04-6880 (SFD)loe
o� 0u�trGv
BUILD:NG & SAFETY DEPARTMENT
P.O. Box 1504. (760),777-7012
OF 78-495 78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-71.53
BUILDING PERMIT
Application Number 0:4-00006880 `Da'te 11/03/0,4
Property Address 53465 AVENIDA VI-�-
APN-:. 774-093-023-11 -000000-
Application description DWELLING - SINGLE FAMILY DETACHED
Property Zoning COVE RESIDENTIAL;
Application valuation... 125287
Owner Contractor
GEORGE SCHENKMAN TORRES CONSTRUCTION, A.O.
53-540.AVE. VILLA 81900.AVENUE 52., 430
LA QUINTA, CA 92253 INDIO CA .92201
(760) 772=2848
WCC: STATE FUND.
WC,:. =76906703 12/01/04
CSLB: '.550498 12/31/04
CCC: B• .
------ Structure Information SINGLE FAMILY DWELLING.
Construction Type . . . . TYPE V' -.NON RATED -
occupancy Type DWELLG/LODGING'/CONG <=10
' Flood Zone NON -AO FLOOD ZONE
Other struct info . . CODE EDITION 2001 CBC
# BEDROOMS 3.00..
FIRE SPRINKLERS NO
GARAGE SQ ,FTG 457.00
PATIO SQ FTG 115.00'
NUMBER OF UNITS 1.00
FIRST. FLOOR SQ FTG' 20Q7.60
Permit BUILDING PERMIT
Additional desc
Permit Fee 730.,50., Plan •ChEck Fee 474 ..83.
Issue.Date Valuation 125287
Qty Unit Charge Per ------- Extension
-BASE FEE % 639.50
26.00 3.5000 THOU BLDG 100,001-500,000:. 91.00
------------ --------
Permit MECHANICAL
Additional desc. rjTY0F4�AOr"JWTA
- Permit Fee 85.00 Plan .CheckFtF,e( :',E I'T 21.25
Issue Date . . . . `Valuation 0
Qty. Unit Charge Per Extension
-BASE FEE 15.00
1.00 .9.0000 'EA MECH FURNACE <=100K
1.00 9.0000 EA MECH B/C <=3HP/100K BTU,9.Oo
4.00 6.5000 EA MECH VENT FAN 26.00
P.O. Box 1504 • 4a"
VOICE (760) 777-7012
78-495 CALLS CALIFORNIAO FAX (760) 777-7011
LA QUINTA, IFOR92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: J 01-686.0- I Date: 11-1G-04
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my License is in full force and effect.
License Class License No.
Date Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or.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).):
U I, 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 not apply to an owner of property who builds or improves thereon, and who does the work
himself or herself or through his or her own employees, provided that the 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 or she did not build or improve for the purpose of sale.).
I, 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.). A n
U I am exempt under Sec. BAP gr this reason
/ / / WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the`f61lowing declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
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 insurance carrier and policy number are:
Carrier Policy Number
I certify that, in the performance is the work for which this permit is iss ed,t1 not employ any person
on in any manner so as to become subject to the workers'
compensation laws of California, and a/c/ a that, if I shout eco sub'e t the workers' corn nsatioh provisions of Section 3700 of the Labor Code, I shall
fgrthwith comply with those provisigps /
WARNING: FAILURE TO SECURE WORKERS' CO NSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND LARS ($100,000), 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
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
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 pert ed unde or following issuance of this permit.
2. Any permit issued as a result of this application becomes null d void if wo mmenc ithin 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to cant la ' n.
1 certify that I have read this application and state that the above in tion is core Ie o corn y�with all city and county ordinances and state laws relating to building
construction, anndy hereby authorize representatives of this county r pon th abov tioned ro arty for inspection purposes.
ate �� !/ Signature (Applicant or Agent):
Page
2
Application Number
.
. . . 04-00006880. Date
11/03/04
Qty Unit
Charge
Per
Extension
4.00
6.5000
EA MECH"EXHAUST HOOD
26:00
Permit
ELEC-NEW RESIDENTIAL
Additional desc
'.
Permit Fee
109.39. Plan'Check�Fee
27.35
Issue Date
Valuation
0
..Qty, Unit
Charge
Per _.Extension
BASE FEE
15.00
2.007.-00
.0350
ELEC NEW RES - 1.OR;2 FAMILY
70.25
4571.00
.0200
ELEC GARAGE OR NON-RESIDENTIAL',
9.14
1.00
15.0000
EA ELEC TEMPORARY POWER POLE
15.00
Permit
PLUMBING
Additional'-desc
Permit.Fee
177.75, Plan Check"Fee
.44.44
Issue'Date .
. . .
Valuation
0
Qty Unit,Charge
Per
Extension
BASE FEE
15.00
15.00.
6.0000
-EA PLB FIXTURE
90.00
1.00
15.0000
EA PLB BUILDING SEWER
15:00.
3.00
6.0000
EA PLB ROOF DRAIN
18.00
1.00
7.5000
EA PL-B'WATER HEATER/VEIIT
7.50
1.00
3.0000
EA 'PLB WATER INST/ALT/F.EP
3.00
1.00
9.0000
EA PLB LAWN SPRINKLER SSYSTEM
9.00
- 7,.00
.7500
EA PLB GAS PIPE >=5.
5.25
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.
Qty Unit
Charge
Per -
,Extension
BASE .FEE
15..00
Special Notes
and Comments
2007 S.F. SFD
PERMIT
DOES NOT INCLUDE
BLOCK WALL, POOL/SPA.OR
DRIVEWAY
APPROACH
Other Fees
--------------------
ART IN PUBLIC PLACES -RES
00
DIF COMMUNITY CE14TERS-RE8
97-.00
Page 3
Application Number
04-00'00688.0
Date
11/03/04
Other Fees
DIF CIVIC CENTER;'-
RES
366.00
ENERGY REVIEW FEE.
47.48
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
12.52
:DIF STREET MAINT FAC
-RES
15.00
DIF TRANSPORTATION
- RES
1098.00
Fee summary
Charged
Paid Credited
Due
Permit Fee Total
111.7.64
.00
.00
1117.64
Plan'Check Total
567.87
250.00
.00
317.87
Other Fee Total
.2465.00
.00
.00
2465.00
Grand Total
4150.51
250.00
.00
3900.51 .
Building
Address
Owner
P.O. BOX 1504
z. , �.,_T 78-495 CALLE TAMPICO
s� JF� Ce v -i- A LA QUINTA, CALIFORNIA 92253
,y
Address Iry f-. l -fib
City Zip Tel.
%—QI ciZ2-57-/7-6,Z3:3
Contractor
ke.-DA,4L,cs ��r<
Address
City Zip Tel.
1?i�,► �, d � azo �
State Lic. City
& Classif. 5_V Lic. #
Arch., Engr.,
Designer
Address Tel.
Cit Zi State
Y La. P G ZZ 5-3 1
Lic. #
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).
❑ I, 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
ori mproves thereon and who does such work himself or through his own employees, provided
that such improvements are riot 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).
❑ I, 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 Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. ❑ 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
WHITE = BUILDING DEPARTMENT
u o
APPLICATION ONLY
BUILDING: TYPE CONST V'2V OCC. GRP.
A.P. Number .7717 — Oq 7, �+ L
Legal Description A 't J ` 1j `C 2, t3 l Z
Proj�'e_g Description
Sq. Ft. ^ No. No. Dw
g .
Size !� ® % Stories rf Units
Add ❑
Newv(
Estimated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
j
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
�—
Infrastructure
,
TOTAL
REMARKS
Alter ❑ Repair ❑ Demolition ❑
UL r
QUI-.
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:
YELLOW = APPLICANT PINK = FINANCE \v
CERTIFICATE OF COMPLIANCE ��Fs
Desert Sands Unified School District 4f ?0
47950 Dune Palms Road < BERMUDADUNES
q Cn RANCHO MIRAGE
Date 11/16/04 La Quinta, CA 9225) INDIANWELLS
C✓i PALM DESERT
No., 26626 c}> LA QUINTA
(760) 771-8515 ��QINDIO
Owner George Schenkman APN # 774-093-023'
Address 53-465 Avenida Villa Jurisdiction „La Quinta
City La Quinta Zip 92253 Permit #
Tract # Study Area
Type Single Family Residence No. of Units 1
Lot # No. Street S.F. Lot # No. Street S.F.
unit.1 53465 Avenida Villa 2007 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
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 or 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 $2.24 X 2,007 S.F. or $4,495.68 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 C/C-Washington Mutual Bank Check No. 580068200
Name on the check Telephone 777-8233
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exem ed by Patri is Barbuzza Payment Recd 50.00
$4,495.68 Over/Under
Signature '
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period 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 if Duplicated
Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting
All
RC ' DISTRICT - PLANNING REVIEW FORM
This form is to be used by CDD. staff for review of single family dwellings`.in the RC '(Cove
Residential) District per Section 9.50.090 of the Zoning Code. Its purpose is to determine; 1)
that the proposed housing design does not duplicate the same architectural* style of any house
within 200 feet of the applicant, .and/or 2). if there is a need for the appllicant to file for Master.
Design Guidelines. If the applicant does need to file' a Master Design `Guideline, please 'transmit
this information to the Building and -Safety Department as!. par, ofyou' coirecttiion list. Please
attach additional explanations as necessary.
APPLICANT: , Q
SITE ADDRESS: V_ 1% Ila ,.
APN CASE` NO I �3�
LEGAL: LOT i i BLOCK I3 UNIT .. O S-C..0V'.L.Q.
CHECK AND APPROVED BY: `D'ATE: A
Inform the assigned Building plan•checker-upon your,assignment.to this case. The CDD
Executive Secretary maintains a log book to.track applications andassign case numbers.
REQUIRED ITEM
Y-
N
COMMENT/CORRECTION
Verify legal and APN information
Consistent with MDG on file (cis
applicable)
.MDG'filing required (5 filings
since 9/3/98)
Apr..)rovgo bv: "' Date Reso A
Architectural variety within 200
feet of the surrounding area:P16ornmunity
Architectural'desigri features
U Panning Commission
®City Council
Dev.: Dept.
Initials' ffk1MYl
Case No.fda-3t (40_
0 With Conditions
Other Requirements:
.