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04-4348 (RER)BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA•,QUINTA; CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number04�Q-000434.8-i Date 5/17/04 Property Address-,—... . . . . 54760 RIVIERA APN: 775-031-035- - - Application description . . . REMODEL -'RESIDENTIAL Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . 8000 Owner Contractor PGA WEST RESIDENTIAL ASSN. INC OWNER D Q 54.320 SOUTHERN HILLS LA QUINTA CA 92253 JUN 0 4 2004 --------------=----------- Structure Information - clTr of u► QUINTA --------- ______Construction Construction Type TYPE V - NON RATE FINANCE DEPT. Occupancy Type . . . . .. . DWELLG/`LODGING/LONG <=10 Flood Zone . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC ---------------------------------------------------------------------------- Permit BUILDING PERMIT Additional desc Permit Fee 99.00 Plan Check Fee .00 Issue Date Valuation 8000 Qty Unit Charge -Per Extension BASE FEE .45.00 6.00 9.0000 THOU- BLDG -2,001-25,000 54..00 -------------------------------------------------:--------------------------- Special Notes and Comments VOLUNTARY SEISMIC STRUCTURAL REPAIRS ---------------------------------------------------------------------------- Other Fees . . . . . . ... STRONG MOTION (SMI) - RES .80 Fee summary Charged Paid Credited Due Permit Fee Total 99.00 .00 .00 99.00 Plan Check Total .00 .00 .00, .00 .Other Fee Total .80 .00 .00 .80 Grand Total 99.80 .00 .00 99.80 P.O. Box 1504 �/ 78-495 CALLS TAMPICO VOICE (760) 777-7012760) 777-7011 LA QUINTA, CALIFORNIA 92253 FAX INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number:4l • l�,j Date: (o Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer' Address: 5 PA 9aio I BUILUING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I 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 force and effect. License Class License No. Date Contractor - OWNER -BUILDER DECLARATION 1 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 tha* 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 applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of,the property, or my employees with wages as their sdle 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 1, 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. , BA P.C. for this reason W. WORKERS' COMPENSATION DECLARATION I hereby affimi 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 1of the work for which this permit is issued. 1 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. M�workers' compensati urance carrier and_policy number are: - rrier ST19•r� t �.� Policy Number l �6 QyC �{1�.. pp _ 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 forthwith comply with those provisions. n 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.). Lenders Name Lender's Address ENT IMPORTANT Application is hereby made to the Director of Buildingand Safety tyfor CKNOWLEDGEo the I. Each person upon whose behalf this application is made, each prson at whosee Irequest t a defor hose benefit ork isconditions and performedunder or pursus set forth on this ant to any permit cessation of work for 180 days will subject permit to cancellation. ty of La l]uinta, its issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnify and hold harmless the Ci 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 is issuance of such permit, or I certify that 1 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 county to enter pon the a ove tinned property for inspection purposes. �te�� .q•. (7 S re (Applicant or Agent): DAVE, STEAVENS' Inspection Services PROJECT?0(pIA. es -7 - ADDRESS Sid -_7&Q RiJ/e_.ZA' LA CA BLDG. PERMIT # Q H 114 9 ENGINEER ,,,,A INSPECTION TYPE Page of �. to PROJECT CLIENT "PGN �,_)C S �o R DATE oo ARCHITECT (,oL_:aP-, CONTRACTOR L 7 INSPECTION REPORT FOLLOWINGLOCATIONS EPDXY SHAPSON ETF. EXP. HOLES 'DEPTH CHECKED, BRUSHED AND CLEAN OF DEBRIS.. APPLICATION AND INSTALLATION AS PER ICBO 4945 -RK- Q fl, LL- a Lo(_S - �o �Oost6 L r: 6 U\- b, P, l3' MA5, 8E3 LOCS o L—, ;L .1 k N. OZ kR4 L-r- dC5 R k k- C, S f4t -i;T iL P - E7--f-711::YLk02 - n CERTIFICATION OF COMPLIANCE: To,the best of our knowledge, all.of the reported work, unless otherwise noted, esubstantially complies with approved plans, specif ication's and applicable sections of the building codes. This report covers he locations of the. work inspected only and does not constitute engineering opinion or proj6ct control. CERT. No. 0859348-500 C 9 INSPECTOR NAME DAVE STEAVENS .(Print C1ear.1,1 "t DATE P INSPECTOR SIGNATURE ,I PC M S. CIOVOMM SL OCOMMW CA 9205k Tog: -(7601 q@&5M Fax- (74019"-636o Fax-. TO: 41OVIOHO"hol,.Reco!iatnmtfonmans W RHM-M,- SAVOIE AW %b geeting they -Com Of. -74 d 'rit A Few. I hv6ft OWer sheet - BMW. Ttesdar, Febmww, 2886. PGA VW Irbw i CC. The Ga Derjes 13 WOOM 13 Fcw Raw C! pw"&.Cammw4M PWw RepW Please Rocycle WRE: RFW(20W>-Vm2#,iatdeW4U" MW 8r5"&*KWhen-peFemWW-eK 1 Detaff VS3 @ MBR (6f Q- It is Understood that only aft is available above the shear wall for Will provide continuity to the plywood stew wall repair. 2)'Dfto 3AfS3 @ tftNm (6M4t iS understood OW Only SR is available out the raft Reaw ad"W84diUM W A34 A—A— I pep baa ea* top plate. me.*. 8864369- if yct- have an yr . f Whw