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05-0625 (SFD)-P.O. BOX 1504 t ,� ^� VOICE (760) 777-7012 ' y, 78-495 CALLE TAMPICO Y- ,' + t FAX (760) 777-7011;; LA QUINTA, CALIFORNIA -92253 - . _ ; . BUILDING &SAFETY• DEPARTMENT ,+' "INSPECTIONS (760) 777-7153 - BUILDING PERMIT *' Date' , 6/28/06 ' ..Application Number: 05-00000625 Owner: Property Address: 80340 VIA PESSARO ' M/M WILLIAM PEDERSON w, ' „APN: 772-550-001- - + t 5095 NAPILIHAU ST '# 187 Application`description: DWELLING - SINGLE FAMILY DETACHED LAHAINA HI 96761 1' Property Zoning: ;LOW DENSITY RESIDENTIAL } Application valuation: - 345791 , + rt. • - `` t Contractor: !tl ��U9P1TA• <F Applicant: Architect or Engineer PEDERSON HOMES INCORPORATED CITY OF " ° `,,.. • 50-855 WASHINGTON ST, C288 FINANCE DEPT LA QUINTA, CA 92253_ , '• a f;r (760)969:-2266 Lic.,No. - 873201 • tt L LICENSED CONTRACTOR'S DECLARATION ••r 'r t .WORKER'S COMPENSATION DECLARATION • _ ; N' ,, P 'I hereby affirm under penalty of perjury that 1 am -licensed under provisions of Chapter 9 (commencing with - I herebyaffirmunder penalty of perjury one of the following declarations: , -_ t" - a a �"', '''1'• - ' 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' a ,- N License.Cl s: —.� License 873201 ' '.; r - " k _ �.- ^ for by Section 3700 of theLabor Code, for the performance of the work for which this permit is } M /J,,�� issued. ' �Date'46_6�Ni0� Contractoc,� ' >�'",/ ^ r' �. ,_ I have and will maintain' workers' compensation insurance, as required by Section 3700'of the Labor, •'? , .i ;`"'� • " ' ' • w� �; " Code, for the performance of the work for which this permit is issued. My workers' compensation- • OWNER -BUILDER DECLARATION `.. `� L '�' _ , ' insurance carrier and policy number are: • it thereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier •EXEMPT Policy Number •' EXEMPT • • _ ' C�• 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 d• ; person in any manner so as to become subject to the workers' compensation laws of California,'- • ' 'permit to files 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 '• 3,700 of the Labor�71 I o ith comply with those provisions. - , y ` ••^ ' ' d' •--tthat he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 byny applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (55001.: ,I Date: Appicant: •a (_ ) I, as owner of the property, or my employees with wages as their sole compensation; will do the work, and . •���- - - ,, '` 1 ° ," 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 . t' • 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 r 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 orshe did'not build or • - 6 ' - "' - improve for the purpose of sale.). - i, - _ APPLICANT ACKNOWLEDGEMENT' > + 1—) 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, I am exempt under Sec. , B;&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 hereby 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.). - ._r- city and county ordinances and state laws relating to building cons coon, and hereby authorize representatives _ _ . �.) -+• ., of this coup y to mer upon the abo-ve-mentioned property f e do urpo as. . Lender's Name: .,'. s • ,,,,�-^� _ Date: Signature IA_pplicant or Agent): _ Lender's Address: 't LQPERMIT , • ^ s _ -• Application Number . . . . 05-00000625 ------ Structure Information SFD ----- Construction Type . . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . NON -AO FLOOD ZONE Other struct info . . . . CODE EDITION 2001- 001BEDROOMS BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 1008.00 PATIO SQ FTG 450.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 3961.00 Permit BUILDING PERMIT Additional desc.. Permit Fee 1500.50''. Plan Check Fee 975.33 Issue Date . . . 2/10/06 Valuation 345791 Expiration Date 8/09/06' - Qty Unit Charge Per Extension 'BASE FEE 639.50 246.00 3.5000 THOU BLDG 100,001-500,000 861.00 Permit ELEC-NEW RESIDENTIAL Additional desc . Permit Fee 188.80 Plan Check Fee 47.20. Issue Date 2/10/06 Valuation 0 -•\, Expiration Date 8/09/06 Qty Unit Charge Per Extension BASE FEE 15.00 :a 3961.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 138.64 1008.00 0200 ELEC GARAGE OR NON-RESIDENTIAL 's 20.16 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00. Permit GRADING PERMIT Additional desc . Permit Fee . . . . 15:00 Plan Check'Fee . .00 Issue.Date . . . . 2/10/06 Valuation' 0 Expiration Date 8/09/06 Qty Unit Charge Per Extension BASE FEE 15.00 Permit . . . . . . MECHANICAL LQPERMIT Application Number 05-00000625 Permit . . MECHANICAL Additional desc . Permit Fee . . . . 126.00 Plan Check Fee 31.50 Issue Date . . . . 2/10/06 Valuation . . . 0 Expiration Date 8/09/06 Qty Unit Charge Per Extension ' - BASE FEE 15.00 4.00 9.0000 EA MECH FURNACE <=100K 36.00 4.00 9.0000 EA MECH B/C <=3HP/100K BTU 36.00 . 5.00 6.5000 EA MECH VENT FAN 32.50 1.00 6.5000.EA MECH.EXHAUST HOOD 6.50 Permit PLUMBING Additional desc Permit Fee 196.50 Plan Check Fee_ 49.13 Issue Date . . . . 2/10/06 Valuation 0 Expiration Date 8/09/06 Qty Unit Charge Per Extension a-: BASE FEE _ 15.00 20.00. 6.0000 EA PLB FIXTURE 120.0.0 _ 1.00 15.0000 EA PLB BUILDING SEWER 15.00 2.00 _ 7.5000 EA PLB WATER HEATER/VENT 15.00 a5. 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00.- 6.00 .7500 EA PLB GAS PIPE >=5• 4.50 1_00----_---15_0000_EA- PLB GAS METER ------- --"--------------------- ---------_---._15_00- Special Notes and Comments SFD - (3,961 sgft) Permit does -not include block wall, pool or driveway. approach.6-28-06 CHANGE TO PEDERSON HOMES INC AS GENERAL CONTRACTOR -- - Other Fees. . . . . . - - - - - - - -- ------------------------- . ART IN PUBLIC PLACES -RES ------------- 364.47 CHANGE OF CONTRACTOR 4.50 DIF COMMUNITY CENTERS -RES .97.00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 97.53 DIF FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 225.00 DIF PARK MAINT FAC - RES 5.00 DIF PARKS/REC - RES 502.00 STRONG MOTION (SMI) - RES 34.57 DIF STREET MAINT FAC -RES 15.00 LQPERMIT _. P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 1Z Property Address: APN: Application description: Property_ Zoning: Application valuation: Applicant: T4ht " BUILDING & SAFETY DEPARTMENT t BUILDING PERMIT 05-0000062-5__ 80340 VIA PESSARO 772-550-001- - - DWELLING - SINGLE FAMILY DETACHED LOW DENSITY RESIDENTIAL 345791 Architect or Engineer: Owner: M/M WILLIAM PEDE 5095 NAPILIHAU S LAHAINA HI 96761 Contractor: Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 ' W� Date: 2/10/06 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 1 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: License No.: _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: Contractor: - 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 Policy Number , following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to ] 1 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 becom subject to the workers' .compensationprovisions of Section License Law (Chapter 9 (commencing with Section, 7000) of Division 3 of the Business and Professions Code) or 700 of the Labor Cod , I,���}}}t 'th comply with those provisions. - that he or she is exempt therefrom and the basis fr 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).: // 'D'r ate �0 Applicant 1—) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and l�!�1 the structure is not intended or offered for sale ISec. 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 (X) 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, I—) I am exempt under Sec. , B.&P.C. for this1pason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City 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.I. Lender's Name: Lender's Address: LQPERMIT 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. 1 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 above-mentioned property for"pWtionyurposes. Application Number . . . . . 05-00000625 ------ Structure Information SFD ----- �r Construction Type . . .. . . TYPE V - NON RATED Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10 Flood Zone . . . NON -AO FLOOD ZONE �. Other struct info . . . . . CODE EDITION 2001 # BEDROOMS 3.00 FIRE SPRINKLERS NO GARAGE SQ FTG 1008.00 PATIO SQ FTG 450.00 NUMBER OF UNITS 1:00 1ST FLOOR SQUARE FOOTAGE 3961.00 r . Permit . . . BUILDING PERMIT Additional desc . Permit Fee 1500.50 Plan Check Fee 975.33 - Issue.Date Valuation . . . . 345791_. Expiration Date .5/28/06 . Qty -Unit Charge Per Extension BASE FEE - 639.50 ; 246.00 3.,5000 THOU .BLDG 100,001-500,000 - .861..00 Permit . . . ELEC-NEW RESIDENTIAL Additional desc Permit Fee 188.80 Plan Check Fee 47.20 Issue Date:, Valuation . . . . 0. Expiration Date 5/2$/06 Qty Unit Charge Per Extension BASE FEE 15.00 3961.00 .0350 ELEC NEW RES - 1 OR,2* FAMILY 138.64 " 1008.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL 20.16 1.00 15.0000 EA I ELEC TEMPORARY POWER POLE' 15.00 Permit GRADING PERMIT' Additional desc . Permit Fee 15.00 Plan.Check.Fee. .00 Issue Date Valuation 0 Expiration Date 5/28/06 Qty Unit Charge Per Extension �. BASE FEE 15.00. Permit . . . . . MECHANICAL LQPERMIT Application Number . . . . . 05-00000625 Permit . . . MECHANICAL Additional desc . �.- Permit Fee . . .. 126.00 Plan Check Fee 31.50 Issue Date . . . Valuation 0 Expiration,Date 5/28/06 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 9.0000 EA MECH FURNACE <=100K 36.00 4.00 9.0000 EA MECH B/C <=3HP/100K BTU 36.00 5.00 6.5000 EA MECH VENT FAN 32.50 1_00 6.5000 EA MECH EXHAUST HOOD 6.50 Permit PLUMBING' Additional desc . Permit Fee . . . . 196.50 Plan Check Fee 49.13 Issue Date Valuation 0 Expiration Date 5/28/06 Qty Unit Charge Per Extension BASE FEE 15.00 20.00' 6.0000 EA PLB FIXTURE 120.00 - 1.00 15.0000 -EA PLB BUILDING SEWER 15.00 2.00 7.5000 EA. PLB'WATER HEATER/VENT 15.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 ' 6.00 7500 EA PLB GAS PIPE >=5 4.50 - 1.00- 15.0000 EA PLB GAS METER _ 15.00 - -------------------------------------------- Special Notes and Comments SFD - (3961-sgft)._Permit does not include block wall, pool'or driveway. approach., ----------------------------------------------------------- Other Fees . . ... : . . . ART IN PUBLIC PLACESLRES 364.47 DIF COMMUNITY CENTERS -RES 97:00 DIF CIVIC CENTER - RES 366.00 ENERGY REVIEW FEE 97.53 DIF'FIRE PROTECTION -RES 97.00 GRADING PLAN CHECK FEE .00 DIF LIBRARIES - RES 225:00 DIF PARK MAINT* FAC '- RES 5..00 DIF PARKS/FEC - RES. 5,02.00 STRONG MOTION (SMI) ' RES 34.57 DIF STREET MAINT FAC -RES 15.00 DIF TRANSPORTATION - RES --1098.00 -- Fee summary Charged Paid Credited Due LQPERMIT Application Number . . . . . 05-00000625 : Permit Fee Total 2026.80 .00 .00 2026.80 Plan Check Total 1103.16. 500.•00 .00 603.16 Other Fee Total 2901.57 .00 .00 2901.57 Grand Total 6031.53 500.00 .00 5531.53 LQPERMTT .. , D Q 444" FEB 2005 BOX 1504 Buil in d J P.O.78-495 CALLE TAMPICO Adores-3--T�=-� LA QUINTA, CALIFORNIA 92253 Mailing Address tsbo L_^`Z,1EWOOX) 'be,, City C. Zi Tel. Lo3z, o � )A 0 Aaaress Pro lam, I b4 L1 State Lic.% City �O9 (0 O & Classif. '� CJ Lic. # i © Arch9ilei Engr., DesibiF Cik Altvv Ren- I M C, Address ,,Tel, 7.1 `-�?� W -o 00 WI 1 '?1)-`76 ILIC. #+'g$'70I LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE 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 ($500). ❑ 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 Profes- sions 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 im- provement 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). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct _ 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) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKER'S COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation nsuranc or a certified copy thereof. (�. 3800nLabor Code.) Policy No.. Company-S'71A 4�flwa_.L�. ❑ Copy is filed with the city. O Certified copy is hereby furnished. 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 work for which this permit is issued, I shall not employ any person in any manner so as to become subject to 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, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby 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 applicant Date Mailing Address City, State, Zip O APPLICATION ONLY BUILDING: TYPE CONST. OCC. GRP. 7 7Z S.:o-ave A.P. Number Legal Description— Project escription Project Description SFt. Size Stories / Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ n�7,4 c Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. �Q 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 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: COMMAND. AMOUNT: DATE, RFr.F.IPT- r..HFCK H- INITIAI.S• CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: Residence is ataThe Hideaway Date: February 9, 2006 Owner's Name: Dan Anderson Phone No.. Project Address: 80-340 Via Pessaro La Quinta, CA Project Description: Single family residence APN: 772-550-001 Tract #: Lot #'s: 187 Type of Development: Residential 1 X Commercial Industrial Total Square Feet of Building Area: 3,961 sq. ft. 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 the owner/developer. Dated: February 9, 2006 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 Number of Sq.Ft. 3,961 Amount per Sq.Ft. $2.88 Amount Collected $11,407.68 Building Permit Application Completed: Yes/No , By: Carey M. Carlson, Asst. Supt., Business Services _ Certificate issued by: Elvira Mattson, Office Technician Signature: c NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT 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 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 maybe 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., tlV:cim die idevlcea;ecrtiiieat� t;fccmpliance 1�)rm u ble l'O USE.doe 1/16/03 T Application Number 05-00000625 ; ---------------------------------------_-------------------- ' Other Fees. . . . . . . DIF TRANSPORTATION RES 1098.00 Fee summary .------------------ Charged Paid Credited Due Permit Fee Total ---------- 2026.80 ------- --- ---------- ---------- 2026.80 .00 .00 Plan Check Total 1103.16 1103.16 .00 .00 Other Fee Total 2906.07 2901.57 .00 4.50 Grand Total 6036.03 6031.53 .00 4.50 LQPERMIT - , Bin # City�of La Quinta Building u Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit.# ?� Project Address: pl��,50. Owner's Name: A. P. Number: Address: Legal Descriptio City, ST, Zip. j 2Z53 Contractor: r{—^/C. Telephone:. Project Description: 5 i l?&j T714.t, Address: City, ST, Zip: Telephone: State Lic. # : City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic: #: Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACEI NG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan. Plans resubmitted Mechanical Grading. plan' tad Review, ready for correctionsrssue Electrical Subcontactor. List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval: Plans resubmitted Grading . IN HOUSE:- '^' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person t A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees WEDDLE J • SURYEYING,MAPPING, INC.. Boundary • Construction • Topographic -'Aerial Surveys • ALTA Surveys •.GPS • Consulting., July 28; 2006 Mr. =Tim' R.. Jonasson Public' Works Director / City Engineer City of La Quinta x 78495 Calle Tampico La Quinta;-"CA ' 92253.1504 -Re: Pad/Form Grade Verification '4-Ci a umta:: ; :�-//-Lot, 187 Tract No. 29894-2 Amended 0-340 VIATESSARO - . THE'HIDEAWAY -APN 772=550-001'` 4,1',• " Dear Mr. -Jonasson: _ We -have performed- a f eld .survey to determine the vertical'' location of the building pad = - - Fy: andform'for the-above referenced project. The-elevation's observed are as follows: PAD (DESIGN) -PAD (AS BUILT) ,,•1015.0 • to 14.9 < . . • .FORM (DESIGN) F0RM4-(AS-BUILT)~ 1.015.50 10 15.51 . LL These "field-observations- are ,in substantial- conformance with the-precise grading plan 'prepared,by ESSf'SHAHANDEH, CIVIL`ENGINEER; dated 10/04 ,and the building. - honzontal' .location substantialfy conforms .to the required setbacks..,and site layout as" shown on the approved' site plan: Sincerely _ J - WEDDLE SURVEYING MAPPING, INC. 09. t David L. Weddle, President * ExP L.S. 5570, Exp 9/30/05' . _ oFC . f. _. P.O.-Box 10418 PalmDesert, CA'92255-041Y'8 - .. .- ,. M 73-960:Hwy: ]]I,•Ste.- 6 -•Palin Desert,-,CA 92260 • 760.346.,3748 ~E-Mail: WedSury@aol.com • Fax' 760.'346:.3749, " '"" WEDDLE J • SURYEYING,MAPPING, INC.. Boundary • Construction • Topographic -'Aerial Surveys • ALTA Surveys •.GPS • Consulting., July 28; 2006 Mr. =Tim' R.. Jonasson Public' Works Director / City Engineer City of La Quinta x 78495 Calle Tampico La Quinta;-"CA ' 92253.1504 -Re: Pad/Form Grade Verification '4-Ci a umta:: ; :�-//-Lot, 187 Tract No. 29894-2 Amended 0-340 VIATESSARO - . THE'HIDEAWAY -APN 772=550-001'` 4,1',• " Dear Mr. -Jonasson: _ We -have performed- a f eld .survey to determine the vertical'' location of the building pad = - - Fy: andform'for the-above referenced project. The-elevation's observed are as follows: PAD (DESIGN) -PAD (AS BUILT) ,,•1015.0 • to 14.9 < . . • .FORM (DESIGN) F0RM4-(AS-BUILT)~ 1.015.50 10 15.51 . LL These "field-observations- are ,in substantial- conformance with the-precise grading plan 'prepared,by ESSf'SHAHANDEH, CIVIL`ENGINEER; dated 10/04 ,and the building. - honzontal' .location substantialfy conforms .to the required setbacks..,and site layout as" shown on the approved' site plan: Sincerely _ J - WEDDLE SURVEYING MAPPING, INC. 09. t David L. Weddle, President * ExP L.S. 5570, Exp 9/30/05' . _ oFC . f. _. P.O.-Box 10418 PalmDesert, CA'92255-041Y'8 - .. .- ,. M 73-960:Hwy: ]]I,•Ste.- 6 -•Palin Desert,-,CA 92260 • 760.346.,3748 ~E-Mail: WedSury@aol.com • Fax' 760.'346:.3749, " '"" r ES-I/1=ME,Inc'. STRUCTURAL ENGINEERS & CONSULTANTS K. -J, , Plan Check Reply ` ,Plan Check No.: 05-0625 Date: 03/18/05 Project Address: La Quinta, CA ESI/FME #: 4846 Project: Anderson Residence Page: 1 of 1 ITEM. RESPONSE = 1.) Floor loading was omitted as requested. Soffit loads will be reviewed at our check of them. 2.) Beam 2 calculations revised to show per plan.. + 3.) See added calculation beam #6. Beam size still okay. 4.) Refer to sheets 7 &8, which show locations of,'strip lines along with shear wall lines. We have specified plate splice callouts for drag and chords as'needed and added a detail'per your request. See attached calculations for largest diaphragm, which shows plans to be okay. 5.) They were not specified but omitted per your request. 6.) Wall 1 plans specify heavier and more shear than calculations therefore okay. Wall 3 AB callout revised to 56. 7.) Plans revised to match calculations. Calculations added for required reb_ar for negative movement. See sheet 20.1 & 20.2. 8.) Verified revised 6mil visqueen to 10mi1 per soil report. Specified rebar is correct as noted for design and soil report. 9.) Revised SGN as requested. 10.) We increased callout to 48" or to utilize the plywood specified. We added a note to refer architectural plans for porch slab location. Plans specify detail 6/FDl if a porch exists. - , CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION / el D12- &- i�, f a??0FFEsso �®R EA1 Nq� Exoc LU Li. No C-30407 m March 31, 2006 r C/ ZD ESI/FME, Inc. Structural Engineers CALIF • le L. Forbes, ...�. p MAR 212005 1800 E. 16th Street, Santa Ana, CA 92701. (714) 835-2800 Fax (714) 835-2819