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12-0010 (SFD)P.O BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000010 Property Address: 53866 ROSS AVE APN: 767-200-998-41 -330761- Application description: DWELLING - SINGLE FAMILY Property Zoning: LOW DENSITY RESIDENTIAL Applicotion voluotion: 020039 Applicant: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT DETACHED Architect or Engineer: . . A 1, ------------------ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I a licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business a Professionals Code, and my License is in full force and effect. License Class: B License No.: 848057 V Date: 1—j6./ZV/0e 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).: (_ 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 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.). - (_ 1 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.). (_ 1 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.). Lender's Name: _ Lender's Address: LQPERMIT Owner: ALAN AUSTIN LIVING 80760 VISTA BONITA LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 4/03/12 Contractor: BRADSHAW CONSTRUCTION 46248 ROUDEL LN LA QUINTA, CA 92253 (760)347-4246 Lic. No.: 848057 ------------------ 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 71950202311 _ 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 t ecome subject to the workers' compensation laws of California, and agree that, if I should be ome subject to the workers' compensation provisions of Section 3700 of the Labor Code, I all forthwith comply with those provisions. /ate: /��1415 Applicant: WARNING: FAILURE TO SECURE W RKERS' 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, indemnity 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 above information is correct. I agree to comply with all city and county ordinances and state laws relating to building c struction, and hereby authorize representatives' /of this county to enter upon the above-mentioned property to nspection purposes. • late: �1/ Signature (Applicant or Agent): Application Number . . . . . 12-00000010 Permit . . . . . . MECHANICAL LQPERMIT Structure Information Construction Type . . . . . TYPE V, UNPROTECTED Occupancy Type DWELLG/LODGING/CONG <=10 Other struct info . . . . . CODE EDITION 2010 # BEDROOMS 6'.00 FIRE SPRINKLERS YES GARAGE SQ FTG 2007.00 PATIO SQ FTG 1375.00 NUMBER OF UNITS 1.00 1ST FLOOR SQUARE FOOTAGE 8705.00 ----------------------------------------- 2ND FLOOR SQUARE FOOTAGE ------------------------------------- 592.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 3026.50 Plan Check Fee 1967.23 Issue Date . . . . Valuation . . . . 828039 Expiration Date 9/30/12 Qty Unit Charge Per Extension BASE FEE 2039.50 329.00 3.0000 -------------------------------------- THOU BLDG 500,001-1,000,000 --------------------------------------- 987.00 Permit . . . ELEC-NEW RESIDENTIAL Additional desc . Permit Fee . . . . 395.54 Plan Check Fee 98.89 Issue Date Valuation . . 0 Expiration Date 9/30/12 Qty Unit Charge Per Extension BASE FEE 15.00 9297.00 .0350 ELEC NEW RES -'l OR2 FAMILY 325.40 2007.00 ..0200 ELEC GARAGE OR NON-RESIDENTIAL 40.14 1.00 15.0000 ------------------------------------------=-------------------.-------------- EA ELEC TEMPORARY POWER POLE 15.00 Permit GRADING PERMIT Additional desc . Permit Fee . . . .. 15.00 Plan Check Fee .00 1 Issue Date Valuation . . . . 0 Expiration Date 9/30/12 Qty Unit Charge Per Extension -------------------------------------------- BASE FEE -------------------------- 15.00 ------- Permit . . . . . . MECHANICAL LQPERMIT Application Number . . 12-00000010 Permit . . . MECHANICAL Additional desc . Permit Fee . . . 225.00 Plan Check Fee 56.25 Issue Date Valuation 0 Expiration Date 9/30/12 Qty Unit Charge Per• Extension BASE FEE 15.00 3.00 9.0000 EA MECH B/C <=3HP/100K BTU 27.00 4.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 66.00. 7.00 6.5000 EA MF(H AH <=10K CFM 45.50 .10.00 6.5000 EA MECH VENT FAN 65.00 1.00 6.5000 - ---------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50 Permit PLUMBING Additional desc . Permit Fee . . . . 336.75 Plan Check Fee 84.19 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/30/12 Qty Unit Charge Per Extension BASE FEE 15.00 36.00 6.0000 EA PLB FIXTURE 216.00 1.00 15.0000 EA PLB.BUILDING SEWER 15.00 7.00 6.0000 EA PLB ROOF DRAIN 42.00 2.00 7.5000 EA PLB WATER HEATER/VENT 15.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00 9.00 .7500 EA PLB GAS PIPE >=5 6.75 1.00 15.0000 - EA PLB GAS METER =---------------------- 15.00 ----------- =----------------------------------------- Special Notes and Comments 9297 SF SFD [LIVING = 8241SF MAIN + . 592SF STAFF + 464 SF CASITA] TYPE V -B CONSTR. W/ FIRE SPRINKLER. 2010 CODES. 2008 DIF. **PERMIT DOES NOT INCLUDE BLOCK WALLS,. FENCES, SWIMMING POOLS; SPA, BBQ'S and DRIVEWAY APPROACH** GORDON STEIN DESIGN + CIVIL: S. MALHAS C23092 ----------------------------- Other Fees . . . . ----------------------------------------------- . . . . ART IN PUBLIC PLACES -RES 1570.10 BLDG STDS ADMIN (SB1473) 34.00 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 995.00 ENERGY REVIEW FEE 196.72 DIF FIRE PROTECTION -RES 140.00 LQPERMIT POST IN A CONSPICUOUS PLACE Certificate of Occupancy Community Development Department This Certificate is issued pursuant to the requirements of Chapter 1 Section R110 of the California Residential Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 53-866 ROSS AVENUE Use classification: SINGLE FAMILY DWELLING Building Permit No.: 12-0010 Occupancy Group: R-3 Type of Construction: VB Land Use Zone: RL Code Edition: 2010 Sprinkler Installed: YES Sprinkler Required: YES Owner of Building: AUSTIN ALAN Address: 80-760 VISTA BONITA TRAIL City, ST, ZIP: LA QUINTA, CA 92253 ____________ GREG BUTLER_________________ By: AJ ORTEGA Building Official Date: JANUARY 3, 2014