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05-0598 (AR)
W1178 495V BUILDING & SAFETY DEPARTMENT x 1504. (760),777-7012 ALLE TAMPICO FAX (760) 777-7011 4TA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT \-'A plication Number . . . . X05 -00000598_f Date 3/04/05 Property Address. . . . . . . 79205 CANTERRA CIR APN: 604-263-007-24 -23913 Application description . ADDITION - RESIDENTIAL Property Zoning . . . . . LOW DENSITY RESIDENTIAL Application valuation 30000 Owner Contractor ------------------------ WILMETH ROBERT D ------------------------ PAGE CONSTRUCTION .79-205 CANTERRA 77820 MOUNTAIN VIEW AVENUE LA QUINTA CA 92253 PALM DESERT CA 92211 (760) 345-1936 - WCC: COMBINED WC: 005-00024753 01/01/06 CSLB: 716999 06/30/06 CCC: B =.----- Structure Information 183 SF. ADDITION ----- Construction Type . . . . . TYPE V -_NON RATED. Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10 Flood Zone . . . . . . . . NON -AO FLOOD.ZONE Other struct info.. . . CODE EDITION 2001 CBC 1ST FLOOR SQUARE FOOTAGE 183.00 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee .284.50 P1an,Check Fee 184.93 Issue Date Valuation . . . . 30000 Qty Unit Charge Per - Extension BASE FEE 252.00 5.00 6.5000 THOU BLDG 25,001-50,000 32.50 ------------------------ ----------------------------------------------------- Permit . . . . . . MECHANICAL Additional desc Permit Fee . . . . 32.50 Plan Check Fee 4.88 Issue Date Valuation . . 0 Qty Unit Charge. Per Extension BASE FEE 15.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 2.00 6.5000 EA MECH VENT FAN 13.00 ----=----------------------------------------------------------------------- Permit . . . . . . ELECT - ADD/ALT/REM Additional desc Permit Fee . . . . 39.90• Plan Check Fee 9.98 Issue Date . . . . Valuati.on 0 Qty Unit Charge Per Extension P.O. BOX 1504�� VOICE (760) 777-7012 Tilf 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Applicant: Applicant's Mailing Address: Date: V ' T- 05 - Architect 5' Architect or Engineer: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 %License -Ni% ate 1�ntractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 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 fora 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, 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 contractors) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. __B,& P.C. for this reason 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 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. 'CZI: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: .d�ame�--olicy-Number 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, I shall 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. CONSTRUCTION LENDING AGENCY 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 Lenders Address 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 above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this c ty o enter upon the above-menfigned property for inspection purposes. Fee summary Charged Permit Fee Total 449.90 Plan Check Total 223.04 Other Fee Total 21.49 Grand Total 694.43 Paid Credited Due ---------- ---------- ---------- .00 .00 449.90 .00 .00 223.04 .00 .00 21.49 .00 .00 694.43 Page 2 Application Number . . . . . 05-00000598 Date 3/04/05 Qty Unit Charge Per Extension BASE FEE 15.00 20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 15.00 22.00 .4500 EA ELEC DEVICE/FIXTURE >20 9.90 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING Additional desc . . Permit Fee 93.00 Plan Check Fee 23.25 Issue Date Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 8.00 6.0000 EA PLB FIXTURE 48.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 2.00 6.0000 EA PLB ROOF DRAIN 12.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ------------------------------------------------------ Special Notes and Comments --------------------- 183 SF. ADDITION ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ART IN PUBLIC PLACES -RES .00 ENERGY REVIEW FEE 18.49 STRONG MOTION (SMI) - RES 3.00 Fee summary Charged Permit Fee Total 449.90 Plan Check Total 223.04 Other Fee Total 21.49 Grand Total 694.43 Paid Credited Due ---------- ---------- ---------- .00 .00 449.90 .00 .00 223.04 .00 .00 21.49 .00 .00 694.43 Permit 571 0--) 1� .Project Address: A.Y. Number: Legal Description: x P 8 t �° K City of La Quanta ©S - S90 4 Q Building &E Safety. Division P.O. Box 1 SO4, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet ef*W 1je0/' d Owner's Nampc: /. � / , l Contractor. W-;> -e � x X �X A aC :Address 77 S- 2— Q City. ST, Zip; A Telephone: State Lie. # Arch., Engr., Designer: Address: City, ST, Zip:- ip:Telephone: Telephone: State Lic. #: Name of Contact Pcrson:' Telephone # of Contact Puss Tran Cala. city. ST. Zip: LW �c FTelcphonc: jest Description: L 4 , 7�, City Lic. #: CA!/E'D Bel6 �2 V•af JAT�cn! 3.3 •05 81 � A -/!Y Vf►! /'753Z ADZ Construction Type: Occupancy: Ptojcct type (circle one): New Add'n Alter Repair Demo p C . Sq. Ft.: # Stories: A Units: NMnated Value of Project:. •30, < 9 APPLICANT: DO NOT WRITE BELOW THIS UNE Rec'd TRACKING Plan Check snbmitfed Reviewed, ready for corrections Called Contact Person a ! pS Pians Picked up Z !7 Plans resubmitted 2" Review, ready for corrections/issue ` Called Contact Person. Plans picked up Pians resubmitted Review, ready for eorrtctio u 31�d, Called Contact Person 3/y V! Date of permit Issue' PERMIT FEES Item Askount Plan Check Deposit Plan Check Raise" Construction. Mechanical Electrical Plumbing SAM. Grading Developer Impact Fee A.I.P.P. . ' Total Permit Fees lqj�PA- -7--o # Submittal Req Plan Sets ZU zn Structural Cites. Tran Cala. Ene'r'gy Cales. 2 Flood'ptalu plan ' Grading plan Subcontactor Ust Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees APPLICANT: DO NOT WRITE BELOW THIS UNE Rec'd TRACKING Plan Check snbmitfed Reviewed, ready for corrections Called Contact Person a ! pS Pians Picked up Z !7 Plans resubmitted 2" Review, ready for corrections/issue ` Called Contact Person. Plans picked up Pians resubmitted Review, ready for eorrtctio u 31�d, Called Contact Person 3/y V! Date of permit Issue' PERMIT FEES Item Askount Plan Check Deposit Plan Check Raise" Construction. Mechanical Electrical Plumbing SAM. Grading Developer Impact Fee A.I.P.P. . ' Total Permit Fees lqj�PA- -7--o Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 Project Name: Owner's Name: Robert Wilmeth This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMWIND. AMOUNT: nATF., RF.r..R1PT- Cw..r..K N. FNTT1A1.C- 1 CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Address: 79-205 Canterra, Cir., La Quinta, CA 92253 Project Description: Addition to existing house APN: 604 263 007 t #: Type of Developme Residential XX! `Dotal Square Feet of Building Area: Commercial 183 Date: March 7, 2005 Phone No. 360-3334 Lot #'s: Industrial Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorize d to sign on behalf of the owner/developer. r - Dated: —7- 40 �S Signature: *********************************************************************** SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code 17620 Number of Sq.Ft. Amount per Sq.Ft. Amount Collected Gov. Code 65995 183 $ 0.00 $ 0.00 Project Agreement Existing Not Subject to Fee Approval Prior to 1/1/87 Requirement Note: Pursuant to AB -181 any room additions or enclosures of 500_, square feet or less,rare exempt from developer fees: Building Permit Application Completed: Yes/No By: Carey M. Carlson, Asst. Supt., Business Services Certificate issued by: Elvira Mattson, Office Technician Signature: Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a wr n tice 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 mposi on 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 otic hall 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. ii':c;mydocs`devle�s certiticat� or compliance 60mi tablesT(? LtSli.dvc 1/16/03 T 1 0� g' Notice: Document Cannot Be Duplicated Desert Sands Unified School District 82-879 Highway 111 Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE Date 3/13/96 No. 14240 Owner Name Roger Snellenberger & Associates No. 79205 City La Quinta Tract # 23913 Type of Development Comments By Street Canterra Ct. Lot # 24 Single Family Residence APN # Jurisdiction La Quinta zip 92253 604-263-007 Permit # Log # Study Area 223 Square Footage 2359 No. of Units 1 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 or replacement mobilehomes. It has been determined 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 fees imposed pursuant to Government Code 53080 in the amount of 1.72 x 2,359 or $ 4,057.48 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 Roger Snellenberger & Associates _ -� Telephone 777:"766 Name on the check Ill �1 Dolores A. Ballesteros=. �f Superintendent Fee collected /exempted by Pauline Pearson Payment Received $4,057.48 Check No. 11437 Signature Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting