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04-5176 (AR)BUILDING,& SAFETY DEPARTMENT Box 1504 (760),777-7012 9---U�� 5 CALLE TAMPICO FAX (760) 777-7011 D L ' INTA, CALIFORNIA 922.53 INSPECTION REQUESTS (760) 777-7153 CRY 2 3 2005 BUILDING PERMIT CIiK of: LA Quit TA FINANCE pEPT• - cation Number `04-00005176 Date 3/16/05. -Property Address . .r 44380 VIA CORONADO APN: 6,04-211-037=44 -'23971. Application description ADDITION— RESIDENTIAL Property Zoning LOW DENSITY RESIDENTIAL Application valuation . . .22880 Owner Contractor ZENS MARK THOMAS OWNER 44-380-VIA'CORONADO LA'QUINTA ;CA 92253 - Structure Information 40 SQ. FT. MASTER BEDROOM ADD/REM. - 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 1.00 FLOOD ZONE NO,, 1ST FLOOR SQUARE,FGOTAGE 400.00'r ----------------------------------------------------------------------------- Permit BUILDING PERMIT Additional-desc Permit Fee 234.00 ..Plan ChEck Fee 152.10 Issue'Date - R Valuaticn 2288x0 Expiration Date 9/16/05 Qty Unit Charge Per Extension BASE FEE45.0;0 21.-00 9.0000 THOU BLDG 2,001-25,000 189.040 Permit ELECT - ADD/ALT/REM Additional desc Permit:Fee 29.00 Plan Check 'Fee 7.25 Issue Date Valuati,cn 0 Expiration Date 9/16/05. Qty Unit .Charge Per. _Extension _ BASE FEE 15.00 400.00 0350 ELEC NEW RES - 1 OR 2 FAMILY 14.0.0 Permit . . MECHANICAL Additional desc Permit Fee . . 24.00• Plan Check Fee 6.00. Issue Date Valuation 0' Expiration Date .9/1`6/05 Q.t Unit .Chas e Per Y 9 ;Extension P.O. Box 1504 • ��-V 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Applicant: Applicant's Mailing Address: BUILDING & SAFETY DEPARTMENT Architect or Engineer: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 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 I 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.). U 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.). U I am exempt under Sec , BA P.C. for s reason Date �/"erJ Owne WORKERS' 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. I�Qy wor acts' compensation insurance carrier a lid( number are• Carrier v j�}r _ �-{/ �) Policy Number '7 I certify that, in the performance of the work for which this permit is issued, T'shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that 'f I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall �►forthwith comply with those provisions. Date Applica WARNING: FAILURE TO SECURE RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUND 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. 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 employeesfor 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 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 bove-mentioned property for inspection purposes. Date ZO B Signature (Applicant or Age Page :2 Application Number . . . . 04-00005176 Date 3/16/05 " Qty Unit Charge Per Extension - BASE FEE 15.00 1.00 9.000Q EA MECH APPL REP/ALT/ADD 9..00 Permit . . . .. . . PLUMBING Additional desc Permit Fee 55.50 Plan-Che'ck Fee .13.88 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/16/05 Qty Unit Charge Per Extension BASE FEE 15.00/ 5.00., 6.0000 EA PLB FIXTURE, 30.00" 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000,EA PLB WATER INST/ALT/REP 3.00 Special.Notes and Comments 400 sq. ft. ADD. MASTER BEDROOM.3/16/05 8:2"7:53 AM jjohnson Other Fees . . . . ENERGY REVIEW FEE 15.21 STRONG MOTION (SMI) -RES" 2.28 Fee summary Charged ---------- -- Paid Credited Due --=-------- Permit Permit Fee Total ---------- 342.50 ---- 7--"=- 00 ---------- 00 -- - 342.5.0 Plan Check Total 179.23 00 00 179.23 Other Fee Total 17.49 .00 .00 17.49 Grand Total" 539.22 .0.0' .00 539.22 .. CERTIFICATE OF COMPLIANCE � � tF�� DesertSands Unified School District 47950 Dune Palms Road BERMUDA DUNES r tr RANCHO MIRAGE Date 3/23/05' La Quinta, CA 92253 r INDIAN WELLS No. 27014 � P La C. NTA �y (760) 771-8515 sU. yeti Owner Mark Zens APN # 604-211-037 ' Address 44-380 Via Coronado Jurisdiction La Quinta City La Quinta Zip 92253 Permit # Tract # Study Area Type - Residential Addition _' No. of Units 1 Lot # No.. Street ' S.F. Lot # No. Street S.F. Unit 1 44380 Via Coronado .400 Unit 6 Unit 2 ,' Unit 7 Unit 3 ' Unit 8 Unit 4 Unit 9 Unit 5 �r' ., 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: 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. t; in the amount of $0.00 X 400 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 - Mark Zens Check No. Name on the check Telephone 345-6869 Funding Exempt By . Dr. Doris Wilson Superintendent Fee collected /exempted ,by haron MCGllvrey Payment Recd $0.00 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 prcject is issued, or from the date on which those amounts are paid to the District(s) or to another. publicentity authorized to collect them on the District('s) beha:'f, whichever.is earlier. NOTICE: This Document NOT VALID if Duplicate Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting o� P.O. BOX 15.04 LA Q.UINTA, CALIFORNIA 92247.-1504 BUILDING &.SAFETY DEPARTMENT 78-495 CALLE TAMPICO (760) 777-7012 OF T LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 January 31, 2005 Mr: Mark Zens 44380 Via Coronado La Quinta, CA 92253 RE: Plan Review Extension. Request — 44380 Via Coronado Dear Mr. Zens: . I have received your letter dated 12/7/04, requesting a time'extiension for the Plan Review of the structure proposed to be built at the above .address under' Application #04-5176. Plan review status: Original application date: 6/24/04 180-day expiration date: 12/21/04 180-day extension date:. 6/14/05 Under the provisions of California Building Code Section 107.4, your request is hereby granted. Because the Building Code-specifies that"no application shall be extended more than once," please be advised that unless a building.permit for :his project is issued on or before Tuesday; June 14, 2005, your application will expire automatically. Yours truly, Greg Butler Building & Safety Manager