Loading...
04-6264 (AR)T �F �wQ�rw BUILDIi�G &SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE T.AMPICo ;' FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT > anon_ Number 04-0OQ062�6�4_ Date. 3/15/05 operty Address 562. VILLAGE DR APN: 764-040-017-. - - description ADDITION - RESIDENTIAL � ,.Application Property Zoning. . . . . LOW DENSITY RESIDENTIAL Application valuation 159788 _ Owner - Contractor - -------------- - - - - _ .. - - - - - -•- - - - - - -------- --=-JERRY JERRYWILLIAMS J W DESIGN & CONSTRUCTION, INC 5365 CANDELABRA PL P 0 BOX- 1154 SAN.LUIS OBISPO CA 93401,, ,SAN LUIS OBISFO CA 93406 (805):` 544-3130 WCC: STATE FUND WC: 173035404 04/01/05 CSLB: 5549LO 01/31/07 CCC:, B ------ Structure Information SINGLE FAMILY DWELLING ----- Occupancy Type . . . .DWELLG/LODGING/LONG <=10 Flood Zone . . . . . . NON -AO FLOOD ZONE Other struct info.. . . CODE EDITION •. 2001 CBC # BEDROOMS 5.00 FLOOD ZONE OT GARAGE`SQ.FTG 504.00 PATIO SQ FTG 57`3.00 :, 1,ST FLOOR SQUARE._FOOTAG ;:1761.00 --------------------------------'=---= -------------------------------------- Permit BUILDING PERMIT .Additional desc Permit Fee, 849. _ 50_. Plan Check• Fee ,. �, : 552.18 Issue Date -' 'Valuation 159788 Qty Unit Charge Per Extension BASE FEE 639.50. 60.00 3.5000 THOU BLDG.100,001-500,000 210.00 Permit. . . ELECT - ADD/ALT/REM Additional desc `. Permit Fee 86.72 Plan Check Fee 21.68 ' I:ssue Date. . . . Valuation .0 Qty Unit Charge ,Per Extension BASE: FE,E, 15.00 1761.00 .0350 ELEC..NEW. RES -1 OR 2 FAMILY . 61.64 504.00 .0200 ELECGARAGE.OR NON=RESIDENTIAL 10.08 ----- -,- --------------------- - Permit MECHANICAL ------- Additional desc P.O. B o x 1504 • �����/ 78-495 CALLE TAh1PIC0 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: V -t - WotWLt Applicant: Applicant's Mailing Address: I hereby affirm under penalty of perjury that I am licensed Cede, and my License is in full force and effect. /License Class t+j "ate ontractor am VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Architect or Engineer: Date: _ 3 15.05 Architect or Engineer's Address: A Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exam 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, i prove, 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 pr visions 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 th' efrom 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 h dred dollars ($500).): U 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 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 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 properly 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 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. X4 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 insupanrp carrier and policy number are amer _ �forman Num r LZtcj _ I certify that, in the performance of the work for c this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree t i ho d come subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. , WARNING: FAILURE TO SECURE WORKERS' COMPEN ATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLA S ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND TTORNEY'S FEES. I hereby affirm under penalty of perjury that there is a CONSTRUCTION LENDING AGENCY lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address IMPORTANT Application is hereby made to the Director of Building and Safety Jor a permit ACKNOWLEDGEMENT GEohe 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 applic t, each agrees to, and shall, defend, indemnify and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission related t e ork bein erformed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null n void s t commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellaf n I certify that I have read this application and state that the above inform " ' is co c I agr a to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize re sentatives of this county to en u -m ntioned property for inspection purposes. ate: �J SigAp licant or Agent): P 9 ) Page 2 Application Number .04-00006264 Date 3/15/05 Permit Fee . . . . 77.00 Plan Check :Fee 19.25 Issue Date Valuation- 0 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100,K 18.00 2.00, 9.0000 EA MECH B/C <=3HP/100K BTU 18.00 4.00 6.5000 EA MECH VENT FAN 26.00 Permit z. . . . . . • PLUMBING . Additional desc Permit Fee . . . . 120.75 Plan Check Fee 30.19 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 12.00° 6.0000 EA PLB FIXTURE 72.00, 1.00 15.0000 EA PLB BUILDING SEWER 15.00 2.00 7.5000 EA PLB WATER HEATER/VENT 15.00 5.00 1 .7500 EA: PLB GAS PIPE >=5 3.75 Special Notes and Comments - 1761.SF. ADDITION TO ORIGINAL.HOUSE WITH 504 SF. DETACHED GARAGE &,573 SF. PATIO COVERS Other Fees. . . . . . ENERGY, -REVIEW FEE 5.5.22 STRONG MOTION ( SMI) -` RES 15.97 Fee summary` Charged Paid Credited Due Permit Fee Total 1133.97 .00 .00. 1133..97 Plan Check Total 623.30 :00 .00 623.30 Other Fee Total 71..19;,. .00- .00 71.19 Grand Total 1828.46 .00 .'00 1828.46 A. Coach-olla 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 . • r AREA: - AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: "MITIGATION AMOUNT: COMMAND. AMOUNT: DATF: RFCF.WT. GHF.r.K 11- INITIALS - CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: Date: March 15, 2005 Owner's Name: Jerry Williams Phone No. Project Address: 56-222 Village Drive La Quinta, CA Project Description: Addition plus guest house APN: 764-040-017 Tract #: Lot•#'s: Type of Development: Residential XX Commercial Industrial Total Square Feet of Building Area: 1,761 sq. ft. Certification of Applicant/Owners: The person,signing certifies that the above fo ati is correct and makes this statement under penalty of perjury and further represents that he/she is authorized to sign on behal f th r/developer. Dated: March 15, 2005 Signature: SCHOOL•DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT AVE 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 • '" Note: Number of Sq.Ft. 1,761 Amount per Sq.Ft. $ 2.68 Amount Collected $ 4,719.48 Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Business Services Certificate issued by: Elvira Mattson, Office Technician - _ Signature: NOTICE OF 90 DAY. -PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES' Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this Eistrict provide (1) a written 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 the 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 paymem of the fees or performance of anyother 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, if a building permit has not beer issued 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. z t':c:hmdocccrtihcate E;;. complimce, i)ml tables170 U.sf]>.doc 1/16/03 T 1 T F Td4 ' _� Building & Safety. Department c of9�� 78-495 Calle Tampico PO Box 1504 La Quinta, CA 92253 (760) 777-7012 voice — (760) 777-7011 fax' CERTIFICATION OF BUILDING AREA STREET ADDRESS OF JOB 56T22�2'VILLAGE'DR: APN: 764-040- O 1 ? 3�U o DESCRIPTION OF WORK: AD (TION PLUS GUEST HOUSE SQUARE FOOT, `GE::1.761-Sf-7 OWNER'S NAME:•JERRY WILLIAMS E Y OF LA QUlNTA DING & SAFETYDEPT. PPROVED R CONSTRUCTION Coachella Valley Unified School District 83-733 Avenue 55 POBox 847 Thermal, CA 92274 (760).398 5909 SCHOOL FACILITY FEES COLLECTION HOURS: 8.00 A. M. - 4.00•P.M. Monday - Friday PLEASE NOTE: FEES MUST BE PAID IN CHECK OR.CASHIERS CHECK. NO CASH. For questions regarding this letter, please call: Ed Randall, Counter Technician (760) 777-7012