05-1810 (AR)I ll,
P.O. BOX 1504 4^' 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: 8/25/05
Application Number: -05-0000_1810 Owner:
Property Address: 60392 LAVENDER CT THOMAS LAVALLE
APN: 764-270-999-161 -300232- 60392 LAVENDER COURT
Application description: ADDITION - RESIDENTIAL LA QUINTA, CA 92253 D
Property Zoning: MEDIUM HIGH DENSITY RES jpl
Application.valuation: 30808 1)
AUG 2 9u :.
• Contractor:
Applicant: Architect or Engineer: ML CONSTRUCTION CITY 012
OO8
INTA,
LAQUINTA, CA 92253 FA CEDEPT
(760)564-4447
P�A
Lic. No.: 343335
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 C8 C36 LicenseNo.: 343335
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 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.).
(_) 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.AP.C. for this reason
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: N r\
LQPERMIT
WORKER'S COMPENSATION DECLARATION
1 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 STATE FUND Policy Number 0014757-2005
AI 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' mpensation provisions of Section
83700 of the Labor Code, I shall thwith comply with a provisions.
adte:'G'� plicant: -
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.gree to comply with all
city and county ordinances and state laws relating to buildin construction, and hereb thorize repre 'ves
of this county tof�enntt�ej upon th ove-mentioned pro f r inspection purpos
bate: " gnature (Applicant or Agentl:
Application Number . . . . . 05-00001810
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee
291.00 Plan Check Fee
189.15
Issue Date . . . .
Valuation . .
30808
Expiration Date
1/23/06
Qty Unit Charge
Per -
Extension
BASE FEE
252.00
6.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
39.00
Permit . . . ELECT
- ADD/ALT/REM
Additional desc .
Permit Fee . . . .
33.70 Plan Check Fee
8.43
Issue Date . . . .
Valuation
0
Expiration Date . .
1/23/06
Qty Unit Chatge
Per
Extension
BASE FEE
15.00
384.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
13.44
263.00 .0200
----------------------------
ELEC GARAGE OR NON-RESIDENTIAL
------------------------------------------------
5.26
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . .
19.50 Plan Check Fee
4.88
Issue Date . . . .
Valuation . . . .
0
Expiration Date
1/23/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
" 1.00 4.5000
EA MECH VENT INST/ DUCT ALT
4.50
-----------------------------------
Special Note's and Comments
-----------------------------------------
SINGLE FAMILY ADDITION
OF 384 SQ.FT.
W/ PATIO OF 263 SQ.FT.
2001 CODE.
----------------------------------------------------------------------------
Other Fees . . . .
ENERGY REVIEW FEE
18'.92
STRONG MOTION (SMI) - RES
3.08
Fee summary Charged
Paid Credited
Due
Permit Fee Total
344.20 .00 .0'0
344.20
Plan Check Total
202.46 .00 .00
202.46
Other Fee Total
22.00 .00 00
22.00
Grand Total
568.66 .00 .00
568.66
I fivwv T
EI
Application Number . . . . . 05-00001810
7'olaI Permit Fees
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Bin #
City of La Quintj
'
Building &r Safety Division
Permit # P.O: Box 1504, 78-495 Calle Tampico
I ,0 1a Quinta, CA 92253 - (760) 777-7012
1 Building Permit Application and Tracking Sheet
.Project Address: 60 J L, A V C R✓J C /� C�,�;,v
( Owner's Name:
�P,,�•5 L+9ll�
i
A. P. Number: - s 'Address: 60-3q-?_
Legal Description:
.
City, ST, Zip: Lam- �, •-�?.� �' i � 5 �
Contractor:. (o Z
i Telephone:
Address: Project Description:
City, ST, Zip:
• • tax t� r. � :-t- �
Telephone:
ePh one:
State Lic. # : City Lic. #:
Arch., Engr., Designer. .
Address:
City, ST, Zip:
Telephone:
Construction t'
t on Type: •
P e. cc
O u Pan cN:
"
Sta to• c_
Lt #
.
Pr o1e
............. ct type (circle one): )N
�A dd'n Alter Repair Demo
Name of Contact Perso6:_T0yA Li{ UkLL e= Sq. Fl:: #Stories:
#Units:
Telephone # of Contact Person.? (oto 'Z tf ? —1 (
Estimated Value of Project:
APPLIUNT: DO' NOT WRITE BELOW THIS LINE
# Submittal Req'd Rec'd TRACKING PER -MIT FEES
3 Plan Sets Plan Check submitted 11 Item
t
Amount21
Structural Calcs. Reviewed, ready f rreclions 4r.5. 1 o6 Plan Check Deposit
Truss Calcs. .Called Contact Person 411Z Plan Check Balance
Title 24 tales. Plans picked up (Q/a Construction
tted 2 Mechanical
Flood plain plan Plans resub�rea:dv
Grading plan 2"d Review, for correction ass Electrical
Subcontactor List Called Contact Person Plumbing
i
Grant Deed Plans picked up S.111.i.
Ii.O.A. Approval Plans resubmitted Grading
IN IIOUSE:- 34 Review, ready for corrections/issue Developer Impact Fee
Planning Approval Called Contact Person
A.LP.P.
Pub. Wks. Appr Date of permit issue
a
.School Fees
7'olaI Permit Fees
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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:
LEVEL TWO AMOUNT:
MITIGATION AMOUNT:
COMM/MD. AMOUNT:
DATE:
RECEIPT:
CHECK #:
INITIALS:
CERTIFICATE OF COMPLIANCE
(California Education Code 17620)
Project Name: Thoomasla_valle Date: August 29, 2005
Owner's Name: Thomas Lavalle Phone No. (
Project Address: 60-392 Lavender Court, La Quinta, CA 92253
Project Description: Casita Addition
APN: 764-380-055
Tract #:
Lot #'s:
Type of Development: Residential XX Commercial Industrial
Total Square Feet of Building Area: 384 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 t�q owner/developer.
Dated: 08/29/05
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 Gov. Code Project Agreement Existing Not Subject to Fee
17620 65995 Approval Prior to 1/1/87 Requirement
Note: Pursuant to AB -181, any mobilehomes being replaced
Number of Sq.Ft. 384 or relocated within the same school district are exempt from
Amount per Sq.Ft. $ 0.00 developer fees. Any additions of 500 sq. ft. or less is also
Amount Collected $ 0.00 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: Leticia C. Torres
Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, require tha is 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 t e 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.
t?t' c;urodocs d:vfi)es%certificate
Of C0111pliance iOLITI U.1111e (0 Util:i.aoe 1/16/03 T
t
Building & Safety Department
78-495 Calle Tampico
PO Box 1504
La Quinta, CA 92253
(760) 777-7012 voice — (760) 777-7011 fax
CERTIFICATION OF BUILDING AREA
STREET ADDRESS OF JOB: 60-392 Lavender Court
APN: 764-380-055
DESCRIPTION OF WORK: Casita Addition .._ .-
SQUARE FOOTAGE: 384 s.f.
OWNER'S NAME: Thomas Lavalle
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
8'.x.9'05 w•�L•
Coachella Valley Unified School District
83-733 Avenue 55
P O Box 847
' Thermal, CA 92274
s (760) 398 5909
SCHOOL FACILITY FEES COLLECTION HOURS. -
8. 00
OURS:8.00 A. M. - 4.00 P.M. Monday - Friday
PLEASE NOTE:
FEES MUST BE PAID IN CHECK OR CASHIERS CHECK. NO CASH.
For questions regarding this letter, please calla
Ed Randall, Counter Technician
(760) 777-7012
'4v,O �=4,r.BG G+� W -«iv +4t, ' jca7 ,'� 06 4
TANDY`S INSPECTION:SERVICES, INC.
PO BOX 13766 - PALM DESERT, CA 92255.3766
a— OFFICE / FAX - 951.769.9717
PAGER 760.776.3339 -
�-SPECIAL INSPECTION DAILY I WEEKLY REPORT
TYPE OF INSPECTION PERFORMED
167 a n
PERMIT NUMBER
TYPE OF STRUCTURE
DATE
PROJECT ADDRESS (BNCLUDESTREETADDRESS AND CRTORcouNTY).
3 12 G�Ypv 0 � 61,
PROJECT NAME( INCLUDECOUNWCLUBIBUSBffSSSPARK=F4PORATE cENIEREcT.NAME)
ARCHITECT
ENGINEER
GENERAL CONTRACTOR
(�• ,vL Gov � /
SUB CONTRACTOR
,t DESCRIPTION OF WORK INSPECTED
0.1 -?s 1i L1E 1� P LA6K A E Ai r 2-0
/Jo icl FLS �X7 41 AE 1 /?. P L A G L A 7 A if" 196"P79
d Q r f
WELDING INFORMATION
WELDERS NAME CERTIFYING AGENCY NAME AND NUMBER PROCESS AND ELECTRODE
SAMPLE INFORMATION
TIME SUPPLIER" TICKET NUMBER MIX NUMBER AIR TEMP SAMPLE SLUMP WATER TIME IN
TEMP ADDED MIXER
LOCATION TAKEN: r ' v K"
LOCATION TAKEN:
/. I HEREBY CERTIFY THAT I HAVE INSPECTED ALL OF THE ABOVE RVORTED WORK. UNLESS
1/ OTHERWISE NOTED. AND TO THE BEST OF MY ABILITY I HAVPFOUNDTHIS WORK TO COMPLY WITH
, THE APPR�LA�ECIFICA�i PLICA LSE BUILDING LAWS.
f
INSPECTORS SIGNATURE
INSPECTORS CERTIFICATION AGENCY AND NUMBER