07-1521 (AR)a
A.
P.O. BOX 1504
•� .
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 ' BUILDING & SAFETY DEPARTMENT
° - I - BUILDING PERMIT "
Application Number:__. 07 -00001521 -
Property Address: 49241 AVENIDA. VISTA BONITA
APN: 773-350-029-29 -14496
Application description: ADDITION - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application. valuation: 15000
Applicant:
Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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: B License No.:: 80077645
- -. -Date:"_., tractor. ( �zt,<:;�7 ✓ . C
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).:
(_ 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 of 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
1, 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 contractorls) licensed
. pursuant to the Contractors' State License Law.).
I—) I am exempt under Sec. B.&P.C. for this reason
Date: Owner:
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.).
.L'ender's Name:
Lender's Address: .
LQPERMIT
r
Owner:
BETTS
49-241 AVENIDA VISTA BONITA
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/30/07
Contractor:
SCRIVENS CONSTRUCTION INC,
P.O. Box 13302- AUG 3 0 2007
PALM DESERT, CA 92255
( 760 ),837-9918 C1�OF� QUIN
Lic. No.:.807645 F1 OF
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 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 carrier and policy number are:
Carrier STATE FUND Policy Number 229-2947707
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 s bec subject to the workers' compensation provisions of Section _
. Cyt 3`700 of the Labor ode, s orthwith c ply with those provisions.
Date:,I O V- Applicant:
WARNING: FAILURE TO SECURE WORKE '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 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 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 ab a info atio orrect. I agree to comply with all
city and county ordinances and "state laws relating to buildi constr i d hereby horize representatives
of this county to enter uoorm)e above-mentioned property or ins p urposes
Date:Signature (Applicant or Agent):
7
r, Application Number .
. . . . 07-00001521
------ Structure Information
131SF ADDITION TO MASTER/V-NR/RES-3
-----
rf Other struct info ..:
CODE EDITION _200i/2005
#,BEDROOMS
1.00,
FLOOD ZONE NO
1ST FLOOR SQUARE FOOTAGE
131.00
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee
162.00 Plan Check -Fee
105.30
Issue DaLe . .'. .
ValuaLiuii
19000
Expiration Date
2/26/08
Qty'.Unit Charge
Per
Extension
BASE FEE
45.00
13.00 9.0000
-THOU BLDG 2,001-25,000
117.00
Permit
ELECT - ADD/ALT/REM
Additional desc
Permit Fee
19..59 Plan Check Fee.
4.90
Issue Date.
Valuation
0
Expiration Date
2/26/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
131.00 .0350
ELEC NEW RES - 1 OR'2 FAMILY
4.59
Permit
MECHANICAL
Additional desc .
Permit Fee
19.50 Plan Check Fee
4.88
Issue Date
Valuation . .
0
Expiration Date
Qty Unit Charge
Per
Extension"
BASE FEE
15.00
1.00 4.5000'EA
MECH VENT INST/ DUCT.ALT
4.50,
Permit
PLUMBING
Additional desc .
Permit Fee
.27.00--.. Plan Check Fee
6.75
Issue Date
Valuation
0
Expiration Date
2/26/08
Qty Unit Charge'
Per
Extension
LQPERMIT - -
- -
-
Application Number . . . . . 07-00001521
Permit . . . . . . .PLUMBING
Qty. Unit Char ge Per
Extension
BASE FEE
15.00
1.00 6.0000 EA PLB FIXTURE
6.00
1:00 6.0000 EA PLB ROOF DRAIN
6.00
-----------------------------------
Special Notes and Comments
-------
--------------
131SF ADDITION TO MASTER/V-NR/RES-3.
THIS PERMIT DOES NOT INCLUDE
BLOCKWALLS. August 30', 2007 1:08:49 PM
AORTEGA
-----------------------------------------------------------
Other Fees 'ENERGY REVIEW FEE
10.53
STRONG MOTION (SMI)
- RES
1.50
Fee.summary Charged Paid Credited
Due
Permit Fee Total 228.09 00
.00
228.09
Plan Check Total 121.83 .00
.00
121.83
Other Fee Total 12.03 .00
.00
12.03
Grand Total 361.95 .00
.00
361.95
LQPERMIT -
CERTIFICATE OF COMPLIANCE 9
Desert Sands Unified School District �p 0
CO
47950 Dune Palms Road Q BERMUDA DUNES r
RANCHO MIRAGE
Date 7/24/07 La Quinta, CA 92253 INDIAN WELLS
_ (760) 771-8515 �'
P
No. 29595 LAQUINTA
- 11�1QINDIO y7 ,
Owner Betts APN # 773-350-029
Address 49241 Avenida Vista Bonita Jurisdiction La Quinta
City La Quinta Zip Permit #
Tract # Study Area
Type Residential Addition No. of Units 1 ,
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 49241 Avenida Vista Bonita 131 Unit 6
Unit 2 ' Unit 7
Unit 3 Unit 8
Unit 4 Unit
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, 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 131 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 -John Dadanian Check No.
Name on the check Telephone 455.5252
• Funding Exempt
By Dr. Doris Wilson
Superintendent
c' Ec°1 4 , . , ri
f-
Fee collected /exe ,pted b S ron 'Ivrey Payment Recd
` 'Over/Under
'Signature 4AI
r,'� 1
NOTICE: Pursuant to Government Code Section 66020(d)(1), thi ill se 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 w e 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