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04-4806 (AR)t BUILDING & SAFETY DEPARTMENT 504 ^a (760).777-7012 LLE TAMPICo ;Y FAX (760) 777-7011 CALIFORNIA 92253 INSPECTION REQUESTS .(760) 777-7153 BUILDING PERMIT Application Number 04-00004806 Date 7/07/04 Property Address .. . . . . 51133 AVENIDA VALLEJO APN: 773-062-017-6 -000000- Application'description ADDITION.- RESIDENTIAL Property Zoning.. .. COVE RESIDENT -IAL Application valuation.. 5865 Owner Contractor BILL.&.MAGGIE GORDON MARK TUVELL(ONE ITEM SUBLIST). 5.1133 , AVENIDA. 'VALLEJO' .3 CA 9.22 53 =----- Structure Information CONVERT CARPORT TO DINNING ROOM, _---- Constructi n.Type TYPE V - NON RATED Occupancy Type:.. DWELLG/LODGING/.LONG:<=10 . Flood Zone -. NON=AO.'FLOOD ZONE Other. s.truct.;nfo .. ,. :, CODE `EDITION .: 2001 BCB FLOOD ZONE NO FIRST FLOOR S,Q FTG .156.00 Permit BUILDING PERMIT Additional desc Permit Fee. 8.1.:00 Plan Check -•Fee .. 52..65 Issue..Date Valuation 5865 Expiration. Date :. .1/07/05' , Qty`.. 'Unit..- Charge'.'.. Per:Extension. BASE FEE 45.00 .4.00 9.0000 THOU BLDG 2,001-25,000 36.00 .5 rmit ELECT:.:-. APD/ALT/REM Additional desC 'Permit Fee 26.46 Plan Check Fee 6.62 Issue.Date Valuation 0 Expiration Date... 1/07/05 Qty Unit Charge Per Extension BASE FEE 15..00 .156..00.. ..03.50 ELEC NEW RES - 1 OR 2 -FAMILY 5'.46 8..0..0.` 7500' PER ELEC DEVICE/FIXTURE 1ST 20 6.00 : Permit MECHANICAL Additional. desc P.O. Box 1504 • VOICE (760) 777-1012 78-495 CALLS TAMPIC6 FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: (9 - �. $ p a Date: 7- - o Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and.,Professionals Code, and my license is -in full force and effect License Class License No. Date Contractor 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, after, 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 (corronendng 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 theapplicant to a civil penalty of not more than five hundred dollars. ($500)J: U I, as owner of the property, or my employers with wages es 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 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.). 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 taw.). .0 I am exempt under Sec. BA P.C. Pr this reason j Date 7—L/'d WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: . _ I have and will maintain a certificate of consent to selfAnsure 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 wilk maintain workers' Compensation insurance, as required by Section 3700 of Lire labor Code, for the performance of the work for which this permit is Issued. My workers' compensation insurance carrier and policy number are: Cartier Policy Number rmt._ 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 Cardomia,.and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, l shall forthwith comply with those provisions;_ `? 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 1 hereby affirm under penalty of peijury that there Is a construction lending agency for the performance of the work for which this permit Is issued (Sec. 3097, Civ. C.). Lenders 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." 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 correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize.representatives of this county to ente upon the above -mention ,p dy for inspection purposes. Date . 7 _Z Signature (Applicant or Agent): Page 2 Application Number 04-00004806. Date -7/07/04 Permit•Fee . . 24.00. Plan Check Fee ,. 6.00 Issue Date Valuation . . 0 Expiration Date 1/07/05 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.000`0 EA MECH"APPL REP/ALT/ADD 9.00 Special. Notes and -Comments CONVERT -CARPORT TO DINNING ROOM 156'SQ. ''FT. Other Fees ENERGY REVIEW FEE 5..27 STRONG MOTION (SMI) - RES .5.8 Fee summary Charged Paid Credited Due. •Permit Fee Total 131.46 .00 .00 131.46 Plan Check Total 65.27 .00 00 65.27i` Other -Fee Total 5.85 .00 .00 5.85 Grand Total 202.58 .00 .00 202.58 1 CERTIFICATE OF COMPLIANCE �c'iF�sc Desert Sands. Unified School District �y 47950 Dune Palms. Road a,� q •,� Q._6ERMUDApUNES r. - Date 7/9/Q4 La Quinta CA 92253 • ;; ! 'RAN IAN WELLSMIRAGd Quinta, � INDIAN WELLS ti No.. 26153 (760) 771-8515 ��f?P�LA gU1NTA y ,MI Owner ` Bill & Maggie Gordon APN # 773-•062-017 7 Address 51113 Avenida Vallejo'. I Jurisdiction : La Quinta City La Quinta Zip 92253 <Permit # Tract # Study Area Type Residential Addition No. of Units 1 Lot # No.* ` Street+ S.F. Lot # No. Street . S.F. Unit 1 51'113 Avenida Vallejo 156 Unit 6` Unit 2 .51 13'.3 Unit 7 Unita Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments At the present time, the Desert Sands Unified School Districtdoes 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: " Residential Addition 500 Sq Feet or Less . EXEMPT This certifies that school facility fees imposed pursuant to ` Education Code Section 17620 and Government Code 65995 Et Seq. ? in the amountof $0.00 X -156 S.F. or $0.00 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 EXEMPT -Mark Tuvell . - Check No, Name on the check. Telephone Funding, Exempt By Dr. Doris' Wilson _ t. N Superintendent Fee collected /exempted by Beth Schieferstine Payment Recd $o.00 4• 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 • I, Embossed Original - Building DepartmenUApplicant Copy - ApplicanUReceipt • Copy - Accounting