06-2723 (SOTB){
1111111 IIIII III IIIII IIII 26
IE
P.O. BOX 1504 - -- -- - - -
78-495 CALLE TAMPICO .
LA QUINTA, CALIFORNIA 92253
T-4wt 4 4 "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 06-00002723
Property Address: 60915 AZUL CT
APN: 764-270-999-88 -300234-
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 60.0
Owner:
KAREN MIKKELSEN
60915.AZUL CT
LA QUINTA, CA 92253
Contractor:
Applicant: Architect or Engineer: ARTISTIC LANDSCAPE
78601 POMPEII CT
LA QUINTA, CA 9225
(760)360-1395
Lic. No.: 379421
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/18/06
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -f _ w - - - - - - _ _ _ - _ _ - _ - - _ - - - - - - - - - _ - - _ - _ - - - _ _ - - - - - - _ _ - - - - - - - - - - _ _ - - _
I hereby affirm under penalty of perjury t I am licensed u99der pr isi n_ s of C�d er 9 commencing with
Section 7000) of Division 3 of the Bu sand Professiorl�ls Co , a my l,� se Yin full force and effect.
Licenseflass:_ CQ7 _ Licen 3 9 21
V I OV1fNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason ISec. 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 T(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.).
(_) 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.).
( 1 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:
LQPER,NIIT
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 CLARENDON INS Policy Number 01KR-0032-02'
certify that, in the perform a of the work for which t ' permit is iss/d'roh'a'wnlot employ any
person in.any manners to beco a su lect tothe rers' com lasofCalifornia,
and agree that, ifI sh become bje to the w k s' compen tivisions of Secton
9 70of the Labor I shall fo wi comply those pro ion
Datp:�� Applicant: '
WARNING: FAILURE TO SEC RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$ 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 per 't.
2. Any permit issued as a result of this application a mes null and void if work is not co a ed
within 180 days from date of issuance of su p rmit, or cessation of or for 18� s ill subject
permit to cancellation.
I certify that I have read this application and state that a ove inform ion is c rec . I age o c ply with all
city and county ordinances and state laws relating to ui ing construe 'n, and er y aulph ze re resentatives
of this coun to n r u n the above-mentioned q o rty for in e n purp
Date: f✓S'ture (Applicant or Ag
Application Number . . . . . 06-00002723
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . .17.00
Plan Check Fee
11.05
Issue Date
Valuation . . .
. 600
Expiration.Date 1/14/07
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 2.0000 HND BLDG
----------------------------------------------------------------------------
501-2,000
2.00
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 18.00
Plan Check Fee
4.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 1/14/07
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
FIREPIT AND FUTURE GAS LINE ONLY
PER
PLAN
Fee summary Charged
--------------------------------------
Paid
Credited
--------------------
Due
Permit Fee Total 35.00
.00 .00
35.00
Plan Check Total 15.55
.00 .00.
15.55
Grand Total 50.55
.00 .00
50.55
LQPERn1IT
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 #
3
Project Address:'622 L G
Owner's Name: <A
A. P. Number:
Address: L67
Legal Description:
City, ST, Zip-
Contractor: �L !Azw) 1
Telephone:
Address:G c
Project Description: L
City, ST, Zip: L
Telephone:
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
EM
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New dd Alter Repair Demo
Name of Contact Person:ILIA
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: �j
Estimated Value of Project7u::0_
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
SOT 6
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d Review, ready for corrections/issue
Electrical
'Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
' " Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person -�
A.I.P.P.
Pub. Wks. Apprwte-o
' eruirs�__
—i
School Fees
t �A AFC ,► �EPT•
V 1 f0, ...4 r1
I 60,4 -ME Q_ i"
NSTRU
4C -,0.a �, e:� k �? y ; 1',i.`` f
Total Permit Fees
�+
��• 7
BY. y