05-0838 (AR)BUILDING & SAFETY DEPARTMENT
'P.O. BOX 1504
(760),777-7012
OF 78-495 C . ALLE
TAMPICO-.
FAX -(760) 777-7011
LA QUINTA; CALIFORNIA 0253 INSPECTION REQUESTS. (760) 777-7153
BUILDING PERMIT
OT
PARyt UN05-00000838 . .
05-00000838
. 78540 VIA MELbDIA
Date 3/16/05
A CITY
646-290-028-
'RESIDENTIAL
App I i"IRCE)aEpale s c r i tion
ADDITION
roper y Zoning
LOW DENSITY RESIDENTIAL
Application valuation,
50000
Owner
Contractor
----------------------------------------------------
BONILLA RUBEN S
OWNER
78-540 VIA MELODIA
LA QUINTA,
CA 92253
--- Structure Information
374 SQ. FT. 'ADDITION ,PATIO
&'REM. -----
Construction Type.
TYPE V --NON RATED
OCcUpanCy'Type
:DWELLG/LODGING/CONG,<=10
Flood Zone
NON -AO FLOOD ZONE".
Other stru*ct info
CODE EDITION'
2001 CBC
#,BEDRobms
1.00
FLOOD ZONE
NO
GARAGE SQ FTG
28.00
,PATIO SQ FTG
171.00
1ST FLOOR SQUARE FOOTAGE
374.00
Permit . . . 'BUILDING,
- - - - - - - - --- - - - - - - - - - 7 - - --- - - - - - - - - -
-PERMIT
- - - - - - - - - - - - - - - - -
Additional desc
Permit Fee
414.50 Plan Check Pee
Issue Date
valuation . .
.,,269.43
. . 50000
Qty Unit Charge
Per
Extension
-BASE FEE
252.00
25.0.0 6,.5000
------------------------------------------------------------------
-THOU BLDG, 25,001-50,000
162.50
Permit . . . . . . .
ELECT ADD/ALT/REM
--------------
Additional.desc
Permit.Fee . . . .
28.65 Plan Check Fee
7,.16
Issue Date.
Valuation
0
Qty Unit Charge
Per
Extension
BASE FEE','
15.00
374.,00.. -.0350
ELEC NEW -RES 1 OR 2, FAMILY
13.09
28.00 0200
-------
ELEC GARAGE OR NON-RESIDENTIAL .56
-----------
7 - --- - -
Permit
- - - - - - -----------
MECHANICAL.
- - - - - - - I - - - - - - - - - -
Additional desc
Permit Fee
39.50 Plan Check Feel.-
91,.88
..Issue Date
'Valuation
Qty Unit Charge
'Per
Extension
y r
P.O. Box 1504 • -V
VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
Date: -4./5-05
Architect or Engineer:
Architect or Engineer's Address:
-1,1--1
Lic. No.
BUILDING PERMIT DECLARATIONS `0A.)1�19,L-) YT)3
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 1 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 1, 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.).
I, as owner of the property, am exclusively contracting with licensed con r dors to construct the project (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an o�er of property(who builds r improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State Licenge Law.).
U 1 am exempt under Sec. (, BA q,.C. foythis reason
WORKERS OMPENSATION DECLARATION
I hereby affirm under penalty of perjury one o a following declarations:
_ I have and will maintain a certifiEate of consent to self -insure for worke asaHon, 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. My workers' compensation insurance c1mer and olicy number are:
Carrier PolicyJ�umb�r
I certify that, in the performance of the work for whl h this reit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, antf!agree that, 1 shou e e subject to the workers' comp�nsabon provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisi ns. \ �,
WARNING: FAILURE TO SECURE WORKE COMPENSATION C)DACZAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUS, f)j DOLLARS ($100;6600), I TION 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.).
Lenders 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 bei . g perfo d under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and
j`�oid if wo is not ce men ed within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to cancella 'din!
I certify that 1 have read this application and state that the abovye info tion is correct.
I ree to co with all city and county ordinan sand state laws relating to building
construction, and hereby authorize representatives of this couhty tom er� the above -m tion pe y inspection purposes.
Page
2
Application Number
05-00000838 Date
3/16./05
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
55.50 Plan Check Fee
13.88
Issue Date
Valuation
0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
4.00 6.0000
EA PLB FIXTURE
24.00
1.00 7.5000
EA PLB„_WATER HEATER/VENT
7.50
1.00 3.0000
EA ` ' PLB' WATER INST/ALT/;REP'. 4
3 .00
3.10000
,EA' PLB '' GAS PIPE' 1- 4 °OUTLETS '
6.00
Special Notes and Comments
374 SQ. FT. ADDITION,
PATIO""171 SQ."
FT.AND INT. REMODEL.
3/16./0.5 9:15:30 AM
JJOHNSON
Other Fees
ENERGY°.REVIEW FEE
26.94
STRONG 'MOTION ( SMI) - RES
5.0.0
Fee summary charged
'`''Paid. `"Credited
Due
Permit Fee -Total'
538:15 .00 .00
538.15
Plan Check Total
300.35 :00 .00
300.35
Other Fee Total
31.94 00 .00
31.94
Grand Total
870.'44 - .00 .00
870.44
N
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M
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N
In
0
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CITY OF LA QUINTA SUB -CONTRA OR LIST w
a
JOB This ore sh Rha S�5 ted an /7! _/a t a, PERMIT NUMBER OWNE I� n.d,� L n� BUILDER IL
arr tide job. My changes to this Ilat mutt be approved the BuUdi Division fy Persons appearing on this list or their employees are authorb*&*D work
pP by nil Prior to commencement of work. Failure to comply will result In a stoppage of work and/or thewidance
vt
building emit. For each applicable trade all Information requested below must be completed by apeficant. "On File" is not an acts table response.
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City of La Quinta.
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit#
Project Address:
Owner's Name: 9--
A. P. Number:
Address:
Legal Description:
City, ST, Zip-./ ,,q
Contiactor:NT
TelephgLe.Z(a--2
-
xxx` ............
... .............
...............
....................... ..
..............
. . . ...............
................
Address:
. .............
Project Description:
City, ST, Zip:
telephone:
State Lic. #
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
................ ......
... .....
State Lic. #: x ...... x
X ...... .....
XXXx XX,
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add Alter Repair Demo
Sq. Ft./o # Stories: #Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural CaIcs.
Reviewed, ready f corrections
21fl�t—
-Pla—nCheck Deposit
I Truss CaIcs.
Called Contact PeM�
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
3
Plumbing
Grant Deed
n
Plans picked up &,
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3,d Review, ready for correction /issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
I Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
w� 6"zx-- %
,31,22-
6Arr IIPC
M
- CERTIFICATE OF COMPLIANCE ��FS
Desert Sands Unified School District gr�rnyo
47950 Dune Palms Road BERMUDA DUNES O
RANCHO MIRAGE 0
Date
3/29ro5 La Quinta, CA 92253 V� INDIAN WELLS
No. 2729 dPALMOESERT
VDIO
UINTA
- t'
y7
Owner Ruben Bonilla APN # 646-290-028
Address 78540 Via Melodia Jurisdiction La Quinta
City LaQuinta 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 78540 Via Melodia 374 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, cooldng, 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
in the amount of $0.00 X 374 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- Ruben Bonilla Check No.
Name on the check y Telephone 546-4203
Funding Exempt
By Dr. Doris Wilson '
Superintendent
Fee collected /exempted by Pharyn MCGilvrey ' Payment Recd
~ Over/Under
Signature.
F
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 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
Em bossed Original -Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting