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12-0422 (AR)P:U%'B_O_X 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000422 Property Address: 53065 AVENIDA, NAVARRO APN: 774-0647026-3 -0,00000- Application description: ADDITION - RESIDENTIAL Property Zoning: COVE RESIDENTIAL Application valuation: 28639 Applicant: Architect or Engineer: atN Ea �? BUILDING & SAFETY DEPARTMENT BUILDING PERMIT ----------------------------------------------- --- LICENSED CONTRACTOR'S DECLARATION 1 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 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).: (_ I 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 La .1. (_) I am exempt under Sec. B.&P.C. for"is reason KDate: ©� O6 7� 12 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 Owner: KNALL,CHRISTIAN I 4224 LA SALLE AVE 53065 AVENIDA *Tnt>nvvn CULVER CITY, Contractor: Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760).777-7153 Date: . 8/06/12 ----------------------------------------------- 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 Policy Number 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 bec�fwith ct to the workers' compensation provisions of Section dd 3700 of the Labor Code, 1 shcom ly ith those provisions. <Date:01 6 I6pplicant: 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 ($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 infor tion is correct. I agree to comply with all city and county ordinances and state laws relating to building construc on, and hereby authorize representatives of this ccoouuInttyj�too ennntter upon the above-mentioned property for inspec n purpose Dater ` I Signature (Applicant or Agent): Application Number 12-00000422 ------ Structure Information 493SF ADDITION/VB/RES-3/CLASS .A [CONV) ----- Other °struct info . . . . . CODE EDITION° 2010 FLOOD ZONE NO PATIO SQ FTG 33.00 ---------------------------------------------------------------------------- 1ST,FLOOR SQUARE FOOTAGE 493.00 Permit BUILDING PERMIT Additional'desc . Permit Fee . . . 278.00 Plan Check Fee 180.70" Issue Date ,. Valuation . . . . 28639" Expiration Date 2/02/13• Qty Unit Charge Per Extension BASE FEE 252.00 4.00 6.5000 THOU BLDG 25,001-50,000 .26. 00 Permit ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . 32.26 Plan Check. Fee, 8.07 Issue Date . . . . Valuation 0 Expiration Date 2/02/13 Qty Unit Charge" Per Extension BASE FEE. 15.00 493:.00 .0350 ELEC NEW RES.- 1 OR 2.FAMILY 17.26 Permit . . MECHANICAL Additional desc . Permit Fee . . . 36.00 Plan -Check Fee 9.00- Issue Date Valuation 0 Expiration Date 2/02/13" Qty' Unit"Charge Per Extension BASE FEE 15.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 1.00 16.5000*EA MECH B/C.>3-.15HP/>100K-500KBTU 16.50 Permit . . . PLUMBING Additional desc ... " Permit Fee 30.00 Plan Check Fee 7.50 Issue Date . . . Valuation 0 Expiration Date 2/02/13" Qty Unit Charge Per Extension LQPERMIT - . Application Number 12=00000422, Permit . . . . . PLUMBING Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB FIXTURE 12.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00' ----------------------------------- Special Notes and Comments -------------- 493SF ADDITION/VB/RES-3/CLASS A -FR (CONVENTIONAL), THIS PERMIT DOES NOT INCLUDE BLOCK WALLS, WATER HEATER CHANGE OUT, -OR ALTERATION TO THE EXISTING DWELLING. 2010 CALIFORNIA BUILDING CODES. August -6, 2012 8:20.:.03 AM A,ORTEGA. ----------------------------------- Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473) -------------- 2.00 ENERGY REVIEW FEE 18.07 STRONG MOTION (SMI) -.RES 2.86 Fee,summary Charged Paid Credited Due Permit Fee Total 376:26 .00 .00 376.26, Plan Check .Total 205.27 .00 .00 205.27 Other. Fee Total 22.93 .00 .00 22.93 Grand Total 604.46 •.00 .00 604.46 LQPERMIT P.O. BOX 1504 LA QUINTA; CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S -PACRA G.E (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Raiders Applying for Construction Permits M I No urg IMF�2fYFi?i?Tv r►tuwr�n Dear Property Owner,` Aii. aWfication for a buitding. P"mit has beers "milted in your name listing yaunelf as the builder of The property invW-Mnelftwed at A-ki1 u iy ► QU ((�C�4 ZZS3 Ifo are providing you � an Owner-Buikkr Tdt r�ttsibilitic�s and posrible cid' t �. otimatieu SlaifiEati� norm w MIMyar am= of yewWWQfl-$talder. We wW � may incur by pmt- 'as year` as &e nos Ihue a baildf -pu * until y,= have read, I unci of snit' slgned, and ce[urned' Mb form to us at our. official address indleate& An agent of the owner cam>ot eaceea eair notice unless you, the property owner, obtain the prior approval of the permitting authority. — yLT. .V,1 0 ;JX, +. + a.a 0�— 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building permit that erroftr,sly implies that the property owner is providing his or her own labor and I.1, as an Owner -Builder, may be held liable and subject to serious financial risk for. any injuries sustained by an unlicensed person and his or her employees while working on MY property. My h©meowrner's insurance may not provide covarW for those injuries. I am willfe Y acting as an Owner -Builder and am aware of the limits a'my insurance for injuries to women on � property. C."— 2. I understand building pe mits are not required to be signed by property owners unless they are respon3ible for th construction and are not hiring a licensed Contractor to assume thistg _ -F I I understand as afl "OWKcr-Buddei" l am.cite responsible party of revord on the permit. i understand brat I may prole myself from potential financial risk by hiring a licensed Contractor and having fe permit filed mi his or name load of o own. —___*r- 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers permits and contracts. C -e-- 5.1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total vi of my construction is at least five hundred dollars ($500), inchtding labor and materials, I may be considered an "emplo: under state and federal law. 6. I understand if I am considered an "emptoyee, under state and Werallaw, I must register with the state. and fey government, withhold payroll taxes, provide workers, compensation disability' insurance, and conic sure to tmeunp[oy, risk. compensation for each "employee." I also understand my failure to abide by these lays may subject me to serious fim 7. 1 understand under California Contractors' State License Law; an Owner -Builder who builds. single-family resid structures cannot legally build them with the . intent to offer them for sale, unless all work is performed by 6c subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is perf under contract with a licensed general building Contractor. C -e- 8. 1 understand as an Owner -Builder if I sell the property for which this peru►it is issued,.1 may be held Iiable for any financial- or. pets W. j urits suaUtned by any subsequent • owner(s) that result from any latent construction defects in the workmanshrp,or materi4k . C L 4. I understand I may obtain . more information regarding my obligations as an "employs" Roto 010 Iatecrtal IOenuo Service, the United States Small Business Administration, the California Department of Benefit PayMCM. and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (=Z) at 1- 800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors - C._. 10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the per' legally and financially responsible for proposed construction activity at the following address: Cr- l 1. [ agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirettteats that govem Owner -Builders as well as employers. Cr— 12. I agree to notify the issuer of this form immediately of any additi?ons; &k6"s, of oketua twaay ,4 the I have provided on this form. Licensed omtractors are regulated by laws designed to protect the public- It you contract with someone who does not have a limen, am Coatxaators' State License Board mt,y be unable to amist you with any 911A alai loss You may sustain as a result of a complaint. Your only remedy against unlicensed Contractors moll bQ igV" cotta. h is also WWmtant for you to adwtand that if am wdioaased Counctor oa Captoyaa of that W&vi&id of &m is h&ad whik, wor1ng on your property. you may be held Hift A'w drmaaVm If you obtaina permit as Owwr-Builft and iv * to lino C.o Untors, you wdi be mVoasA&. for ve�riug v or not ftm C iguacton are p mpe* Beensed am,d Lha Mtn of *W wo&ms' eompemaBion kwasme covenw. Before a building permit eua be issued, this form mast be completed and signed by the property oRmr and retained to the agency respowAble for iuW ft.S aVaaa LL Lifete A copy. of (keproperV o 's 4*409 r f6m +fin+ yr oilier vas kauan asap to liracq fs e+e+gah-ad to 4e pr+areaeacd �n &Vis tea the�1 proP owner's signaftwe. - J . Signawre of property owner ' ` 9�& Date o4,1-7 l �- Note: The following Authorization Form is required to be completed by the property o~r oedly whon designatin an agent of the property owner to apply for a construction permit for the Owner -Builder - AU MRMA 1 M (F AOIiT TO AOT ON PROPER'�Y �'S B Excluding the Notice to Property Owner, the; execption of which I understand is my petaomal respoesibility, I hereby authori the following pm* $) to act as my sgeaut(s) to VP1Y for, sign, and file the documents necessary ter obUin an Owner-Builrle Permit for my pwje ct. Scope of Construction Project (or Description of Work): Project Location or Address: Name of oluthoriaed Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the information and axtify its accuracy_ Note: A copy of the owner's driver's License, form notarization. or other vaOcatio, acceptable to the agency is required to be prvaented when the permit is issr ed to verify the property owner's sianat"re Property Owner's Signature: Date: CITY- OF LA QUINTA'SUB-CONTRACTOR LIST JOB ADDRESS PERMIT NUMBER OWNER. BUILDER This form shall be posted on the job with the Building Inspection 'Card. at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work chancres t -commencement of work. Failure to comply will result in a stoppage of work and/or.the voidance, on this iob. Anv s o this list must be approved by the Building Division prior to :)f building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. ass'Contractori_s Trade Classification Contractor,' .. .... ' cerise . Yw` "k pe '' tion- nsurance:: or &S. ns 'a City-136siness Company Name Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp, Date (xx/xx/xx) EARTHWORK (6-12) PLUMBING'(C-.36j* /A C0NCRETE (C'8)'::' t` I4 �U(WS. INC- b -C-3 �2_�> 133 OW N k C__Q_ 2- 2- Li .12101/12- (bWO I S 9 -7 9 FRAMING .(C-5) N t N Cb"R� t -A i N C_ 691901 0 _1j -j (Ilk C� Fvl',�t 000 CTG Ott —2,okl 000c) o,),f k LLL STRUCT.':STEEL- 1d-51) �A MASONRY -IC -29) PLUMBING'(C-.36j* /A LATH PLASTER (P.735) OW N k C__Q_ DRYWALL (C-9) 0 _1j -j (Ilk C� .HVAC. (C -20Y:..-.-,-:' 5-\- - C 0 20a K r_1\11 PIT boo I 9,9� 0 (0 -0 ELECTRICAL. OBJ N e -Z RQqFING (C71'39)::-..':-.,--,'-" \9J N :'SHEET.METAL (C43) FLOORING (C�1*5)Y.".._:'.­.'. "E7� GLAZING fC-: INSULATIOR: (C72) t\( SEWAGE DISP%-(C-42)­. PAINTING (.C-33) 0 Vj N (E�� CERAMIC TILE (C-54) A CABINETS (C-6) G -1-y FENCING (C-13) LANDSCAPING (C=27).--`-.- ©k-4) v I POOL (C-53) CERTIFICATE OF COMPLIANCE Desert Sands Unified School District r 47950 Dune Palms Road Q BERMUDA DUNES r - " - CA RANCHO MIRAGE b .F Date r 8/6/12 La Quinta, CA 92253 N INDIAN WELLS �i PALM DESERT No. 31348 OA OUINTA r4 INDIO y� - 0 owner Christina Knall f APN # 774-064-026 Address 53056 Avenida Navarro Jurisdiction La Quinta City . La Quinta Zip 92253 Permit # Tract # No. of Units Type Residential Addition ' Lot # No. Street S.F. Lot # No. Street S.F. • Unit 1 53056 Avenida Navarro 493 Unit 6 Unit 2 - Unit 7 Unit 3 - Unit 8 Unit 4 Unit 9 Y Unit 5 Unit 10 - Comments h At the present time, the Desert Sands Unified School District does not collect fees on garagestearports, 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 493 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 -Christian Knall .' Check No. Name on the check Telephone 310/703-4849 1 Funding Exempt BY Dr. Sharon P. McGehee • . }^J'' `3.� Superintendent ' Fee collected /exem ,d by Patrl a BarbUzza Payment Recd $0.00 Over/W.ider Signature e'r'' iqt;; NOTICE: Pursuant to Government Code Sectio 01(d)(1), this will serve 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 f t P.O. BOX 1504 BUILDING & SAFETY DEPARTMENT' 78-495 CALLE TAMPICO (760) 777-7012 FT19 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 r Jo: Greg Butler, Building & Safety Director To PD:August 6, 2012 From: Les Johnson, Planning -Director Due Date: August 13, 2012 Permit #: 12-0422 Status: 1 st Building Plans, Approva (This is an approval to issue a Building Permit) t The Planning Department has reviewed the Building Plans for the following project: Description: Roof Mounted Equipment Screening 3 + Address or General Location: 53-065 Avenida Navarro fed _reW Applicant Contact: Christian Knall — (310) 703-4849 City 04 LLS 6� Sh1iStG 'The -Planning Department finds that: DeA`�`nenl 0 `.these. Building Plans do not require Planning Department approval ..these Building Plans are approved by the Planning Department. 0 :..these Building Plans require corrections: Please forward a copy of the attached corrections to the applicant. When the corrections are made please return them to.the Planning Department for review. Les Johns n, D rector -Planning Date C Bin # 4: . . Cl y. :. of : Bulkgng &r Safety Division P.O. Box .1504,-78-495 Calle Tampico . . LI.Quinta, CA 92253 - (760) Y7770,12 ' Building Pennit Application and Tracking Sheet Pe 2 ProjectAddress:�j0(off 1��1 (� NAVA Owner's Name. C,KP-k�jI-lAN' ' "AU-- A- P. Number. / 7 L% —.0 6 (t 02-C-, Address: Lt-2_,2J+ >-A SA ,A\t F Legal Description: City, ST, zip: W L-V t� e-( i`/ � . O Z32 Contractor. - ' Q UV Int IaR ?jU IL l� Jelephone: ?> 1 O -7 O 3 - b- g'Itcl Address: Project Description: City, ST, Zip: /� a 1-TI O N E.-& M 0 p�L.-- Telephone: State Lia #: ACity Lic. #; Qaa tsu 0, )C�3 cJ 0.��1 � : ' 2x C� Ax AJ Arch', Engr., Designer Address: City., ST. Zip: dDemo Telephone: Construction Type:Occupancy: State Lie. #:_ Project type (circle one): New Add'n Alter Repair Name of Contact Person: C,K PA�l K-nq�_ Sq, Ft: # Stories:. ' ' # Units: Telephone # of ContactPerson: '2(0 .-70 ?D =1.1• 1+. Estimated Value of Project: APPLICANT: DO.NOT WRITE BELOW THIS UNE # Submittal Req'd Reed TRACKING PERMIT FEES an Sets Plan. Check submitted. Item Amount Structural C RIM Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person �j Plan Check Balance- Title 24 C ales. Plans picked up 5 S ,. Canstructio-x Flood plain plan Plans resubmitted. . Mechanical Grading plan 2" Review, ready fo rrec ' issue � � Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. ILOAL Approval Plans resubmitted ho Gradlog IN ROUSE:- 3" Review; ready for correcdo Developer Iatpact Fee Planaing Approval. Called Contact Person AXP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Sl�law+.-�.wq�4'c �0�5� �Fvicei GQ - 1