04-7582 (RER) IIIIII V I I I VIII III 24
10:j,
U, Yr
BUILDING & SAFETY DEPARTMENT
--P-0`. ,BOx 1504 (760).777-7012
��1pF9 78„49;5 CALLE TAMPICO FAX (760) 777-7011
Q,UINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . . . C04=000-07582 Date 12/03/04
Property Address . . . . . 4-97-5-4—AVI'LA DR .
APN: 646-270-005- - -
Application description . . . REMODEL -. RESIDENTIAL
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation . . . . 2500 .
Owner Contractor
------------------------ ------------------------
CURT DUNHAM OWNER
49754 AVILA DR
LA QUINTA CA 92253
Other struct info . . . . . CODE EDITION 2001
---------------------=------------------------------------------------------
Permit . . . . . . ELECT - ADD/ALT/REM
Additional desc
Permit Fee 17 . 25 Plan Check Fee 4 . 31
Issue Date Valuation . . . . 0
Qty Unit Charge Per ' Extension
BASE FEE 15 . 00
3 . 00 . 7500 PER ELEC DEVICE/FIXTURE 1ST 20 2 . 25
----------------------------------------------------------------------------
Permit PLUMBING
Additional desc
Permit Fee . . . . 33 ..00 Plan Check ,Fee . 00
Issue Date . . . Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15 . 00
3 . 00 6 . 0000 EA PLB FIXTURE 18 : 00
----------------------------------------------------------------------------
Special Notes and Comments
REMODEL EXISTING BATHROOM PER APPROVED
PLAN.
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 50 .25 . 00 . 00 50 . 25
Plan Check Total 4 . 31 . 00 . 00 4 . 31
Grand Total 54 . 56 . 00 . 00 54 . 56
P.O. Box 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 61 - � 9 Z Date: t2, 3
Applicant: Architect or Engineer:
Applicant's Mailing Address: Architect or Engineer's Address:
Lic. No.:
BUILDING 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
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).):
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: a 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 o he 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 am the wner-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 exclu iv ontracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code: The Contractors'
State License Law does nle
wrier of property who builds or improves thereon,and who contracts for the projects with a contractor(s)licensed pursuant to
the Contractors'State LicU Iam a mp under Sec. for this reason
r--Date '� OwWORKERS'COMPENSATION DECLARATION
I hereby affirm under penalty of e following declarations:
_I have and will maintain a lete of t to self-insure for workers'compensation,as provided for by Section 3700 of the Labor Code,for the performance
of the work for which thit is' sued.
—I have and will maintain wo pensation surance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is
issued. My workers'cotio insurance arrier and policy number are:
Cartier o" um er
I certify that,in the performf th work or ich this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Ca, n ag e t at,if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,1 shall
f hwiitth comply with thw i0 s.Date , V \ (Applicant
WARNING: FAI URE TO SECURE WS'CO ENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UPTO ONE HUNDRED D D LLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODR , ND 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 f Bui ing and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this applicati n is m de,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,theown th applicant,each agrees to,and shall,defend,indemnify and hold harmless the City of La Quinta,its
officers,agents and employees for any act o missi elated to the work being performed under or following issuance of this permit.
2. Any permit issued as a result of this applica o bec s 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 p it a cellation.
I certify that I h e read this application and state that t ove i formation is correct. I agree to comply with all city and county ordinances and state laws relating to building
construction,an 7%�A' gi§nature(Appfic
by authorize representatives of unt to enter upon the above-mentioned property for inspection purposes.
Date-- ant or ent):
l _
3
. GCS
vp
1 .
- l
f
�ev,j
.. I LA
..
N u4 L
CITY OF
AV
LA QUANTA
-7.5q � I P� � BUILDING $SAFETY DEPT.
APPROVED
I I1. tN1a LXISt` '^'S 9 v M t3 wS FOR CONSTRUCTION
n
rovide mechanical ventilation system capable of providing five air ohan DAT / —BY
rovide exhaust fan(s)at:
i
r+