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