07-0063 (RER)P.O. BOX 1504 414
Qumm
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:OZ^OOA'000.6.3 Owner:
Property Address: 531'50 AVENIDA O REGON BOYCE CAROLYN NOEL
APN: 774'-045-008-8 -000000- 53-150 AVENIDA OBREGON '
Application description: REMODEL - RESIDENTIAL LA QUINTA,. CA 92253 _
Property Zoning: COVE RESIDENTIAL r
Application valuation: 12500 L
Contractor: .
Applicant: Architect or Engineer: DESERT HABITATS GENERA
39203 LEOPARD STREET
PALM _DESERT, CA 92211
(760)'772-6062
Lic. No.: 487909
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/16/07
JAN 17 2007
' LICENSED CONTRACTOR'S DECLARATION
" WORKER'S COMPENSATION DECLARATION -
I hereby affirm under. penalty of perjury'thatI am licensed under provisions of Chapter 9 Icommencing.with'
I hereby affirm under penalty, of perjury one of --.the following declarations: "
. Section.70001 of Division�3 of the Business and Professionals Code;'and my License is in full force and effect.
_ I have and will maintain a certificate`of consent to self -insure for workers' compensation, as provided
License Class: `B s o. 487909
.. -
for by Section 3700 -of the Labor Code, for the performance of the work for which this permit is
�../,.. ,
/
issued. •�.
Date 1 �Contractor,:�k"'Gi�-/
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 workerscompensation
- OWNER -BUILDER DECLARATION
insurance earner, and policy number are: -
I hereby affirm underpenalty of perjury that I am exempt from tie Contractor's State License Law for the
Carrier . ENDURANCE INS " Policy Number WEN001174901
following.reason (Sec. 7031.5, Business and Professions Code: Any city orcounty that requires a permit to
_ I certify that, in the performance of the work for which this permit is'issued; I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so: as to become subject to the workers' compensation laws of California,,
permit,to file a signed statement that he she islicensed pursuant to the provisions of the Contractor's State
and agree that, if.f should become subject to the workers' compensatio provisions of Section
_ License Law (Chapter 9 (commencing with Section 70 0) of Division 3 of the Business and Professions. Code) or
- 3700 of the.Laoor ode, I sha fo it o ly ith os pr v si
that heiorshe is exempt therefrom and the"basis for thealleged exemption.�Any violation.of Section 7031.5 by gpF;':
of more five hundred dollars
1 ;.,/�•�1 - -
D`ate%�• ��-
any applicant for a permit subjects the applicant to a civil penalty not than ($500):
( as-oviner of the -property, or my employees with wages as their, sole compensation,. will do the work, and
-
• _)A,
the structure is not intended or -offered for sale (Sec. 7044; Business and Professions Coder The
WARNING: FAILURE TO —Az, COVERAGE ( UNLAWFUL, AND'SHALL ..
Contractors' State.Cicense Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL -FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herselfthroughhis or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THECOSTOF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).-,
APPLICANT ACKNOWLEDGEMENT
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT. Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application..
. property who builds or improves" thereon, and who contracts for the projects with a contractor(s) licensed
- 1. .Each person•upon whosebehalf this application is made, each person at whose request and for
pursuant to the'Contractors' State License Law.).
whose benefit -work is performed under or pursuant to any permit.issued as a result of this application,
(_) I am exempt under Sec. . , B.&P.C., for this reason
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. _
"
Date: Owner:
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 .
" CONSTRUCTION LENDING AGENCY
permit to cancellation. "
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above information is correct. "1 agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).-
city and county ordinances and state laws relating to building construction, avV he aut r sen ves
for inspecY}an a S. 77 " _
of tpiscounty to enter upon the above-mentioged progeny7
Lender's Name:
Lender's Address:
LQPE%-,IIT
0e
Application Number . . . . . 07-00000063
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . 144.00 Plan Check
Fee
93.60
Issue Date Valuation
. . .
. 12500
Expiration Date 7/15/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
11.00 9.0000 THOU .BLDG 2,.001-25,000
99.00.
Permitt " . . . . . ELECT .'- ADD/ALT/REM
Additional- desc .
Permit Fee 21.75 Plan_'Check
Fee,• ..
5.44
Issue Date Valuation
. .
0
Expiration Date. 7/15/07.
Qty Unit Charge. .Per
Extension
.BASE .FEE
15.00
9.0'0. 750.0 .PER ELEC DEVICE/ FIXTURE, 19T.
20
6.75
Spec-ial.Notes and Comments
' REPAIR FLRE DAMAGE :AT' EAS•T.,WALL: ~.SEE
` SCOPE,.,OF WORK AN .PLANS . January 16, ;,2007.
9 30:0;8 AM`'JJOHNSON
Other Fees . . . . . . ENERGY:REVIEW FEE,
9.36
STRONG" MOTION•(SMI.)
- RES
1.25
Fee summary Charged 'Paid Credited.
Due
Permit.Fee' Total 165.75 00
.0-0
.165.75.
Plan Check Total '99.04 00_
00
99.04
Other .Fee ,Total 10..61 .00
.06
10.61 ,
Grand Total 275.40. .00
00
275.40
LQPERDIIT
Coe
City of La Quinta
Building. U Safety Division
P.O. Box,1504, 78495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application, and Tracking Sheet
Permit #''
Project Address: — �� v `' U
Owner's Name:
A. P. Number:
Address: V�p
Legal Description:
Contractor: best A 1311V'iVA5 _MlX
City, ST; Zip:1 .1. Qv;^ (219 1-7ZZ
Tele hone: �Q B
t��
P 'Z68" SCOSS
Address: ' 9 ' 203 L56peajo'C7Z�
Project Description:
City, ST, Zip: PLM -���'
Telephone: r7 1Z— 606 Z
State Lic. # &I O City
Arch., Engr., Designer:
AkmoVe nk o
/c/A RAy TS
�"'1t9��1V2-G
Address:
il
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
`. Project type (circle:one): _ New. Add'n Alter Repair Demo
Name of Contact Person: M)Q,) e(_ b0,)3R6V:5
',Sq. Ft.: `,� ��
4 Stories:
# Units:
Telephone # of Contact Person(90 ' Z7 T= J 576
R Estimated Value of Project: `� 5,00i
APPLICANT: DO NOT WRITE BELOW THIS LINE.
#
Submittal
Req'd : ,
Reed.
TRACKING .
PERMIT FEES
Plan Sets
Plan Check submitted'
NO
Item
Amount
Structural Calcs'.
Reviewed, ready forjfo rection
Plan Check Deposit
Truss Calcs.
Called Contact Person r
Plan Check Balance
Energy Calcs.
Plans picked up.
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2' Review, ready for correcti srssue
` / I
Electrical
Subcontactor List
Called Contact Person '
Plumbing
Grant Deed
Plans picked up
S.M.I.
H:O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
1n° Review, ready for. corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A:LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
I I v l/ i-- lJly twH r< V C l n h OU 5E'J
;k0pewy IA� so
OF $30 CONSTRUCTION H®3
A RE -INSPECTION FE I CO
WILL BE CH RGED IF THE APPROVED I October 1st - April 30
PLANSANO Monday .
P 08 CAR6,ARE NOT. ON -Friday: 7:99 4-m° to 5:30 p.m.
THE SITE FOR A SCHEDULED Saturday: 8:004.4n. -1 to 5i. -OO pan�
INSPECTION - Sunday: None
N1 I EXCEPTIONS1 Government Code Holidays: None
May 1st - September 30th
funda - Friday: 6:00 a'm. to 7:60 p.m�
Saturday: 8:00 a.m. to 5:00 p.m.
Sunday. None
(Govern Menf rnAp VFnliA a WT
I .. il = I Sc A . Le,
1/4 -, '
CITY OF LA
BUILDING & SAF
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P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-00000063
Property Address: 53.150 AVENIDA OBREGON
ON: 774-045-008-8 -000000-
Application description: REMODEL - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 12500
Applicant:': Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-7011
.BUILDI.NG &' SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
,BUILDING PERMIT
Date: 1/16/07
Owner:
BOYCE CAROLYN NOEL
53-150 AVENIDA OBREGON
LA QUINTA;- CA 92253
DESERT,'HABITAT&-GENERAL•CONTI
39203. -LEOPARD STREET.,
PALM DESERT; ' CA `92211-
�. UCENSED:CONTRACTOR'S DECLARATION ' ..
I hereby affirm under penalty, of perjury that) am licensed-under;pr'ovisions of; Chapter 9 (commencing; With,
Section,70001:of Division 3 of,theBusiness and Professionals Lode,: and rry License. is infull:force and,'effect.
Licensa ass: B `s. _ _ - - vUcensa-No.: 487909'.. -
Date: Contractor.:
_ .. ,;i. .. ..
`OWNER -BUILDER -DECLARATION ` -
I hereby affirm under penalty. of, perjury, that I amexempt from the Contractor's state License Law fob the ,
following reason.(Sec.j7031.5,:Businessand'.Nofessions Code Any city. or. county; that regwres.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 isdicensed pursuant to the provisions of tl°e Contract&"s'State
License: Law (Chapter 9 (commencing wittiSectionDi
7006) of vision 3.6f the Business and.Piofessioris.Code) or
thathe or she is exempt therefrom and the .basis for the"alleged;exemption. Any wolatior :'& Section 7031 -.5 -by.
any a plicant for a-permitsubjects the applicant -to a civil penalty of -not more than five hundred. dollars.(@500).:
(_ 1;� as owner;of'ttie property;,or� myeniployees with wages;as their sole compensation, will dothe'.work, and
the structure is not intended or offered for sale (Sec. 7044 Business and professions Code: The, .
._ Contractors' State Licensa`Law does not apply to an owner of property wI o builds orimpioves thereon,
and who does the
.w
and or. herself through his.orfierowmemployees;'provided'thatthe'
iniprovaments' a not intended or offered for sale. If, however, the budding 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 1, as ovaner.of the property,'am ex6usively'contracting with licensed contractors to construct the project (Sec.
' 7044, Busine4sand 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.).
(_ I' 1 am exempt under Sec. , B.&P.C.'forthis reason -
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is 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 _
(760072 15'062
U
JAN 17 ,2007
U'
tic., No.-.' 4'87909
CITY, OF LA QUINTA
FIA9ICE DEPT :..
. WORKER'S COMPENSATION DECLARATION
-
hereby affirm under,penalty of perjury one, of the following declaFations ;
4 I have and'will,mamtain a cemficate of,consent -toker
-self-insure for,wois compensation- asiprovided...
for by. ction•3700 of the-Labor;Code, for the performance of the work for'whichahis permit_is'
issued i*.
• Ihave and will�maintainworkers -compensation insurance; as required'by Seciion 3700 ofaFie Labor
..: 'Code, for the performance of .the work,for which this permit is -issued -�My workers' compensation
' insurance.carner and policy number are:
Carrier .ENDURANCE• INS. Policy Number WEN001174901.
' _.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 asto�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 Coo de;:l shall_ rthwith comply:with those provisions.
,
Date: Applicant_.. -
WARNING: FAILURE TO SECURE WORKERS',COMPENSATION COVERAGE IS UNLAWFUL, AND -SHALL '
SUBJECT AN£MPLOYERTO CRIMINAL PENALTIES AND, CIVIL"FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000): IN ADDITION TO THE.COST OF COMPENSATION, DAMAGES ASPROVIDED FOR IN -
SECTION 3706 OF THE LABOR.CODE,�INT EREST.' AND-ATTORNEY'S.FEES.
APPLICANT ACKNOWLEDGEMENT ..:
IMPORTANT Application is hereby made to the�Director of Building and Safety:for a permitsubject to the
conditions and restrictions set forth on this,application. s -
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;permitissued as result of this application, - -
- the owner, and the applicant, each agrees to, aniishall defend, indemnify and hold harmless the City, -
of La Quinta, its officers, agents and employees'far:any actor omissionrelated 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 ofissuance 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 withall
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this. county to.enter upon the above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
LQPERMTf
l�
�d
Application Number . . . . . 07-00000063
Permit . . . . . BUILDING PERMIT
Additional desc .
Permit Fee 144.00 Plan Check Fee
93.60
Issue Date. Valuation
12500
Expiration -Date 7/15/07
Qty. Unit Charge Per
Extension
BASE FEE
45.00
11.00 9.0000 THOU BLDG 21.001-25,000
99.00
Permit ELECT— `- ADD/ALT/REM-' ,. , .
Additional .desc .
Permit Fee. 21.75 Plan Check Fee .,
5.44
.,Issue Date- Valuation
0
' Expiration, Date 7/,15'/07
>-<:.
Qty Unit'Charge, Per..
Extension
:;:BASE: -FEE
15;i 00
9'i00 .7500 .PER. ELEC >DEVICE/FIXTURE, 1ST 20
6.75
r..---------------------------
Special Notes and Comments
--------------
REPAIR:' -FIRE DAMAGE AT EAST WALL.'SEE
" SCOPE`bF WORK AN.'VLANS.January_i6, 2007
°" : r•
9:- 3 0 8 • AM JJOHNSON' '
4
- - - - - - - - - -- ----- ---- - -------- - -
--
------ - - - --- "i r
--'9.36
Other•.Fe'es: ENERGY REVIEW FEE *
STRONG MOTION (SMI)-- RES
1-.25
Fee_ summary Charged = -Paid Credited
Due
-< --_---
Permi.t Fee Total 165.75' .00 .00
165.,75 .
Plan Check Total 99.04: 00 0'0_:.
99>:0,4
Other, Fee ;Total' 10.61 .00 .00
10%61
Grand Total 275 40 00 00
275,'40
LQPERMTf