06-4354 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: :0.'6: 1160'0'04354
Property Address: 53250 AVENIDA OBREGON
APN: 774 -045 -012 -12 -000000 -
Application description: REMODEL - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
�t Application valuation: 3000
T-iht 4 4 Q"
Applicant: Architect or Engineer:
- - --LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that Pam licensed under provisions of Chapter 9 (commencing with, -
Section 7000),of Division'3 of the Business and Professiohals Code, and my License is in full force and effect.
License Class:- License No.: '
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of.perjury that, l;am'ezemptfrom the Contractor's State License Law for the .
following reason (Sec. 703.1.5. 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 1$500).:
1 _ 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 m
improveent is sold within
one'year. of completion, the owner -builder will have the burden of proving that he or she did notbuild or
improve for the purpose of sale.).
(_) l; as owner of the property,'am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors"StateLicense 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.).
( 1 I.am exempt under Sec. ', B.&P.C. for this reason
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 ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
_LQPER111IT
Owner:
GONZALEZ LUIS
53250 AVENIDA OBREGON
LA QUINTA, CA 92253
Other struct info .
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153.
Date: 12/27/06
... ; .: r MN_ =X11111
Contractor: U ®®e
Owner DECE8
r
AI�IWA
DITION 20�®
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty"ofperjury one of the following declarations:
have and will maintain a certificate of consent to self -insure for workers' compensation, as. provided
foc.by Section 3700_ofthe Labor Code;:forthe 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 - - ---- :'----=--- - - -- Policy 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
.
37,00 of.the Labor Code, I shall forthwith com IV, with those provisions.
-DaiieW� a7 Ap,�, plant: _ `
WARNING: FAILURE TO SECURE WORKERS! COMPENSATION COVERAG .UNLAWFUL, AND SHALL
',SUBJECT AN EMPLOYER TO CRIMINALPENALTIES AND CIVIL FINES UP.Td. 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.uponwhose 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 cou ty to nt,/er upon the above-mentioned property for inspection purposes.
a.Datf�&ignalurec(*plicant-orrAgent): !�/� � •�.�Q. `--�4✓
LQPERDIIT
Application Number . . . . . 06-00004354
Permit . . . BUILDING PERMIT INV FEE
Additional desc
Permit Fee . . . . 108.00 Plan Check Fee 35.10
Issue Date . . . . Valuation . . . . 3000
Expiration Date 6/25/07
Qty Unit Charge Per Extension
BASE FEE 90.00
1.00 18.0000 THOU BLDG 2,001-25,000 18.00
----------------------------------------------------------------------------
Permit . . . ELECT - ADD/ALT/REM.
Additional desc .
Permit Fee . . . . 29.25 Plan Check Fee 7.31
Issue Date . . . . Valuation 0
Expiration Date 6/25/.07
Qty Unit Charge Per Extension
BASE FEE 15.00
19.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 14.25
----------------------------------------------------------------------------
Permit . . . . . MECHANICAL
Additional desc . .
Permit Fee . . . . 15.00 Plan Check Fee 3.75
Issue Date . . . . Valuation . . . . 0
Expiration Date 6/25/07
Qty Unit Charge Per Extension
BASE FEE 15.00
----------------------------------------------------------------------------
Special Notes and Comments
move fireplace and add soffits and new
lighting.code case, permit will be
doubled fee.
December 26, 2006 4:07:16 PM jjohnson
--------------------------------------------------7-------------------------
Other Fees . . . . . . . . . ENERGY REVIEW FEE 3.51
STRONG MOTION (SMI) - RES .50
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 152.25 .00 .00 152.25
Plan Check Total 46.16 .00 .00 46.16
Other Fee Total 4.01 .00 .00 4.01
Grand Total 202.42 .00 .00 202.42
IM
Bin #
Ci ty :of La0u---'inita
Building i Safety Division
P.O. Box :1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (7.60) 777-701.2
Building Permit Application. -and Tracking Sheet`
Permit #
i
1}
Project Address:
55150Ave--. V br
Owner's Name: (�Y �. n 1f
A. P. Number:
Address:53 0JS� . f e b
Legal Description:
Contractor:
City, ST, Zip:
Telephone['Q6
Address:
ProjectDescription: L.re (QeC _
City, ST, Zip:
d me S , S T an
Telephone:
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
:.,Construction Type: Occupancy:
; Project type (circle one): New Add'n Alter Repair Demo
FL:.
# Stories:
# Units:
p.Sq.
`,
Telephone # of Contact Person: b Z' 86 3'
;Estimated Value of Project: —
J %�ZY e 11,'APPLICANT: DO NOT WRITE BELOW.THIS UNE
#
Submittal
Req'd ..
Rec'd•
TRACIQNG .
PERMiT FEES
2.
Plan Sets
Plan Check submitted ` ;.^
l:
Item
Plan Check Deposit,
Amount
Structural Calcs
Reviewed, ready for'•a ifttiom
Truss Calcs.
Called Coutact.Person.„
Plan Check Balance
Energy Calcs:.
Plans picked np
Construction
Flood plain plan
Pians resubmitted
Mechani
Grading, plea2"
Review, ready for correctio issue
�- : .
Electri I - 0 U (
3 -'
Subcontactor List
Called Contact Person
plumbin
Grant Deed
Plans picked up:
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''Review; ready for.correction§/issue
Developer Impact Fee
Planning Approval
-Called.Contact Person
A LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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RESIDENTIAL KITCHEN: LIGHTING WORKSHEET WS -5R
C 5 l�
Project Title
Date
At least 50% of the total rated wattage of permanently installed luminaires in the kitchen must be in luminaires that are high
efficacy luminaires as defined in Table 150-C. Luminaires that are not high efficacy must be switched separately.
Kitchen Lighting Schedule. Provide the following information for all luminaires to be installed in kitchens.
Luminaire Type High Efficacy? Watts x Quantity = High Efficacy Watts or Other Watts
l2t tt2'SC�lL'f- Yeses No o_ x _ _ O or
Yes o No o x = or
Yes o No ❑ x = or
Yes o No o x = or
Yes o No o x = or
Total: A: B:
COMPLIES IFA >_ B Yes No o
Residential Compliance Forms
March 2005
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A RE-INSPECTIONEEF
WILL BE CHARGED
F THE
APPROVED
PLANS AND 1 OR AA ARE
THE SITE F
INSPECTION.
NO EVEPTIONSI
"AN ADEQUATELY �E D DEBRIS OB SITE DURING ALL
IS REQUIRED ON
;'BIASES OF CONSTRUCTION AND MUST BE
{ ED AS NECESSARY. FAILURE TO DO SO
-;Y CAUSE THE CITY TO HAVE THE CONTAINER
Is j1► E(D( AT THE EXPENSE OF THE OWNER/
CONSTRUCTION HOURS
October lst - Ap p 00 a.m. to 5:30 p•�
Monday Friday:
. 8:00 a.m. to 5:00 p•
Saturday:m
Sunday:hone
Government Code Holidays: None
May 1st - September 30th
Monday - Friday -<6 .00 a.m. to 7:00 p.m•
Satjirdxy: 0p. � .m. to 5:00 p.m.
Sunday:
Coecrmmeut Code-1p(idays:. None
ITY OF LA QU1�E A
G SAF.EV .D
Bu►LoIN P RSV E
FAOP ONSTRUC►ION
BY
DAT
Construction is NOT PERMITTFD
on the following Code Holidays:
New Year's Day .
Dr. ,Martin Luther King Jr. Day
President's Day
Memorial Day
Independence Day
Labor Day
Vo*Ws Day
oar