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05-0264 (AR)� OS BUILDING & SAFETY DEPARTMENT c�My P.O. Box 1504 (760) 777-7012 01 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 FEB 0 7 2005 BUILDING PERMIT CI'I"Y O� � Q1�O�IiA Number . . . . . 05-00000264 Date 1/26/05 Property Address . . . . . . .79675 TOM FAZIO LN.N APN: 766-032-020- - Application description . . . ADDITION•- RESIDENTIAL Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation 8032 Owner Contractor HILL ROBERT M - - - - - .. SUN... V I STA DEVELOPMENT CORPORAT 79620 TOM FAZIO LANE NORTH P.O. BOX 1144 HOLTVILLE CA 92250 LA QUINTA CA 92247 (760) 771-4722 WCC: HRH INS WC: 17054605 01/01/06 CSLB: 744091 12/31/05 CCC: B ------ Structure Information PATIO CONVERSION TO ROOM 119 SQ. FT. --- Construction Type . . . . .. TYPE V - NONRATED 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 119.-00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . 108.00 Plan Check Fee 70.20 Issue Date Valuation . . 8032 Qty Unit Charge Per Extension BASE FEE 45.00 7.00 9.0000 THOU BLDG 2,001-25,000 63.00 ---------------------------------------------------------------------------- Permit ELECT- ADD/ALT/REM. Additional desc Permit Fee 19.17 Plan Check Fee 4.79 Issue Date . . . . Valuation . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 119.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 4.17 ----------------------- ----------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee 24.00 Plan Check -Fee 6.00 Issue Date . . . . Valuation . . . . - Qty Unit Charge Per Extension P.O. BOX 1504 78-495 CALLE TAMPICO � VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 0-57- oa=&¢ I Architect Applicant: Date: Applicant's Mailing Address: %A Engineer. Arcnnect 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 m� License i in full force and effect. ©� License Class License NLLo. Date—;17/0 Contractor_ ✓L", VlhlT'1 Pe y OWNER43UILDER 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 Processions 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 sects the applicant to a civil penalty of not more than five hundred dollars ($500).): r+Dl U I, as owner of the property, or my employees with wages as their sole compensation, will do the worts, and the structure is not intended or offered for sale (Sec044, . 7 Business and Professions Code: The Contractors' State License Law does not apply to an owner of property builds its himself or herself or through his or her own employees, provided that the ipy who ormproves thereon, and who does the work mprovements 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 contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' 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 ,' MY NS 'compensation insurance Cartier anum�r are: Cartier itJ Policy Number i' _ I certify that, in the performance of the work for which this Perm d is issued, I shall not employ any person in any manner so as to became 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 shay forthwith comply with those p Date Z7 K Applicant WARNING: FAILURE TO SECURE WORK S' COMPENSA ION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO SAND DOLLARS (3100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, I TEREST, AND ATTORNEY'S FEES. I hereby affirm under penaltyof CONSTRUCTION LENDING AGENCY 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 Lender's Address IMPORTANT APPLICANT ACKNOWLEDGEMENT 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 u s tnt to a, its officers, agents and employees for any act ti 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 tram date of issuance of such pemmil•or cessation of work for 180 days will subject permit to cancellation. 1 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 a ter upon above- mentionedro rt for P Pe Y inspection purposes. Date � Signature (Applicant or Ag t): Page 2 Application Number . . . . . 05-00000264 Date 1/26/05 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 convert patio into room 119 sq. ft.addition. under existing roof. 1/26/0 5 3:54:26 PM jjohnson ---------- ----------------------------------------------------------------- Other Fees ENERGY REVIEW FEE 7.02 STRONG.MOTION (SMI) - RES ..80 .Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 151.17 .00 00 151.17 Plan Check Total 80.99 .00 .00 80.99 Other Fee Total 7.82 00 .00 7.82 Grand Total 239.98 .00 .00 239.98 # City of LaQ uinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application. and Tracking Sheet Permit # Project Address: '71 &-76- -fowl ryZro i-:1 /, Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: V17 h Telephone: one:��U Address: P, 0, Project Description: City, ST, Zip: 1:1 QUr h h LJc* c_ --�,,e eX t5TI %, (5,00e-r-e%Q Telephone: eP hone: ` % 0 ,e c G `i fi J 1 h IL YYI State Lic. # : 7q q 0 -q ( City Lic. #: o,, 1 Arch., Engr., Designer: ,. 1 L) r- `,f -� of c8 l 5 11 Address: `I �l�drr ll°I o���P tea City, ST, Zip: Telephone: State e Lic. #: .....: Con Construction Type: Occupancy: Y cu an cY. P Project type (circle one New Ad ' o Alter Repairai Demo:: r Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 71 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal R<d Ree'd TRACKING PERMIT FEES Zr Plan Sets Plan Check submitted Item Amount Structural Cales. 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 2"d Review, ready for correctio /issue 2` Oj Electrical Subcontactor List Called Contact Person s / Plumbing Grant Deed Plans picked up S.M.I. Ii.O.A. Approval Plans resubmitted Grading IN HOUSE:- Jrd 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 $ F� STeaU'G, Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMM/MD. AMOUNT: DATF.- RF.CFIPT, CHECK N- TNITIAIS- CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: Residence tsat=TheH•>fleaway Date: February 7, 2005 Owner's Name: Robert Hill Phone No. Project Address: 79-676 Tom Fazio Lane La Quinta, CA Project Description: addition APN: 766-032-020 Tract #: Lot #'s:/ Type of Development: Residential XX Commercial Industrial Total Square Feet of Building Area: 119 sq. ft. 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 he/she is authorized to sign on behalf of the owner/developer. Dated: February 7, 2005 Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN 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 Note: Number of Sq.Ft. 119 Amount per Sq.Ft. $ 2.680 Amount Collected $ 318.92 Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Business Services C' - Certificate issued by: Elvira Mattson, Office Technician Signature: vuolx NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) 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 Government 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 of 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 latter, the 90 days starts on the 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 extensions may be granted. At such time as this Certificate expires, if a building permit has not been issued for the project that is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. h1V:c,""mpdpcside elceslcc rtiiicate of compliance. firm Utbles'FO US1:i.doc 1/16/03 T �—- CITY OF LA QUINTA /S uVi,5ta n BUILDING & SAFETY DEPT. f APPROVED Development Corporgj* n cI'�R FOR CONST U_ CTION POST OFFICV U&�EAAYcgpDr ir4RN Iii •PHO b 17,21-472 •FAX (76 1-771 4922 ''JJ D ON THE JOB SITE DURING ALL DA 10 p� B PHASES OF CONSTRUCTION AND MUST BE EMPTIED AS NECESSARY, FAILURE TO 60 SO MAY CAUSE THE CITY TO HAVE TRE C6NTAlIVER DUMPED AT THE EV E�/ CONSTRU&I January 25th; E OF TH1 OwN 2005 COON, ON HOURS October 1st = April 30 Monday - Friday: 7:00 a.m. to 5:30 p.m. Hill Residence Saturday: 8:00 a.m. to 500pm. Sunday: None Lot 41 Quarry Government Code Holidays: None - 79-675 Tom Fazio Lane North May 1 St - Ser-` inber 30th "La Quinta, CA 92253 ]Monday - F day• 6:00 a.m, to 7:00 pin. Saturday: '8:00 a.m. to 5:00 p.m. Sunday: - None Permit # 04-4702Government Code Holidays:. % None S, Description of Work: Enclose the existing covered terrace, (located, off the morning room) into living space. Add 119 sq.ft living space, subtract 119 sq.ft covered patio. , A RE -INSPECTION FEE' OF '$30 WILL BE CHARGED IF THE APPROVED Enclosed: PLANS AND JOB CARD ARE NOT ON ' ' THE SITE FOR A SCHEDULED • Title 24 Letter of Compliance INSPECTION. • Existing floor plan - NO D(CEPTIONSI • Proposed change, floor plan • Proposed change, electrical plan, HVAC • Stamped letter, and engineering package and calcs Construction is NOT PERMUTED on the following Code Holidays: New Year's Day Dr. Martin Luther IGngJr. Day President's Day Memorial Day Independence Day Labor Day Veteran's Day Thanksgiving Day Christmas Day 6 76 r Futo oFF1C1 roPV aot c$c