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04-5173 (GRES)9_00----- 9.00QQ THOU .-BLDG .00 -------- ------- - - -- - - - - - - - - - - 7 7 Spec.ial,:',Notes and,Com'ments. Resident al. -.Garage Addition,(550 ,sqf t): - - - - - - - - - - - - Other Fees STRONGMOTION , Fee summary Charged,-:, Paid`. jUrN_ _a 0 -200 4- 'LA QUINTA Cre.dited �. _.- I ---81 00------ RES .1.07 Due- BUILDING & SAFETY DEPARTMENT P.O.,b, ox 5 �'V (760).777.-.7012 0*JFc.978-495 CAL.LE TAMPICO,. FAX (760) 777-7011 - LA QUINTA,, ItALIFORNIA 922'53 1WSPECT10N,KEQUESTS ( 760) 777-7153 Application Numbe r C..�0,4 7Date 6/29/,04 Property Address -a,SI,2`952 AVEN1DA7 OBREGON - APN: 773'-315 , -T_0 -.,00;0000- 00:0000- Application description GARAGE ttiRESIDENT.IAL - Property Zoning .:COVE. -:RESIDENTIAL.. A,pplicat:�,1.on.-va-lu'at'idn, "10.7`8.0 Owner Contractor --------------------------- Brad. Hoffman, --- -------------------- OWNER 52-952 Avenida Obregon LA,QUINTA-'. RESIDENTIAL 'GAR*AGE3- ADD1 T I ON Con.stfuct,i6h. Type`' TYPE NON RATED Occupancy:: Typeii. iV GAR, CARPORT, SHED., 'AG. Flood-"- Zone NON AO {,FLOOD ZONE Other structs i kf o CODE.-. ,EDITION"`.; 2001-.1. FLOOD ZONENO GARA0E,S0' '550 90. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - 7 Permit ELECTRICAL-CARPORT/GARAGE" Additional desc Perm -,t• Fee rs .2:6,. 0,0, C k,Fee .6.5.0 Issue Dateb.n V41.uati 0 Qty.. .-Unit Charge,. Per Ekt.e'nsion -� BASE', FEE: 15.00 550.00 .02-.00* ELEC 'GARAQE4OR NM -RESIDENTIAL 11.00 ------------------------------------ -------- ------------------------ Permit . . . CARPORT./GARAGE Addi.ti.onal des. Permit Fee 126.00 n, Che'dk" Fee81.90 Issue,Date Valuation 10780 ''Qty -Unit' Charge Per Extension BASE QP !P'PLI "A C nn 9_00----- 9.00QQ THOU .-BLDG .00 -------- ------- - - -- - - - - - - - - - - 7 7 Spec.ial,:',Notes and,Com'ments. Resident al. -.Garage Addition,(550 ,sqf t): - - - - - - - - - - - - Other Fees STRONGMOTION , Fee summary Charged,-:, Paid`. jUrN_ _a 0 -200 4- 'LA QUINTA Cre.dited �. _.- I ---81 00------ RES .1.07 Due- P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 4 BUILDING & SAFETY DEPARTMENT Application Number: (91- 5-17 Applicant: 00 Applicant's Mailing Address: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: Architect or E dineer: 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 7000) of Division 3 of the Business and Professionals Code, and my License is in full forceand effect. License Clas§ License No. Date Contractor 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 for a permit subjects qV applicant to a civil penalty of not more than five hundred dollars ($500).): 1, 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.). 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. a , BA P.C. for this reason � Da WORKERS' COMPENSATION DECLARATION 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 I Policy Number. 1 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 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / 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 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 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, 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 vold 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. 1 certify that I have read this application and state that the above information is correct. 1 gree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize. representatives of this county to enter upon thea ntioned property for inspection purposes. wat Signature (Applicant or Agent): Y" . I . _ . , Application Number . . . . . 04 -00005173 ----------------- ---------- Permit Fee Total 152.00 ---------- .00 Plan Check Total 88.40 .00 Other Fee Total 1.07 .00 Grand Total 241.47 .00 .00 .00 .00 .00 Page 2 Date 6/29/04 152.00 88.40 1.07 241.47 T IL City of La Quinta Building 2Z Safety Division Permit Ii* P -O. Box 1504, 78-495 Cade Tampico 0q yl 7j La Quinia, CA 92253' (760) 777-7012 Building Permit Application and Tracking Sheet 1f Project Address: Owner's Name: A. P. Number1. 1_ X jC uca L+ npuon: I Contractor. Address: City. ST. Zip: FTelephoae: dip - _ sect Dcsaip�ion: 0 Z Z ,�ya _ 7� City, ST, Zip: Telephone: 1 State Lic * : City Lie./ Arch, Eng., Designer. ' Address t ELV City. ST, Zip: Telephone: Cdr.'• lti� '• :S.s •'�•� ='�,. Construction Type: Occupancy: State Lic._f- - - Project type (circle one): New Add'n Alter Repair Dano 1C Name of Contact Person: `g . Sq. FL: / Stories: X ` /Units: Telephone / of Contact Person: d =R/Z . . ed Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Reed TRACKING Pla■Sets PER HT FEES Plan Check submitted. Structural talcs. Reviewed. ready for corrections em Amount Plan Check Deposit. Truss Gla. Called Contact Person Plan Cbeck Balance . ��Energy Gla. Plans licked up Construction Flood plain plan Plans resubmitted littebanical Grading plan 2'' Review+. ready for eorrectio issue 6 Subcontactor LFst Called Contact Person Z� etrieal Plambiag Grant Deed Plans picked up S.1►t.l. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for eorrectionsrusue Developer Impact Planning Approval .Called Contact Person Pah. Wks' Appr • A.LP.P. Date of permit issue School Fees OIL Total Permit Fen a &Aff_A* IV 7Yr M abOo t�%