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05-4682 (AR)c... P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: " Applicant: 05-00004682 78390 CRESTVIEW TER 643-192-003-35 -2117 - ADDITION - RESIDENTIAL LOW DENSITY RESIDENTIAL 22202 T4,Yl 4 a V a" Architect or Engineer: 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 Class: - - - - - - - - - - License No.: E FOOTAGE 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 aaa ,,licant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ,IC�1, its 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 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 I am exempt under Sec. , B.&. for this reason•j 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: LQPERTN11T Owner: RANDY HEETHER 78-390 Crestview Terrace LA QUINTA, CA 92253 Other struct info . Contractor: Owner DITION Lic. No.: E FOOTAGE 2C VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/01/05 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 NO Policy Number I certify that, in the performance of the work for which this permit is issued, 1 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 Co I sha fort�mplye provisions. Date: /� - SApplicant: r WARNING: FAILURE TO SECURE WORKER 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 issuedas 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 npct purposes. Date: �ignature (Applicant orAg Application Number . . . . 05-00004682 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 234.00 Plan Check Fee 152.10 Issue Date Valuation . . . . 22202 Expiration Date 5/30/06 Qty Unit Charge Per Extension BASE FEE 45.00 21".00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 189.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 28.20 Plan Check Fee 7.05 Issue Date. Valuation• . . . . 0 Expiration Date 5/30/06 Qty Unit Charge Per Extension BASE FEE 15.00 377.00 .0350 -------'--------------------------------------------------------------------- ELEC NEW RES - 1 OR 2 FAMILY 13.20 Permit MECHANICAL Additional desc . Permit Fee . . . . 30.50 Plan Check Fee 7.63 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/30/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH APPL REP/ALT/ADD 9.00 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH VENT FAN 6.50 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 36.00 Plan Check Fee 9.00 Issue Date Valuation 0 Expiration Date 5/30/06 Qty Unit Charge Per" Extension BASE FEE 15.00 3.00 6.0000 EA PLB FIXTURE 18.00 - 1.00 3.00"00 EA PLB WATER INST/ALT/REP 3.00 -------------------------------------- Special Notes and Comments -------------------------------------- ADDITION / REMODEL LQPER\7IT LQPERDIIT Application Number . . . . . 05-00004682 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 15.21 STRONG MOTION (SMI) - RES 2.22 Fee summary ----------------- Charged ---------- Paid -------------------- Credited ---------- Due Permit Fee Total 328.70 .00 .00 328.70 Plan Check Total 175.78 .00 .00 175.78 Other Fee Total 17.43 .00 .00 17.43 Grand Total 521.91 .00 .00 521.91 bin # City of. La Quinta Building 8L -Safety Division - — P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # os ProjectAddress: -390 C�F_Sj V! l✓ jr Owner's Name:fEj%'t�Ak A. P. Number: U C7 3 Address: 7? --3 9Q CREWV16W 7.604 0a r— Legal Description: ``0 7 315 City, ST, Zip: ZAy�(JiAJ7"A 64 Contractor: Telephone % Address: Project Description: City, ST, Zip: i D D17*10N f<`44 -d DEC %J Telephone: State Lie. # : City Lie. #: Arch., Engr., Designer: CdwG41,-�P/�r Address: Zi,6 City, ST, Zip:Z/� avl4) iA- 9z2,�-3 Telephone: div S6G/- G/7o 7 S/.d 6 L E Fb'm Construction Type: Occupancy: State Lie. #: Project type (circle one): New dd' Alter Repair Demo Name of Contact PecsoSq. Ft.: 3 % # Stories: # Units: Telephone # of Contact Person: — Estimated Value of Project: Sa 0 O APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING . PERMIT FEES ZPlan Sets Plan Check submitted k d o5 Item Amount Structural Cates. Reviewed, read r corrections ` Plan Check Deposit LTruss Cates. Called Contact on I i 1, I 01; Plan Check Balance Energy Cates. Plans picked up (✓ U NIL, I Construction Flood plain plan Plans resubmitted Il Mechanical Grading plan 2" Review, ready f corrections/issue a Electrical Subcontactor List Called Contact Person y L I, I Plumbing Grant Deed Plans picked up ��l�R S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review, ready for correcti ns/issue Developer Impact Fee Planning Approval Called Contact Person �L P Pub. Wks. Appr Date of permit issue School Fees T716 0Z o L I Total Permit Fees 0 Date 12/2/05 No. 27905 Owner Randy Heether Address 78-390 Crestview Ter. City La Quinta Zip 92253 Tract # Type Residential Addition CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 APN # Jurisdiction Permit # Study Area No. of Units 4. 0 OBERMUDA DUNES Cn RANCHO MIRAGE INDIAN WELLS �. d PALM DESERT LA QUIINDITA �y 643-192-003 La Quinta Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 78390 Crestview Ter. 377 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 5 00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho mes. 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 377 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-Larisa Stafford Check No. Name on the check Telephone Funding Exempt By Dr. Doris Wilson Superintendent Fee collected /exe ted by Pat icia Barbuzza Payment Recd Over/Under Signature :. { NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees o r 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 if Duplicated Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting �y CITY OF LA QUINTA SUB-CONTRACTORLI S JOB ADDRESS / �� ` G'C5P V_1,_e4e2PERMIT NUMBER . OWNER S� �-r' BUILDER C �✓�'T This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous Rlace. Only pers ns appearing on this list or their employees are authorized to work. on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. Trade/ 1 sification Tr /Cas Contractor' ::::'<>s>'':::..:::::>.S tate..0 o . ntractor.s. L�cerise . .:..:....... . W.or.kes.C.om egsatiori;l�isurance:..: ;:.:. Bu Li. City Business cense::.:• Company Name Classification (e.g. A. B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xxl 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 (C-121 ..; CONCRETE (C-8) 3cr4!�tfl__t66 4 04 If FRAMING STRUCT. STEEL. (C-51) -MASONRY (C•29) PLUMBINC3 'IC -361 U v ' ke 1 kvh C- 3 LATH; PLASTER (0--3'5)'- C-35) DRYWALL (C-9)..... -,DRYWALL L--� �L� �r� C - u l 20 7 �� �� .S<��� �v.✓a� %( o C 'L�� 3/ .°�j HVAC. (C-20)'..::: ELECTRICAL. (CA 0)':.' .`: Oe,1 C ROOFING (Q=`3!9):`-':-:::.-' SHEET METAL 10-431 _ FLOORING \ 52-3 2 F GLAZING (C-171` ` INSULATIONIC-2). SEWAGE DISP: (0-42) : PAINTING (C=33) CERAMIC TILE (C-54) CABINETS (C-6) FENCING (C-13) LANDSCAPING (C=27).•.`:' POOL (C-53)