12-0494 (AR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12-00000494
Property Address: 79770 CITRUS
APN: 772-170-019- - -
Application description: ADDITION - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 48766
Tit!t 4 4 Q"
Applicant: Architect or Engineer:
�a71tSt2AtJlta/1. 1114"
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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:
B License No.: 6019 1
�[ Date: !7 / [;[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, 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 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.).
(_) 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/13/12
Owner:
CHENG, JULIA M Y
SFr 13
2012
Contractor:
BECKER CONSTRUCTION
CO
81355 CAMINO SEVIL
OF LA QUINTA
FINANCE QUIN
BERMUDA DUNES, CA 9
(760)567-2138
Lic. No.: 601981
-----------------------------------------------
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 NTL INS Policy Number AWL001958-12
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 Cp/�/e�hy/a/fI/forthwith comply ith rho/s/fiWprov, ns.
Date: )3 I1LApplicant: / u\(/Lf.cI dl...J
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,0001. 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 this county to enter upon the above-mentioned property or s ction purposes.
�*�gnature Date: (Applicant or Agent): - r
Application Number . . . . . 12-00000494
Structure Information 604SF CASITA/VB/RS-3/CLASS A -FR [CONV]
Other struct info . .
. . . CODE EDITION 2010
# BEDROOMS
1.00
FLOOD ZONE NO
----------------------------------------------------------------------------
IST FLOOR SQUARE FOOTAGE
604.00
Permit . . .
BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
408.00 Plan Check Fee
265.20
Issue Date . . . .
Valuation . . . .
48766
Expiration Date
3/12/13
Qty Unit Charge
Per
Extension
BASE FEE
252.00
24.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
156.00
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
36.14 Plan Check Fee
9.04
Issue Date . . . .
Valuation . . . .
0
Expiration Date . .
3/12/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
604.00 .0350
----------------------------------------------------------------------------
ELEC,NEW RES - 1 OR 2 FAMILY
21.14
Permit . . .
MECHANICAL
Additional desc . .
Permit Fee . . . .
43.50 Plan Check Fee
10.88
Issue Date . . . .
Valuation . . . .
0
Expiration Date . .
3/12/13
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
2.00 6.5000
----------------------------------------------------------------------------
EA MECH VENT FAN
13.00
Permit . . . PLUMBING
Additional desc .
Permit Fee 64.50
Issue Date . . . .
Expiration Date . . 3/12/13
LQPERMIT
Plan Check Fee . . 16.13
Valuation . . . . 0
s
Application Number . . . . . 12-00000494
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
BASE FEE
15.00
6.00 6.0000 EA PLB FIXTURE
36.00
1.00 7.5000 EA PLB WATER-HEATER/VENT
7.50
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
604SF DETACHED CASITA/VB/RES-3/CLASS
A -FR [CONVENTIONAL] THIS PERMIT DOES NOT
INCLUDE BLOCK WALLS, POOL OR SPA, PATIO
COVERS, OR ALTERATIONS TO THE EXISTING
DWELLING. 2010 CALIFORNIA BUILDING
CODES.
August 30, 2012 11:16:37 AM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
2.00
ENERGY REVIEW FEE
26.52
STRONG MOTION (SMI) - RES
4.88
Fee summary Charged
Permit Fee Total 552.14
Plan Check Total 301.25
Other Fee Total 33.40
Grand Total 886.79
LQPERMIT
Paid Credited Due
.00 .00 552.14
.00 .00 301.25
.00 .00 33.40
.00 .00 886.79
lin.#
77,
:. City. of- U- Quinta
Buliding 8i Safety DWon
P.Q. Box 1504,78-495 Calle Tampico
La.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
a— �T
Project Address: . (: " Owner's Name:. `�&,Itl�
A. P. Number.. - 1070 . O . 3 -79 Address: e_1Legal
Description: Tib City, ST, Zip: CA 07X.
Contractor: Telephone:
Address: /&t OV7, Project Description:
City, ST, Zip:
Telephone:
i Cro. y
; ,<
City Lia #;
State Lie. # :
Arch, Engr., Designer.
Address: . Q 1% µ j L►
City, ST, Zip: '�� •�b� " I
Telephone: • !07 Construction Type: Occupancy:
• v
State Lic. #: M . w�i»irs _ Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Perso . Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: Q J5719. 1 667:� Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
u
Submittal
Req'd
Recd
TRACKING PERMIT FEES
Plan Check submitted / a em Amount
Plan Sets
Structural Cales.
Reviewed, ready for corrections Plan Check Deposit. .
'!fuss Calc$.
'S
Called Contact Person '�'� Plan Check Balance -
Tule 24 Cales.
Plans picked up lvy - Construction
Flood plain plan
Plans resubmitted.. Mechanical
Gilding plan
V Review, ready for correction isstt Electrical
Subcontactor List
Called Contact Person umbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN ROUSE,
''" Revlew',ready for correctionsfissut Devetoper Impact Fee-
eePlanning
PlanningApproval
Called Contact Person P.P.
Pub. Wks. Appr "
Date of permit Issue
School Fees
Total Permit Fees
tI30
�x+P'kalr+tSs Sar'
S`��1 ti • Cam 04404 — t.�s'[ ;Btu Pe""I"Go To. Sw AXL W-4AMWL W4&-WAV07
Date
9/13/12
No.
31407
Owner
Cheng, Julia M Y
Address
79770 Citrus
City
La Quinta Zip
Tract #
Type
Detached Guest House
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515
APN #
Jurisdiction
Permit #
No. of Units
Q BERMUDA DUNES
(n RANCHO MIRAGE
N INDIAN WELLS
PALM DESERT 6,
LA QUINTA
INDIO
�Q,.y7ti
0
776-170-018
La Quinta
1
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 79770 Citrus 604 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 patios/walkways, 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:
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 $3.20 X 604 S.F. or $1,932.80 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/Chase - Klaus Becker
Check No. 9502702477
Name on the check Telephone
Funding Residential
By Dr. Sharon P. McGehee
Superintendent
Fee collected /exempt9id ky Sha on MCG'Cvrry Payment Recd�.p� o
$1,932.80 Over/Under
1
Signature�y
L , '
NOTICE: Pursuant to Government Code Section 66020(d)(1), thisili a 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