13-1215 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tjht 4.4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760)'777-7011
INSPECTIONS (760) 777-7153
Date: 12/18/13
Application Number: 13-00001215 Owner:
Property Address: 52520 AVENIDA HERRERA FOREMOST HOMES
APN: 773-294-002-22 -000000- 70600 COUNTRY CLUB DR.
Application description: DWELLING - SINGLE FAMILY DETACHED LA QUINTA, CA 922
Property Zoning: COVE RESIDENTIAL (760)537-1502.
Application valuation: 102388
Contractor: �E 7 2013
Applicant: Architect or Engineer: DANTOR MARTINEZ qON TRUCT ION
81057 AVENIDA RO ERO CITY OF l A CiUINTA
INDIO, CA 92201 FINANCEDEPT.
(760)702-6209
144 Lic. No.: 926128
-------------------------------------------------------------------------------------------------
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: B - License No.: 926128for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
(� issued.
XDatel '71 Contractor: l 1QVI\lf3y Y 1 d j ✓L2_ ca�t"S �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:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier WESTCO INS CO Policy Number QWCA1970514
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 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 forthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by 1
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date: \ Z1 q—i� Applicant: �vi� tM b t 4- �0 VM -C -t �h Q _k Q� , ��
(_ 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
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.l.
1 _) 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.).
(_ 1 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:
,rsst D $alt Flo xropwr/oNS
LQPERMIT
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 0100,0001. 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.
1 certify that I have read this application and state th a above information ' correct. I agr a to comply with all
city and county ordinances and state laws relating to ui ing construction, a hereby auth r ze represe t_ives
of this county to enter upon the above-mentioned pro for insp tion pur os
Date: YL-14t—t / Signature (Applicant or Agent):
�ttes zoiy• /syr
-
Application Number . . . 13-00001215
Permit . . . . . . PLUMBING 2013
LQPERMIT
Structure Information
Construction Type . .
. . . TYPE V, UNPROTECTED
Occupancy Type . .
. . . DWELLG/LODGING/CONG <=10
Other struct info . .
. . . CODE EDITION
2010
# BEDROOMS
3.00
FIRE SPRINKLERS
YES
GARAGE SQ FTG
424.00
NUMBER OF UNITS
1.00
--=-------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
1585.00
7 -----------
Permit . . .
BUILDING 2013
Additional desc . .
Permit Fee . . . .
495.04 Plan Check Fee
00
Issue Date . . . .
Valuation . .
. . 102388
Expiration Date
5/06/14
Qty Unit Charge
Per
Extension
BASE FEE
431.86
78.00 .8100
----------------------------------------------------------------------------
THOU BLDG $25,001-$200,000
63.18
Permit . . .
ELECTRICAL 2013
Additional desc .
Permit Fee . . . .
178.99 Plan Check Fee
.00
Issue Date
Valuation.
0
Expiration Date
5/06/14
Qty Unit Charge
Per
Extension
1.00 23.8300
EA ELEC TEMP POWER POLES
23.83
1.00 143.0000
LS ELEC NEW RES, FIRST 1 KSF
143.00
1.00 12.1600
------------------------------------7---------------------------------------
EA ELEC NEW RES, ADD'L 1 KSF
12.16
•Permit . . . MECHANICAL 2013
Additional desc . .
Permit Fee . . . .
131.10 Plan Check Fee
.00
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
5/06/14
Qty. Unit Charge
Per
Extension
1.00 35.7500
EA MECH FURNACE
35.75
1.00 35.7500
EA MECH CONDENSER/COMP
35.75
4.00 11.9200
EA MECH VENT FAN
47.68
1.00 11.9200
-----------------------------------------
EA MECH EXHAUST HOOD
-----------------------------------
11.92
Permit . . . . . . PLUMBING 2013
LQPERMIT
i
Application Number . . . . . 13-00001215
Permit
. . . PLUMBING 2013
Additional
desc . .
Permit Fee
. . . . 166.88 Plan Check Fee
.00
Issue Date
. . . . Valuation . . .
. 0
Expiration
Date . . 5/06/14
Qty Unit Charge Per
Extension
10.00
11.9200 EA PLBG FIXTURE/TRAP
119.20
1.00
11.9200 EA PLBG BUILDING SEWER
11.92
1.00
11.9200 EA PLBG WATER HEATER/VENT
11.92
1.00
11.9200 EA PLBG WATER INST/ALT/REP
11.92
1.00
11.9200 LS PLBG GAS SYS, 1-4 OUTLETS
11.92
----------------------------------------------------------------------------
Special Notes
and Comments
1585 SF SFD
R-3 TYPE V -B W/FIRE
SPRINKLERS
THIS PERMIT DOES NOT INCLUDE
POOL, SPA BLOCK
WALLS, OR DRIVEWAY
APPROACH &
BBQ, FIRE PITS.
November 7,
2013 12:07:08 PM JJOHNSON.
-7--------------------------------------------------------------------------
Other Fees
. . . . . . . . BLDG STDS ADMIN (SB1473)
5.00
DIF COMMUNITY CENTERS -RES
129.00
DIF CIVIC CENTER - RES
942.00
DIF FIRE PROTECTION -RES
433.00
HOURLY PLAN CHECK
280.00
DIF LIBRARIES - RES
344.00
MULTI -SPECIES (MSHCP) FEE
531.00
PLAN CHECK, ELECTRICAL
68.88
DIF PARK MAINT FAC - RES
40.00
PLAN CHECK, MECHANICAL
71.51
PLAN CHECK, SFD GRADING
143.00
PLAN CHECK, PLUMBING
174.02
DIF PARKS/REC - RES
2048.00
BLDG PC 25001-200K
458.23
STRONG MOTION (SMI) - RES
10.24
TUMF: RESIDENTIAL
1837.44
DIF STREET MAINT FAC -RES
116.00
DIF TRANSPORTATION - RES
2842.00
Fee summary
Charged Paid Credited
Due
-----------------
Permit Fee
---------- ---------- ---------- -----
Total 972.01 .00 .00
7 ----
972.01
Plan Check
Total .00 .00 .00
.00
Other Fee
Total 10473.32 .00 .00
10473.32
Grand Total
11445.33 .00 .00
11445.33
LQPERMIT
Date
11/22/13
No.
31889
Owner
Foremost Homes LLC
Address
52-520 Avenida Herrera
City
La Quinta Zip
Tract #
Type
Single Family Residence
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515
APN #
Jurisdiction
Permit #
No. of Units
[EDSc�O
z cCS�� o
Q BERMUDA DUNES r
RANCHO MIRAGE (,7
�. INDIAN WELLS
PALM DESERT y
LA QUINTA
4INDIO y�
O
773-294-002
La Quinta
1
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 52520 Avenida Herrera 1585 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 patios/walkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
Addition of Sq. Ft. to New Construction
This certifies that school facility fees imposed pursuant to
in the amount of $3.20 X 1,585 S.F. or $5,072.00 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 California Bank & Trust/James Fortson Check No. 379433
Bank Name/Recipient of Certificate Telephone
Funding Residential
By Dr. Gary Rutherford
Superintendent
Fee collected /exempted by Spe Lara Payment Recd 30.00
$5,072.00 ='0"dunder
Signature
NOTICE: Pursuant t5 Government Code Section 66020(d)(1), this will serve to notify you that the 9D -day approval period in which you may protest the fees
or 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
3s�
4 Sep�I�IGJ
,J� r 3—IZI5
P.O. BOX 1504 APPLICATION ONLY (.,VO
Building , ^ 78-495 CALLE TAMPICO
Address ��. 111[[[/// [[[&Zak QUINTA, CALIFORNIA 92253
Owner
Mailing
Address
lz� I
Contractor (�
Address
City Zip I Tel.
State Lic. City
& Classif. I Lic. #
Arch., Engr.,
Designer
Address T .
r3(o� ��y voI_ s
Zip State
Cf7 /_ /!tA 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. 7031A Business and Prolewlans Code, Any City Or Counry winch requires 3 permit! 10 ConstruC�
alter, ""prove, der"Olish, orropetr44structure, prlorfin its issuance also mqurms the applicant for
such permit to life a signed valemerrt that he Is .ci t%ed putsuanf to the prOvisicns Of Me Contras•
for's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Cade, or that he is exempt therefrom, and the basis for the alleged exemption. Any
violation otSectforl 7031.5 by any appi'l-N for a permit subjects the applicant to a civlf panaffy of
not more than lve hundred dollars {$500).
❑ I, as owner or the property, or my employees with wages as their sole camponsation, wID do
the work, and the structure is not Intended qr offered for sate. (Sec. 7044. Business slid Profes-
sions Code: The contractor's bJcanse 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 ar olfared forsale. If, however, tho bu"tdrng or improvement
is sold within one year of completion, the owner -builder will have the burden df proving that he did
not build or improve for the purpose of sale).
01, as owner of the property. am exclualvely mniraciing wilts licensed contraclors to construct the
project. (Sec. 7044. Buslress and Professions Coda: The Contractor's License Law does not apply
fd an owner of property who buifds or Imptdves thereon, and who contracts for such projecls with
a contractor(s) licensed pursuant to the cfoCs License Law.)
❑ 1 am exempt under Sec. or this reason
Hate r �:OE
OR CO NSATION DECLARATION
I hereby affffm that I t1pWa certificate of consent to self -insure, or a certificate of Worker's
Compensation Insurance a certified copy thereof. "Sec. 3800, Labor Cade.)
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 became subject to Workers' Compensation Laws of California.
Date Owner
NOTICE TO APPLICANT.' Of. after waking Ihis Cerfllfcats of Exarrlption you sfrou!d become
subject to the Workers' Ccmpensatidn provisions of the Labor Code, you must forthwith
comply with such provisions ortfrls 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.
cor* that I have read this appllcatlon and state that the above information Is correct.
I agree to comply with all city and county ordinances and state taws relating to building
corrstructfon, and hereby authorize representatives of this city to enter the above -mentioned
property for inspection purposes.
Signature of applicant
Mailing Address —
City, State, Zip
Date
BUILDING: TYPE CONST. OCC. GFIR
A.P. Number 1+3 ~ A9 L2—
Legal Description je4s-2-L- �S!
Project Descriptions -
Ft. _` size
,5
Slue JOJ
New Add ❑
No. No. Dw.
Stories Units
Alter ❑ Repair ❑ Demolition ❑
I Estimated Valuation rI D ff)' 1 tCD
PERMIT
Plan Chk. Dep,
Plan Chk. Bal.
Const.
Mech.
Electrical
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL I
CONTACT INFORMATION
NAME:
PHONE:
ZONE: BY:-
Minimum Setback Distances:
Front Setback from Center
Rear Setback from
Side Street Setbac r
Side Setbac m Prop
FINAL DATE NSPECTOF
Issued by: Date
Validated by:
Line
AMOUNT
Line
WHITE = BUILDING DEPARTMENT
Validation:
YELLOW = APPLICANT PINK = FINANCE