06-3238 (AR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00003238
Property Address:
60595 WHITE SAGE DR
APN:
764-270-999-71 -300231-
Application description:
ADDITION - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
15172
T4ht
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
l
Owner:
PAUL BOTTIAUX
60595 WHITE SAGE DR.
LA QUINTA, CA 92253
(714)420-0530
Contractor:
CLASSIC BUILDERS, INC.
45-475 CLUB DRIVE
INDIaN WELLS, CA 92210
(760)772-1991
Lic. No.: 691405
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/08/06
-------------------------------------------------------------------------------------------------
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.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: B L' ense No.: 691405
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
9a /_ tractor: : �.
_r 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
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier EXEMPT Policy Number EXEMPT
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labo Code, I shall forthwith comply with those provisions.
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).:
e: plicant:
(_) 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
WARNING: FAILURE TO SECU WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
1 _ 1 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
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 and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the ove-mentioned p [y for inspectio /p ose
D�t :�/i3v Si ture (Applicant or Age _ C.G/��
Application Number . . . . . 06-00003238
Permit .
. . . . .
ELECT - ADD/ALT/REM
Additional
desc . .
Permit Fee
23.93 Plan Check Fee
5.98
Issue Date
. . . .
Valuation
0
Expiration
Date . .
5/07/07
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
255.00
----------------------------------------------------------------------------
.0350
ELEC NEW RES - 1 OR 2 FAMILY
8.93
Permit
. . .
BUILDING PERMIT
Additional
desc . .
Permit Fee
. . . .
171.00 Plan Check Fee
111.15
Issue Date
. . . .
Valuation . . . .
15172
Expiration
Date . .
5/07/07
Qty
Unit Charge
Per
Extension
BASE FEE
45.00
14.00
------------------------------------------------------
9.0000
THOU BLDG 2,001-25,000
Z.
126.00
. . .
MECHANICAL
Additional
desc .
Permit Fee
. . . .
39.50 Plan Check Fee
9.88
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date . .
5/07/07
Qty
Unit Charge
Per
Extension
BASE FEE
15.00
1.00
9.0000
EA MECH FURNACE <=100K
9.00
1.00
9.0000
EA MECH B/C <=3HP/100K BTU
9.00
1.00
----------------------------------------------------------------------------
6.5000
EA MECH VENT FAN
6.50
Permit
. . .
PLUMBING
Additional
desc .
Permit Fee
. . . .
61.50 Plan Check Fee
15.38
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
5/07/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
5.00
.6.0000
EA PLB FIXTURE
30.00
1.00
7.5000
EA PLB WATER HEATER/VENT
7.50
1.00
3.0000
EA PLB WATER INST/ALT/REP
3.00
2.00
3.0000
EA PLB GAS PIPE 1-4 OUTLETS
6.00
LQPEUIIT
_:O -
LQPERAIIT
Application Number
. . . . .
06-00003238
----------------------------------------------------------------------------
Special Notes and
Comments
255 SQ. FT. CASITA AND 44 SQ.
FT.
PATIO.November 1,
2006 3:02:32
PM
JJOHNSON
----------------------------------------------------------------------------
Other Fees . . .
. . . . . .
ENERGY REVIEW
FEE
11.12
STRONG MOTION
(SMI) - RES
1.51
Fee summary
Charged
Paid
----------
Credited
----------
Due
-----------------
Permit Fee Total
----------
295.93
----------
.00
.00
295.93
Plan Chccls Total
113.39
.00
nn
149 "19
Other Fee Total
12.63
.00
.00
12.63
Grand Total
450.95
.00
.00
450.95
2�
City of La Quinta
Building U Safety Division
P.O. Box 1504, 787495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
ll_ �
lY' �2
Project Address: 105-2 [��� S , I
411.
Owner's Name: L
A. P. Number: 33 ._.-Q
'Address: /
Legal Description:
Contractor:
City, ST, Zip:
Telephone: •
Address:
Project Description:
City, ST, Zip:
Telephone:
State Lic. # : City Lic. #:
Arch., Engr., Designer:
•
JIM
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: �(,{(� ux
Sq. Ft.:
# Stories#Units:
Telephone # of Contact Person: 7 ' q t94 - -711 7
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
5
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan.Check Deposit
Truss Cales.
Called Contact Person
Plam Check Balance
Energy Cales.
d
Plans picked up
Construction
Flood plain plan
Plans resubmitted Z
p6
Mec_ianical
Grading plan
gnu Review, ready for correction ssue
`•
Elec_rical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALI.
H.O.A. Approval
Plans resubmitted
Grating
IN HOUSE:-
'"' Review, ready for corrections/issu
Developer Impact Fee
Planning Approval
Called Contact Person
A.I .?.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Totil P
f.5� dCf�Du� �Iy�D� ���F1�a(o -�VCp D�� 103
q��2 y15 1z VC l0/2�(66 57lLAPPR�v
o� 572 ZFG
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is ow Ir 1 IL19
• coo APPROwe
F r -AI
°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:
LEVELTWOAMOUNT
MITIGATION AMOUNT:
COMM/MD. AMOUNT:
DATE:
RECEIPT:
CHECK #:
INITIALS:
CERTIFICATE OF COMPLIANCE
(California Education Code 17620)
Project Name: PAUL BOTTIAUX Dzte: NOVEMBER 3, 2006
Owner's Name: PAUL BOTTIAUX Phone No. (714) 420-0530
Project Address: 60-595 WHITE SAGE AREA DR.
Project Description: ROOM ADDITION
APN: 764-330-027 Tract #: Lot #'s:
Type of Development: Residential XX Commercial Industrial
Total Square Feet of Building Area: 255 sq. feet
Certification of Applicant/Owners: The person signing certifies that the above information is -orrect and makes this statement under
penalty of perjury and further represents that he/she is authorized to sign on behalf of the ownerMeveloper.
Dated: 11/03/06
Signature: PAUL BOTTIAUX (RECEIVED BYFAX)
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
17620 65995 Approval
Number of Sq.Ft. 255 sq. ft.
Amount per Sq.Ft. $ 0.00
Amount Collected $ 0.00
Building Permit Application Completed: Yes/No
By: Carey M. Carlson, Asst. Supt., Business Services
Certificate issued by: Leticia C. Torres, Facilities Analyst
Agreement Existing Not Subject to Fee
Prior to 1/1/87 Requirement
Note: Pursuant to AB -151, 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.)
NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENX OF FEES
Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this 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 the )0 -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.
MV:c/mydocs/devfees/certificate of compliance form tablesTO USE.doc 1/16/03 T