05-1938 (AR)P.O. BOX. 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253'
Application Number: 05-00001938
Property Address:' .51175 AVENIDA HERRERA
t3 APN: 773-063-017-6 -000000-
Application description: ADDITION - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 24939
Applicant:
Architect or Eng
T4' 4 4v Q"
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 forr.P 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 l'
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: L
%1 ) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
t—.. 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.).
( 1 I am exempt under Sec. , B.&P.C. for this reason -
Date: �/10�ds i�'��Own /r
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:
LQPERn11T
M
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/19/05
Owner:
SATO LUIS ,
51-175 AVENIDA HERRERA
LA QUINTA, CA 92253
Other struct info . . . .
Cdntractor:
Owner
DITION 2001 CBC
Lic. No.: E FOOTAGE
------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: .
I have and will maiouiiil 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 .. 1.00 Policy Number NO
Z - 1 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 Code, I shall forthwithcomplywith ose provisions.
.Date:9/?�c, Applicant
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. r
2. Any permit issued as a result of this application becomes rfull 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 hereb authorize representatives
of this county to enter upon the above-mentioned property for inspection purp
Date: ' 20 .` Signature (Applicant or Agent)l:7/
r
Application Number. .
. . . 05-00001938
Permit
BUILDING PERMIT
Additional desc .
Permit Fee . .
252.00 Plan Check Fee
163.80
-' Issue Date
Valuation
2.4934
Expiration Date
3/18/06
i
Qty Unit Charge
Per
Extension.
BASE FEE
45.00
23.00 9.0000
--------------------------
THOU BLDG 2,001-25,000
-------------------------------------
207.00
------- - - - - --
.Permit
ELECT - ADD/ALT/REM
Additional desc .
Permit.Fee . . . .
40.76 Plan Check Fee
10.19
Issue Date
Valuation . . . .
0
Expiration Date
3/18/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
736.00 .0350
------------------ -------------------------------------------------------------
ELEC NEW RES - 1 OR 2 FAMILY
25.76
-Permit
MECHANICAL
-
Additional desc .
Permit Fee
30.50 Plan Check Fee
7.63
Issue Date . . . .
Valuation . . . .
0
Expiration Date
3/18/06
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 EXHAUST HOOD
6.50
Permit -
PLUMBING .
Additional desc .
Permit Fee . . . .
27.00 Plan Check Fee
6.75
Issue Date . . . .
Valuation . . .
0
Expiration Date
3/18/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
EA PLB FIXTURE
6.00
2.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
6.00
----------------------------------------------------------------------------
Special Notes and Comments
living room addition
and
LQPERAIIT
LQPERAIIT
Application Number
. . . . .
05-00001938
----------------------------------------------------------------
Special Notes and
Comments
------------
remodel.September
19, ,2005 6:37:44
AM
jjohnson
-------------------------------------------------------------------------'---
Other Fees . . .
. . . . . .
ENERGY REVIEW
FEE
16.38
STRONG MOTION
(SMI) - RES
4.20
Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
350.26
.00
.00
350.26
Plan Check Total
188.37
.00
.00
188.37
Other•Fee Total
20.58
.00
.00
20.58
Grand Total
i
559.21
.00.
.00
559.21
LQPERAIIT
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
Date 9/20/05 La Quinta, CA 92253
No. 27672 (760) 771-8515
Owner Luis Sato APN #
Address 51-175 Avenida Herrera Jurisdiction
City La Quinta Zip 92253 Permit #
z. ;o
BERMUDA DUNES
Cr RANCHO MIRAGE
�d INDIAN WELLS
.`, PALM DESERT y
`r LA OUINTA
QINDIO y�
773-063-017
Tract # Study Area
Type Residential Addition No. of Units 1
Lot # No. Street S.F.
Unit 1 51175 Avenida Herrera 436 Unit 6
Unit 2 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 garages✓carports, covered patioshaalkways, 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 436 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 - Luis Sato Check No.
Name on the check Telephone
Funding Exempt
By Ar. Doris Wilson
Superintendent .
Fee collected /exempted by Sharon M Gilvre Payment Recd I. t ./�
Y ,. #0.00
ver/Unger "
"
Signature c
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 tD 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