05-1017 (AR)Ted
44Q�rw
BUILDING & SAFETY DEPARTMENT
Box 1504 (.760),777-7012
95 CALLE TAMP,ICO. FAX'(760) 777-7011
�UINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777=7153
BUILDING PERMIT
zmber 05-00001017 Date 3/22/05
eroperzy Aaaress . . . 44065 TIARA PL
APN: 604-141-005-5 -23269 _
Application description ADDITION - RESIDENTIAL
Property Zoning . . . . .. .LOW DENSITY RESIDENTIAL,
Application. -valuation . . . . 2860
Owner. Contractor
------------------------ --------- -------------
CULLEN MICHAEL C MAESTRO CAROENTERO
340 CALLE MAYOR
REDONDO'BEACH CA 90277
s ,
------ Structure Information., 50 SQ. FT. ADDITION -----
Construction Type . TYPE V-- NON RATED
Occupancy Type . . . . DWELLG/LODGING/CONG <=10
Flood Zone . . . . . . NON -AO FLOOD ZONE
Other struct info . . . . CODE EDITION 2001 CBC
FLOOD ZONE NO
1ST FLOOR -SQUARE FOOTAGE .50.00
Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee 54.00 Plan Check Fee 35.10
Issue Date . . . Valuation . . . . 2860
Expiration Date 9/22/05
Qty Unit Charge Per Extension
BASE FEE 45.00
1.00 9'.0000 THOU BLDG 2,001-25,000 .9.00
----------------------------------------------------------------------------
Permit . . ELECT - ADD/ALT/REM
Additional desc
Permit Fee . . 16..75 Plan Check Fee 4.19
Issue Date . . . . Valuation . . 0
Expiration Date 9/22/05
Qty Unit Charge Per Extension
BASE FEE 15.00
50-00 .0350 ELEC NEW RES -.1 OR 2 FAMILY 1.75
Permit . . . MECHANICAL
Additional desc
Permit Fee . . . 24•.00 Plan Check Fee 6.00
Issue Date Valuation . . 0
Expiration Date 9/22/05, <
Qty Unit Charge 'Per Extension
P.O. Box 1504 • '�C���
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 922$3 4
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: n_S� / O %
Applicant: '
Applicant's Mailing Address:
Date: 3/27V c0—
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
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.
Date Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 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 or 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.).
U 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 contractors) licensed pursuant to
the Contractors' State License Law.).
U 1 am exempt under Sec. , BA P.C. for this reason
Date
V L WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of pedury 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 become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date 3 tea- US Applicant
WARNING: FAILURE TO SECURE W KERS' COMPEN TION 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.
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.).
Lenders Name
Lenders Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safely 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 Ouinta, 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 160 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 for inspection purposes.
Date P_ 5 -Signature (Applicant or Agent
Page 2
Application Number 05-00001017 Date 3/22/05
Qty Unit. Charge Per Extension -
BASE FEE 15.00
1.,00 9.0000 EA MECH APPL REP/ALT/ADD 9.00
----------------------------------------------------------------------------
Special Notes and Comments
50 SQ. FT. ADDITION RELOCATE FRONT DOOR.
--------------------------------------------==------------------------------
Other Fees . . . . ENERGY REVIEW FEE 3.51.
STRONG MOTION (SMI) - RES .50
Fee summary Charged Paid Credited Due
Permit Fee Total 94.75. .00 .00 94.75
Plan Check Total 45.29 .00 .00 45:29
Other Fee Total 4.01 .00 .00 4.01
Grand Total 144.05 .00 .00 144.05
CERTIFICATE OF COMPLIANCE ��itFtEns
�.- Desert .Sands Unified School District
. a� 0
'47950 Dune Palms Road BERMUDA DUNES r
_ U= RANCHO MIRAGE
Date 3/22/05 La Quinta, CA 92253 INDIAN WELLS .
2701 ,, 1 d� QUINTA ?
DESERT
No. LA y .
(760) 771=8515 INDIO
Owner Michael Cullen APN # 604-1411005'
Address 77-065 Tiara PI .. Jurisdiction. La Quinta
City La Quinta Zip 92253 Permit #
Tract # Study Area
Type Residential Addition No. of Units 1 ,
Lot # No., Street S.F. ' Lot # No. Street S.F.
Unit 1 44065, Tiara PI 50• Unit 6 r
Unit 2 Unit 7 -
Unit 3 ' Unit 8
Unit 4 s • ' - Unit 91
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.50 '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 - Jennifer: Cullen • Check No. -
• Name on the check Telephone 772-5650
Funding Exempt '
By Dr. Doris Wilson
Superintendent r
Fee collected /exempted by 'Sh ron MCGllvre Payment Recd 50.00
Over/Under
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 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
-
Construction is NOT PERMITTED
CONSTRU&ION HOURS -A RE -INSPECTION FEE OF $30 on the following Code Holidays:
October 1st - April 30 ' v WILL BE CHARGED IF THE APPROVED' A
Monday -Friday: �•oo a.m. to 5:30 p. PIANS AND JOB CARD ARE NOT ON ,� New Year's Day ' r
Saturday: s:oo a.m. to 5:00 p.m. , E SITE • FOR A r SCHEDULED'"..Dr. Martin Luther IGngJr. Day
Sunday: None INSPECTION.
Government Code Holida President's Day
ys: None NO IMEPTIONS .' Memorial Day
May 1 st - September 30th X - Independence Day z
Monday- Friday*: :,•
- y: 6:0o a.m. to � oo p.m. • -, � � " � �;` . � Labor Day.
Saturday: 8:00 a.m. to 5:00 p.m. ! '
Sunday: None Veteran's Day
;y -
Government Code Holidays: None Thanksgiving Day ,
Christmas Day
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REQUIRED ON THE JOB SITE DURING ALL
.,!BASES OF CONSTRUCTION AND MUST BE
:%TTIED AS NECESSARY. FAILURE TO DO SO
-CAUSE THE CITY TO HAVE THE CONTAINER
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