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07-2734 (SFD)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: 2/20/08 Application Number: 07-00002734 r Owner: Property Address: 78250 WINNIE WY DEXTER & GINA WILLIAMS - APN: 770-340-010- - 11826 DOROTHY STREET APT 201 Application description: DWELLING -.. SINGLE FAMILY DETACHED LOS ANGELES, CA 90049 Property Zoning: LOW DENSITY RESIDENTIAL D Appliootion 'aoluation: 424053 Contractor: AN Applicant: Architect or Engin r: SUN VISTA DEVELOPMENT CORPCiUINTA P . O . BOX 1144 Ci1T�( ®� #Ierj FINANCE DEPT. LA QUINTA, CA 92247 (760)771-4722 Lic. No.: 744091 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 lass: B - License No.: 744091 for by Section'3700 of the Labor Code, for the performance of the work for which this permit is issued. Z, Dat ontractor.�. _ 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: - 1 -hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the - Carrier 'STATE' FUND Policy Number 0000179-2007 following reason (Sec. 7031.5, Business and Professions Cade: Any city or county that requires a permit to I certify that, in the performance of the work foi,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 Labor Code, I shall forthwit ly 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).: ate �7� "`� Applicant: v-- (_ 1 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 SECURE 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.). APPLICANT ACKNOWLEDGEMENT (_) • I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is. hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code% The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. - property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_ 1 I am exempt under Sec. , 8.&P.C. for this reason 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. ' Date: Owner: .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 CONSTRUCTION LENDING AGENCY permit to cancellation. I he'reby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and hereby authorize representatives . of. this cou"toenterponthe above-mentioned propert or in ection pur oseLender's Name:L Date. nature (Applicant or Agent)t-ir�✓j�J Lender's Address: - _ LQPERVIIT Application Number 07-00002734 -----.'Structure ,-Information ,'4888 SF SFD. ----- Other struct info . . ... . CODE EDITION 01BMP04E05EN # BEDROOMS 4.00 FIRE SPRINKLERS NO GARAGE SQ FTG 847.00 PATIO SQ FTG 940.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 4888..00 Permit BUILDING PERMIT Additional desc 4888 SF (LIVING)'SFD Permit Fee : . . 1777.00 Plan Check Fee 1155.05 Issue Date . . . Valuation 424053 Expiration Date 8/18/08 Qty Unit Charge Per Extension" BASE FEE 639.50 ' 325.00 3.-5000 THOU BLDG 100,0.01-500,0'00 1137.50 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . 219.88 Plan Check Fee*. 54.97 Issue. Date, Valuation 0 Expiration Date 8/18/08 Qty Unit Charge Per Extension BASE FEE 15.00 4888.00 :0350 ELEC NEW RES - 1 OR 2 FAMILY 171.08 940.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 18.80. 1.00 15.0000 ------------------------------------------------------------- EA ELEC TEMPORARY POWER POLE - --------------- 15.00 Permit . . . . . MECHANICAL. . Additional desc Permit Fee . . 170.00 Plan Check Fee 42.50 Issue. Date Valuation . . . 0 Expiration Date 8/18/-08 Qty Unit, Charge Per Extension BASE FEE 15.00 5.00 9,0000 EA. MECH FURNACE <=100K 45.00 5.00 9.0000 EA MECH B/C <=3HP/100K.BTU. 45:00 9.00, 6-.5000 EA MECH VENT FAN. 58.50 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 LQPEMWIT - - - L, - Application Number 07-00002734 ' Permit -PLUMBING Additional desc Permit Fee . . . 199.50 Plan Check Fee 49.88 Issue Date Valuation- 0 Expiration Date 8/18/08 Qty Unit-Charge. Per. Extension BASE FEE 15.00 21.00 6.0000 EA PLB FIXTURE 126.00 1.44 15.4449 EA PLB BUILDINC CEWER 15.00' - 1..00 7.5000 EA PLB WATER HEATER/VENT 7.50 3.00 3.0000 EA PLB WATER INST/ALT/REP, 3.00 1..00 9.0000 EA_ PLB LAWN SPRINKLER SYSTEM 9.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 8.0,0 .7500 EA PLB GAS PIPE >=5 6.00 1.00 15.0000 EA _- PLB GAS METER._ ---------------------------------------------------------------------------- 15.00 - Permit GRADING PERMIT Additional desc Permit Fee 15:00 Plan.Check Fee .00 Issue Date . . . Valuation 0 Expiration Date 8/18/08 Qty Unit Charge _Per Extension BASE FEE 15.00 Special Notes and Comments - 4888 SF (LIVING) SINGLE FAMILY DWELLING, R-3 OCCUPANCY, TYPE V-N CONSTRUCTION. 2001 CBC,CMC,CPC,. 2004 CEC, 2005 ENERGY CODES. PERMIT EXCLUDES WALLS/POOL /DRIVEWAY APPROACH. NOTE: COMPLIANCE WITH ALL FEDERAL & STATE LAWS, INCLUDING -THE •ENDANGERED SPECIES ACT OF 1973 IF APPLICABLE,IS ' REQUIRED. . Other Fees . . •ART IN PUBLIC PLACES-RES 560.13 DIF COMMUNITY CENTERS-RES .74.00 DIF CIVIC .CENTER - RES 995.00 ENERGY REVIEW FEE 115.51 DIF FIRE PROTECTION-RES 140.00 r DIF LIBRARIES - RES 355.00 -DIF PARK MAINT FAC - RES 22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION.(SMI) - RES 42.40 Application Number . . . . . 07 -00002734, ------------- Other Fees DIF STREET MAINT FAC•=RES 67.00 DIF.TRANSPORTATION - RES .1930.00. .Fee summary Charged Paid Credited- Due Permit Fee Total 2381.38 .00 .0.0 2381.38 Plan Check Total 1302.40 500.00 .00 802.40 Other Fee Total 5193.04 .00. 00 5193.04 Grand Total 8876.82 500.00 .00- 8376.82 - LQPERAIIT - - 1 ` - P.O. BOX 1504 � 78-495 CALLS TAMPICO APPLICATION ONLY Building q _ �S� �� • 1 Address O 1 Y1 T''11 r \w�L1t� OUINTA, CALIFORNIA 92253 owner 1 � � Q � �Q;K4w_Y— W X 11 I �,y�rs BUILDING: TYPE CONS_To% OCC. GRP. A.P. Number_ 1 Legal Description Project Description �� w►) �. Mailing Address ©, 3 px 1 `� 4 City L4 (? v I r4TA- Zip Z Z-5- ,sContra Tel. ; i _ y .1 ZL Contraor Addre Ity Qv I Zip . Tel. �i-z z.s3 -711 tet-) ZZ Sq. Ft. u -8 V Q rP No. No. Dw. Size 1 0 a Stories Units State Lic. City & Classif. -74 Lic. # Arch., Engr ,� Designer W� New J--- Add ❑ Alter ❑ Repair ❑ Demolition ❑ Addrl,, sully Lip Jiaie �+H C1 rw I "12-�O -) I Lic. # C� LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I a licensed under provisions of Chapter 9 (commencing with Section 7000) of Division of i Busi ss and Professions de, and my license is in full force and effect. SIGNATURE DATE OWNER -BUILD ECLARATIO 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 hprovi3 of tsions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of 'vision he Business and Professions Code, or that he is exempt therefrom, and the basis /o he alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the plicant to a civil penalty o/ not more than five hundred dollars (5500). ❑ I, a owner of the property, or my employees with wag their sole compensation, will do the wor and the structure is not intended or offered for ale. (Sec. 7044, Business and Profes- sions Co :The Contractor's License Law dInot ap ly to an owner o/property who builds or improve hereon and who does such worelf r through his own emplo ees, provided that such im ovements are not intended od or sale. If, however, the building or Im- provement is Idwithin one year o/ compa owner -builder will have the burden of proving thdnotbuild or improve for tose of sale). 0 I, as owner of t property, am exclusivelycting with licensed contractors to construct the project. (Sec. 44, Business and ProfeCode: The Contractor's License Law does not apply to an owns of property who buildsproves thereon, and who contracts for such projects with a contra or(s) licensed pursuhe Contractor's License Law) O Iam exempt under S 8.for this reason WORKS 'S C MPENSATION DECLARATION I hereby affirm that I have a c 'tate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a cert ed copy thereof. (Sec. 3800, Labor Code.) Policy No. /manner p y ❑ Copy is filed ❑ C 'tied copy is hereby furnished. ICATE F EXEMPTION FROM ' COM NSATION INSURANCE (This section need ed if the p it is /or one hundred dollars ($100) valuation or less). I certify that in ce of the wor for which this permit is issued, I shall not employ any person io as to becom ubject to Workers' Compensation Laws of California. Date Owner NOTICE TO AP (CANT. If, after making this Certi/ica of Exemption you should become subject to the orkers' Compensation Provisions of t Labor Code, you must forthwith comply with ch provisions or this permit shall be deeme evoked. CONSTRUCTIOPhENDWG AGEN /h.b y affirm that there is a construction lending agency f\validate mance of the work for hispermit is issued. (Sec. 3097, Civil Code.) Lename _ Lender's Address This is a building permit when properly filled out, signed a, 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. ,1 Signature of applicant Date Mailing Address City, State, Zip WHITE = BUILDING DEPARTMENT Estimated Valuation PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS b7- �R LA AMOUNT ZONE: BY: Minimum Setback Distances: Front Setback frDm 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 j Validated by: - p Validation: YELLOW = APPLICANT PINK = FIAANCE CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road ¢BERMUDA DUNES O RANCHO MIRAGE CJ Date 6/27/08 La Quinta, CA 92253 INDIANWELLS PALMDESERT No. 30100 (760) 771-8515 �� LA QUI NTA TA INO 0 y� 0 Owner Dexter Williams APN # 777-340-010 Address 78-250 Winnie Way Jurisdiction La Quinta city La Quinta Zip 92253 Permit # Tract # No. of Units 1 Type Single Family Residence Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 78250 Winnie Way 4888 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments $0.14 change from petty cash. At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, residential additions under 5 00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating cr sanitation) or replacement mobile ho mes. 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 4,888 S.F. or $14,517.36 have been paid for the property listec 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, Bill Leddy Check No. 418116291 Name on the check Telephone 275-9734 Funding Residential By Dr. Sharon P. McGehee Superintendent Fee collected /exe p ed by Patric Barbuzza Payment Recd $0.14 -� $14,517.50 "-r/Udder' 4 Signature ' NOTICE: Pursuant to Government Code Section 66690(d)(1), this will serve to notify you that the 90 -day approval perioc in which you may protest the fees o r 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 J