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04-4147 (AR)BUILDING & SAFETY DEPARTMENT P.O. Box •1504. (760)' 7774012 78-495 CALLE TAMP166 FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS..(760).777-Z 1.53 BUILDING PERMIT Application Number 0.4-0.0_0.04147 %; Date 7/14/04 Property Address "48-4.54 VISTA "PALOM APN; 649-540-035- Application description ;ADDITION.- RESIDE L Property Zoning LOW DENSITY RESID AL �Appl:i;cation. valuation 57429 }{jL.. 1 2oQi Owner Contracto MCCARTHY KENT C'TRUST CAL TECH DEVELOPMENT CORP ...4845.4 ­VI STA, PALOMINO 78150 CALLE TAMPICO-STE 2'05A RANCHO:: SANTA .. FE ., : - CA 92,0.67': . '. LA QUI NTA :.' ; . CA.: 92:25:3. WCC: EXEMPT'.' WC: `EXEMPT : 08/14/04 CSLB:. ` 68396:9. 0.8/,31/04 ' CCC: B --=.--- .Structure Itformatioia :.1004 SQ. FT. CAS,ITP, : ---.-- Construction Type TYPE.V.-.NON:RATED. Occupancy Type . . . . DWELLG/LODGING/LONG <=10. Flood Zone NON -AO FLOOD ZONE Other struct info CODE E.D.ITION 2001 CBC BEDROOMS 1:00 FLOOD. ZONE.: ... NO ... FIRST FLOOR SQ FTG.. .1-004-.'00. Permit:' .' :.• ..::: .:. `.. _ BUILDING PERMIT ` Additional •cTesc:, .: Permit Fee 4'50.50 Plan -Check Fee 292.8.3 Issue.Date Valuation. 574.29. Qty .Unit Charge Per Extension `BASE FEE 414:50 8.00 4.5000 THOU BLDG 5.0,001-100,000 ----------------------- 36.00 Permit ELECT - ADD/ALT/REM Additional .desc Permit Fee 50.14 Plan Check.Fee 12.54 Issue Date '. Valuation 0 Qty.. Unit Charge Per Extension BASE.FEE:' 15.:00 1004:00 :0350 ELEC NEW RES -'1 -OR .2 FAMILY 35.14 e. P.O. Box 1504 VOICE'(:! -§0) 777=701"2 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 922.53 INSPECTIONS (76.0)'777-7153 Application Number: Applicant: Applicant's ailing Address: BUILDING & SAFETY DEPARTMENT Date: Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I air licensed under provision ' of C pter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals ,'Code, and my Licens"in full force and effect. (� License Class If License No. t \fl a' Data `� -I 04 Contractor W� VVI � SCJ V'G • V iJ WA P. I J�"('�L "•I rhos 4 0 -t -Z OWNER43UILDER DECLARATION 1 hereby affirm under penalty of perjury that.1 am exempt from the Contractors' State License Law for the following reason (Sea 7031.5, Business and Professions Code: Any city or county that requires a permit to constrict, 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 (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 contractbrs to constrict the project (Sea 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 this reason Date Owner WORKERS' COMPENSATION DECLARATION hereby affirm under penalty of perjury one of the following declarations:. I have and will maintain a certificate of consent to self4nsure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which INs 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 Policy Number I certify that, in the performance of the work for which this permit Is issued, l 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'I JZ — ' ` APPlicanf •!` d `lJv .l 1 �lJ r Vll W d 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 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there Is a construction lending agency for the,perfornance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lendees 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, indemnity 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 1pfommation 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 the mentioned property for Inspection purposes. Date ` ' �J Signature (Applicant or Agent): Page 2 Application Number 04-00004147 Date 7/14/04 Permit MECHANICAL Additional desc Permit Fee : 39.50 Plan Check Fee 9.88 Issue Date Valuation 0 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 6.500:0 EA MECH VENT PAN 6.50 ---------------------------------------------------.------------------------- r Permit PLUMBING Additional:desc". Permit Fee' 64.50 Plan Check Fee 16.13 Issue Date Valuation 0 Qty Unit Charge. Per i 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 3.00 3.0000 EA PLB GAS, PIPE 1-4 OUTLETS 9.00 Special Notes and Comments '1004 S.F. DETACHED ADDITION PER MINOR -USE PERMIT # Other Fees .. . : ART`IN PUBLIC PLACES -RES .00 ENERGY REVIEW FEE 29.28. STRONG MOTION (SMI) -'RES 5.74 ' Fee summary ChargedPaid ---- - - - - - - - Credited - - Due - Permit Fee Total.. - - - - - -i. ------ - - -- -- 604.64' .00 .0.0". - - -- 604.64 Plan Check Total :331.38 .00 .00 331.3.8 Other Fee Total .35.02 00 00 35.02 Grand Total 971.04 .00 00 971.04 Date 7/21/04 No. 26206 CERTIFICATE OF COMPLIANCE• Desert Sands Unified School District �4��0, 47950 Dune Palms Road Q BERMUDA DUNES r La Quinta, C A 253 rn RANCHO MIRAGE (� M . 927L J �. INDIAN WELLS ti (760) 777 8515,. - �.� PALM DESERT y LA QUINTA QINDIO O Owner McCarthy A.PN # 649-540-035 Address 48454 Vista Palomino 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 48454 Vista Palomino 1004 Unit 6` Unit 2 Unit 7. } Unita Unit 8 Unit 4 Unit 9 ' Units Unit 10 Comments f At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, 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: • I EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. - i in the amount of $2.24 X,1,004 S.F. or $2,248.96 have been paid for the property listed. above and that a building permits and/or Certificates of Occupancy for this square footage in. this proposed project may now be issued. Fees Paid By OC -Wells Fargo Bank -Lori Hatzopoulos Check No: 0737703203 Name on the check Telephone 771-3738 r Funding Residential By Dr: Doris Wilson Superintendent 1. Fee collected /exempted by Beth. Schieferstine , Payment Recd $0.00 , $2,248.96 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 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 if Duplicated ' Embossed Original - Building Department/Applicant ' Copy - Applicant/Receipt Copy - Accounting