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06-1982 (AR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: C� - 06-00001982 54979 LAUREL VALLEY 775.-120-057- - - ADDITION - RESIDENTIAL LOW DENSITY RESIDENTIAL 4860 T4ht " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: pla VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION 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: B License No.: 839472 ate: ontractor: 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).: 1 _) 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 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 Law.). (_) I am exempt under Sec. , B.&P.C. for this reason Date: 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.). Lender's Name: Lender's Address: LQPERMIT Date: 7/26/06 ----------------------------------------------— WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ 1 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. 111 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 STATE FUND Policy Number 46-0014644-2005 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 3700 of the Labor Code, 1,10all ffoorthwith comply with those provisions. 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 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. I agree to comply with all city and county ordinances ands a laws relating to building construction, and hereby authorize representatives of this cJ my to enter upon above-mentioned propertyfor in pe ion purposes. ,imite: / ` e nature (Applicant or Agent): V Owner: ZEHNDER 54-979 LAUREL VALLEY LA QUINTA, CA 92253 Q O tiQ !J Contractor: AMERICAN BUILDING CONTRACTORS U. O Q 49950 JEFFERSON ST STE 130-335 INDIO, CA 92201 V (760)342-8450 Lic. No.: 839472 -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION 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: B License No.: 839472 ate: ontractor: 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).: 1 _) 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 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 Law.). (_) I am exempt under Sec. , B.&P.C. for this reason Date: 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.). Lender's Name: Lender's Address: LQPERMIT Date: 7/26/06 ----------------------------------------------— WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ 1 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. 111 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 STATE FUND Policy Number 46-0014644-2005 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 3700 of the Labor Code, 1,10all ffoorthwith comply with those provisions. 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 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. I agree to comply with all city and county ordinances ands a laws relating to building construction, and hereby authorize representatives of this cJ my to enter upon above-mentioned propertyfor in pe ion purposes. ,imite: / ` e nature (Applicant or Agent): V P..4 Application Number 06-00001982 Permit . . . BUILDING PERMIT Additional desc . Permit Fee 72.00 Plan Check Fee 46.80 Issue Date . . . . Valuation 4860 Expiration Date 1/22/07 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 9.0000 --------------------------------------------------- THOU BLDG 2,001-25,000 -------------- 27.00 ----------- Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 17.52 Plan Check Fee 4.38 Issue Date Valuation 0 Expiration Date 1/22/07 Qty Unit Charge Per Extension BASE FEE 15.00 72.00 .0350 ------------------------------------- ELEC NEW --------------------------------------- RES - 1 OR 2 FAMILY 2.52 Permit . . .. MECHANICAL ' Additional desc Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/22/07 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 ---------------------------------------------------------------------------- EA MECH APPL REP/ALT/ADD 9.00 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 24.00 -Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Expiration.Date 1/22/07 Qty Unit Charge Per Extension:'' BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 -------------------------------------------------------------------- Special Notes and 'Comments 72 SQ. -FT. -UNDER EXISTING ROOF OVERHANGJuly 25, 2006 2:25:14 PM LQPERMIT Application Number . . . 06-00001982 -------------------------------=-------------------------------------------- Special Notes and Comments jjohnson ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 4.68 STRONG MOTION (SMI) - RES .50 Fee summary - Charged Paid Credited Due ----------------- Permit Fee Total ---------- 137.52 -------------------- .00. ---------- .00 137.52 Plan Check Total 63.18 .00 .00 63.18 Other Fee Total 5.18 .00 .00 5.18 .Grand Total 205.88 .00 .00 205.88 LQPERMIT 06-/98z City of La Quinta Building U Safety Division Permit .# P:O. Box 1504, 78-495 Calle Tampico \ La Quinta, CA 92253 - (760) 777-7012 1 , ..Building Permit Application and Tracking Sheet Project Address:' �'�� L�itnl'Z� Owner's Name:r - .A. P. Number: Address: S`��7G1. g t4 rf L4 /lt LA Legal Description: City, ST, Zip: 4. l� 1.2257 Contractor: C(9,11NOON Telephone: Address:: if -try Cin Project. Description: City, ST, Zip: L#4± 0 I Telephone: D _7jLCSY- State Lie. # City Lic. #:Bf� Arch., Engr., Designer: Address: City, ST, Zip: Telephone: qyr . C' y -7 Construction Type: Occupancy: State Lie. #: Project type (circle one): New ' Add'n Alter Repair Demo Name of Contact Person:eed /4 Sq.. Ft-: 7.2 # Stories: # Units: Telephone # of Contact Person: S --7P4 P Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd itec'd TRACKING . PERMIT FEES , Plan Sets plan Plan Check submitted Item Amount ' Structural Calcs. Reviewed, ready for corrections 5 -plan Check Deposit Truss Calcs. Called Contact Person �� Plan Check Balance nergy Cales. Plans picked up Construction ' Flood plain plait. Plans resubmitted aL Mechanical Grading. plan' .. 2ae Review, ready fo correctio Issue✓ Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up H.O.A. Approval �9 Cb Plans resubmitted 1 ZIN EGradin HOUSE:- ter° Review, ready for corrections/issue er Impact Fee Planning Approval Called Contact Person A.I.P.P. • Pub. Wks. Appr Date otpermit issue 7Z. School Tees e (O Total Permit Fees - '72D..e.t,c a - sT � . C.44C, 5 612 9/Cy, 7// //M ff Co e Gila 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: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMMIIND. AMOUNT: DATE: RECEIPT: CHECK #: INITIALS: CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: Mr. Zehnd Date: July 26, 2006 Owner's Name: Mr. Zehnder Phone No. Project Address: 54-979 Laurel Vallley La Quinta, CA 92253 Project Description: Room Addition APN: 775-720-057 Tract #: Lot #'s: Type of Development: Residential XX Commercial Industrial Total Square Feet of Building Area: 72 sq. feet Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized to sign on behalf of the owner/developer. Dated: 07/26/06 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 72 sq. ft. $ 0.00 $ 0.00 Agreement Existing Not Subject to Fee Prior to 1/1/87 Requirement Note: Pursuant to AB -181, any mobilehomes being replaced or relocated within the same school district are exempt from developer fees. Any additions of 500 sq. ft. or less is also exempt from developer fees. (Unless additions are on a structure that is under construction.) Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Business Services Certificate issued by: Maria L. Angulo, Facilities Secretary Signature: ai� NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATE NT OF FEES' Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this istrict 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. At such time as this Certificate expires, if a building permit has not been issued for the project that is the subject of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. ?r1Va `Inydu.�!d vlee,i,ertificat.c o? compliance farm rahles'R) USG.do,; 1/16/03 T 4 * f✓� �',r�,'.(!,�?+13++�db:..�=syr'; - JCM Inspections - 39725.Garand Lane Suite F Palm DesertCA 92211! INSPECTIONS Phone: 760-345-5554 - Fax: 760-772-3895 INSPECTIONS EPDXY INSPECTION REPORT Date`�7—�i-Q Project Name: rProject No: _Project Address: � � � ` � J �City,:� IBC ❑ Title 24 Other: J Client: Sub -(Contractor: ,General Contractor: Architect: \ Structural L3f:�• Engine' e"r: rw Co r)19 `4 �! �clsZ 1 , Anchor Bolts ®Rebar Epoxy Type: o .•i C 1 t' - G 1 c�•� o v Epoxy Shelf Life: rj�,�l�Q Hole Cleaning Method(s): ,n W, r)e-z' eN t . CQ� c e o� 1'c� r �� u ,�Ri�C \, �( �Ql Weather: Unresolved I� s: None ❑ See Below Description of Work Inspected: 1:.-- ®QX ,,,,\ G. ` QavJe�S �CU rC' �1J �jat �,• ("ems C, R M -i 1 -o 6 ( W�j C' C- C'rN-,na A'_3 Q - Cnv\,- C �- 1N.rts:_Ao n n., ' aofn\ Q �c.c� lar\ �i o n e e.. 4Z a C_ \o�r,�'t'\`r,c `on mrcane _ e ,.a1 �_�' ��.r s1��\ '�d ►��. �o\:ae�s W �c c Q.�Q�t; �� ot`f2o�\c�.�ll'.�, � �� L, e �ctS``-te L4 o • C./ • n' (-le tt (19 " 0 \.X i A 6 Cep I '�C� GIl� . a' �\ � �0 LJ % G, .S�( I• QFC. . � �•�n��o carx�itd �ti cc. l.U�� '�nS�"cF�� ! . �(�� L ��'Z � X N' ai'X� Work complies with written approval from Structural Engineer and ICBG Evaluation Report # q -� I hereby certify that I have inspected all of the above work, unless otherwise noted, and to the best of my ability I have found this work to comply with the approved plans, specifications _applicable building laws. Final report issued atproject completion. Inspector: Jack C.FMillin ICC Certification No;bh42216-49 Contractor's Representative: Copy 1 JCM Inspections �� Copy 2 Project Superintendent Copy 3 Governing Agency Page I of