05-2886 (AR)P.O. BOX 1504
78-495 CA LLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
r05-00002886
44580 VERBENA DR
604-252-010-30 -24208
ADDITION - RESIDENTIAL
LOW DENSITY RESIDENTIAL
37853
Architect or Engineer:
-------------------
LICENSED CONTRACTOR'S DECLARATION
4.4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
'FAX (7.60) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/27/05
Owner:
GONZALEZ.ARTURO E
44-580 VERBINA DR.
LA QUINTA, CA 92253
Other struct info
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: E FOOTAGE License No.:
Date: Contractor:
OWNER -BUILDER DECLARATION .
I hereby affirm under penalty of perjury that I 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 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 pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred -dollars ($5001.:
() 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.).
(_ 1 I, as owner of the property, am exclusively contracting with li nsed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' ate License Law does not apply to an owner of
property who builds or improves thereon, tra s for the projects with a contractor(s) licensed
pursuant to the Contractors' State L' a Law.l '
I—) I am exempt under Sec. , B. r this reason
Date: .. 'Zoo � � � Owner:
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 ISec. 3097, Civ. C.I.
Lender's Name:
Lender's Address:
LQPERN11T
C
2001 CBC
--------------- - - -
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 number are:
Carrier 2 . 00 Policy Number NO
I certify that, in the performance of the 4suct
which this permit is issued, I shall not employ any
person in any man o as to becomto the workers' compensation laws of California,
and agree that, if me, ue workers' compensation provisions of Section
37000of the La ode shall forthply with those provisions.
Date: "2S -0' Applicant: .
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 1$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 iork is not commenced
within 180 days from date of issuance of suc"cessation tion of rk for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that theis rr . I agree to comply with all
city and county ordinances and state laws relating to buildid he authorize representatives
of this county to enter upon the above-mentioned propertyoses.
FDa2e:� Z 'fi' Signature (Applicant or Agent): '-
Application Number .
. . . . _ 05-00002886
Permit . . .
BUILDING PERMIT
Additional desc
Permit Fee . . . .
336.50
Plan Check Fee
218.73
Issue Date
Valuation
37853
Expiration Date
3/26/06
Qty Unit Charge
Per
Extension
BASE
FEE
252.00
13.00 6.5.000
----------------------------------------------------------------------------
THOU BLDG
25,001-50,000
84.50
Permit
ELECT'- ADD/ALT/REM
Additional desc .
Permit Fee . . . .
40.41
Plan Check Fee
10.10
Issue Date . . . .
Valuation
0
Expiration Date
3%26/06
Qty Unit Charge
Per
Extension
BASE
FEE
15..00
726.00 .0350
=---------------------------------------------------------------------------
ELEC
NEW RES - 1 OR 2 FAMILY
25.41
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
61.50
Plan Check Fee
15.38
Issue Date
Valuation . . . .
0
Expiration Date
3/26/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 9.0000
EA MECH
FURNACE <=100K
9.00
1.00 9.0000
EA MECH
APPL REP/ALT/ADD,
9.00
1.00 9.0000
EA MECH
B/C <=3HP/100K BTU
9.00
2.00 6.5000
EA MECH
VENT FAN
13.00
1.00- 6.5000
-----------------------------------------------------------------.-----------
EA MECH
EXHAUST HOOD
6.50
Permit . .
PLUMBING
Additional desc .
Permit Fee . . .
82.50
Plan Check Fee
20.63
Issue Date
Valuation . . . .
0
Expiration Date.
3/26/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
8.00 6.0000
EA PLB
FIXTURE
48.00
1.00 7.5000
EA PLB.
WATER HEATER/VENT
7.50
LQPERAIIT
Application Number . .
05-00002886
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
1.00 3.0000 EA PLB
WATER INST/ALT/REP
3.00
3.00 3.0000 EA PLB
GAS PIPE 1-4 OUTLETS-
9.00
----------------------------------------------------------------------------
Special Notes and Comments
remodel addition /quest house.September
27, 2005 10:36:26 AM jjohnson
----------------------------------------------------------------------------
Other Fees . . . . . . . .
ENERGY REVIEW FEE
21.87
STRONG MOTION (SMI) - RES
3.78
Fee summary Charged
----------
Paid Credited
---------- ---------- ----------
Due
---------- - ------
Permit Fee Total 520.91
.00 .00
520.91
Plan Check Total 264.84
.00 .00
264.84
Other Fee Total 25.65
.00 .00
25.65
Grand Total 811.40
.00 .00
811.40
LQPERIIIT
0
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, residential additions under 5
00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooldng, eating or sanitation) or replacement mobile ho
mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.24 X 726 S.F. or $1,626.24 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 C/C-Pacific Western Bank, Gonzalez Check No. 255802
Name on the check Telephone 360-4685
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exeMpted by P
Signature /1Z..". ,
Etc
k . �• 4.� � �Yw LL
icia Barbuzza Payment Recd y` $0.00
'= ,•Over/larder
$1,626.24,,;,, .. .
NOTICE: Pursuant to Government Code Secd6n 66020(d)(1), this will serve 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 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
Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting
CERTIFICATE OF COMPLIANCE
i
Desert Sands Unified School Districto�<`
�o
10
47950 Dune Palms Road
< BERMUDA DUNES
Date
9/28/05
La Quinta, CA 92253
Cr RANCHO MIRAGE
��INWANWELLS
No.
27710
(760) 771-8515
PALM DESERT
IaNDINTA �y
INDIO
v y
Owner
Arturo Gonzalez
APN #
604-252-010
Address
44580 Verbena
Jurisdiction
La Quinta
City
La Quinta Zip 92253
Permit #
Tract #
Study Area
Type
Detached Guest House/Casita No. of Units
Lot # No. Street
S.F. Lot # No.
Street S.F.
Unit 1
44580 Verbena
726 Unit 6
Unit 2
Unit 7
Unit 3 .
Unit 8
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 5
00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooldng, eating or sanitation) or replacement mobile ho
mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.24 X 726 S.F. or $1,626.24 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 C/C-Pacific Western Bank, Gonzalez Check No. 255802
Name on the check Telephone 360-4685
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exeMpted by P
Signature /1Z..". ,
Etc
k . �• 4.� � �Yw LL
icia Barbuzza Payment Recd y` $0.00
'= ,•Over/larder
$1,626.24,,;,, .. .
NOTICE: Pursuant to Government Code Secd6n 66020(d)(1), this will serve 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 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
Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting
712 FMPI%t�✓lr �„r i �n ,4„Dr�� 0
Bin W,
V t4F
IS City, of La 1q. Uen i
Building &r Safety Division .
P.O. Box 1504, 78-495 Calle Tampico . ..:.
U Quinta, CA 92253 - (760)'777-7012
Building Permit Application and Tracking Sheet
Permit
Project Address:
L
Owner's Name: elm Z11- C9'2 -
Address:
City ST, Zip:
CA
A.. P. Number: .. � D. -a�a —p jO
Legal DescriQtion:.: LCT 30 !2 2cL a 1f'o2�
Contractor:
fele P. h one 6
Address:. _
City, ST, zip:
Project Description: 7 �S
4.DD / 177 o.J 0
-
Tcie ii�utie:
1
State Lic. # :
City Lic.
-Asch., Engr., Designer: E?,- Qjir. g�� ( Of l
Address: •Z��O n ( �' S`�.Aq_v"
V"0 S
City, S'i!. gip:
. el ..t fl
.. P V l . —�
l '1
;;:;::
construction strutt
t on T YPe: Occupancy:
anc.
_C
State Li . #•
.. . .
ProJ e
ct type �circ le n e
Nev Ad ' o Alter Repair Deano
Name of Contact Person:
1g�
Sq. Ft.: # Stories: # Units:
Estimated Value of Project:
Telephone # of Contact Persol:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
—
Submittal
4 f S64etr,�--
Plan Sets
Structural Calcs.
Req'd
Recd
TRACKING PERMIT FEES
Plan Check submit te -7Amount
Item
Reviewed, ready or correctionsQQ Plan Check Deposit
Called Contact Person (7 Plan Check Balance
Truss Calcs.
Tille 24 Cales.
Plans picked up / Construction
Flood plain Plan
Plans resubmitted Mechanical
2" Review, ready or corrections/is a Electrical
Called Conl-I Person Plumbing
(trading plan
Subcontactor List
Grant Deed
—
Plans pichcd cap
Plans resubmitted Grading
—
..
H.O.A. Approval
IN HOU SE:-
''d Review, ready for correction issue Developer Impact Fee
Called Contact Person A,I.P.P.VAk . .
Date of permit issue
Total Permii Fees
Planning Approval
Pub. Wks..A.ppr
School Fees
—
r i Gk- �(.o . / S)
A