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11-0747 (RER)`s _ r P.O. BOX 1504 78=495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00000747 Property Address: :53530 AVENIDA VALLEJO APN: 774-123-001-24 -000000- Application description:. REMODEL - RESIDENTIAL Property Zoning: COVE RESIDENTIAL Application valuation: 100000 Applicant: Architect or Engineer:. LICENSED CONTRACTOR'S DECLARATION ^' VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 10/07/11 Owner: HUNTLEY LOUISE B 60 HIGH OAK DR - MEDFORD, OR 97504 / I hereby affirm under penalty of perjury that I 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 1 am exempt from the Contractor's 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 Contractor's State License Law (Chapter 9 (commencing with Section -7000) of Division 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).: . (_) I, 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 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 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.). (_) 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 ith a contractor(s) licensed pursuant to the Contractors' -State License Law.). ( I am exempt under Sec. B.&P.C. for this reason CJ6f2 t`�S.p 1 �y Ly'2 CONSTRUCTION LENDING AGENCY I.hereby affirm under penalty of perjury 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: . Lender's Address: LQPERMIT Contractor:� Owner C -----------_------------- ------------ ------ - - - - - - WORKER'S 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 permit is 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 insurance carrier and policy numberare: Carrier Policy Number 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 California, and agree that, if I should become subject to the workers' compensation provisions of Section 37YO of the Labor Codd IIS—ihh 11 forthwith comply with those provisions. DC.� '1 .rAppli– ca�ntf•. 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. 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 ofissuance 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. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter.upon the above-mentioned property for;'.ppe n purposes. 1.: . �e:.?1�Signature-(Applicant-or.Ag�=ntl: Application Number 11-00000747 ------ Structure Information ADDITION+REMODEL/VB/RES-3/CLASS A [ENG] ----- Other struct info . . . . . CODE EDITION 2010 ---------------------------------------------------------------------------- # BEDROOMS 2.,.00 Permit BUILDING PERMIT Additional desc . Permit Fee . . . 639.50 Plan Check Fee 415.68 Issue Date Valuation 100000 Expiration Date 4/04/12 Qty Unit Charge Per Extension BASE FEE 414'.50 50.00 4.5000 --------------------------------------------------------------=-------------- THOU BLDG 50,001-100,000 -------------Permit 225.00 Permit ELECT - ADD/ALT/REM Additional desc . Permit Fee-. 66.49 Plan Check Fee 16.62 Issue Date Valuation 0 Expiration Date 4/04/12 Qty- Unit.Charge Per Extension BASE FEE 15.00 1471.Oo .0350 ELEC.NEW RES - 1' OR 2 FAMILY 51.49 Permit . . . MECHANICAL Additional desc . Permit Fee 62.00 Plan Check Fee 15.50 Issue Date Valuation . . . . 0 Expiration Date 4/04/12 Qty _Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 -EA MECH-VENT INST/ DUCT ALT 4.50 1.00 16.5000 EA . MECH B/C >3-15HP/>100K-500KBTU 16.50 1.00 6.'5000 EA MECH AH <=10K CFM 6.50 3.00 6.5000 EA MECH VENT FAN 19.50 Permit . . . PLUMBING: Additional desc . Permit Fee 103.50 Plan Check Fee 25.88 Issue Date Valuation 0 Expiration Date 4/04/12 Qty Unit Charge. Per Extension LQPERMIT Application Number 11-00000747 Permit PLUMBING Qty Unit Charge Per Extension BASE FEE 15.00 13.00 6.0000 EA PLB FIXTURE .78.0.0 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 .1.00 3:0000 EA PLB WATER INST/ALT/REP 3.00 Special Notes and Comments ADDITION + REMODEL/VB/RES-3/CLASS A -FR [ENGINEERED] SQUARE FOOTAGE BREAKDOWN: 155SF ADDITION + 61SF STORAGE ROOM AND 150SF GARAGE CONVERSIONS TO RESIDENCE WITH 162SF ADDITION TO GARAGE [TOTALS - 1,471SF RESIDENCE/523SF GARAGE/'156SF PATIO] THIS. PERMIT DOES NOT INCLUDE BLOCKWALLS OR DRIVEWAY APPROACH. MINOR. ADJUSTMENT: 2011-636 FOR REDUCTION TO SIDE -LOADED GARAGE SETBACK [13'-611] 2010 CALIFORNIA BUILDING CODES. October.6, 2011 5:05:32 PM AORTEGA OK TO ISSUE PER B.H. -- - - - -- - ------------------------ Other Fees . . . . . ' BLDG-STDS ADMIN (SB1473) -------------- 4.00 ENERGY REVIEW FEE 41.57 STRONG MOTION (SMI) -_RES 10.00 Fee summary Charged Paid Credited Due . Permit Fee Total 871.49 .00 .00 871.49 Plan Check Total 473.68 .00 .00 473.68. _ Other Fee Total 55.57 00 00. 55.57 Grand.Total: 1400.74 .00 .00 1400.74 Ti4P.O. BOX 1504 W 78-495'CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 11-00000747 Owner: Property Address: 53530 AVENIDA VALLEJO HUNTLEY LOUISE B APN: 774-123-001-24 -000000- 60 HIGH OAK DR Application description: REMODEL'- RESIDENTIAL MEDFORD, OR 97504 -- Property Zoning: COVE RESIDENTIAL _ Application valuation: 100000 _ Contractor: Applicant: _ Architect or Engineer:. Owner 7 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/07/11 --------=-------------------=----------------------------==---=--=--------------- - - - - - - - LICENSED CONTRACTOR'S DECLARATION - I hereby affirm under penalty of perjury that I am licensed under. provisions of Chapter 9 (commencing with _ WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect._ License.Class: - I have and will maintain a certificate of consent to self•inswe for workers' compensation, as provided License No.: for by Sktion 3700 of the Labor Code, for the performance of the work for which this permit is Date: Contractor: - issued. I have and will maintainworkers' compensation insurance, as required by Section 3700 of the Labor OWNER -BUILDER DECLARATION Code, for the performance of the work for which this permit is issued. My workers' compensation I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the insurance carrier and policy number are: Carrier Policy Number 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 _ I certify that, in the performanceof the work for which this permit is issued, I shall not employ any permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State person in any manner so as to become subject to the workers' compensation laws of California, and agree that, If I should become subject 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 37 0 of the Labor Cade, I shall torthwlth comply with those provisions. ' that he she o exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031:5 li any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001. 1. 1—) I, as owner of the �' leant: at 14 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 -0 WARNING: FAILURE TO SECURE 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.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. APPLICANT ACKNOWLEDGEMENT 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 hh,a contractorls) 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.). ( I am exempt under Sec. B.&P.C. for this reason Lal of $Y$ � - whose benefit work is performed under or pursuant 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 ,v OWaer.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 - CONSTRUCTION LENDING AGENCY within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject ' I hereby affirm under penalty of perjury that there is construction lending agency for the performance of the permit to cancellation. I certify that 1 have read this application and state that the above information is correct. I agree to comply with all work for which this permit Is Issued (Sec. 3097, Civ. C.).- city and county ordinances and state laws relating to building construction, and hereby authorize representatives Nam¢: � of this county to enter upon the above•meritioned property for i pen purposes. Lender's Address: � MIPLender's -�!/7j��i+—SignaSutat{Applica�t,p�,�Ag�nt): _� A.a�....� .��-v��.-�- ' LQPERMIT Application Number . . . . 11-00000747 -=---- Structure Information ADDITION+REMODEL/VB/RES-3/CLASS A [ENGJ ----- Other struct info . . CODE EDITION 2010 ------------------------------------7--------------------------------------- # BEDROOMS 2.00 Permit . . . BUILDING PERMIT Additional desc Permit Fee . . .�. 639.50 Plan'Check Fee 415.68 Issue Date . . . . Valuation 100000 Expiration Date 4/04/12 _. Qty Unit Charge Per Extension BASE FEE 414.50 50:00 4.5000 ---------------------------------------------------------------------------- THOU BLDG 50,001-100,000 225.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . . Permit Fee . . . . 66.49 Plan Check Fee .. 16.62, Issue Date . . . Valuation . . 0 Expiration Date 4/04/12 Qty Unit Charge Per Extension BASE FEE 15.00 1471.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 51.49 Permit . . . MECHANICAL Additional desc _ Permit Fee . . . . 62.00 Plan Check Fee 15.50 Issue Date . . . Valuation . . . . 0 Expiration Date 4/04/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 - 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 1.00 16.5000 EA MECH B/C >3'-15HP/>100K-500KBTU 16.50 1.00 6.5000 EA MECH AH <=10K CFM 6.50 3.00 6.5000 ------------------------------------------------- EA MECH VENT FAN 19.50 . . PLUMBING Additional desc . Permit Fee 103.50 Plan Check Fee 25.88 Issue Date Valuation . . . . 0 Expiration Date 4/04/12 Qty Unit Charge Per Extension LQPERMIT - Application Number 11-00000747 Permit . . . . . . PLUMBING Qty unit Charge. Per Extension BASE FEE 15.00 13.00 6.0000 EA PLB FIXTURE 78.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 -----------------------------------------------=---------------------------- Special Notes - and Comments • ADDITION + REMODEL/VB/RES-3/CLASS A -FR [ENGINEERED] SQUARE FOOTAGE BREAKDOWN: 155SF ADDITION + 61SF STORAGE ROOM AND 150SF GARAGE CONVERSIONS TO RESIDENCE WITH 162SF ADDITION TO GARAGE [TOTALS- 1,471SF RESIDENCE/523SF GARAGE/156SF PATIO] THIS PERMIT DOES -NOT INCLUDE BLOCKWALLS OR DRIVEWAY APPROACH. MINOR ADJUSTMENT: 2011-636 FOR REDUCTION TO - SIDE -LOADED GARAGE SETBACK [13'-611] 2010 CALIFORNIA BUILDING CODES. October 6,'2011 5:05:32 PM AORTEGA OK TO ISSUE -PER B.H. -------------------_------------------------------------------ Other Fees . . . BLDG STDS ADMIN (SB1473) -------------- 4.00 ENERGY REVIEW.FEE 41.57 STRONG MOTION (SMI) - RES 10.00 Fee summary Charged Paid Credited Due -------- ---------- ---------- ---------- ---------- Permit Fee Total 871.49 00 00 871.49 Plan Check Total 473.68 00 00 473.68 Other Fee Total 55.57 .00 :00 55.57 Grand Total 1400.74 .00 .00. 1400.74 LQPERMIT -. Bin # ` City of La Quinta Building 8t Safety Division Box 1504, 78-495 Calle Tampico La Quinta, CA -92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #P.O. Project Address: O A us-.uift Owner's Name: go R fJ 1JC\AR Wd vi�ST A. P. Number: - d Z _ Address: U fl Legal Description: , vF Contractor: �t3D L`�- C�i'� City, ST, Zip: : l% :v:;'i.?:: r' tY;; A•: i 1;;::;v::::;'{i: vi' Telephone: _541 Qj _'Z �8 :ri:nr<€><:'•.<:��r:::%:^:,:: Address:JC -- 6 �'c9 ��� Project Description: City, ST, Zip: IlkLQ-210' _ TZ 2 S 3 tJ W Telephone--zi •:: .:.. . toW -`•,&) State Lic. # : Kg4 02 Lp City Lic. #: Arch., Engr., Designer: .�__ \ �� Address: ST5 S, City., ST, Zip: Q .<3 z.S Telephone: '74p 5& Construction Type: !�S Occupancy: State Lic. #: Project nPa circle one): New Add'n Alter Repair Demo Name of Contact Person:Sq. Ft.: S's # Stories: #Units: Telephone # of Contact Person: S 1- S35 -" ZZ1 3 Estimated Value of Project: pp O o APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted %/8 l Item Amount . Structural Calcs. z Reviewed, ready for corrections 1 'A ( Plan Check Deposit t� Truss Calcs. Called Contact Person IWUU Plan Check Balance. Title 24 Calcs. Plans picked up' Construction •� Flood plain plan Plans resubmitted Ali Mechanical '(s Grading plan 2°" Review, ready rrections ' ue'J.JjIkt Electrical Subcontactor List Called Contact Person $ Plumbing ZS Grant Deed Plans picked up $01 t S.M.I. H.O.A. Approval Plans resubmitted 9 Grading r— IN HOUSE:- '"' Review, ready f orrec issue 9 Developer Impact Fee Planning Approval Called Contact Person9 L' A.I.P.P. ►--� Pub. Wks. Appr Bele�Lpaswliiscuq P�(,� g :�� School Fees L S40 ss X kFtftto I Total Permit Fees 3q .718 --�� "� ?/22-/11 . too Oft-. iliql;tt - s4*t, --!P CERTIFICATE OF COMPLIANCE J�1Ft Desert Sands Unified School District o 47950 Dune Palms Road ¢BERMUDA DUNES 0 N RANCHO MIRAGE d Date 10/7/11 La Quinta, CA 92253 INDIAN WELLS �i PALM DESERT ,y No. 31119 L INTyA - IND % Owner Huntley Louise B/McLaren APN # 774-123-001 Address 53530 Avenida Vallejo Jurisdiction La Quinta - City La Quinta Zip Permit # Tract # No. of Units 1 Type Residential Addition Lot # No. Street S.F. Lot # No. Street S.F. Unit 11' 53530 'Avenida Vallejo 366 Unit 6 Unit 2 Unit 7 Unit 3 Unit , Unit 4 Unit 9 Unit 5 Unit 10 Comments At the present time, the Desert Sands Unified -School District does not collect fees on garages/carports, covered patiostwalkways, 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 amount of $0.00 X 366 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 - George Lambert Check No. Name on the check Telephone 541-535-2213 By Dr. Sharon P. McGehee Superintendent Fee collected /exempd by Signature • Funding Exempt /fe Payment Recd Y /f ;Over/Under =r,r, r NOTICE: Pursuant to Government Code Section 66020(d)(1), t is'A serve to nofrfy 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 n ich 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 without embossed seal Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting