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06-1853 (SFD)P.O. BOX 1504` _ 78-495 CALLE TA'MPICO ' - LA QUINTA,jCALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS,(760) 777-7153 • Date: 4/23/07 ' Application Number:06-00001853 Owner: Property Address: 78662 TALKING ROCK TURN M/M GREGORY J. SKJONSBY " APN:- 7707300-023- - - 2551 VISTA DRIVE Application description: DWELLING - SINGLE FAMILY DETACHED. NEWPORT BEACH, C&4-9- A Property Zoning: LOW DENSITY .RESIDENTIAL (949) 631-9179 Application valuation: 591429 MAY - 03 2007 ' Contractor: Applicant: Architect or Engineer: ENGSTROM CONSTROF LA4UIN7A • 77455 EVENING STANCEDEPTINDIAN WELLS, CA fr' (760) 668-3961 Lic. No.: 835648 N 00 LICENSED CONTRACTOR'S DECLARATION _ _° •r. WORKER'S COMPENSATION DECLARATION - I hereby affirm under penalty of,perjury hat'I am licensed under.provisions.of Chapter 9 (commencing with I hereby affirm under penalty of, perjury one of the following declarations: Section 7000) of Division 3 of the Bus ssi a s C e, and my License is in full force and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class B No.: 835648 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is ' Dat (7 ntractor - _ 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 OWNER -BUILDER DECLARATION - insurance carrier and policy number are: ' I hereby affirm under penalty of perjury that I am exempt from -the Contractor's State License Law for the Carrier STATE FUND Policy Number 229-36824-06 following reason (Sec. 7 031 .5,. Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner o as to become subject to the workers' compensation laws of California, ` permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I s uld become subi ct to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section,7000) of Division 3 of the Business and Professions Code) or 700 of,the Labor i ply with those provisions. _ • 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).: ate: dn pplicant: • (_ 1 1, 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 WARM G: AILURE TO SEC E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL . Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN - - , improvements are not intended or offered for sale.- If, however, the building or improvement is. sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - one year of completion, the owner -builder will have the burden of proving that he or she did not build or . ' _ # - I ' improve for the purpose of sale.). - APPLICANT ACKNOWLEDGEMENT (_) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for • pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as -a result of this application, (_ 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City ' 9f 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. _ Date: -Owner: 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 CONSTRUCTION LENDING AGENCY permit to cancellation. ' - I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that th above information is correct.. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). _ city. and co my ordinances and state laws relating to in-- o cti nd hereby authorize representatives of this y t enter upon the ove-mentioned prop f r.ins ec ' n s. Lender's Name: _ ate* ig re (Applicant or Agent)' Lender's Address: LQPERMIT , • e Application Number . . . . . 06-00001853 ------ Structure Information SFD ----- Other•struct info CODE.EDITION 01BMP04E05EN # BEDROOMS 5.00 FIRE SPRINKLERS NO GARAGE SQ FTG 966.00 PATIO SQ FTG 3313.•00 NUMBER OF UNITS 1.00 ----------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 6540.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee 2315.50 Plan Check Fee. 1505.08 Issue Date .. . . Valuation . . . . 591429 Expiration Date 7/23/07. - Qty Unit Charge Per Extension BASE FEE 2039.50 92..00 3.0000 ----------------------------------------------------------------------------- THOU BLDG 500,001-1,.0010,000 276.00 Permit MECHANICAL Additional desc . Permit Fee . . . . 235.00 Plan Check Fee 58:75 Issue Date Valuation . . . . 0 Expiration Date 7/23/07• Qty Unit Charge Per Extension. BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 4.00 .11.0000 EA MECH FURNACE >100K 44.00 5.00 16.5000 EA` MECH B/C >3-15HP/>100K-500,KBTU 82.50 12°:00 6.5000 EA MECH VENT FAN 78..00 1.00 6.5000 EA MECH EXHAUST HOOD 6..50 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee 344.48 Plan Check Fee 86.12 Issue Date . . . . Valuation . . . . 0 Expiration Date .7/23/07 . Qty Unit Charge Per Extension BASE FEE 15.00 6540.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 228.90 4279.00. .0200 ELEC GARAGE OR NON-RESIDENTIAL 85.58 1.00 15.0000 EA ELEC TEMPORARY POWER POLE. 15.00 LQPERMIT Application,Number. . . . . . 06-00001853 Permit . . . PLUM_BING Additional desc 31 Permit'•Fee 333.00 Plan Check Fee 83.25 Issue Date . . . . Valuation . . . . 0 Expiration -Date 7/23/07 Qty Unit Charge Per - Extension BASE FEE 15.00 31.00 6.0000 EA PLB FIXTURE 186.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 9.00 6.0000 EA PLB ROOF DRAIN 54.00 3.00 7.5000.EA PLB WATER HEATER/VENT 22.50 1.00 3.0'000 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 14.00 .7500 EA PLB GAS PIPE >=5 10.50 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 Expiration Date 7/23/07 Qty Unit Charge Per Extension BASE FEE 15.00 Special.Notes and Comments - 6540 LIVING SF SINGLE FAMILY RESIDENCE:R-3 OCC. TYPE V -N CONSTRUCTION 2001 CBC, CMC, CPC, 2004 CEC 2005 ENERGY CODES. **PERMIT DOES NOT INCLUDE BLOCK WALLS, FENCES, SWIMMING POOLS, SPA, WATER. FEATURES,BBQ'.S AND DRIVEWAY APPROACHES. COMPLIANCE WITH ALL FEDERAL &-STATE LAWS, INCLUDING THE ENDANGERED SPECIES ACT OF.1973 IF APPLICABLE,IS REQUIRED** Other Fees . . . ART IN PUBLIC PLACES -RES 978.57 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES • 995.00 ENERGY REVIEW FEE 150.51 DIF FIRE PROTECTION -RES 140.00 DIF LIBRARIES - RES 355.00 LQPERMIT Application Number . . . . . 06-'00001853 -- Other Fees ---------- ---------------------------• DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC -.RES 892.00 STRONG MOTION '(SMI) - RES 59.14 DIF STREET MAINT FAC -RES 67.00* DIF TRANSPORTATION - RES 1930.00 " Fee .summary •Charged -Paid Credited Due Permit Fee Total, 3242.98 -------- .00 .00 ------- 3242.9'8 ^ Plan Check Total 1733.20 - 500.00 .00 1233.20 Other Fee Total 5663.22 .00• .00 5663.22 Grand Total 10639.40 500.00 .00 10139.40 k Building a ZTIe C&tvl 4.4 0 47 a"iii�-3 P.O. BOX 1504 APPLICATION ONLY 78-495 CALLE TAMPICO /z V14/LA QUINTA, CALIFORNIA 92253 ,Wwner- Mailing Address Cty �'^ ' Zlpq� Contractor G(� T(3iEN > Ems► Address City [Zip JTel & Classif Arch., Engr., �"Vtv Designer � Address TeIQa �lr5 Mvljt t Zip Lic. # g ca I �zi�5 i I Li°. # 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 Contractor's License Law for the following reason: (Sec. 7031.5, Business 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, 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 Profes- sions 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 im- provement 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, as owner of the property, am exclusively contracting with licensed contractors to construct 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 contractors) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKER'S 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 O Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less). 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 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 No. Stories No. Dw. Units This is a building permi n p perl d t, si ed and validated, and is subject to expiration if work thereund i u de 1 day I certify that I have r is tic stat that he above information is correct. I agree to comply with II y a c di an s d state laws relating to building construction, and hereb horiy tat' a th' ity to enter the above-mentioned property for inspection S Signature of appliccate Date - Mailing Mailing Address t� City, State, Zip ►J Estimated Valuation WHITE = BUILDING DEPARTMENT DZ BUILDING: TYPE CONST. tyTAIV-16 OC P. A.P. Number - ,{O b Legal Description �" �-t ��`C T �(��� Project Description ZONE: BY: Minimum Setback Distances: FINAL DATE_ Issued by: Validated by: Validation: YELLOW = APPLICANT PINK = FINANCE Sq. Ft. Size No. Stories No. Dw. Units Nev"I Add ❑ Alter ❑ Repair ❑ Demolition ❑ kPay 11vc1 AW — Z7 2 - 66 `zf Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: FINAL DATE_ Issued by: Validated by: Validation: YELLOW = APPLICANT PINK = FINANCE CERTIFICATE OF COMPLIANCE Sc�o Desert Sands Unified School District 47950 Dune Palms Road ¢ BERMUDA DUNES 0 N RANCHO MIRAGE Date 5/3/07 La Quinta, CA 92253 k. INDIAN WELLS P No. 29391 (760) 771-8515 `yd PALM A 1 � _ �QINDIO- y7 Owner Greg & Hanna Skjonsby ' APN # 770-300-021 Address Jurisdiction La Quinta City Zip Permit # Tract # Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Unit 1 78662 Talking Rock Road 6540 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 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: 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 '$2.63 X 6,540 S.F. or $17,200.20 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 CC/Union Bank of California - Glenn Engstrom Check No. 0061007275 Name on the check Telephone 668.3961 Funding Residential By Dr. Doris Wilson Superintendent ILL, • .� art. ` + Fee collected /exemp y Sh r0 Y 0.00 t b rey Payment Recd $ �. - $17 200.20 •-��over/UrrieF� �� _ Signature C • J�r,rl �, �';i�.taLi NOTICE: Pursuant to Government Code Section 66020(d)(1), this ill s e 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 _Y Certificate of'Occupancy € � Ih'COWiCA7FD �� . 1762 G OBuildin & Safet DepartmentE F g y This Certificate is* issued pursuant to the requirements of Section 169.of the California Building Code, certifying that, at. the time of issuance, this. structure was in compliance with the provisions -of the -Building Code and the various ordinances of the City regulating building, construction and/or use. BUILDING ADDRESS: -78-662 TALKING ROCK TURN Use classification:, SINGLE FAMILY DWELLING Building Permit No.: 06-1853 Occupancy Group: R-3 Type of Construction: V -N Land Use Zone: RL " e Owner of Building: M/M.GREGORY J. SKJONSBY Address: 2551 VISTA DRIVE City, ST, ZIP: NEWPORT BEACH, CA 92663 By: STEVE TRAXEL Date: DECEMBER 4, 2008 Building Official = - POST IN A CONSPICUOUS PLACE Bin # City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico `v La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #M�� O� , Project Address: 8 6P61, Alyrer's Name: �/'C �� 14 Address: -79'4 �a A. P. Number: Legal Description: City, ST, Zip: Contractor: Ons fj t-.1, Telephone: Address: -77 so, S- J Project Description: City, ST, Zip: I rW� 1%v1ti well -01i Telephone:Z� ' () ,dy State Lic. # 149CityLic. #: Arch., Engr., Designer: �� /�� (/ Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: " 4 6na Construction Type: Occupancy: P Y: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: -7&0 Q d q(07— (c/ Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted o2<p Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan tad Review, ready for corrections ssue Electrical Subcoutactor 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 B� .Z IL IS 1 Bin # City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 �yy Building Permit Application and Tracking Shit J Permit # Project Address: Owner's Name: Address: A. P. Number: J Legal Description: Contractor:Ix e4T S.j tov<__ City, ST, Zip:La —A 9 Telephone: ` Address: Project Description: City, ST, Zip: tS �� Telephone: l..L-s Cf� • �Oyp rr\ �L State Lie. # : City-Lic. #: Arch., Engr., Designer: OL)CT Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lie. #: Name of Contact Person: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: (o © (e Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted `5 Item Amount Structural Calcs. Reviewed, ready fo rrections y Plan Check Deposit Truss Calcs. Called Contact Person 2 Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan �, Plans resubmitted l*c4u 6,14 -Mechanical Grading plan 2"" Review, ready for corrections ss e t7 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 correctionsrssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees IS 1