BRES2017-0225a
78-495 CALLE TAMPICO
LA. QU I NTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
WILLIAM KISPENCER
71946 ELEANORA LN
RANCHO MIRAGE, CA
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BUILDING RESIDENTIAL/ADDITION
BRES2017-0225
49080 EISENHOWER DR
658290036
RUBENSTEIN RESIDENCE / ADDITION 520 SF
$92,000.00
A
OCT 2 4 2017
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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 Professions Code, and
my License is in full force and effect.
License Class: B, D03 License . ..
Date 113 -1`4 `1`1 Contractor:
OWNER -BUILDER DECLARATION
'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, atter, 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).:
(_J 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.).
( ) 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.).
( I I am exempt under Sec. . B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/24/2017
Owner:
CRAIG RUBENSTEIN
49080 EISENH OWER DR
LA QUINTA, CA. 92253
Contractor:
SHADE BUILDERS
P'0 BOX 66
THOUSAND palms, CA 92276
(760)578-2930
Llc. No.: 87002-6
WORKER'S COMPENSATION DECLARATION
1 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 3730 of the Labor Code, for the performance
of the for which this permit is issued.
I have and will maintain workers',=ompensation insurance, as required by
ection 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My workers' compensation insuranca carrier and polity number are:
Carrier: EXEMPT Policy Number: _
I certify that in the performance or the work for which this permit is issued, I'
shall not employ any person in any manner s:) 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 Sectior 3700 of the.Labor Code, I shall forthwith
comply witt/�
hthos�e provisions.
Date) `"�1 _Apprc,
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 ACKIVOWLEDGEMENT
IMPORTANT: Application is hereby made to -=he Building Official 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 Citr of La Quinta, its officers, agents, and
employees for any act or omission related torthe 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 :tate that the above information is correct.
I agree to comply with all city and county orcinances and state laws relating to building
construction, and hereby authorize represen-a' is a enter upon the above-
mentioned property for inspection 2iu-p es_
Ute: tN-44-D Sig nature:(Applican�or�A(
C
Date: 10/24/2017
Application Number:
BRES2017-0225
Owner.
PropertyAsddress: %`'.-.49080
EISENHOWER DR
CRAIG RUBENSTEIN
APN:
658290036
49080 EISENHOWER DR
Application Description:
RUBENSTEIN RESIDENCE/ ADDITION 520 SF
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$94000.00
Applicant:
Contractor:
WILLIAM KISPENCER
SHADE BUILDERS
71946 ELEANORA LN
P 0 BOX 66
RANCHO MIRAGE, CA
THOUSAND palms, CA 92276
(760)578-2930
---------------------------------------------
-=----------------------------------
Llc. No.: 870046
Detail: 520 SQ FT. ADDITION PER 2016 RES. CODES CONVENTIONAL LIGHT FRAMED CONSTROCTION.
--=--------
'
C
.z DESCRIPTION
ACCOUNT
QTY
AMOUNT .
ADDITION, EA ADDITIONAL 500 SF
101-0000-42400
0
$67.10
DESCRIPTION.
ACCOUNT
QTY
AMOUNT.
ADDITION, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$18.72
DESCRIPTION
ACCOUNT
QTY
AMOUNT
ADDITION., FIRST 100 SF
101-0000-42400
0
$131.07
DESCRIPTION
ACCOUNT
QTY
AMOUNT
ADDITION, FIRST 100 SF PC
101-0000-42600
0
$184.13
Total Paid for ADDITION: $401.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HOURLY CHARGE - YES ADMINISTRATIVE STAFF
101-0000-42600
0.2S
$10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HOURLY CHARGE - YES ADMINISTRATIVE STAFF
101-0000-42600
0.25
$10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HOURLY CHARGE - YES STRUCTURAL PLAN REVIEW ENGINEER
101-0000-42600
1
$95.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT.
HOURLY CHARGE -YES STRUCTURAL PLAN REVIEW ENGINEER
101-0000-42600
2
$190.00
Total Paid for BLDG CITY STAFF - PER HOUR: $305.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$4.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $4.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, FIRST 1,000SF
101-0000-42403
0
$156.04
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, FIRST 1,000SF, PC
101-0000-42600
0
$51.49
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $207.53
Total Paid for MECHANICAL:. $162.14
FIXTURE/TRAP 101-0000-42401 0 $76.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$76.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$13.00
DESCRIPTION
ACCOUNTQTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$26.01
DESCRIPTION
ACCOUNT `
QTY
AMOUNT
WATER HEATER/VENT
101-0000-42401
0
$12.67
DESCRIPTION
ACCOUNT I
QTY
AMOUNT
WATER HEATER/VENT PC
101-0000-42600 I
0
$7.60
DESCRIPTION
ACCOUNT
'QTY
AMOUNT
WATER SYSTEM INST/ALT/REP
101-0000-42401
0.
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP PC
101-0000-42600
0
$12.67
Total Paid for PLUMBING FEES: $236.66
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$11.96
Total Paid for STRONG MOTION INSTRUMENTATIDN SMI:. $11.96
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Bin#'
City of La Quinta
Building & Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit#
O
Proj kgs .' B
q� 1
Owner's
A.P. Number
Address: 0-0
1
Legal Description:
City, ST, Zip& v -7
Contractor: p e 0 I/ter' ' N 1
Telephone: 5
(o a
Address:
Project Description:
City, ST, Zip:
.►
Telephone:
State Lie. #:
City Lie
Arch, Engr., Designer:
p 1 �`..�-✓`
,1 J
Address: -7
t�rl / p ;
Illi
City, ST, Zip: 14IR
Telephone: -3
VV
Construction Type:
P ype 1�'ew Ad n
Occupancy: ,
Alter Repair Demo
State Lie. #:. /'6
Name of Contact: CL(o
SgFt: hD
#Stories
ON
f
#Units: 1
l�
Telephone of Contact: 950 D
301qEstimated
Value of Project:
7
!�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check Submitted
Item
Amount
Structural Calcs
Reviewed, ready for corrections
Plan Check Deposit:
Truss Calcs
Called Contact Person
Plan Check Balance:
Title 24 Cales
Plans Picked Up
Construction:
Flood Plain Plan
Plans Resubmitted
Mechanical:
Grading Plan
2nd Rev, Ready for corrections /
Electrical:
Subcontractor List
Called Contact Person
Plumbing:
Grant Deed
Plans Picked Up
S.M.I.
HOA Approval
Plans Resubmitted
Grading
IN-HOUSE
3rd Rev, Ready for corrections /
Developer Impact Fee
Planning Approval
Called Contact Person'
A.I.P.P.
Pub. Wks. Apps
Date of permit issue
School Fees
Total Permit Fees
Date: 10/24/2017
No.: 17-00775-1
Owner: Rubenstein
Address:
City:
Type: Residential Addition > 500 sq ft
Lot # Street No.
49080
Comments:
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760)771-8515
Street Name
Eisenhower Dr
J
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coy r SCyo
W BERMUDA DUNES
RAKCNO MIRAGE a
1-' INDIAN WELLS y
C PALM DEESERT y
COACHELLA0
LA0((11INTA 7�
Q IN010 Y
RECEIVE®
Email:
Jurisdiction: La QuinlKT 2 4 2017
Tract #: '
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT
Sq. Feet APN Permit No.
520 658-290-036
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions
under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking eating, or sanitation) or replacement
mobile homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fess imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $3.48 X 520 S.F. or $1,809.60 have been paid for the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in the proposed project may now be issued.
Fees Paid By: CC/Rabobank -Robert Bambusch Check No.: 8006704
Bank Name/Recipient of Certificate Telephoner 8-2930
Funding: Residential
By Scott L. Bailey
Superintendent
Fee Collected/ Exempted by: Sharon McGilvr Certificate Feesuec. $1,809:60' ,
Original Paymentt's) Rec do i$0.00
C New Paymentl3c'd: $1,809.60 rt
Over/Unde`r: $0.00 "
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify yotha the 90 -day approval period in which you `riay-protest the:fees o'r
other payment identified above will begin to run from the date on which the building nstallation permit for this project is issued;,or "r'dm theldate 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 to Building Department: THIS DOCUMENT VALID ONLY IF IMPRINTED WITH EMBOSSED SEAL.
CITY OF LA QUINTA SUB -CONTRACTOR. LIST
JOB ADDRESS PERMIT NUMBER OWNER _ _ „BUILDER
This form shall be job with the Building Inst)ection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant.. "On File" is not an acceptable response..
:.:..
Cit Qusiricss LiCenSe
it i t Corttrac or State Contractor s License'- Workers Coii�perisabort liisurancc C Y
Trade J Class scat o t t
Company Name Classification License Number Exp. Date Carrier Name Policy Number Exp. Date License Number Exp. Dat
(e.g. A, B, C-8) (xxxxxx) (xxlxx/xx) (e.g. State Fund, CalComp) (Format Varies) (xx/xx/xx) -77
(xx/xx/xx
/1C--0)