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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 a M G N In 0 N 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. coa "Rom• ChmWlcaftn Menu V..ba P.EAffMWRK (4-}21. . �aaaaait, ��� 7-1. O -� P G �AA- r* �c�,.�a /7 9 V75 0 2 M G CLI U) m J H Z (O m i r :M N Q V) G CLI Ln i 0 PRANIMtf'lf.•6)X1. Q s Omumay (C -Zai `• (O IC 361 eFPiAnMQ J 2 S 7 tAl1lo L� Its,i1CALfC-t91 COX19 7 'I�U�TT1L (C� 4B) ''NII (FAS} . i% w ir/CI (6171-,11out (C-21 j .S9089f; M42) Q (cam 15 LAI N CE UUWC TILE NC -64) 7 A - ,S 1 CAfiMM (Gel 3', RE-Snq, FERWAO IC -131 LANQSCAPD= (C•-271 ' • w / �aaaaait, ��� 7-1. O -� P G �AA- r* �c�,.�a /7 9 V75 0 2 M G CLI U) m J H Z (O m i r :M N Q V) G CLI Ln i 0 Bin # 0 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