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05-0191 (AR)504 :.LE TAMPICO CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT (760),777-7012 FAX (760) 777-7011 INSPECTION. REQUESTS (760) 777-7.153 BUILDING PERMIT ' er r 0-5 r000�0191 Date .2/17/05 . . . . . . 54783 SOUTHERN•HILLS 775-101--074-. - - iption ADDITION..- RESIDENTIAL Property Zoning'. LOW DENSITY RESIDENTIAL Application valuation 10020 ' Owner Contractor ------------------------ ..=�-- "--= - ; .ti_: - ----------.-f- x' �'- ED ARCHIBALD EDWARDS' CONSTRUCTION, BOB 51455 DESERT CLUB DRIVE 54-783 SOUTHERN HILLS LA QUINTA CA 92253 LA QUINTA CA 92253 WCC: VIRGINIA SURETY. WC: 00500027012. 01/01/06 y CSLB: 684857• 03/31/06 CCC: B ------ Structure Information 124 SQ. FT.•ATRIUM.ENCLOSURE ----- Construction Type TYPE V - NON RATED Occupancy Type . . . . DWELLG/LODGING/LONG <=10 Flood Zone NON -AO FLOOD ZONE Other struct info CODE EDITION 2001 CBC FLOOD -ZONE. NO 1ST - FLOOR SQUARE ,FOOTAGE 124:0:0 Permit . . . BUILDING PERMIT Additional desc Permit Fee 126.00 , Plan ,Check Fee ' 81 . 9�p Issue Date--'-/'.,,,,>Va,luation' y ` 10020, Expiration Date 6/17/05 Qty Unit Charge Per Extension BASE FEE 45•.00 9.00 9.0000 THOU BLDG,2,001-2.5,000 81'.00 ----------------------------=----------------------------------------------- Permit. ELECT- ADD/ALT/REM Additional desc ` Permit Fee 19.34 :Plan Check Fee 4.84 Issue Date Valuation 0 Expiration Date 6/17/05 Qty Unit Charge Per - Extension BASE,,FEE 15.00 124-00 . 0350 ELEC 'NEW RES`7 1 OR 2 FAMILY 4.34 ----------------------- - - - - - , - - - ` f i - - - - - - - - - - - - - ` t''• - - Permit MECHANICAL'•-�2--�-.----,M�«--- -'� Additional desc P.O. Box 1504 " VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: a .6 - I C, I I Date: d/- 5 049^ Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: ai a Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 'I hereby affirm unde�gqpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals �e, and my Lc is is in full force and effect. / � ��✓% License C s \\\ L' nse No. l•�/ _J ` ate Contractor OWNER -BUILDER DECLARATION 1 hereby affirm under penally of pedury 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 ?heir 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 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. , B.& P.C. for this reason 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 it is issued. I have and will maipWh work mpensati n insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is i d M wor tion i nce carrier aid ppkCy��bect� arrier JJJ-rVJJJ olicy Number /iU 3 U _ I certify hat, in the performan e f the work for which Is permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califom' nd gree that, 'rf ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall A& ortlh\with comply with those p)- isio �at. —L t / �n'nli,ant 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 pedury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lenders Address 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, indemnify and hold harmless the City of 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. 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 ellation. I certify that I have ead this application and state that the abo inf ati is ct agree to comply with all city and county ordinances and state laws relating to building construction and ereby authorize re sen tatives of this cou ty t ente u ve-mentioned property for inspection purposes. ate 011�> Signature (Applicant or Agent): Page 2 Application Number.,. 05-0000.0191 Date .2/17/05 Permit Fee 24.00 Plan.Check•Fee 6:00 Issue Date. Valuation . . . 0 Expiration.Date 6/17/05 Qty Unit Charge. Per Extension BASE FEE 15.00. 1.00 9.0000 EA MECH APPL REP/ALT/ADD...-9.00 ------------------------------------------------------------------------------- Permit . . . PLUMBING Additional de.sc Permit Fee 21.00 Plan.Check'F6e 5.25 Issue Date . . Valuation . . . . 0 Expiration.Date '6/17/05 w. ,Qty Unita Charge "Per Extension. BASE FEE 15.00 1.00 6.0000'EA PLB ROOF DRAIN 6.00 Special Notes and Comments ENCLOSE ATRIUM 124 SQ. FT:2/17/05 3:15:3 3 PM JJOHNSON Other Fees . . . ENERGY REVIEW FEE 8.19 STRONG MOTION (SMI') - RES 1.00 Fee summary Charged Paid Credited Due Permit.,Fee Total 190.34`, .00 .00 190.34 Plan Check Total 97.99 .00 .00 97.99 Other Fee Total 9.19 .00 .0.0 9.19 Grand Total 297.52 .00. .00 297.52 { r �� • z ` ... M � ti ti',i � # �+ Y1 A'+'.,'� • +' . ' ' A , ' it h u CERTIFICATE OF'COMPLIA►NCE ,.'► • , ��FIEDSC� It � 'Desert Sands Unified School'®istrict z C) 47956 Dune Palms Road �, ' - � '< .BERMUDA DUNES � 'Date • 2/24/05 )• i • E RANCHO MIRAGE (Z) La Quinta' CA 92253 '' r INDIAN WELLS No. , 269231, # ' 4 �Q%PALM L QUINTAT'� (760 771-86'I 5 r INDIo i Owner Ed Edwards APN # 775-10.1-074 Address' 54783 SoutherrrHills ' " ; ; • Jurisdiction=' La Quinta City LaQuinta Zip 92253 ,Permit # r ' Tract # r f .. ti Study Area Type Residential Addition R ry €' No. of Units 1 ' Lot # No <,. Street,. S.F. Lot #' - No.Street p S.F. al i` • Unit 1� 783" oaths n Hills :-124 Unit 6 Unit 2 w a Unit 7 Unit 3 [` as:. 3 Unit 8 f :. Unit 4 i; Unit 9 Unit 5" Unit 10 ' Comments 'Atrium enclosure 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 accessorystructures (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 ifeis at this time due to the following reason: �► Residential Addition 500 Sq Feet.or Less `• This certifies that school•facility fees imposed pursuant to Education Code Section 17620 and Government'Code 65995 Et Seq. in the amount. of $0.00 X 124 S.F. or $0.00 have been paid for the property listed above and that building permits and/or Certificates of Qccupancy forthis square footage in this proposed project may now be issued. Fees'Paid By Exempt - Adrian Perez - E Check No}, Name on the check Telephone W7-8202 r udiug Excmpt By Dr: Doris Wilson,- +1 Superintended r _ . Fee collected /exempted y'Sh' MCGilvre �' Payment Recd $o oo0' Over/Under �a •= ; Signature NOTICE: Pursuant to Government -Code Section 66020(d)(1), this W se a 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 ori-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. y. Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy- Accountin TANDWS INSPECTION SERVICES, INC. �+ PO BOX 13766"= PALM DESERT, CA 92255-3766 OFFICE /FAX - 951.769.9717 ' PAGER 760.776.3339 SPECIAL INSPECTION DAILY I WEEKLY REPORT TYPE.OF INSPECTION PERFORMED PERMIT.NUMBER TYPE OF STRUCTURE DATE PROJECT ADDRESS (INCLUDE STREET ADDRESS AND CITY OR COUNTY) PROJECT NAME QNCLUDE COUNTRY CLUBMUSINESS PARK/CORP ORATE CENTER ECT. NAME) ARCHITECT(,,' � . �' >�' ,�.` g • ENGINEER. GENERAL CONTRACTOR , ; , SUB CONTRACTOR ;DESCRIPTION OF WORK INSPECTED' �1 -"ltk 1-7� c/At, �,y.�` _ � t ,. .��' `� ! 1.!!� +'• R ' :F>� ! ,amu. . < .i. _ a.� J,0, , J"'f` T'' .•.w►1+"W � �Fy fir: , �J 1`.. VJYr j �.y •„ ��io'-, , ��'CT`!;,'�c ''`.''. _ h:ii 'iQt ..^. rC,:", �. -1,.tiw+ 4.,v� , 4. .,107 ; r-4 �t i i - ��'+• r . 4T f"`'' r:�•' . .. 4c IF Y `*' •W` '� 1 j��wa.iM •'` 1 � .'.� 4-� '� •i�r'��` ,� �, . � a f 4 WELDING INFORMATION WELDERS NAME ,i' 'CERTIF,,YING AGENCY NAME'AND NUMBER PROCESS AND ELECTRODE L Y„A' 0-fo• SAMPLE INFORMATION TIME 4SUPPLIER TICKET NUMBER' "t' MIX NUMBER F� ,1#'1 '• ��, afys e SAMPLE WATER TIME IN AIR TEMP- SLUMP TEMP ADOED MIXER LOCATION TAKEN: i t i LOCATION TAKEN: { ""'r.a"� "" ".M • ". ` I HEREBY CERTIFY;THAT I HAVE INSPECTED ALL OF THE ABOVE REPORTED WORK, UNLESS OTHERWISE NOTED, AND TO THE BEST OF MY ABILITY I HAVE FOUND THIS WORK TO COMPLY WITH _ _ ` + , • /TTHH{EN"&VED PLANS, SPECIFICA�TIONS & APPLICABLE BUILDING LAWS. 100 INSPECTORS SIGNATURE - INSPECTORS CERTIFICATION AGENCY AND NUMBER