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BRES2015-0196Vol Applicant: DAZ P 0 BOX 5083 LA QUINTA, CA 92253 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 Professions Code, and my License is in full force and effect. License Class: B License No.: 944325 ` Date"')) Contract 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, 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.). (_) 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Contractor: DAZ P 0 BOX 5083 LA QUINTA, CA 92253 (760)285-3793 Llc. No.: 944325 Date:, 6/3/2015 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 wP7OO r which this permit is issued. ave and will maintain workers' compensation insurance, as required by Sectionof 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 become subject to the workers' compensation provisions of Section 3700 f th bor Code, I shall forthwith comply with tose p ovisions. Date:." U Applican't:� WARNING:,FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 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 Building Official 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 city o enter upon the above- ment/io//n�ed pro rty for inspection purposes. , �„* , � . Dafe:' Signature (Applicant or Agent):' C f 78-495 CALLE TAMPICO D �} LA QUINTA; CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRES2015-0196 Owner: 'Property Address: 61080 TALEA DR R SPIRES APN: 764800003 P 0 BOX 4908 Application Description: TRILOGY/SPIRES/263 SQFT ADDITION (CASITA) AND BLOCK WALL BLUE JAY, CA 92253 Property Zoning: Application.Valuation: $21,250.40: Applicant: DAZ P 0 BOX 5083 LA QUINTA, CA 92253 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 Professions Code, and my License is in full force and effect. License Class: B License No.: 944325 ` Date"')) Contract 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, 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.). (_) 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Contractor: DAZ P 0 BOX 5083 LA QUINTA, CA 92253 (760)285-3793 Llc. No.: 944325 Date:, 6/3/2015 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 wP7OO r which this permit is issued. ave and will maintain workers' compensation insurance, as required by Sectionof 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 become subject to the workers' compensation provisions of Section 3700 f th bor Code, I shall forthwith comply with tose p ovisions. Date:." U Applican't:� WARNING:,FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 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 Building Official 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 city o enter upon the above- ment/io//n�ed pro rty for inspection purposes. , �„* , � . Dafe:' Signature (Applicant or Agent):' FINANCIAL INFORMATION ` r DESCRIPTION ' ' r t .. ACCOUNT y ; r -QTY; AMOUNT: _• , `.'PAID • :PAID DATE ADDITION, EA ADDITIONAL 500 SF 101-6000-42400,, 0 $62.36 `. $0.00 PAID BY ; .. METHOD a Y ;".. ; k RECEIPT # t t _ " :CHECK # ' d; w .. CLTD BY t ' DESCRIPTION Y'.. ACCOUNT` QTY AMOUNT- Y r PAID�T �; 'PAID DATE ADDITION, EA ADDITIONAL 500 SF PC 101-0000-42600 •0 $17.40 $0.00 .s .y. PAID 13Y 3 METHOD - RECEIPT # _- •',CHECK ' `CLTD BY ' yy'DESCRIPTION, • i _.' ACCOUNTS:,: •CITY .' 'AMOUNT -":� ,RAID ` PAID DATE' ADDITION, FIRST 100 SF 101-0000-42400 0 $120.83 $0.00 IR PAID BY `• f. ' % METHOD ' RECEIP#r CHECK # ' ,CLTD BY` L` ' .. DESCRIPTION v w .:ACCOUNT r c ; .;CRTY. ;AMOUNT .. ,, `,iPAID , w• PAID'DATE. ADDITION, FIRST 100 5F PC 101-0000-42600 0 $171.14 $0.00 "f "';'E ^°' ;1 % s PAID�BY r r r METHOD x ' Y z RECEIPT,# L T CHECK# ` '. CLTDiBY.. Total Paid forADDITION: $371.73 $0.00 Yk ACUNT QTYRTION iAMOUNTDESC PAID 4 s`4 PAID `DATE' BSAS SB1473 FEE' 101-0000-20306 0 $1.00 $0.00 :fit _ '} ° •1'r PAID BY r , : �` s • ,: METHOD, r � � � � RECEIPT # , CHECK # f ' CLTD BY,r Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 ' , ? DESCRIP,TION. : ,; ACCOUNT QTY , AMOUNT;; " ' PAID PAID DATE RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $145.03 $0.00 PAID BY � J ti -METHOD: ,` ,. RECEIPT # CHECK.# . r ' CLTD BY DESCRIPTION x. `� ^ ' ACCOUNT '�` a QTY" r "AMOUNT''"' F. PAID ,- x1Y .+ PAID. DATE RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $47.86 $0.00 ,PAI D-BY3 r : �. -.. ; ' a �Y `. METHOD t' i"; RECEIPT # tix CHECK # CLTD BY Total Paid for ELECTRICAL - NEW CONSTRUCTION: $192.89' ` $0.00 u . DESCRIPTION' ;ACCOUNT, L`t QTY `'xr AMOUNT ry :PAID xPAID.DATE CONDENSER/COMPRESSOR 101-0000-42402 0 $36.26 $0.00 PAID BY qs 'r' : ;fi METHOD, :RECEIPT.# i"a ;3 . .".. CHECK # ` `CLTD BY' 'nDESCRIPTION`r,- 1 7 ,ACCOUNT- QTY pAMOUNT-= �PAIDS ;} x RAID,DATE CONDENSER/COMPRESSOR PC 101-0000-42600 0 $24.17 $0.00 r, PAID BY';^' r x . r "w SMETHOD tiRECEIPT.# CHECK # CLTD BY y' ,,"DESCRIPTION ? y t t M ACCOUNT F T.Sr �a QTY' AMOUNT. t PAID >' PAID DATE r • FURNACE 101-0000-42402 0 $36.26 $0.00 _PAID BY`� s3:. r -METHOD r . RECEIPT # 'CHECK # CLTD BY :DESCRIPTON' ACCOUNT QTY.AMOUNT . PAID PAID DATE FURNACE PC 1,101-0000-42600 0 $24.17 $0.00 PAID BY r ,"^ g i ' METHOD ` RECEIPT # a - CHECK# '' ! � CLTD BY DESCRIPTION` ;} .ACCOUNT sQTY. ,;:AMOUNT PAID PAID DATE , VENT FAN 101-0000-42402 0 ., $12.09 $0.00 .PAID BYs ,''METHOD "` RECEIPT # ; " CHECK # CLTD.BY:T" 3 t . ,DESCRIPTION ;; �''• • a :: ACCOUNT AMOUNT." �; " PAID i. PAID DATE VENT FAN PC ' 101-0000-42600 0 $4.83 $0.00 v a PAID BY r , _ -,METH "RECEIPT #' ':} _ CHECK # CLTD BY ' Total Paid for MECHANICAL: $137.78. $0.00 + s .,DESCRIPTION ° ; .ACCOUNT ' QTY AMOUNT' .j PAID v , ,PAID DATE FIXTURE/TRAP - 101-0000-42401 0 $36.27 $0.00 '-,-; P/!iID BY, ' e ,` x� 'METHOD„ ` tRECEIPT # t, CHECK # ,� ? CLTD BY j "DESCRIPTION S F ' ACCOUNT QTYa' `x AMOUNT F`T" PAID PAID DATE FIXTURE/TRAP PC , 101-0000-42600 01 $36.27 $0.00 a ` `PAID"BY �. ` ". METHOD h: t r . xr. RECEIPT # �t CHECK# i 'ri CLTD' BY s 'DESCRIPTION;x , • ACCOUNT QTY• AMOUNT r. tr . •' PAID ;p PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 ' $0.00 x - . PAID BY x. :,',. �, METHOD .r RECEIPT # -,C HECK# CLTD -6Y .; -DESCRIPTION y" .;,A000UNTx QTY. aAMOUNT.{ „- ; ,`PAID ' PAID DATE WATER,SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.09 $0.00 PAID, BY w.ix' '� t METHOD'+ RECEIPT #''-" CHECK # Ew' r CLTD BY; Total Paid for PLUMBING FEES: $96.72 $0.00 DESCRIPTION * ; • '"ACCOUNT +, >. QTY PAID ' , 'PAIDf)ATE SMI - RESIDENTIAL 101-0000-20308 0 $2.76 $0.00 ;PAIDBY METHOD,. �. RECEIPT# it;+ tCHECK# :1k ; CLTDBYr n Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $2.76 $0.00 TOTALS::0• •- Description: TRILOGY/SPIRES/263 SQ FT ADDITION (CASITA) AND BLOCK WALL Type: BUILDING, RESIDENTIAL Subtype:ADD,ITION Status: APPROVED Applied: 5/14/2015 SKH - Approved: 6/3/2015 JJO Parcel No: 764800003 Site Address: 61080 TALEA DR LA QUINTA,CA 92253 Subdivision: TR 35996 Block: Lot: 3 - Issued: Lot Sq Ft: 0 - Building Sq Ft: 0 Zoning:. _ Finaled: Valuation: $21,250.40 - Occupancy Type: ' - Construction Type:' - '- Expired: f No. Buildings: 0 No. Stories: 0 No. Unites: 0 , z ' � ACTION DATE s COMPLETION DATE c 2 NOTES" Details: NEW 263 SQ. FT. ATTACHED CASITA THIS PERMIT DOES NOT INCLUDE BLOCK WALLS. 2013 CALIFORNIA BUILDING CODE. Process Su.mmary ADDITIONAL si f STAFF NAME z ' � ACTION DATE s COMPLETION DATE c 2 NOTES" TYPE :� k S ; _ PLAN CHECK PICKED UP • Applied to 413med " • ~ Printed: Wednesday, June 03, 2015 2:34:03 PM .1 of 4 CSYSTEMS ADDITIONAL CHRONOLOGY f STAFF NAME z ' � ACTION DATE s COMPLETION DATE c 2 NOTES" TYPE :� k S ; _ PLAN CHECK PICKED UP • STEPHANIE KHATAMI 5/22/2015' 5/22/2015 Y PLAN CHECK CORRECTIONS PICKED BT ALBERTO, PLAN CHECK SUBMITTAL MARY FASANO _ . 5/26/2015 5/26/2015 RECEIVED - ' ' -- CALLED ALBERTO TO INFORM HIM THAT PLANS ARE READY TELEPHONE CALL `• JIM JOHNSON; 5/22/2015 5/22/2015 FOR CORRECTION CALLED ALBERTO DAZA TO INFORM HIM THAT PLANS ARE TELEPHONE CALL JIM JOHNSON 6/3/2015 6/3/2015 READY TO ISSUE AFTER SCHOOL FEES ARE PAID. CONDITIONS t 'NAME TYPE `� Viµ• "t z ; :'y:�,,�ADDRESsi Tr• :CITY ^Y., ,. STATE; ZIP' '.PHONE FAX; ' EMAIL , rsNAME- APPLICANT DAZ P O BOX 5083 LA QUI NTA CA 92253 Printed: Wednesday, June 03, 2015 2:34:03 PM .1 of 4 CSYSTEMS iNAME TYPE NAME,-'-.�_ A,-,i� ADDRESS1�z CITY'. STATE PFF6—N 74 FAX CONTRACTOR DAZ P 0 BOX 5083 LA QUINTA CA 92253 OWNER R SPIRES P 0 BOX 4908 BLUE JAY CA 92253 FINANCIAL Printed: Wednesday, June 03, 2015 2:34:03 PM 2 of 4 SYSTEMS c7w FINANCIAL INFORMATION DESCRIPTION ACCOUNT , 1.y QTr- L" AMOUNT PAID PAID DATE RECEIP.i# [ CHECK # j-Mitk6Df�,1.,.--,`PAID y CLT6 B ADDITION, EA 101-0000-42400 0 $62.36 $0.00 ADDITIONAL 500 SF ADDITION, EA • 101-0000-42600 0 $17.40 $0.00 ADDITIONAL 500 SF PC ADDITION, FIRST 100 SF 101-0060-42400 0 $120.83 $0.00 ADDITION, FIRST 100 SF 101-0000-42600 0 $171.14 $0.00 PC Total Paid forADDITION: $371.73 $0.00 ---------- BSAS SB1473 FEE 101-0000-20306 '0 $1.00 $0.00 tTotal Paid forBUILDING STANDARDS ADMINISTRATION $1,.00 $0.00 - BSA:. RESIDENTIAL, FIRST 101-0000-42403 0 $145.03 $0.00 1,0005E RESIDENTIAL, -FIRST 101-0000-42600 µ 0 $47.86 $0.00 1;000SF, PC Total Paid forELECTRICAL - NEW CONSTRUCTION: $192.89 $0.00 CONDENSER/COMPRES 101-0000-42402 0 $36.26 $0.00 SOR CONDENSER/COMPRES 101w0000-42600 .0 $24.17 $0.00 • SOR PC FURNACE 101-0000-42402 •0-$36.26 '$0.00 'FURNACE PC 101-0000-42600. 0 $24.17 $0.00 Printed: Wednesday, June 03, 2015 2:34:03 PM 2 of 4 SYSTEMS c7w S_EQIID: ��INSPOIOWYYPE' INSPECTOR',- ',.SCHEDULED'. ,COMPLETED 1161ift- REMARKS % 7k, -"RECEIW -ek 6 4'� METHOD t" PAIP, BY, �CLTD; 5S. ' . ty- kmliW '-T'Y_P.E` RE VIEWER ,SENT DATES 1, DUE DATE �"AMOUNT%� PAI Ij PAID DATE r # , � k BY BLD NON-STRUCTURAL- JIM JOHNSON 5/14/2015 5/28/2015 5/22/2015 REVISIONS REQUIRED - VENT FAN 101-0000-42402 0 $12.09 .$0.00 NON-STRUCTURAL- JIM JOHNSON VENT FAN PC r 101-0000-42600 0. $4.83 $0.00 Total Paid forMECHANICAL:, $137.78 .-$0.00 FIXTURE/TRAP 101-0000-42401 0, $36.27 $0.06, "FIXTURE/TRAP PC. -101-0000-42600 - 0 $36:27 $0.00 WATER SYSTEM 101-0000-42401 0- $12.09 $0.00 INST/ALT/REP WATER SYSTEM 101-0000-42600 0 $12.09. $0.00 INST/ALT/REP PC Total Paid for PLUMBING FEES: $96.72 $0.00 SMI -RESIDENTIAL -0 10 000-20308 0 $2.76 $0.00 Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $2.76 $0.00 k TOTALS: $802.88 $0.00 S_EQIID: ��INSPOIOWYYPE' INSPECTOR',- ',.SCHEDULED'. ,COMPLETED 1161ift- REMARKS PARENT PROJECTS . -7 � i, ' I 7r; RETURNED 5S. ' . ty- kmliW '-T'Y_P.E` RE VIEWER ,SENT DATES 1, DUE DATE _'4'. 1;1%., S - NOTjS'!2 —I 'Z �� I I FINAL** BLD NON-STRUCTURAL- JIM JOHNSON 5/14/2015 Printed: Wednesday, June 03, 2015 2:34:03 PM 3 of 4 1 CRWYsrfms PARENT PROJECTS . -7 � i, ' I 7r; RETURNED REVIEWS -'v U ,'.4-e,.STAT " -REMARKS ' . ty- kmliW '-T'Y_P.E` RE VIEWER ,SENT DATES 1, DUE DATE _'4'. 1;1%., S - NOTjS'!2 —I 'Z �� I I �["e . . NON-STRUCTURAL- JIM JOHNSON 5/14/2015 5/28/2015 5/22/2015 REVISIONS REQUIRED - 2 WK NON-STRUCTURAL- JIM JOHNSON 5/26/2015 6/9/2015 6/3/2015 APPROVED- Printed: Wednesday, June 03, 2015 2:34:03 PM 3 of 4 1 CRWYsrfms "Birn# :City of La QUinta Building & Safety Division P.O. Box 1504,'78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012. (07 ('1=1 Building Permit Application and Tracking Sheet Permit # 5�(�_ Project Address: 5VS-4A /r A. P. Number: �� 'p� �� Address: <0 60tIe„ oil y IO Legal Description: Contractor: City, ST, Zip: a ZZ' telephone: e ho e. . P 0 Address:,09?J- Project Description: City, ST, Zip: G. GG tt Telephone: hone r1 3 AIS r .F b State Lic. # : City Lic. #•: Arch., Engr., Designer: (,�j 10 / ,►c..` WOW/ G Qrjl 19t cam, 04,4 Address:. v i %jIM J City., ST, Zip: Telephone: e ne: P 0 Constructiontru ti on Type: e: OaneY •ccuState 3D ic. #• pe (circle one): New Add'Alter Repairarir e mo Name of Contact Person:�Zp Sq. Ft.: #Stories: # Units: Telephone # of Contact Person: �. 'L�� S Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Coles. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person .Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan god Review, ready for correction /issue `13 Electrical Subcontactor List Called Contact Person ` Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees . Total Permit Fees Coachella Valley Unified School District 'This Box For District Use Only. a 837733 Avenue 55,,T'hermal, CA' 92274 DEVELOPER FEES PAID' AREA: AMOUNT ' LEVEL ONE AMOUNT: ` LEVEL TWO AMOUNT: MITIGATION AMOUNT:', COMM/IND. AMOUNT: , DATE:' •' •. " RECEIPT,. _ CHECK #: .• INITIALS• -• j r ,CERTIFICATE OF COMPLIANCE (California Education Code 17620)' Project.Nanie: , t [Fpm -& Susan Spires ' ", c 4'Date:. June 5, 2015 "-Owner's Name: Tom & Susan Spires E '` Phone No. = Project Address: 61-080.Talea Drive, La Quinta, CA C g.. Project Description: Attached Casita la, I) APN: • 764-800-003 ' 4 Tract #: ' k j. Lot #'s: Type of Development: Residential "• XX! _• Commercial Industrial Total Square:Feet'of Building Area: 263 SQ: FT Y ,; w Certification of Applicant/Owners: The person•signing certifies that the'above" information is correct and makes this statement under . penalty of perjury and further represents that lie/she is'authorized to signon behalf of the owner' /developer.; Dated: ®: Signature: ? a ! r SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT -HAVE BEEN OR WILL BEeSATISFIEDIN° ' ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code Project Agreement Existing Not Subject to Fee 17620 65995 Approval Prior to 1/1/87 Requirement 4t, Number of Sq.Ft 263' I ote� < + _ ` •} - ursuant to AB 181 any room additions or enclosures of 500 • ' ` 1 s.f.-or_less -are -exempt.from-developer _ fees,: Any mobile homes Amount per Sq.Ft: EXEMPT being relocated or replaced within the same school district's Amount Collected. 0.00 - jurisdiction are exempt from developer fees. I'f _ Building Permit Application -Completed: Yes/No,` By: Elsa F. Esqueda, Director of Facilities and -Maintenance K . Certificate issued by Leticia Torres; Facilities Analyst Sig ature: " NOTICE OF 90 DAY PERIOD FOR PROTEST F S D TA19MENT OF FEES . . . Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires at this District provide.(l)-a written notice to the project appellant, at. the time of payment of school fees, mitigation payment or other exactions ("Fees" of the 90 -day period to protest the imposition of these' Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Governmerit code and other applicable law, this Notice shall serve to 'advise you that the 90 -day protest period in regard to such Fees -or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount o.the fees imposed is as herein set forth, whether payable at.this ,time or in whole or in part prior to issuance'of a Certificate of Occupancy. .As in the lateen, the 90 days,.starts on'tbe date hereof.:. This Certificate of Compliance is valid for thirty (30) days from the date`of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extension_ s may be granted. � 1. M V:cMiydocs/dcvfees/cerliticale of comFliancc fom undated M007 11/2010 t _ _t