d)(1), this OKQLs,9&e to notify you that the 90 -day approval period in which you may protest the fees
or other payment identified above will begin to run from the date on which the building or 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 NOT VALID without embossed seal
Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting
La Quinta Golf Estates
Community Association
Architectural Committee
P.O. Box 553
La Quinta, CA 92247
(760) 564-0136
jimandjaynew@verizon.net
February 18, 2011
Mr. Gary Ferguson
Dear Mr. Ferguson:
The Architectural Committee for the La Quinta Golf Estates Community Association has
reviewed the plans that you submitted for the 109.25 square foot addition to the home at
49265 Avenida El Nido, La Quinta, CA 92253-2754 and we have approved them.
Please remember that the approval is for these plans only and if you make changes to
your plans they will have to be resubmitted for approval.
Yours truly,
ac'- o
Le D. Woods
Chairman, Architectural Committee