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08-1502 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 08-00001502 Property Address: 55539 RIVIERA APN: 775-242-008- - - Application description: REMODEL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 10000 T4ht 4 4 Q" Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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: BLicense No.: 921546 Date: (1e_dap Contracto . NIR -1311 LDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 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 ($500).: (_ 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 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 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.). ( I I am exempt under Sec. , B.&P.C. for this reason Date: Owner: 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: _ Lender's Address: LQPERMIT Owner: DEVINE, JIM & LAURIE 55539 RIVIERA LA QUINTA, CA 92253 ( Contractor: BIRMINGHAM, LOUIS E. 64860 BURKE COURT DESERT HOT SPRINGS, CA 92 (760)808-7792 Lic. No.: 921546 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/15/08 ------------------ WORKER'S 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. 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 EXEMPT Policy Number EXEMPT _ 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 9 3700 of the labor Code, I s dl forthwith compl Yh thos isions. Date: ` Applicant WARNING: FAILURE TO SECURE WORKERS' COM SATION 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. 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 county to enter upon the above-mentioned property for in ection purposes. Date: 1f_ XSignature.(Applicant or Agent Application Number 08-00001502 Permit . . . . . BUILDING PERMIT Additional desc . Permit Fee 117.00 Plan Check Fee 76.05 Issue Date 'Valuation . . . 10000 Expiration Date 3/14/09 Qty Unit Charge Per Extension BASE FEE 45.00 9.00 9 nnnn THOTT RT,DG 2,001-2.5,000 72.00 ---------------------------------------------------------- ----------------- Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee - 26.00 Plan Check Fee 6.50 Issue Date . . . . Valuation 0 Expiration Date 3/14/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 11.0000 EA ELEC MISC. 11.00 ------------------------------------------------------------------------ Permit PLUMBING Additional desc . Permit Fee . . . . 18.00 Plan Check Fee 4.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 3/14/09 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3:00 ------------- Special Notes and Comments RELOCATE FIREPLACE WITH NEW GAS LINE,NEW CHIMNEY,HEARTH PER'MANUFACTURE,AND COVER EXISTING CHIMNEY OPENING IN ROOF, ROOF TILE TO MATCH EXISTING. ------------------------- Other Fees . .. . . . . . ENERGY REVIEW FEE 7.61. STRONG MOTION (SMI) RES 1.00 Fee summary Charged Paid Credited Due_ Permit Fee Total 161.00 .00 .00 161.00 - Plan Check Total 87.05 .00 .00 87.05 Other Fee Total 8.61 .00 .00 8.61 Grand Total 256.66 .00 .00 256.66 LQPERMIT Bin # City of La Quinta Building » Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # OZ �5 Project Address: A'O/ 111 CIC4 Owner's Name: L4 LJJC, 6 /✓,FPI U A. P. Number: Address: Legal Description: City, ST, Zip: !.� (JlMrA 4!'—**A 9 Contractor: 16-00/J_ E Telephone: Address: (&,f.,t167 Project Description: City, ST, Zip: 9.20? y() TelephoneO60N 90'R'-77 j(V State L City Lic. #: Arch., Engr., Designer: 5A" 45' AS Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Lc�L/�s ��M/��AM Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person '74 V09 --7 ?7c?, Estimated Value of Project: O 0e) APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Plan Sets Req'd Rec'd TRACKING Plan Check submitted 9 PERMIT FEES Item Amount Structural Cales. Reviewed, ready fo corrections Plan Check Deposit Truss Cales. Called Contact Person v. q$ Plan Check Balance Energy Calcs.Plans picked up J Constriction Flood plain plan Plans resubmitted Mechanical Grading plan 2i' Review, ready for correction issue Electrical Subcoutactor List Called Contact Person Plumting Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue Devel:aper Impact Fee Planning Approval Called Contact Person A.LPB. Pub. Wks. Appr Date of permit issue School Fees IL r Tota= Permit Fees °� il$/0 P(AA)5 R�- �ds A4'r�) 44� to 666--)