07-1307 (AR)u
P.O. BOX 1504
78-495 CALLE TAMPICO -
LA QUINTA, .CALIFORNIA 92253 - BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
fApp'llcation Number: 07-00001307 Owner:
Property Address: , 80195 VIA MIRASOL NRI,. CCP I
APN: 772-430-009- - 81100 AVE 53
Application descrADDITION DDITION - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
` Application valuation: 26810
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with x
'Section 7000) of. Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Clas : B / License No.: 744091
Dat Contractor: ✓
OWNER -BUILDER -Cl ARATION
r I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 Contractor's State
. License Lave (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)::
1 _ 1 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 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.).
1—) I, 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.). -
1 1 I am exempt under Sec. B.&P.C. for this reason
Date: Owner: -
• CONSTRUCTION LENDING AGENCY • -
Ihereby 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 kr'
LQPERAIIT -
? VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: - 4/30/07
Contractor:
SUN VISTA DEVELOPMEN RP d
P.O. BOX 1144 Q
LA QUINTA,"CA 92247
i (760)771-4722
Lic. No.: 744091 MAY
.04
C OFLgQU►yTq
_ _ �'. �A1VCE DEQ
WORKER'S 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.
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
-- - J Code, for the performance of the work for which this permit is issued. My workers' compensation
•' insurance carrier and policy number are: '
Carrier'STATE FUND Policy Number 170546206
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in anymanner so as to become subject to the workers' compensation laws of. California,
and agree that, if I, should become subject to the workers; compensationprovisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions. -
Dat Applicant: G� --
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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
- - APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permitsubject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at w_ hose 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 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 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 the above-mentioned property for inspection purposes. -
iDat Signature (Applicant or Agent):
_� t
LQPERDIIT
Application Number
. . . . 07-00001307
Permit
BUILDING PERMIT
Additional desc .
Permit Fee . . . .-
265.00 Plan Check Fee
172.25
Issue Date
Valuation 1
26810
Expiration Date ;
10/27/07
Qty Unit Charge
Per
Extension .
BASE FEE
252.00
2.00 6.5000
THOU BLDG. 25,001-50,000
13.00
Permit
ELECT- ADD/ALT/REM
Additional. desc....
Permit. Fee -..
29.67 Plan Check Fee
Issue -Date
Valuation . .
0
Expiration`Date
10/27/07
Qty Unit Charge
Per
Extension.
BASE - FEE
15.00
419.00 0350
;, `ELEC NEW. RES'- 1, OR •2 FAMILY
14.67•
Permit .,
MECHANICAL
Additional desc ...
'• Permit Fee
24.00 -Plan-Check Fee
:.: Issue Date. '.
Valuation
0;
Expiration Date
_ 10/27/07=.
1. Qty'. Unita Charge
.Per..Extension
-BASE FEE :"
15.00
1..0.0 9.0000
EA, MECH APPL REP/ALT/ADD =.
9..00-. -
Permit:
PLUMBING
Additional desc .:
Permit Fee
36 .00 . Plan Check Fee .'. -.
9.00
Issue Date.
-,Valuation,
0
Expiration Date
10/27/07
Qty Unit Charge
.Per
Extension
BASE FEE
15.00
2.0,0 6.0000
EA PLB,FIXTURE
12:00
1.00 3'.0000
EA PLB.WATER INST/ALT/REP
3:00
2.00 3.0000
EA PLB GAS PIPE.1-4'OUTLETS
6.00. ..'.
Special Notes and Comments
MOVE POOL BATHROOM,ENCLOSEPART OF
LQPERDIIT
Application Number
07700001307
---------------- - ---------------
Special Notes and Comments
--
--------------------------------
EXISTING PATIO ADD 419 SQ. FT.CHANGE
.
ENTRY TO MASTER -BATH AND ADD LAUNDRY
ROOM TO WEST SIDE OF HOME.April.30,
2007"11:00:54 AM JJOHNSON
Other Fees . . . . . .
ENERGY
REVIEW
FEE
17.23
STRONG
MOTION
(SMI) - RES
2.68
Fee summary Charged
Paid.
Credited
Due
Permit Fee Total 354.67
.00
.00
354.67
Plan Check Total 194.67
.00
.00
194.67
Other,Fee Total: 19.91
.00
'00
19.91
Grand Total 569.25
..00
.00
569.25
LQPERMIT
_
Bin #
C�7^ r*z of La Quinta
Building U -Safety Division a
Pgtmit iy P.O. Box 1504, 78-495 Calle Tampico
�6 , �7 La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: 1), /4 M /�A-S oL Owner's Name:
A. P. Number: — — Address:
Legal Description: ,L
City, ST, Zip:
Contractor:
• Telephone:
Address: Project Description: A I f.o L
City, ST, Zip: v A
Telephone:
00 %ef
State Lie. #
.
City # A5 Lic. • i
C.�i Ate/ - ,G
� • ✓��s�- �4
Arch., Engr., Designer:232
Address:
City, ST, Zip-
' .
Telephone:
Construction Type:
Occupancy:
State Lic. #:
Project type (circle one): New Add'n. Alter Repair Demo
Name of Contact Person: p /%Z
-
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
/—
Estimated Value of Project:
APPUCANT:
DO NOT WRITE BELOW THIS UNE
#
19
Submittal
Req'd
Reed
TRACKING
PERMIT FEES
Plan Sets.
Plan Check submitted
aTtp,
Calcs.
Reviewed, read or correctionsheck
AmountStructural
Deposit
Truss Calve.
Energy Calls.
Called Contac rson
Z .S
Plan Check Balance
G
Plans j�ieked.up
Flood plain plan
Plans resubmitted
77construction
Mechanical
Grading. plan'
2" R�1��dfororreed n&%sue
Electrical,
Subeon'tactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
•
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:=
'`' Review, ready for,correetious/issue
Developer Impact Fee
Planning Approval
Called .Contact person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
--------------------
07 Wz
Ove : 3� 07
Total Permit Fees
0?_4e
3.5 w N 15 P -PC
' Coachefla Valley Unified School District, This Box For District Use Only
83-733 Avenue 55, Thermal, CA 92274. DEVELOPER FEES PAID
(760) 398-5909 — Fax (760) 398-1224
- AREA:'` •�
AMOUNT '
LEVEL ONE AMOUNT:
LEVEL TWO AMOUNT:
MrrIGATION AMOUNT:
COMM/IND. AMOUNT:
DATE:
RECEIPT:
CHECK 9: .
INITIALS:
CERTIFICATE OF COMPLIANCE ,
(California Education Code 17620)
Project Name: NRI CCP tl Date:. 05/03/07
Owner's Name: NRI CCP 1 Phone No.' 760-771-4722
Project Address: 80195 Via Mirasol, La Quinta
Project Description: 1 SFD ,
APN: 772430=009 Tract #:. ' - Lot #
Type of Development: Residential xx '' Commercial • `
Total Square Feet of Building Area: 419 sq. ft. ,
Certification of Applicant/Owners: The person signing certifies that the above information is correct'and makes this statement under
penalty of perjury and further represents that he/she i's authorized to sign on behalf of the owner/developer. .
Dated:' 05/03/07. Signature:
SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN
ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE)
Education Code. -Gov. Code Project Agreement Existing Not Subject to Fee
17620 65995. Approval ' Prior to 1/1/87 Requirement
x
Number of Sq.Ft.. 419 sq ft t
Amount per Sq.Ft. , S A.91 per sq. ft. 1
Amount Collected S 1638.29
By: Carey M. Carlson, Asst. Supt., Business Services, f -
Certificate issued by:. Maria L. Angulo, Facilities Secretary Signature:
A,
NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND S ATEM OF FEE
Section 66020 of the Government Code asserted by Assembly Bill 3081, effective"January 1, 1997, requires that this Dis tet provide ( a ritten notice to the
project appellant, at the time of payment of school fees, mitigation payment or other'exactions ("Fees"), of the 90 -day period to protest t to imposition of these
Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to
advise you that the 90 -day protest period in regard to such Fees or. the validity thereof, commences with the payment of the fees or performance of any other
requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this
time or in whole or in part prior to issuance of a Certificate of Occupancy. As in'the latter, the,90 days starts on the date hereof. This Certificate of
Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause; as determined by the School District, and up
to three (3) such extensions may be granted. At such time as this Certificate expires, ifa-building permit has not been iss_ucd for the project that is the subject
of this Certificate, the owner will be reimbursed all fees that were paid to obtain this Certificate of Compliance. ,
I T c�mvdos/tiLvtocs/celtiticau: ul'c+uIiplianLei6irn lahles'fU USS .doe �, r 1/16/03 T