12-0781 (AR)'(:
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 ,
BUILDING PERMIT
Date: 8/02/12
Application Number: ' `1"2=00000781 Owner:
Property Address: 55491 — SOUTHERN HILLS ELECH MIKE
°APN: 775-200-020- 55491 SOUTHERN HILLS
Application description: ADDITION - RESIDENTIAL LA QUINTA, CA 92253.
Property Zoning: LOW DENSITY RESIDENTIAL (760)777-8202
Application valuation: 34825 D d
Contractor:
Applicant: Architect or Engineer: EDWARDS CONSTRUCTION INC, . O
51455 DESERT CLUB DRIVE
LA QUINTA, CA 92253 CI
I� (760) 777-8202 Fla 'QU/pT
Lic. No.: 684857 fCAj
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I'am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty.of perjury one of the following declarations:
..Section 7 001 f Division 3 of the Bu ' ss an Prof nals Code, 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 C ss• B C27 'cense No-: 6 4857 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
Q �/ issued.
ate: • C9 tractor: - V• 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 GRANITE STATE. Policy Number WC1914223 -
following reason (Sec. 7031 .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 as to ome 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 out
bec c o e workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business an_d Professions Code) or - 3700 of the Labor Code sh I f t co ly with those provi ons.
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: �Apt:' 1, as owner of the property, or'my employees with wages as their sole compensation, will do the work,andthe structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE 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
improve for the purpose of sale.). - APPLICANT ACKNOWLEDGEMENT
(_ 1 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 t,, 1 1 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
of La Quinta, its officers, agents and employees foi 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 t ova i matin ' corr . I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.1. - city and ;fun ordinances and state laws relating to uild' g co tr her y authorize represent tives
- of this my enter upon the above-mentioned prop for in pe n rposes.
Lender's Name: -
• ate: S' atura (Applicant or Agent):
Lender's Address: ;
LQPERMIT
Application Number .
. . . 12-00000781
------ Structure Information
341SF. CASITA/VB/RES=3/CLASS A -FR
[ENG] -------
Other struct info . .
. . . CODE -EDITION 2010
#-BEDROOMS
1:00
FLOOD ZONE NO
.1ST FLOOR -SQUARE FOOTAGE
431.00,
Permit
BUILDING PERMIT
Additional desc,.
' Permit Fee
317.00 P1an.Check Fee
206.05
Issue Date
Valuation ".
34825
Expiration Date
1/29/13
Qty Unit Charge
Per
Extension
BASE FEE
252.00
10.00 6.5000
THOU• BLDG 25.,001-50,0,00
65.00
Permit. . .
ELECT --ADD/ALT/REM
Additional desc .
Permit Fee
26.94 Plan Check Fee
6.74
Issue Date ,.
Valuation
0
. Expiration Date
1/29/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00;
341.00 .0350
ELEC NEW.RES.- 1' OR 2 FAMILY
11.94
Permit
MECHANICAL
Additional desc
'Permit'Fee . .
50.50 Plan Check Fee
12.63
Issue Date
Valuation . . .
0
Expiration Date..
1/29/13
Qty Unit Charge
Per
Extension
`BASE FEE
15.00
1.00 9.0000
EA MECH FURNACE <=100K
9..00"
1.00 4.5000
EA MECH-VENT INST/.DUCT "ALT
1.00. '9..00'00
EA MECH B/C <=3HP/100K BTU
9.00
2.00 .6.5000
EA MECH VENT FAN
13.00
Permit . . .
PLUMBING
Additional desc .
Permit Fee
48.00 Plan•Check Fee
12.00
Issue Date
Valuation
0
LQPERMIT
Application.Number ...;:12-00000781
Permit', PLUMBING ,
Expiration Date .'.. i/29/13
Qty � - -Unit Charge- Per
Extension
BASE FEE
15.00
5..00. 6,.0000 .EA PLB FIXTURE
30.00
1.00 3.0000 EA- PLB WATER INST/ALT/REP
3.00
Special Notes and
•Comments
431SF DETACHED CASITA/VB/RES-3/CLASS
A-FR [ENGINEERED] .THIS PERMIT DOES NOT
INCLUDE CONNECTION TO.THE EXISTING
DWELLING STRUCTURE OR A SEPARATE WATER
HEATING DEVICE. 2010 CALIFORNIA BUILDING
`
-CODES.:
August 2, 2012.8:11:'02 AM AORTEGA
------------------
-----------------.-.---------------------------
Other Fees . . BLDG STDS ADMIN (SB1473)
2.00
ENERGY REVIEW FEE
.20.61
STRONG MOTION (SMI) - RES
3.48
. •Fee , .summary Charged Paid Credited,
Due
----
Permit Fee Total 442.44.' .00 .00,
442:44
Plan•Check-Total 237.42 .00 .00
237.42.
Other Fee Total 26:09 .0.0 .00
26.09
Grand ,Total 705.95 ': '" .00 .00
7.05.95
Bin
0
ii
City of La Quinta ..
Building 8i Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777.7012
Building Permit Application and Tracking Sheet
Perms #P.O.
2 I
Project Address: ' rj
Owner's Name:"
A. P. Number: 7777,g S '70v Vzc!
Address: 1 0 �� (CCS
Legal Description: GOT- T4 19z n 4 FT
City, ST, Zip:
Contractor: / .
Telephone: —1-7 7 Z02—' .................
Address:
Project Description:
City, ST, Zip:
5� 40D ("7c:(
Telephone: p OZ
<.<'s'`»>#"'
State Lit. #:
City Lic. #;
Designer:
Address: —7%—,6 -7iZ 40JPTJL"(� Ct"5
City, ST, Zip�14LEA GST
Telephone: tj .� <>::;?>?:<::<>>.::3::v:'t:<=:<::vn<
State Lic" #: €3??::,>?:';•'<> :<.i:;<>%::z<i:><.:'::!:; >::"<
Name of Contact Person: ���
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft: # Stories: # Units:
Telephone # of Contact Person: IO
Estimated Value of Project:d
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance '
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
20° Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading .
IN HOUSE:-
•
30 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
q
8`a�tie►ti • �Is�s��- MSP � ttd c�oe�cwrt
•
EsGil. Corporation'
In (Alrinesship-with ('Government fo>Building Safety
DATE.. July 25 2012❑�cPPLICANT
0 JURIS.
JURISDICTION:.` .La Quints ❑ PLAN REVIEWER*
❑ FILE
PLAN CHECK NO.: 12-781 SET: I
PROJECT ADDRESS: 55-491 Southern Hills
PROJECT NAME: Elech.Residence. Casita Addition .
❑ The" plans `transmitted, herewith have been corrected where` necessary_ and substantially comply
with the jurisdiction's codes.
The plans transmitted herewith will ,substantially comply with the jurisdiction's building! codes
when minor deficiencies:, identified below are resolved and checked by building department staff.
"Structural Only" review by.EsGil.
❑ The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
The:check list transmitted herewith.is foryour information. The plans are being held at Esgil
Corporation..until corrected plans are submitted for recheck:
Th"e a licant's co of the check listis enclosed for the jurisdiction to forward -to the, applicant
pp copy 1
contact :person.
❑ The applicant's copy of the check list has been sent to:
EsGil Corporation staff did not advise the applicant that the plan, check has been completed.
❑ EsGil Corporation staff did advise'the applicant that'the plan check.. has. been completed.
Person contacted: Telephone #: {
Date contacted:, (by:' ) Email: Fax #:
Mail Telephone Fax In Person
REMARKS: Each sheet ``of the structural: plans (along with the cover sheet of the calculations)
must be signed/sealed by:the engineer.
By:: Kurt Culver Enclosures:
EsGil Corporation
JUL,
El GA ❑ El
a ❑ PC' 7/24/12 : 2 6 2012
By.
9320 Chesapeake Drive, Suite 208. San Diego, California 92123 ♦ (858).560=1468 ♦ Fax(858)560'-'1576