13-0785 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000785
Property Address:
58571 JEREZ
APN:
764-650-004- - -
Application description:
REMODEL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
20000
Applicant:
i
Architect or Engineer:
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
TD DESERT DEVELOPMENT
81570 CARBONERAS
LA QUINTA, CA 92253
, I) //,,! � � -
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business a Professionals Code, and my License is in full force and effect.
License Class: B C110 Liceq�e No.: 746198
Date:« S_ 13.�Contractor:
00#
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 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.).
(_ 1 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.).
I—) I am exempt under Sec. , B.&P.C. for this reason
Date:
e
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 (Sec. 3097, Civ. C.I.
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/15/13
DContractor:
A & M CONSTRUCTION
P.O. BOX 366 JUL
LA QUINTA, CA 92247
(760)564-4832
L i c . No .: 746198 Y F lA QUINTA
rltJANCEDEPT. —
-------------7---------------------------------
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.
440 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor 10
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 497854
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner o as to become subject to the workers' compensation laws of California,
and agree that, if I sh Id become subject to the workers' compensation provisions of Section
3700 of the Labor C e, I shall forthwith comply with those provisions.
0. e:T y�I pplicant:
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 isnot commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
1 certify that I have read this application and state that t above information is correct. I agree to comply with all
city and county ordinances and state laws relating to bu' ing construction, and hereby authorize representatives
of this country to enter upon_t a above-mentioned prop for inspection purposes."
ge:? �7 �� Signature (Applicant or Agent):
Application Number . . . . . 13-00000785
Permit . . .
BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
207..00
Plan Check
Fee
134.55
Issue Date . . . .
Valuation
. . .
. 20000
Expiration Date . .
1/11/14
Qty Unit Charge
Per
Extension
BASE FEE
45.00
18.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
162.00
Permit . . .
ELECTRICAL 2013
Additional desc .
Permit Fee . . . .
23.83
Plan Check
Fee
.00
Issue Date . .
Valuation
. . .
. 0
Expiration Date . .
1/11/14
Qty Unit Charge
Per
Extension
1.00 23.8300
----------------------------------------------------------------------------
LS ELEC FIXTURES,
FIRST 20
23.83
Permit . . .
MECHANICAL 2013
Additional desc .
Permit Fee . . . .
11.92
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . . .
0
Expiration Date
1/11/14
Qty Unit Charge
Per
Extension _
1.00 11.9200
-----------------------------------
EA MECH APPL
----------------------------------------
REP/ALT
11.92
Permit . . .
PLUMBING 2013
Additional desc .
Permit Fee . . . .
11.92
Plan Check
Fee
.00.
Issue Date
Valuation
. . . .
0
Expiration Date
1/11/14
Qty Unit Charge
Per
Extension
1.00 11.9200'LS
----------------------------------------------------------------------------
PLBG GAS
SYS, 1-4 OUTLETS
11.92
Permit
REMODEL 2013
Additional desc .
Permit Fee . . . .
70.07
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . . .
0
Expiration Date
1/11/14
Qty Unit Charge
Per
Extension
LQPERMIT
Application Number . . . . .
13-00000785
Permit . . . . . . REMODEL
2013
Qty Unit Charge Per
Extension
1.00 48.6200 LS MISC
REMODEL, 1ST 100 SF
48.62
1.00 21.4500 EA MISC
REMODEL, ADDL 500 SF
21.45
----------------------------------------------------------------------------
Special Notes and Comments
CONVERT 3 RD GARAGE TO LIVING'SPACE,
AND
INTERIOR REMODEL.
July 8, 2013 11:44:52 AM jjohnson.
------------ 7 ---------------------------------------------------
Other Fees . . . . . . . . .
BLDG STDS ADMIN (SB1473)
=-----------
1.00
ENERGY REVIEW FEE
13.46
PLAN CHECK, ELECTRICAL
23.83
PLAN CHECK, REMODEL
17.16
PLAN CHECK, MECHANICAL
4.77
PLAN CHECK, PLUMBING
23.83
STRONG MOTION (SMI) - RES
2.00
Fee summary Charged
----------
Paid Credited
------------------------------
Due
-----------------
Permit Fee Total 324.74
.00 .00
324.74
.Plan Check Total 134.55
.00 .00
134.55
Other Fee Total 86.05
.00 .00
86.05
Grand Total 545.34
.00 00
545.34
'Bin
u
.. QUI . ECEVE
-
'Perinit #'
P.O. Box 1544,:78-49.5 Calk Tampfw 2013
La Qutnta, CA 92253 21
�7 c
--(760) 777r7012 JUN
Building Permit
Appliption- and Traekin LA QUINTA
U T
Pwject,Add=. 57/ -3-6Qt5tOwners Narnw .n
A. P. Number.
Legg D=ipdoit:
City, ST, Zip:
Contractor. A iN h
I' A Telephone:
�, f
Address: 9 070 6.00
Project Description:
City, ST, ArA .A %
2 i
State. Lic. #:
City Lia. fk M ).QV
Artily Bngr.,-
�/``
'Addi•css: 115• �
�N �' �D �. -
City, ST, Zip• A
fi
Telepho c:
Construction Tit;:. OocuFan
State Lic. #:
Prc jeet type (eatk one}: Now Add'a Repair Demo
,—
Name o€ Contact Person:
W,+�j��Sq. Ft -. Stories: # unitx
Telephone # of Contaei PersaUv
i3stimated varue of Project �-•
APPLICANT:. DO NOT WRITE BELOW THIS, UNE
# Submittal Wd Reed 'fR&CMG PERMr'r-FM-
PtaaSets
Plan Check submitted :S V Y r Amount
Strpdarai CaIca.
Reviewed, ready for eorMdons Phu ChcckDeposit _ _
Truss Cates.
Called Coatatt Person Pisa Cheek Balsas -
Tide 24 Ceks.
pians picked up Construtdoa
Flood plain plan
Plan resubmitted ' MerAari[caI
Grading plan
2" Review, ready for co issue - 8 Electrical
Subcontattorlist
Caped Contact Person PIumbing
Grant Deed
Plans picked up SAU
MOAL Approval
Pians resubmitted Grading
FtY Ht)USl3:-.
Review; ready for correctioudissae Developer impact
Planning Approval-
Called ConUct Penna � P. `
'Pub. Wks. Appr
Dstte of permit issue hie
School Fees '
Total Permit Fees b�
IB -
Coachella Valley Unified School District
83-733 Avenue 55, Thermal, CA 92274
(760) 398-5909 — Fax (760) 398-1224
This Box For District Use Only
DEVELOPER FEES PAID
AREA:
AMOUNT
LEVEL ONE AMOUNT:
LEVELTWOAMOUNT:
MITIGATION AMOUNT:
COMWIND. AMOUNT:
DATE:
RECEIPT:
CHECK#:
INITIALS
CERTIFICATE OF COMPLIANCE
(California Education Code 17620)
Project Name: DLD-e—sert
I Development
Owner's Name:
Project Address: 58-571 Jerez, La Quinta, CA
Project Description: Room Addition
APN: 764-650-004 Tract #:
Date: July 15, 2013
Phone No.
Lot #'s:
Type of Development: Residential XX Commercial Industrial
Total Square Feet of Building Area: 244 Sq. Ft.
Certification of Applicant/Owners: The person signing certifies Pat the above information is correct and makes this statement under
penalty of perjury and further represents that he/she is authorized p sign on behalf of the owner/developer.
Dated: T—`5 �/ / Signature:
SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN
ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE)
Education Code
17620
Number of Sq.Ft.
Amount per Sq.Ft.
Amount Collected
Gov. Code Project
65995 Approval
244
EXEMPT
0.00
Building Permit Application Completed: Yes/No
By: Elsa F. Esqueda, Director of Facilities and Maintenance
Certificate issued by: Leticia Torres, Facilities Analyst
Agreement Existing Not Subject to Fee
Prior to 1/1/87 Requirement
Note.
Pursuant to AB 181 any room additions or enclosures of 500
s.f. or less are exempt from developer fees. Any mobile homes
being relocated within the same school district's jurisdiction
are exempt from developer fees.
NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES ANDISTATEMENT OF FEES
Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requi s t,baf this District provide (1) a written notice to the
project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of. these
Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to
advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other
requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this
time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of
Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up
to three (3) such extensions may be granted.
M V:c, mydocs/dcvfees/cerci ficatc (if compliance form updated 3-2007
It
11/2010 I
io for:
of La Quints
!uinta, CA 92
>53
Andalbsia at Coral Mountain Msociation
June 19,
013
RE: Association Approval
58-571, Je -ez, Lot L4 TD Desert Developme it
Andalusia Homeowners Association
The Desigp Review Committee has approved the Archit ctural Improven ent Request fo the
,ersion of thE guest house garage into a bed oom in accorda ce with the sul mitted drawings and
:rwork.
A copy of the plan is kept for our files. Please bear in m nd that the buil er is responsibl for
fining any builJing permits and or inspections that may be required by the City of La Quinta.
Please remember that this ipproval does not permit you to alter any property that is not withiii the
idaries of your residential lot. Iso, it is impo ant that you and rstand that you, as the owner, you are
onsible for mE intaining and insuring any betterments and improv ments to your home.
All work is to be commenced within thirtY days of final written approval and completed "ithin
ty days of commencement, unl ss written conse it for a longer pei iod is received.
Hours o�onday
onstruction from October 1 through April 30 annually:
— Friday 7:00 a.m. — 5:30 p.m.
S iturday 8:00 a.m. — 5:00 p.m.
Sunday & Holiday No work
Regarding construction debris, the site mus be cleaned up d ily, including t driveway, street and
er. No dumpir g of dirt or other construction deb ris is permitted anywhere on the pi operty.
In accord nce with the Master Design Guidelines, any variations from the oi iginal application and
vings must be approved in writ ng by the Architectural Committe prior to commencement of work.
When all work on these improvements is complete, please notify this offs e so that the Design
iew Committe may inspect the work, sign off Dn the file, and refund your construction deposit. Please
:act me if you have any questio is about your application.
4 SIA AT Cq,RAl..M-b)/Nl'AIN WOCIATION