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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