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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