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10-0814 (SFD)"r P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 12/06/10 Application Number:4 X10-0000 0 814 �. Owner: Property Address: 78745 AVENIDA LA JARITA JONES JODY /CHRISTINE APN: 770-145-005- - - - 6 ( 6 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 307643 S .I iJ Contractor: a 11 Applicant: Architect or Engineer: Owner . ViiY OF L A?:i ?NTA i. LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with 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. _ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. A xDate: 1n 1/ � Contractor: _ 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 OWNER -BUILDER DECLARATION 1 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).: ( X) 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, 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. I , B.&P.C. fort reaso Date: NSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury th ' ere is a construction lending agency for the performance of the work for which this permit is jssued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT insurance carrier and policy number are: 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 IIshodbecomesubject to the workers' compensation provisions of Section 3700 of [he lab orthwith comply with those provisions. *4ate: Z I Applicant: WARNING: FAILURE TO SECURE ORKER ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO C INAL 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 t e i a n is correct. I agree to comply with all city and county ordinances and state laws relating uilding structio , and hereby authorize representatives of thiscounty to inter upon the above -mention property f i spectio urposes. Yate: Signature (Applicant or Agent): LQPERAIIT Application Number . . . . ._ 10-000008T4 ------ Structure Information 3,478SF DWELLING/VB/RES-3/CL A -FR [ENG] ----- Other struct info CODE EDITION 2007/2008 # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE. SQ FTG 795.00 PATIO SQ FTG 830.00 NUMBER OF UNITS 1.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 3478.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . 1367.50 Plan Check Fee 888.88 Issue Date . . . . Valuation 307643 Expiration Date 6/04/11 Qty -Unit Charge Per 'Extension BASE FEE 639.50 208.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 728.00 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . 167.63 Plan Check Fee 41.91 . Issue Date Valuation . . . . 0 Expiration Date- 6/04/11 Qty Unit Charge Per Extension BASE FEE 15.00 3478.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 121.73 795.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 15.90 1.00 15.0000 ------------------------------ EA ELEC TEMPORARY POWER POLE ---------------------------------------= 15.00 ------ - Permit . . . GRADING PERMIT Additional desc . Permit Fee . . . . 33.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/04/11 Qty Unit Charge Per Extension BASE FEE 22.50 1.00 10.5000 ---------------------------------------------------------------------------- HND GRADING 101-1000 10.50 Permit . . . MECHANICAL Additional desc . LQPERAIIT e" -i Application Number . . . . . 10-00000814 Permit MECHANICAL Permit Fee . . . . 134.00 Plan.Check Fee 33.50_ Issue Date . . . . Valuation 0 Expiration Date 6/04/11 Qty Unit Charge Per Extension - BASE FEE 15.00 3.00 9.0000 EA MECH FURNACE <=100K 27.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00, 2.00 16.5000 EA MECH B/C >3-15HP/>.100K-500KBTU 33.00 6.00 G.5000 EA' MECH VENT FAN 39.00 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit PLUMBING Additional desc . Permit Fee . . . . 193.50 Plan Check Fee 48.38 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/04/11 Qty Unit Charge Per Extension BASE FEE 15.00 19.00 6.0000 EA PLB FIXTURE 114.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 4.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 12.00 4.00 .7500 EA PLB GAS PIPE >=5 3.00 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 3,478SF DWELLING/VB/RES-3/CLASS A -FR (ENGINEERED] THIS PERMIT DOES NOT INCLUDE BLOCK WALLS, POOL, SPA OR DRIVEWAY APPROACH. 2007/2008 CALIFORNIA BUILDING CODES. November 17., 2010 4:05:09 ---------------------------------------------------------------------------- PM AORTEGA Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES 269.11 BLDG STDS ADMIN (SB1473) 13.00 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 88.89 DIF FIRE PROTECTION -RES 140.00 GRADING PLAN CHECK FEE 22.50 DIF LIBRARIES - RES 355.00 LQPERWIIT LQPERMIT Application.Number . . . . . 10-00000814 ---------------------.------------------------------------------------------- Other Fees . . . . . ... . . MULTI -SPECIES (MSHCP) FEE 1284.00 DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 30.76 DIF STREET MAINT FAC -RES 67..00 DIF TRANSPORTATION.- RES 1930.00' Fee summary Charged Paid Credited Due Permit Fee Total -- 1895.63 -- -------- ---------- .00 .00 1895.63 Plan Check Total 1012.67 500.00 .00 512.67 Other Fee Total 6183.26 .00 .00 6183.26 Grand Total 9091.56 .500.00 .00 8591.56- U P.O. BOX 1504 APPLICATION ONLY Building 78-495 CALLE TAMPICO Address LA QUINTA, CALIFORNIA 92253 Owner OOI J D n eS BUILDING: TYPE CONST. VAJI(A-1 OCC. GRP. Mailing A.P. Number City Zip Tel. Legal Description ° . � Contractor Project Description 5) Ma rat S I ale Address City Zip Tel. Sq. Ft. No. I No. Dw. Size 3 %8 Stories Units State Lic: & Classif.. City Lic. # Arch., Engr., Designer VAQkfA00^J � 1 h P..eievi NewX Add ❑ Altere----•...._C mplition ❑ Address Tel. P.0, 88 b0s. &So . (es ft AM 2 1 I City 1� A_.,�n'A-r- A �A Zip Q?s, 1 A State Lic. # , I LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that he 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 Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. 11, however, the building or im- provement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale). O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law) ❑ 1 am exempt under Sec. B. & P.C. for this reason Data B % /D Owner WORKX.R-S COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less). 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 Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, alter making this Certificate of Exemption you should become subject to the Workers' Compensation Provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. 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 city to enter the above-mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip WHITE = BUILDING DEPARTMENT IEstimated Valuation qP ,IE 5�0, 0 0Z) ' v O PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical - Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT ZONE: BY: Minimum Setback Distances: Front Setback from Center Line ' Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE Issued by: Validated by:— Validation: YELLOW = APPLICANT INSPECTOR Date Permit PINK = FINANCE CERTIFICATE OF COMPLIANCE �&21ED 'k— Desert Sands Unified School District o 0 47950 Dune Palms Road Q BERMUDA DUNES O RANCHO MIRAGE Date 12/15/10 La Quinta, CA 92253 INDIAN WELLS LM DSERT No. 30877 (760) 771-8515 `y.� ° LA QUENTA , QINDIO yr% Owner Jody Jones APN # 770-145-005 Address Jurisdiction La Quinta City Zip Permit # Tract # No. of Units 1 Type Single Family Residence Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 78745 Avenida La Jarita 3478 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 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: 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 $2.97 X 3,478 S.F. or $10,329.66 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 CC/Bank of America - Jody Jones Check No. 430901955 Name on the check Telephone Funding Residential By Dr. Sharon P. McGehee Superintendent Fee collected /=bySharilvrrey Payment Recd $10, 329.66 `w-Qver1U6der� ^ ~ � 1 Signature 4 r S k NOTICE: Pursuant to Government Code Section 660k(d)(1), thi wil serve to notify, you that the 90 -day approval period in wtiich 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 without embossed seal Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting CITY OF LA QUINTA - PUBLIC WORKS DEPARTMENT GREEN SHEET PUBLIC WORKS CLEARANCE FOR RELEASE OF BUILDING PERMIT Form updated & effective 9/25/2009 Green Sheet approvals are forwarded to the Building & Safety Department directly by Public Works. Please DO NOT submit the Green Sheet (Public Works Clearance) Packet to the Public Works Department until ALL requirements listed below are complete. Incomplete applications or applications which cannot be processed will be returned to applicant. Date: /0 Developer: VOdY - lnt"4 S Tract No.: �5' Tract Name: DES£r'T gLub Lot No.(s): 1.3 Address(s): `79-7AG A1( 1„,4 ZrAgL,r 4- Phone Number: ( ' ` The following are the requirements for Public Works Clearance to authorize issuance of a building permit from the Building & Safety Department: CUSTOM HOMES_: _ PROVIDE ITEMS #2, #3, #4, #5 & #7 BELOW F® ❖ TRACT HOMES: PROVIDE ITEMS #1, #2, #3 & #5 BELOW OCT 22 ZD ❖ COMMERCIAL BUILDINGS/OTHER: PROVIDE ITEMS #1 #2 #3 #5 & #7 BE 1O ❖ WALLS, SIGNS, OTHER: PROVIDE ITEM #6 BELOW VvelOPMellt Selvice� 1. Attach Pad Elevation Certificates in compliance with the .approved design elevation for building pad (ma�Limum allowable deviation of +/- 0.1 foot). Pad Elevation Certificates must be current (within 6 months of current date). If a precise .grading plan creates the pad for approval, please withhold green sheet submittal until a Pad Elevation Certificate can be provided. *g)Attach geotechnical certification of grading plan compliance including compaction reports from a licensed Soils Engineer. Recently rough graded residential developments which have a previously approved geotechnical certification are exempt from this requirement. 3[.0 U W/i-L Cff' < 6,D/n )0Acnan! A6 -a &iZ6if- 6a7-L&f2 Attach recorded final map or title information//yrcanLdeed showing proposed building locations are legal lots. 4. Complete the attached <1 acre per lot or infill project Fugitive Dust Control project information form, PM10 plan & agreement or provide alternative & valid City approved PM10 plan set reference number or hard copy plan. PM10 plans for commercial & residential developments (beyond 1 lot) are submitted separately with grading plans �& are subject to additional requirements. A current PM10.certification number is required. 1,10 a copy of the rough or precise grading plan to the Public Works Department showing building location(s)- —r" for pad elevation verification. AO flood zone developments will require an approved flood plain development plan 6 Attach supporting documentation for wall plan, monument sign, grease trap or special facility installations. /7. Complete and sign the attached water quality management plan (WQMP) exemption form, if applicable. PW; approved building construction projects require either a WQMP or a completed WQMP exemption form. Approved maps/plans may be viewed at the following link: http://www.la-ouinta.ora/PlanCheck/m search.asp I have reviewed and confirmed the requirements listed above as presented and find the improvements to be sufficiently complete for construction of the proposed buildings/structures/walls/signs on the subject lot(s). Pursuant to my findings, the above project may be released for building permit issuance. This section completed b City staff. Recommended by: Date: (/ / JC RECEIVED Public Works Distribution: ( Green Sheet to Building & Safety MV O 5 2010 ( ) Green Sheet to Planning Department Devel©pment Declined for approval for reason(s) as follow(s), please correct and resubmit: to-IS-I� I�D��naES o►-) PL,4NJ,-A 3 0t�- c7JLS/lb a (�— TACheddists - Forms & Applications\Fonns & Applications\GREEN SHEET cover & PM10less than 1 Acre Revised 9.25-09.doc , s ✓ Dev&opment Services City of La Quinta - PM10 Fugitive Dust Control Project Information Construction Phase PM10 Agreement (<1 acre/lot or Infill Project) Project Information Project Contractor: Project Phase (check one) Construction Demolition Project Name: Tone -5 Project Tract/Lot Numbers: D►_Ser+ Project Street Address: %g ta q 2253 a2E51c�ENc¢_' G/wb T',1zaAT tot- /S1; -745 AV L4 IM- 7rA Total Acres in Active Construction (<1 acre per Lot): Anticipated Start Date: 10 Anticipated Completion Date: (o / / / / if PM10 Contact Information Please note: Dust control is required 24 hours a day, 7 days a week, regardless of construction. status. Person listed below is responsible for dust control during business and non -business hours. Name: Title: w ney,; Com an Name: A/ A. Mailing Address: - City, State, ZIP Code: Primary Phone #: Fax #: 24 Hour Emergency Phone#: %/ Cell Phone M ' Email Address: ,� PM10 Certificate #:,t The above stated property owner (or authorized representative): ❖ Shall act as his/her acknowledgement of dust control requirements and their enforceability, pursuant to SCAQMD Rules 403, 403.1, 401, 402-201, 203 and PERP; ❖ Shall constitute an Agreement to comply -with all project conditions as identified in the approved dust control plan. ❖ Acknowledges that dust control is required twenty-four (24) hours a day, seven (7) days a week, throughout the period of project performance, regardless of project size or status; Shall ensure that each and every contractor, subcontractor and all other persons associated with the project shall be in continuous compliance with all requirements of the approved dust control plan; ❖ Shall take all necessary precautions to minimize dust, even if additional measures beyond those listed in the dust control plan are necessary; ❖ Shall authorize representatives. of City/County to enter the property.for inspection and/or abatement purposes; Shall hold harml ity/County and. its representatives from liability for any actions related to this dust control 1 plan o /County ' itiated abatement activities. 5 S:rm-s natfpDl1*ca�brcAnFsXForms ro 'Owner or Authorized Representative Date TACheddists - & & Applications\GREEN SHEET cover & PM10 less than 1 Acre Revised 9-25-09.doc 78-080 Calle Amigo, Suite 102, La Quinta, CA 92253 760-219-9886 760-262-3000 (fax) dale@kellehennapping.com January 7, 2011 Steve Traxel Kay Hensel City of La Quinta Department of Building & Safety (760) 777-7112 (fax) Re: Pad / Grading Certification 78745 Avenida La Jarita La Quinta, CA 92253 APN: 770-145-005 LOT 137 OF DESERT CLUB TRACT UNIT NO. 5, MB 21/61-62 To Whom It May Concern: We have performed a field survey to determine the vertical location of the building pad For the above referenced project. The elevation's observed are as follows: PAD (DESIGN) 102.50 FINISH FLOOR (DESIGN) 103.17 PAD (AS -BUILT) 102.50 TOP OF FORM (AS BUILT) 103.17 These field observations are in substantial conformance with the Precise Grading Plan Prepared by ESSI SHAHANDEH, CIVIL ENGINEER, dated 12/15/2010, approved by the City of La Quinta on 12/15/2010, and the building pad horizontal location substantially conforms to the required setbacks and site layout as shown on the approved Site Plan and Precise Grading Plan. iD LAND SG Sincerely, KE(��, �yF� KEL�,EHER PIN�G P�' No. 6687 Dale Kelleher, PLS 6687 f2 �P cc: Jody Jones jbjones@morso.com`\� Essi Shahandeh essi.shahandeh@eeicompany.com CA r 'a DARKMO N BUILDING DESIGN AND ENGINEERING Date: November 3, 2010 City of La Quinta Building and Safety Department La Quinta, California Re: Jones Residence - Avenida La Jarita, La Quinta California I have reviewed the truss calculations from AC Houston Lumber Company of Indio, CA, (Project Number ITio-o8012) and find that they are in compliance with the structural drawings Darkmoon Building Design and Engineering provided. Sincerely, � Ir Jonathan Villegas, P.E. C-69885 RENEW 09VSQl10 DARKMOON BUILDING DESIGN AND ENGINEERING P.O. Box 88 a Carpinteria • California 93014 0 (805) 68o-6874 • fax (805) 456-3854 9 darkmooneng@cox.net