06-0038 (AR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
(06-000000"38'
l__
79392 CALLE VISTA VERDE
604-392-035-76 -25953 -
ADDITION - RESIDENTIAL )
LOW DENSITY RESIDENTIATi`/
5702
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SLAGLE RODNEY G
V *NOT ON FILE
UNKNOWN, CA 99999
.% ry Other strtict-info
Poo, _ 106
AArrchittgt or Engineer: vF� iq
LICENSED CONTRACTOR'S DECLARATION
I 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 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 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).:
( ►1C 1 I, as owner of the property, or my employees with wages as their sole compensation, will db the work, and
i 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.).
I, as owner of the property, am exclusively contracting with licensedcontractors 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 I am exempt under Sec. , B.&P.C. for this reason -
ate: / ner.
CONSTRUCTIO19 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.).
Lender's Name:
Lender's Address: _-
LQPE%-ATT '
� i
Contractor:
Owner
DITION 2001
Lic. NO.:.E FOOTAGE
VOICE (760) 777-7012
:FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/13/06
C,
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.
I have andwill 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 00 Policy Number NO
I certify that, in the performance of the work for which 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 that, if I should become subject to the workers' compensation provisions of Section
/
3700 of the La Code, Ish all forthwith comply with t./IssE provisions.
ate:/7 plicant:
WARNING: FAILURE TO SECURE WORKERS' COMPS - ION 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 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-beriefit 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.
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 ws relating to building construction; and hereby author'ze representatives
of tht�pon the ve-mentioned property for inspection purposes. -
v
D n re (Applicant or Agent):
Application Number . . . . 06-00000038
Permit . . . . BUILDING PERMIT
Additional desc ..
Permit Fee 81.00 Plan Check
Fee
52.65 -
' Issue Date . . Valuation
5702
Expiration Date 7/12/06
Qty Unit Charge Per
Extension
BASE FEE
45.00
4:00 9.0000. THOU BLDG 2,001-25,000
----------------------
36.00
Permit ELEC-MISCELLANEOUS
Additional desc `
Permit Fee . . . 18.75 Plan Check
Fee
4.69
Issue Date Valuation
0,
Expiration Date 7/12/06
Qty Unit Charge Per
Extension
• BASE FEE
15.00
5.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
3.75
-----Special.Notes and Comments
105 sq.ft. CLOSET ADDITION TO SFD.
ELECTRICAL PERMIT, UNCONDITIONED SPACE.
2001 CBC,.CMC,CPC. 2004 CEC, 2005 ENERGY.
Other Fees . . . . . ENERGY REVIEW FEE
5.27
STRONG MOTION (SMI)
-.RES
.57
Fee summary Charged Paid Credited.
-Due
Permit Fee Total 99.75 .00
.00
99.75
Plan Check Total 57.34. .00
.00
57.34
Other Fee Total 5.84 .00
.00
5.84
Grand Total 162.93 .00
.00
162.93
o-
l •
LQPERbIIT
Bin # `
r City of La nuinta
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
ODALa
Project Address: '7 9 39Z L411 e- V 1$fCl Ve;joe
Owner's Name: R.Q 6 J AI
A. P. Number: 60V-39,Z - d 3S ' 8
Address: '7q3-7;2- C . f I e- j/:i $tic Ve-" e.
Legal Description: J'a 7(p Of 7�rac-11-9,S3
City, ST, Zip: /-q u I /✓4& , J!�4 , 51-2-Z-5-3
Contractor: (Jw/l/L�/ ��/�G7e-
Telephone (7,ov�
Address:
Project Description: C%p,$e-t Rddl•�-iDN
City, ST, Zip:
Telephone:
State Lic. # : City Lic. #:
Arch., Engr., Designer: 6e6, A& f//-7TGTS
Address:
City, ST, Zip: )04LM 4E &X72 GA, y //
Telephone: e %GO) 7 7Z, - 50-S2
State Lic. #: 6-19x2 /,9 i
Name of Contact Person: I --01 //1/
Construction Type: Occupancy:
Project type (circle one): New dd-n Alter Repair Demo
Sq. Ft.: '1,9,5-
# Stories:
Units: I
Telephone # of Contact Person: (Z10) 7 7iO
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
o,6
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Checl, Balance
Energy Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanica-
Gradin plan g P
2°" Review, ready for correctio issue
j D
Electrical
Subcontactor List
Called Contact Person
t /s'
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
f. ,
iy/ rNLA7 ro -If- airL4J6 . • 501. FdL 49)("PAP11-w
P3�/S�i.� mow,
,O�
CERTIFICATE OF COMPLIANCE 08
Desert Sands Unified School District
47950 Dune Palms Road BERMUDA DUNES r
RANCHO MIRAGE
Date 1/17/06 La Quinta, CA 92253 .INDIAN WELLS
No. 28034 d� P QLM UINTAL
(760) 771-.8515 � INDIO
QL
Owner Robin Slagle APN # - 604-292-035
Address 79392 Calle Visgta Verde 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 79392 Calle Vista Verde 105 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 garagestcarports, covered patiosMrallmyv, residential additions under 5
00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, 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
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $0.00 X 105 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 - Robin Slagle Check No.
Name on the check Telephone 776.4t-50 ext 3
Funding Exempt
By Dr. Doris Wilson l Y
Superintendent
Fee collected /exempted byar n MCGllvrey Payment Recd $0.100
N�
rOiier/Und��.
. � 4
v
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 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
Embossed Original- Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting'
WLLf1GwAicuwIr I" T.t%rIv�.:*
READ ELEVATION FSS AND JOB CARD ARE NOT ON
THE SITE FOR ASCHEDULED
SCALE: 1/4" V-0" LNSPECTIO3. 2x s0MIT mviWir� _ ..
SITE PLAN AND ADDITION ROOF PLANcn
Emmmi
l
SCALE: 1/8" = V-0"
W
S!ZED DEBRIS CONTAINER _
tfS, PrOWRED ON THE JOB SITE DURING AL1.
�
_ . 24 6A. GONT DRIP �-
8'-6• P AS �� CONSTRUCTION AND MUST $E Fu�i�i�wi
01PTI ED AS NECESSARY, FAILURE TO DO SO 4" MIN. �.,,
Q
. = U
..
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