Loading...
04-3384 (AR)BUILDING & SAFETY DEPARTMENT, c P.O. Box 1504 (760) 777-7012 OFTt�'9`' 18-495 CALLE TAMPICo FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 r ' INSPE%CTION REQUESTS (760) 777-7153 BUILDING PERMIT Application "Number 04_0.0,0-03384 Date 4/15/04 Property Address-0475 VISTA MONTANA APN: 772-260-007-7 -14r04 - Application description ADDIT,ION,7 RESIDENTIAL Property Zoning VERY LOW DENSITY RES Application valuatibn.. 45442 Owner :Contractor HUBBLE WILLIAM.F DURRETT CONST, AL 74040 HIGHWAY 111 NO2218P-0. BOX 3371 PALM DESERT CA 92260:. - PALM DESERT CA 92,261 (760) 568-3838 (760).774-4368. WCC: STATE FUND- WC:, 1744606 09/01/04 CSLB: 451035 01/31/06 CCC: B ---- Structure•Information 624 SQ. FT., ADD AND 733.•SQ. FT: PATIO ----- Construction Type . . . . TYPE V NON RATED Occupancy Type . . .DWELLG/LODGING/CONG <-10 .Other struct info-.-. . CODE EDITION 2001 FLOOD ZONE NO PATIO SQ FTG.. 733.00 FIRST_FLOOR SQ FTG 624.00 Permit BUILDING PERMIT. .Additional desc . Permit Fee .388.50 Plan Check Fee 252.53 Issue Date . . . . Valuation . . 45442 Expiration Date 10/15/04 Qty Unit Charge Per _ ,� Extension BASE 'FEE 252.00 21.00 6.5000 THOU BLDG 25,001-.50,_000 136.50 Permit ELECT, ADD/ALT/REM Additional desc Permit Fee... . . . 15.75 Plan Check_ Fee 3.94 .Issue Date . . Valuation 0 Expiration Date "10/15/04.. Qty Unit Charge Per Extension BASE FEE, 15.00 1.00 ..7500 PER 'ELEC DEVICE/FIXTURE 1ST 20 .75 ---------------------=----------------------=------------i-------------------- J . P.O. BOX 1504 • VOICE (760) 777.7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: b Date: Y-(5- OK Applicant: S A',) C Applicant's Mailing Address: IA4-y— To Architect or Engineer: Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7010) of Division 3 of the Business and Professionals Code, and myLicense is i�ju11 force and effect A License Class �S License No. 4510 3,5 Date I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following r n ec. 031.5, 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 a 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 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, howeyer, 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 property 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 self4nsure 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 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 issumreed� work compensation insurance carrier and policy numbgr are. Cartier J7 1G N10 Policy Number / At X�qz —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 Labor Code, 1 shall forthwith comply with those provisions. Date D Applicant WARNING: FAILURE TO SECURE WO E COMPENSATION COVE S UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH SAND DOLLARS ($100,000), I DITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FE S. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury tat there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lenders Name �LL/L'S '044a6 Lender's Address 1"iQLzy APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a perr it 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 perfomred 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 Ouinta, 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 corecL I agree to ply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter n the a -menti property for ins ion purposes. Date �J Signature (Applicant or Agent): /fin\\ Page 2 Application Number 04=00003384 Date 4/15/04 Permit . . . . . MECHANICAL Additional desc Permit Fee 37.,00 Plan Check Fee 9.25 Issue Date Valuation 0-. Expiration Date 10/15/04 . Qty Unit Charge Per Extension BASE ;FEE 15.00 1.00 9.0000 EA MECH APPL REP/ALT/ADD 9.00 2.00 6.5000 EA MECH VENT FAN 13.00 Permit PLUMBING Additional desc Permit Fee, 36.00 Plan Check Fee. 9.00 Issue Date . . . 'Valuation. 0 Expiration Date .10/_15/04 Qty Unit Charge Per Extension BASE FEE 1'5.00 1.00 6.0000 EA PLB FIXTURE 6.00 2.00 6.0000 EA PLB ROOF DRAIN 32.00 1.00 3.0000 EA PLB, GAS PIPE 1 -4 -.OUTLETS 3,,.00 Special Notes and Comments 624 SQ. FT. ADDITION AND 73.3 SQ.FT. PATIO Other Fees: . ART IN PUBLIC_PLACES-RES OD ENERGY REVIEW FEE 25.25 STRONG MOTION (SMI) - RES 4.54 . Fee summary 'Charged. Paid Credited Due Permit Fee". Total. 477.25 .00 .00 477.25 Plan Check Total 274.72 .00 .00 274.72 Other Fee Total 29.79 .00 .00 .. 29.79 Grand Total 7'81.76 .00 .00 781..76 Coach0a Valley Unified School District .P.O. B -6i 847, Thermal, CA , 9'2274 160) 398.-5909 Fax (760) 398-1224 This Box For District Use Only T`%VAr1CT l%DICD AT717Q DATTI AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMWIND. AMOUNT: DATE: RECEEPT: CHECK N: INITIALS CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: Date: Agri 1 14 9004 Owner's Name: Bill Hubble Phone No. 7744168 Project Address: 50-475 Vista Montana Road La Ouinta CA Project Description:. house add. = 572 sg. ft.. ram/add.— 624 sa. ft_ APN: 772-260-007-3 Tract #: Type of Development: Residential Commercial Lot #'s: Total Square Feet of Building Area: 1,196 sq. f t . Certification of Applicant/Owners: The person signing certifies that the above information is under penalty of perjury and further represents that he/she is authorized ign on behalf of t}i� Dated: 6� Signature: ' SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEE _ OR ACCORDANCE WITH ONE, OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code Project 17620 65995 Approval Number of Sq -Ft- 1,196 Amount per Sq.Ft. $ 2.24 Amount Collected $ 2,679.04 Building Permit Application Completed: Yes/No Industrial and makes this statement BE SATISFIED IN Agreement Existing Not Subject to Fee Prior to 1/1/87 Requirement Note: By: " Carey M Carlson Asst. Supt., Business Serv. c Certificate issued by: E1 vi ra" Mattson Signature: Office Technician 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 District 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 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, if a building permit has not been 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. MV:c/mydocs/devfees/certificate of compliance 09/30/02 "