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05-3228 (AR)W P.O. BOX 1504 _ 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: _ Property Address: APN: Application description Property Zoning: Application valuation: Applicant: c05-00003228• -- 49040 CALLE"FLORA 658-210-033- - - ADDITION - RESIDENTIAL LOW DENSITY RESIDENTIAL 23089 T4ht 4 4 Q" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153' Date: 9/13/05 Owner: JESSER KENNETH *NOT ON FILE UNKNOWN, CA 99999 Dntractor: ROPEAN CONSTRUCTION ESEP 19 2005 i BOX 161 CHO MIRAGE, CA 92270 COF, "Q."'TrA, (160) 340-0185 rnem'Y Lic. No.: 752885 --------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I 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: B License No.: 752885 Contracto�: / .� OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's 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).: (_ 1 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 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.). (_ 1 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 _ I 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: C LQPE%NIIT --------------- - - - WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following 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 EXEMPT Policy Number EXEMPT 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 the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthw=hply th�rovisions. tDate: � Applicant:/ ?��'� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. 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. 1 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 inspection purpossee'�ss. .Daate:% 1�'� JT FSignature (Applicant or Agen0 �y// •% . + 0n.0, / 1%11 Application Number . . 05-00003228 Permit . . . BUILDING PERMIT Additional des.c . . Permit Fee . . . . 243.00 Plan Check Fee 157.95 Issue Date . . . . Valuation . . . . 23089 Expiration Date . . 3/12/06 Qty' Unit Charge Per Extension BASE FEE 45.00 22.00 9.0000 -------------------7-------------------------------------------------------- THOU BLDG 2,001-25,000 198.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 29.53 Plan Check Fee 7.38 Issue Date . . . . Valuation . . . 0 Expiration Date 3/12/06 Qty Unit Charge Per Extension BASE FEE 15.00 415.00 .0350 ----------------------------------------------------------------------------- ELEC NEW RES - 1 OR 2 FAMILY 14.53 Permit MECHANICAL Additional desc . . Permit Fee . . . . 42.00 Plan Check Fee 10.50 Issue Date . . . . Valuation 0 Expiration Date 3/12/06 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 APPL REP/ALT/ADD 9.00 1.00 9.0000 ---------------------------------------------------------------------------- EA MECH B/C <=3HP/100K BTU 9.00 Permit . . . PLUMBING Additional desc . . Permit Fee 30.00 Plan Check Fee 7.50 Issue Date . . . Valuation . . . . 0 Expiration Date 3/12/06 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 6.0000 EA PLB FIXTURE 12.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ---------------------------------------------------------------------------- Special Notes and Comments addition of mbr. closet, study, LQPER-,91T Application Number . . . . . 05-00003228 ---------------------------------------------------------------------------- Special Notes and Comments laundry,pantry,and upstairs closet.September 13, 2005 11:55:21 AM jjohnson 415 sq. =----------------------------------------- ft. =--------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 15.80 STRONG MOTION (SMI) - RES 2.30 Fee summary - ---- Charged ----=----- Paid ---------- ---------- Credited ---------- Due ------------ Permit Fee Total 344.53 .00 .00 344.53 Plan Check Total 183.33 .00 .00 183.33 Other Fee Total .18.10 .00 .00 18.10 Grand Total 545.96 .00 .00 545.96 LQPERA11T Bin # d.: City Of La Quint' Building 9 Safety. Division Permit #P.O. Box 1504, 7&-495 Calle Tampico b La Quinta, CA 922S3 - (760) 777.7012 Buildin S Building Permit Application and Tracking Sheet Z)R4-tittis • _ �SSe� Project AddresfF7 � ' �/p� 1'4__ Owner's Name: • �jj1� Q.l% A . P. Number: Address: •e L,cgal Description: City, ST, Zip: 9 Z 2 S r Con racto r: s � Address: ©� / fy/ Project Deseiiption: City, ST, Zip: .c a ne: �^ T 1 ho 3 i P 7 rAb.'Ll c. # : 7A~9 f4 City Lic.:..:::, ngr., Designer:s` e I-7 ✓ G . City, ST, Zip: Telephone: Occu anCj°: P Construction Type: P P Q State ct ' Nev;Nc Add'n Aker Repair air D emotitiPecir conaProJce Name of Contact Person: ?Ae )LO y �1% Sq. Ft.: f tj # Stories: #Units; Telephone # of Contact Person: Estimated Value of Project:.) APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Rcq'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitte Itctrical Item Amount Structural Calcs. Reviewed, ready or corrections �� Tlan Check Deposit TrussCalcs. Called Contact Pe Grading flan Check Balance Title 24 Cala. Plans Fkicked'up $ Constr ction Flood pain plan Plans resubmitted 7% .V { hie �anieil Grading.plan 2" Review, ready for correction /issue Itctrical Subcontactor List Called Contact Person I:lumbing Grant Decd Plans picked up S.M.1. II.O.A. App'rovat Plans resubmitted Grading INHOUSE:- '' Review cadr for eorrectionslissue� Developer Impact Fee Planning Approval Called Contact Person A.f.P.P. flub. INTs. Appr Date of permit issue School Fees �. Total Permit Fees 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: Residential Addition 500 Sq Feet or Less EXEMPT This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.00 X 415 S.F. or $0.00 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 Exempt - Peter Hardwick Check No. Name on the check Telephone Funding Exempt By Dr. Doris Wilson Superintendent Fee collected /exempted b Karon McGilvrey Payment Recd x0.00 OverlUnder . Signature C 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