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05-1550 (DSF)O. BOX 1504 BUILDING & SAFETY DEPARTMENT (760):777-7012 -491CALLE TAMPICO A Qu FAX (760) 777-7011 INTA, CALIFORNIA 922,53 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT V C plication Number . . . . . C70-5-- 0 0 0 0 Z55-0-,�A Date 4/25/05 Property Address . . . . . 44870 SEELEY DR - APN: -604-226-003-118 -23268 Application description . . . DEMO - SINGLE FAMILY Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL Application valuation . . . . Owner ----------------------------------- Contractor LAURIE VO --------------------------------- PRECISION BLDG & RESTRTON INC 44870 SEELEY DRIVE 10722 ARROW ROUTE, #416 LA QUINTA, CA 92253 RANCHO CUCAMONGA, CA 91730 (909)980-1701 WCC: STATE FUND WC: 0600433 07/20/05 CSLB: 793303 04/30/05, CCC: B. Other struct info . . . . - - - - - - - - - - - - - - - --- - - - - --- - - - - - - - - . NUMBER OF UNITS - - - - - - - - - - - 7 - - - - - - - - - - - - - - - - - - - - - - 1.00 - - - - - - - - - - - P.O. Box 1504 • �� 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: _ 05- 1550 Applicant: Applicant's Mailing Address: �C VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4,2,1-05, Architect or Engineer: ; . Architect or Engineer's Address: .414A Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I here_andby affirm under penalty of perjury that I am licensed under rovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals C Cl LicQnse is in full force and effect. `� 2 d -3 icense Classss ,[� License No. 7 J ,,�Date ontractor ,!j�ir ,- ,GC.u6L; � JCA V1_ 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 the applicant to a civil penalty of not more than five hundred dollars ($500).): U 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 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. . BA P.C. for this reason Date WORKERS' 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 rriis ued. (*.workers' mpensation�aSurance carrier and policy�ny�ber are: aer: f a /Policy Number C30o 3 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. Date Appplicant WARNING: FAILURE TO SECURE W ERS' COMPENSATION ERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED HOUSAND 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 \ Lender's 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, indemnify and hold harmless the City of La Ouinta, 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 auth2griature ze re esentatives of this county to enter upon th above -m do d property for inspection purposes. to (Applicant or Agent):_ P/ .,7 ------------------------------------------------------- ti, 'Application Number . . . . . 05-00001550 -----------------------------------------------------=--------- ------ --------------- ------------- Permit . . . . . . DEMO PERMIT Additional desc Permit Fee . . . . 45.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/22/05 Qty Unit Charge Per Extension BASE FEE 45.00 ---------------------------------------------------------------------------- Special Notes and Comments FIRE DEMO IN PREPARATION FOR FIRE RE -CONSTRUCTION Fee summary Charged Paid ----------------- Credited Due -------------------- Permit Fee Total 45.00 ---------- .00 ---------- .00. 45.00 Plan Check Total .00 .00 .00 .00 Grand Total 45.00 .00 .00 45.00 Permit # � p Project Address: Tf 2 70 A. P. Number: Legal Description: Contractor: -Pr<z c', 5: G Address: �0 7 ?,4 v ,.,0, , Cit}', ST, Zip: ( Ghr� m t' -C, Telephonegee) ZO 8'6c747 S' State Lic. # : 7 1 3-3,73 Arch., Engr., Designer: Address: Cite, ST, Zip: Telephone: State Lic. #: Name of Contact P on: Telephone # of Contact Person: # Submittal Req'd Plan Sets Structural Cates. Truss Calcs. Title 24 Calcs. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN IiOUSE:- Planning Approval Pub. Wks. Appr School Fees City of La Quinta Building 8t Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet (mv Dr, Owner's Name: Lq L" -Ie- Ve Address: Ly � re. DV- City, rCity, , f STZip: JQQ, Telephone: Project Description: Ce, 7 t 7,30 Lic. #: 3 Total Permit Fees I 4�;, /0 Construction Tv e: P Oc cu P an cN xX Project t ripe (circle I� n e ) New A dd'n Alter. Repair Demo Sq. Ft.: # Stories: �Units: � Estimated Value of Project: DOp, cio APPLICANT: DON WRITE BELOW THIS LINE Recd TRACKING PERMIT FEES Item Amount Reviewed, ready for corrections Plan. Check Deposit Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted Mechanical 2" Review, ready for corrections/issue Electrical Called Contact Person Plumbing Plans picked up S hl I Plans resubmitted Grading Review, ready for correcii s/issue Developer Impact Fee Called Contact Person A.I.P.P. Date of permit issue Total Permit Fees I 4�;, /0