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06-4161 (AR)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 4/12/07 Application Number: 06-0000416 Owner: Property Address: 54-r7'5_AVENZDA HERRERA MIKA INIGUEZ APN: 774-213-019-8 -000000- 54-175 AVENIDA HERRERA Application description: ADDITION - RESIDENTIAL LA QUINTA, CA 92253 r Property Zoning: COVE RESIDENTIAL Other struct info . . . ��1 C Application valuation: 17597 Contractor: Applicant: Architect or Engineer: Owner. APR 181007 I DITION 2001 2005 CITYOF�QU1NT L i c . No.: FINgNCLe DEPT A -=----------------------------------------------------------------------------------------------- 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 I 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 workerscompensation 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 NO Policy Number E FOOTAGE 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 m any manner so as 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 be ome 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, 011 forthwithcomplywith those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by �a to _., --I _ aXpplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1 X{) 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 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 Licen a Law.l. 1 _ 1 I am exempt under Sec. B.&P.0 for this reason 1 7 C 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: LQPERDIIT WARNING: FAILURE TO SECL3RE WORKER" 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 ab information is correct. I agree to comply with all city and county ordinances and state laws relating to he struction, and hereby authorize representatives of this county to enter upon the above-mentioned property fo i spection purposes. (Applicant or Agent): Application Number . . . 06-00004161 Permit . . . BUILDING PERMIT INV FEE Additional desc . Permit Fee . . . . 378.00 Plan Check Fee 122.85 Issue Date . . . . Valuation . . . . 17597 Expiration Date 10/08/07 Qty Unit Charge Per Extension BASE FEE 90.00 } 16.00 18.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 288.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 31.38 Plan Check Fee 7.85 Issue Date Valuation . . . . 0 Expiration Date i0/08/07 Qty Unit Charge Per Extension BASE FEE 15.00. 468.00 .0350 ---------------------------------------------------------------------------- ELEC NEW RES - 1 OR.2 FAMILY 16.38 Permit . . . MECHANICAL Additional desc . . Permit Fee 39.50 -Plan Check Fee 9.88 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/08/07 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 B/C <=3HP/100K BTU 9.00 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH VENT FAN 6.50 Permit PLUMBING Additional desc . Permit Fee 36.00 Plan Check Fee 9.00 Issue Date . . . Valuation . . . . 0 Expiration Date 10/08/07 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 6.0000 EA PLB FIXTURE 18.00 1.00 3.0000 EA PLB .WATER INST/ALT/REP 3.00 ---------------------------------------------------------------------------- Special Notes and Comments. CONVERT WORKSHOP TO CASITA WITH LQPERMIT l Application Number . . . . . 06-00004161 ---------------------------------------------------------------------------- Special Notes and Comments BATHROOM.April 11, 2007 8:28:41 AM jjohnson.DOUBLE FEE STARTING WITHOUT PERMITS.THIS PERMIT IS FOR THE GARAGE/WORKSHOP CONVERSION ONLY. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 12.29 STRONG MOTION (SMI) - RES 1.75 5 Fee.summary Charged ----------------- ---------- Paid ---------- ---------- Credited Due 1 Permit Fee Total 484.88 .00• ---------- .00 484.88 Plan Check Total 149.58 .00 .00 149.58 Other Fee Total 14.04 .00 .00 14.04 Grand Total 648.50 .00 .00 648.50 LQPEn11T Date 4/12/07 No. 29346 Owner Miki Iniguez Address 54175 Avenida Herrera City La Quinta Zip 92253 Tract # Type Residential Addition CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 APN # Jurisdiction Permit # Study Area No. of Units 4���F�Scyo Q BERMUDA DUNES rn RANCHO MIRAGE b INDIAN WELLS PALM DESERT ,y LA QUINTA "IQ, 0 O y� v O 774-213-019 La Quinta 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 54175 Avenida Herrera 468 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 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 468 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 - Mika Iniguez Check No. Name on the check Telephone Funding Exempt By Dr. Doris Wilson Superintendent Fee collected /exen4ted by Signature Payment Recd L`f $0.00 .; " Over/UMOP - ,� _tet NOTICE: Pursuant to Government Code Section 66020(d)(1), this #11 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 21 Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting