04-3904 (SFD)4
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
BUILDING& SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
Application Number .
. . . . 04-00003904
Date 5/20/04
Property Address
79720 TOM FAZIO LN S
APN:
766-045-002-64 -27728 -
Tenant nbr, name . .
. . . . . $2000 PC RET. CREDITED
Application description . . . DWELLING - SINGLE FAMILY
DETACHED
Property Zoning
LOW DENSITY RESIDENTIAL
Application valuation 707288
Owner
Contractor
------------------------
WADE FRANKC
------------------------
KG CONSTRUCTION
79690 S TOM FAZIO LN
73416 SILVER MOON
TRAIL
LA QUINTA
CA 92253 PALM DESERT
CA 92260
WCC: EXEMPT
WC: EXEMPT
05/31/05
CSLB: 819174
04/30/05
CCC: B
------ Structure Information *SFD WITH SUBTERRANEAN GARAGE
-----
-Construction Type . .
. . . TYPE V - NON RATED
Occupancy Type . . .
. . . DWELLG/LODGING/LONG <=10
Flood Zone .. . .
. NON -AO FLOOD ZONE
Other struct info . .
. . . .CODE EDITION
2001
# BEDROOMS
3..00
FIRE.SPRINKLERS
NO
GARAGE SQ FTG
1725.00
PATIO SQ FTG
1045.00
NUMBER OF UNITS
1.00
-----------------------------------------------------------------
FIRST FLOOR SQ FTG,
8467.00,
Permit
BUILDING PERMIT
Additional desc
Permit Fee.
2663.50 Plan Check .Fee
97.23
Issue Date
Valuation . .
. . 707288
Qty Unit Charge
Per
Extension
BASE FEE
2039.50
208.00 3.0000
----------------------------------------------------------------------------
THOU BLDG 500',001-1,0-001-00,0
624.00
Permit ... .
MECHANICAL
Additional desc
Permit Fee
an Check .Fee
. 00
Issue Date
i&L���Igluation
0
Qty Unit. Charge eV MAY 20 2004 10 'Extension
CITY OF L 61(AU1 TA
D "
P.O. BOX 1504 • VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:?� �-¢ I Date: -5 20 • p� '
Applicant: �— Architect or E
Applicant's Mailing Address:
nglnVVI 9
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 ohapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my License is . full farce and effect.
License Class W-
! License No.
OAtA .� _ A. O
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 sate. 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, 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
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:
Cartier '11Policy 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�./.
Dates-- a _0 Z/ Applicant d��s
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.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that t ere 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 V
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, indemnity 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 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 corecL 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 above�nentioned roparty for inspection purposes.
Dat 0 ' 0 / Signature (Applicant or Agent):
Application Number
SYS
. 04-00003904
Page 2
Date 5/20/04
Qty
Unit Charge
Per
Extension.
BASE FEE
15.00
7.00
9.0000
EA
MECH FURNACE <=100K
63:00
7.00
9.0000
EA
MECH B/C <=3HP/100K BTU
63.00
10.00
6.5000
EA
MECH VENT FAN
65.00
2.00
6.5000
EA
MECH OTHER MECH EQUIPMENT
13.00
------------=--
Permit
-----------
----
ELEC-NEW
----------------------------------
RESIDENTIAL
------------
Additional
desc
Permit Fee-
318.51 Plan Check Fee
.00
Issue Date
. . . .
Valuation . . . .
0
--_.._•. W Qty
Unit Charge
Per
Extension
BASE FEE
15.00
8467.00
.0300
ELEC NEW RES - MULTI FAMILY
254.01
1725.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL.
34.50
.1.00
-------------------------------------=-----------------
15.0000
EA
ELEC TEMPORARY POWER POLE
15.00
Permit .
. . . . .
PLUMBING
---------------------
Additional
desc . .
Permit Fee
. . . .
246.75 Plan Check Fee
.00
Issue Date
. . . .
Valuation . . . .
0
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
27.00
6.0000
EA
PLB FIXTURE
162.00
1.00
15.0000
EA
PLB BUILDING, SEWER
15.00
2.00
7.5000
EA
PLB WATER HEATER/VENT
.15.00
1.00
3.0000
EA
PLB WATER INST/ALT/REP
3.00
1.00
9.0000
EA
PLB LAWN SPRINKLER SYSTEM
9.00
1.00
3.0000
EA
PLB GAS PIPE 1-4 OUTLETS
3.00
13.00
.7500
EA
PLB GAS PIPE >=5
9.75
1.00
15.0000
EA
PLB GAS METER
15.00
-------- -------------------------------------------------------------------
Permit .
. . . . . GRADING PERMIT
Additional
desc
Permit Fee
. . . .
15.00 Plan Check Fee
.00
Issue Date
. . . .
Valuation . . . .
0
Qty Unit Charge Per Extension
BASE FEE 15.00
Page 3
Application Number . . . . .
04-00003904 Date
5/20/04
----------------------------------------------------------------------------
Special Notes and Comments
SFD- 8,467 SQ.FT. LIVING, 1725
SQ.FT.
SUBTERRANEAN GARAGE, 1045 SQ.FT.
COV:PATIO. EXCLUDES WALLS/POOL/DRIVEWAY
APPROACH/ R3/UI OCC TYPE
VN 2001 CODES
--------------=-------------------------------------------------------------
Other Fees . . . . . . . . .
ART IN PUBLIC PLACES-RES
1268.22
DIF COMMUNITY CENTERS-RES
97.00
DIF CIVIC CENTER - RES
366.00
DIF FIRE PROTECTION-RES
97.00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI) - RES
70:72
DIF STREET MAINT FAC-RES
15.00
DIF TRANSPORTATION— RES
1098.00
Fee summary Charged
Paid Credited
Due'.
---------------------------
Permit Fee Total 3462.76
------------------------------
.00 .00
3462.76
Plan 'Check Total 97.23
.00 .00
97.23
Other Fee Total 3743.94
.00 .00
3743.94
Grand Total 7303.93
.00 .00
7303.93
'L 41,
P.O. BOX 1504
ing78-495 CALLE TAMPICO
ass `A�QQ��7p2�0/rr``��% iJ4N�LAOUINTA,CALIFORNIA 92253
"ailing
Ad�d�r�es�s����
IT
Contractor
Address
Y
^tea
V ` 2Gq Z8iZ2G00 T(
'7V (5 4 -?:>go �-
APPLICATION ONLY
BUILDING: TYPE'CCONST. V OCC. GRP. FF\—.75() I
'C f
� ` `' A.P. Number cc( CAG — C 0
__15t_ 6` jI Legal Description `'` t ,60 4- 9-112S
10S11
)
State Lic. City
& Classif. I Lic. q
Arch., Engr.,Mc �_ „ f ln�,T�Jts�A Designer ���/
Adreq... 1 Tel.` �.cr.A/
Zip•�„2`�2F+�'•� Lictq�Q,�3�l /
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm 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.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,8usiness and Professions Code: Any city or county which requires a
permit to construct, alter, Improve, demolish, or repair any structure, prior to'its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he 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).
1-; 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such 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 did not build or improve for the purpose of sale.)
(I
I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
I'! I am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
[l Copy is filed with the city. G Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the pemrif is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thip 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.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
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 sof this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
WHITE = BUILDING DEPARTMENT
Prooje\ct Description G �� '{"" ,\ n
A n
Sq. Ft. We ! / No.
Size 7 N� Stories
No. Dw.
Units
New Add 0 Alter ❑
Repair ❑ Demolition ❑
�;D g. �� 19
Estimated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
YELLOW = APPLICANT PINK = FINANCE
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.24 X 7,834 S.F. or $17,548.16 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 OF/Southwest Bank of Texas -Ken Schmale Check No. 593519475
Name on the check Telephone 760-346-6639
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Yolanda Garcia Payment Recd 1$0.00
$17,548.16 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 or
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
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
��1Fisc
47950 Dune Palms Road
Q BERMUDA DUNES r
Date
_
5/19/04
La Quinta, CA 92253
Q0 RANCHO MIRAGE t7
No.
25927
760 771-8515
( )
�� INDIAN WELLDESERT PALM DESERT �
LA
:QINDIO
,� QUINTA �y
Owner
Frank Wade
APN #
766-045-002
Address
79720 Tom Fazio Lane South Jurisdiction
La Quinta
City
La Quinta Zip 92253
Permit #
Tract #
Study Area
Type
Single Family Residence
No. of Units
1
Lot # No. Street
S.F. Lot # No.
Street S.F.
Unit 1 64
79720 Tom Fazio Lane
South 7834 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
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.24 X 7,834 S.F. or $17,548.16 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 OF/Southwest Bank of Texas -Ken Schmale Check No. 593519475
Name on the check Telephone 760-346-6639
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Yolanda Garcia Payment Recd 1$0.00
$17,548.16 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 or
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
', Kenneth'R. Schmale '
KG CONSTRUCTION Phone: (760) 3as�639
s 73416 Silver Moon Trail Fax: (MO)836-0286 s
Palm Desert, CA 92260 „ Cell: -'(760) 275-4920'
September -22, 2004
` CITY OF =_A QUINTA .
City of La ,Quinta
• :" '7-'REC0.
Department of Building -and Safety
BUILDING AND SAFETY
78495 Calle Tampico
La Quinta, CA 92253-
Re:'
2253Re:• Building Permit No: -043904 for the Wade Residence
79720 Tom"Fazio Lane South, La Quinta, California, '
Dear Sirs:
On September 7th, I delivered'a letter to you regarding the cancellation of -the above- "
referenced permit under.the name of. KG Construction for the Wade residence in -La
Quinta:
To facilitate the homeowner and to keep the project moving forward,,( would now like „
to request that you keep this permit in place until further notice., I apologize for any
inconvenience this may cause: :
If you have any questions regarding this matter, pleased don't'hesitate to contactme.
Thanking you in advance for your cooperation. =
Sincerely,
Kenneth R: Schmale
KG Construction '
KRS:cgs - `
Kenneth' R. Schmale
KG CONSTRUCTION Phone: (760) 346-6639
73416 Silver Moon Trail Fax (760) 836-0286.. .
Palm Desert, CA,92260 • cell: (760)275- 4920
September 7., 2004'.
City of La Quinta :.
Department of Building .and .Safety ,
78495 Calle Tampico = ;
La.Quinta, CA 92253
Re: ' Building Permit No: 043904 for the Wade Residence,
79720 Tom Fazio Lane South, La Quinta, -California
Dear Sirs:
As you know, -the above-referenced.permit'.was pulled -reflecting KG Construction
as the builder/general contractor for this project. Due to recently diagnosed medical
difficulties, I am unable to,continue.as the ,contractor on this project.
..I have given notice of my,resignation asthe general contractor for this project
to, Bobbi and Frank Wade, the project -owners. Additionally, I have'given notice to
each of the trade subcontractors on. the job who have contracted with Mr; and Mrs.
Wade for•construction of the residence..
Due to my resignation as the'general contractor, please revise your records to reflect
that I am no longer associated with the Wade residence.
Thank you for your prompt attention to this,matter.
Sincerely; A ,r
Kenneth R. Schmale
KG.Construction
KRS:cgs :.
CITY OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESS _�g %j, ' 7° ZWPERMIT NUMBER 'S1 Of OWNER B I DER Moa�—✓ 2�31e;Z?F
This form shall be posted on the fob with the Building Inspection Card at all times in a conspicuous place. Only persons 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.
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