04-3356 (AR)a><i�
BUILDING & SAFETY DEPARTMENT
- P.O. BOX 1504
(760) 777-7012
7
OFTt�' 79-495 CALLS
TAMPICO FAX (760) 777-7011
LA QUINTA, CA6FORN.IA 92253 INSPECTION REQUESTS (760)777-7153
BUILDING -PERMIT. -
Application Number
.� 04-00003356- Date
4/19/04
Property Address . .
. . . 78705 DESCANSO LN
APN:
646=340—UU8=8 -27-840 -
Application description.. ADDITION - RESIDENTIAL
Property Zoning . . .
. . *LOW DENSITY RESIDENTIAL
Application valuation
9.131
Owner
Contractor
BAGGS RALPH C
------------------------
SAWYER, RONALD.PHILIP
78-705 DESCONSO LANE
78525 AVENUE 41
LA QUINTA
CA 92253 INDIO CA 92201
(760). 200=0893
WCC: HRH INS
WC: 0441988703
10/0.1/04
CSLB: 541336
'09/30/04
CCC.: B
------ -Structure Information-
113 ADDITION
-----
Construction Type
TYPE V - NON RATED
Occupancy Type
DWELLG/LODGING/LONG:<=10.
Flood Zone
NON -AO FLOOD ZONE
Other struct.info . .
. . . CODE EDITION 2001.
FLOOD ZONE NO
FIRST FLOOR SQ. FTG
113.00
------------------------------------------------------
Permit . . .
---------------------
BUILDING PERMIT
Additional desc
113 ADDITION
Permit Fee . . . .
117.00 Plan Check Fee
76.05
Issue Date
Valuation
9131
Qty Unit Charge
Per
Extension
BASE FEE
45.00
8..00 9.0000
THOU BLDG 2,001-25,000
7.2.00
Permit . . . .• . .
MECHANICAL
Additional desc
.Permit Fee
24.00 Plan Check Fee'.
6.00
Issue Date
Valuation
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1:. 00 9.0000
EA MECH APPL- REP/AL-_T-./ADD—
i�,
°,'-_
9.00
-------------=-.----------------------.------=--',-=
---- ------- ------------
Permit
ELECT - ADD/ALT/REM
Additional desc
a
,J
SSI !/
P.O. BOX 1304 VOICE (760) 777-7012
78-493 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 4
INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number. &,)41-335(0 Date: 4-190. 0
Applicant: I Architect or Engineer.
Applicant's Mailing Address:
,I
Architect or Engineer's Address:
Lic. No.
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirn under penalty of perjury that 1 am licensed under provisions of Chapter 9 (eormandng with section 7000) of Division 3 of the Business and Professionals
Code, arid myclass Lioer�is in fulltamand affect. No C- M
OWNER -BUILDER DECLARATION
I hereby aft.. under penalty of perjury that I on exempt from the Contractors' State L kxir s Law for the following reason (Sec. 7031.5. Business and Professions Code: Any
city or county that rewires a permit lo eonsbuct. alter. Wo ve, demolish. or repair any stnuatrm prior to its issuance. also requires the applicant for tie permit torte a signed
'statement 1 at he or she is licensed pursuant 10 the provisions of In Contractors' State License Law (Chapter 9.(commencing with Section 7000) of Division 3 of tie Business
and Professions Code) or that he or she is exempt tiemb om and the basis forChe alleged exemption. Any violation of Section 7031.5 by any sppkw t for a Pam subjects
the applicant to a dvi penalty of not more than five hundred dollars
U 1. 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 rat appy b an owner of property who builds or improves thereon, and who does to work
himself or herself or through his or tar own employees, provided that the improvements are not intended or offered for sale. K, however. the building or improvement is
sold within one year of completion, the ow w4xmlder will have the burden of proving that he or she did not build or improve for the purpose of sale.}
U 1. u owner of tie property. am exclusively contracting with licensed contractors to coristruct the project (Sec. 7044. Business and Professiau Code: The Contractors'
State License Law does not appy to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) ficensed pursuant to
the Contractors' State License Law.).
U 1 am exempt under sec. . BA P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 hereby afrum under penalty of perjury one of the following declarations:
_ 1 have and will maintain a certificate of consent to self-Inwe for workers' cot. rsation. as provided for by Section 3700 of the Labor Code. for the performance
, /of the work for which this permit is issued.
%ool have and will maintain workers' compensation insurance. as required by Section 3700 of the Labra Code. for the performance of the work for which ries permit is
issued.wtoleorkers. compensation insurance racier and pol cV number are.
. _ I certify riot, in the perform a hceIN the work for which this permit is issued. I chap not employ any person in any manner so as to become subject to tie workers'
compensation taws of Caifamia, and agree that, 91 should become subject b the workers' compensation provisions of Section 3700 of to Labor Code. l shad
fonthw4th comply with Case
�i. •Zo-o� ��r �
WARNING: FAILURE TO SECURE WORKERS' C040FiSATION COVERAGE IS UNLAWFUL., AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES LIP TO ONE HUNDRED THOUSAPP DOLLARS (1100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST. AND ATTORNEY'S FEES. .
CONSTRUCTION LENDING AGENCY
1 hereby affirm under penalty of perjury that Care is a construction pending agency for the performance of the work for which Ctrs Permit Is issued (Sec. 3097. Civ. C.).
Lender's Name
Lenders Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby mode 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 arty permit
Issued as a result of this application, the owner. and the applicant. each agrees to, and shall, defend. indemnity end told harmless the City of La Oukda, its
officers. agents and employees for any act or omission related to the work being performed under or following issuance of this perrtrt.
2 Any permit Issued as a result of this application becomes mop and void it work is not commenced within 160 days from date of issuance of such Permit. or
cessation of work for 160 days will subject permit to cancellation.
I ow" that I have read this application end state that the above int mmation is correct. I agree to comply with all city and county ordinances and state laws relating to buYding
construction. and thereby auChortze representatives of Chis eller upon y for inspection purposes.
�Ds* �v nature (Applicarht or Agent).
Page
2
Application Number .
. . . .
04-00003356 Date
4/19/04
Permit Fee
19.50
Plan Check Fee
4.88
Issue Date . . .
Valuation . . . .
0
Qty Unit Charge
Per-
Extension
BASE
FEE
15.00
6.00 .7500
PER ELEC
DEVICE/FIXTURE 1ST 20
4.50
7 ----------------------------------------------------------------------
Special Notes and Comments
113 S.F. ADDITION PER
APPROVED
PLANS.
----------------------------------------------------------------------------
Other Fees . . . .
ART IN PUBLIC PLACES -RES
.00
ENERGY REVIEW FEE
7.61
STRONG MOTION (SMI) - RES
.91
Fee summary Charged
-----------------
Paid 'Credited
Due
----------
Permit Fee Total
160.50
------------------------------
.00 .00
160.50
Plan Check Total
86.93
.00 .00
86.93
Other Fee Total
8.52
.00• .00
8.52
Grand Total
255.95
.00 .00
255.95
Building /
Address
Owner 'n
11
4 4 "
P.O. BOX 1504
78-495 CALLE TAMPICO
kNFLA QUINTA, CALIFORNIA 92253
maltinAddress -7�-i� _b��D Ib" I
Zip q77:�3 ITel.
Zip qn o Tel t
State Ljc.` t City
8 Classif. I nn��� / Lic. #
Des
Arch., E� �L GL�►al/L I p-��
Address31hCNHIND S Tel.
City/Zip n ; State
(� Li #
LICENSED CONTRACTOR'S DECLARATION
I hereb fi that I am Ilcen under provisions of Chapter 9 (commencing with Section
7000) of 1 i' ` f th mess a Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
What
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 (8500).
I: 1, 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, Buisness and
Professions 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. If, however, the building
or improvement 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.)
I 1 I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct 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.)
f] 1 am exempt under Sec. B. 8 P.C. for this reason
Date Owner
WORKERS' 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 ce ified co tfW{e�f. ($qc. 3800, Labor Code.)
P 'cy No. Company lJ�..(� NSJ
I
Copy is filed with the city. ❑ Certified copy is hereby furnished.
C
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 workforwhich 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.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, ybu must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby 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 a0plicant Date
Mailing Address
City, State, Zip
0 ly_--335�4
APPLICATION ONLY
BUILDING: TYPE'CONST. OCC. GRP.
A.P. Number
Legal Description Z,
'7
Project Description 1/ 7 i��� r T�l7 N
Sq. Ft
No.
No. Dw.
Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
infrastructure
TOTAL
REMARKS
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 INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE
Date
4/20/04
No.
25810
Owner
Mr. Baggs
Address
78705 Descanso Lane
City
La Quinta Zip 92253
Tract #
Type
Residential Addition
Lot #
Unit 1 8
Unit 2
Unit 3
Unit 4
Unit 5
Comments
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515
No. Street
78705 Descanso Lane
S.F.
113 Unit 6
Unit 7
Unit 8
Unit 9
Unit 10
APN #
Jurisdiction
Permit #
Study Area
No. of Units
4 J�1F1EDscyo
o
Q BERMUDA DUNES r
V) RANCHO MIRAGE
N INDIAN WELLS
to' PALM DESERT ,y
LA QUINTA
Q INDIO L�
O
646-340-08
La Quinta
1
Lot # No. Street S.F.
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patioshmalkways, 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:
Residential Addition 500 Sq Feet or Less
EXEMPT
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $0.00 X 113 S.F. or $0.00 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 Exempt - Michelle Sawyer Check No.
Name on the check Telephone
Funding Exempt
By Dr. Doris Wilson
Superintendent
Fee collected
Signature
Payment Recd
Over/Under
NOTICE: Pursuant to Government Code Section 66020(d)(1), tiif�`will serve to notify you that the 90 -day approval period in which 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 if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting