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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: .