05-1693 (AR)-o
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00001693.
Property Address: 54620 EISENHOWER DR
APN: 774-285-015-11 -000000-
Application description: ADDITION - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 15101
Applicant:
mil
Architect or
alI
Td4t44Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
•OREILLY ERNEST
P O BOX 884
LA QUINTA, CA 92253
Other struct info . . . . . C
:MAY
U
Contractor:
Owner
17 2005LAQUINTA DITION .2001 CBC
uranFPT Lic. No.: ---------------
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: License No.: ------ -- - - - - - - -
Date: Contractor:
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
a pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$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.).
(_) 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 1 I am exempt under Sec. , B.&P.C. for this reason
/ate:-11_0
CONSTRUCTIOIN11ENDING 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:
LQPERn4IT
Date: 5/16/05
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
y issued.
dl 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 NO Policy Number E FOOTAGE
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 forthwith comply with those provisions.
Date: pplicant:
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. I 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 th above-mentioned property for inspection purposes.
te: ignature (Applicant or Agent): 61
Application Number . . . . . 05-00001693
Permit .
. . BUILDING PERMIT
Additional desc
. .
Permit Fee . .
. . 171.00
Plan Check
Fee
111.15
Issue Date
Valuation
. . . .
15101
Expiration Date
11/12/05
Qty Unit
Charge Per
Extension
BASE FEE
45.00
14.00
----------------------------------------------------------------------------
9.0000 THOU BLDG 2,001-25,000
126.00
Permit .
. . ELECT - ADD/ALT/REM
Additional desc..
.
Permit Fee . .
. . 24.24
Plan Check
Fee
6.06
Issue Date
Valuation
. . . .
0
Expiration Date
11/12/05
Qty Unit
Charge Per
Extension
BASE FEE
15.00
264.00
----------------------------------------------------------------------------
.0350 ELEC NEW RES
- 1 OR 2 FAMILY
9.24
Permit
MECHANICAL
Additional desc
.
Permit Fee . .
. . 30.50
Plan Check
Fee
7.63
Issue Date . .
. .
Valuation
. . . .
0
'Expiration Date
11/12/05
Qty Unit
Charge Per
Extension
BASE FEE
15-.00
1.,00
9.0000 EA MECH APPL
REP/ALT/ADD
9.00
1.00
----------------------------------------------------------------------------
6.5000 EA MECH VENT
FAN
6.50.
Permit .
. . PLUMBING
Additional desc
. .
Permit Fee
1. 42.00
Plan Check
Fee
10.50
Issue Date . .
. .
Valuation
. . . .
0
Expiration Date
11/12/05
Qty Unit
Charge Per
Extension
BASE FEE
15.00
4.00
6.0000 EA IPLB FIXTURE
24:00
1.00
3.0000 EA PLB WATER
INST/ALT/REP
3.00
----------------------------------------------------------------------------
Special Notes and
Comments
264 sq.'ft. bathroom
addition May 16,
2005 7:48:23 AM
jjohnson
----------------------------------------------------------------------------
Other Fees . .
. . . . . . . ENERGY
REVIEW FEE
11.12
LQPERAIIT
Application Number
. . . . .
05-00001693
-----------------------
Other Fees . . .
-------------
. . . . . .
-------------
STRONG MOTION
-------------
(SMI) - RES
---- - - - - -- - --
, 1.51
Fee summary ,
Charged
Paid.
Credited
Due
-----------------
Permit Fee Total
----------
267.74
---------- --------
.00
7- ----------
.00
267.74
Plan Check..Total
'135.34
.00
.00
135.34
Other Fee Total
12.63
.00
.00
12.63
Grand Total
415.71
.00
.00
415.71
LQPEWMIT
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garagestearports, covered patlostwalkways, 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 264 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 - Doug Bogren Check No.
Name on the check Telephone
Funding Exempt
By Ar. Doris Wilson
Superintendent
Fee collected /exempted by Sh o McGilvr y Payment Recd 1$0.00
Over/Under
Signature e -
NOTICE: Pursuant to 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 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
HAMMER PUMPING INC. .JOB INVOICE
P.O. Box 2448
CATHEDRAL CITY, CALIFORNIA 92235-2448
17C.A1 1IRA_7AAQ
DANT.
(760)321-7448
PRICE
CUSTOMER'S ORDER NO.
�RED
PATE O E
Gallons
b
, 0,
R TAKEN BY
DATE PROMISED 0 A.M.
�-
BILL TO
PHONE
ADDRESS
—MECHANIC
Out of Area Fee
1 i 1.
CITY
HELPER
JOQ.NA AND
LOCATION_
{{ ,E
I
❑ DAY WORK
Size System:
DESCRIPTION OF WORK
{/
❑ CONTRACT
`_�4
❑EXTRA
A SERVICE CHARGE OF $20 WILL BE DUE
ON ALL RETURNED CHECKS.
DANT.
DESCRIPTION OF MATERIAL USED
PRICE
AMOUNT
Gallons
Pumping Fee per 1000 gal.
J
�-
Dumping Fee per 1000 gal.
Out of Area Fee
Locating / Opening Fee (per hour)
Size System:
A SERVICE CHARGE OF $20 WILL BE DUE
ON ALL RETURNED CHECKS.
18% PER YEAR WILL BE CHARGED ON
PAST DUE ACCOUNTS OVER 30 DAYS.
HOURS
LABOR AMOUNT
TOTAL
MATERIALS
MECHANICS Q
HELPERS Q
TOTAL
LABOR
1 hereby acknowledge the satisfactory
completi n of the above cribed work:
TOTAL LABOR
TAX
SIGNATURE
DATE COMPLETED
TOTAL
`—
I