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RER (14-0016)60755 Living Stone Dr 14-0016 Application Number:- 14-00000016 Owner: Property Address: 60755 LIVING STONE DR RUSSOMANNO DIANE APN: 764-430-015- - - 60755 LIVING STONE DR Application description: REMODEL - RESIDENTIAL LA' QUINTA, CA 9,2253 Property Zoning: MEDIUM HIGH DENSITY RES ( Application valuation: . 4500 Contractor: Applicant: Architect or Engineer: Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/07/14 D° JAN A 2014 CITY OF 6A QUIPdiA FINANCE DEPT. LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION - I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: License No.: - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date:Contractor: - - - _ 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 OWNER -BUILDER DECLARATION - insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier - - - - - - - - - - - - - - - - - - - - - - -Policy Number . following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to %,I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the �/ person in any manner so as to become subject to the workers' compensation laws of California, . permit to file a signed statement that he or she is licensed pursuant -to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section - License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with those provisions. t he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by a plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500): Date: Applicant: - 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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:). - APPLICANT ACKNOWLEDGEMENT I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the - 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. i property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for - pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, ') I am exempt under Sec. .&P.C. for this reason 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. Ow r _ 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, CONSTRUCTION LDING AG NCY permit to cancellation. - I hereby affirm under penalty of perjury that there is a construction riding ncy for the performance of the I certify that 1 have read this application and state. that the above information is torr ct. agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating buil g construction, and her thorize representatives of this ounty t` er upon the above-mentioned p inspection purpose Lender's Name: , • Dater " Signature (Applicant or Agen :1 Lender's Address: LQPERMIT Application Number . . . . . 14-00000016 Permit REMODEL 2013 Additional desc . Permit Fee- 130.13 Plan Check Fee : .00 Issue Date . . ... Valuation . . . . 0 Expiration Date 7/06/14 Qty Unit Charge Per Extension 1.00 48.6200 LS MISC REMODEL, 1ST 100 SF 48.62 1.00 21.4500 EA MISC REMODEL, ADDL 500 SF 21.45 1.00 60.0600 LS MISC DR/WIN, REPL, 1-7 60.06 ---------------------------------------------------------------------------- Special Notes and Comments REMODEL - CONVERT ROOM BACK TO GARAGE, REPLACE FIRE DOOR, AND MAKE GARAGE DOOR OPERATIONAL. 2013 CALIFORNIA BUILDING CODES. --------------------- Other Fees BLDG STDS ADMIN (SB1473) 1.00 PLAN CHECK, REMODEL - 258.83 Fee summary Charged Paid Credited Due ------------- ----- - Permit Fee Total 130:13 .00 .00 130.13 Plan Check Total .00 .00 00 .00 Other Fee Total 25.9.83 .00 .00 259.83 Grand Total 389.9.6 .00 .00 389.96 LQPERMIT _ - 4 Bin # City of La Quinta Building iii: SafetyDivision P.O. Box 1504, 78-495 Calle Tampico La Quinta,-CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 5 L Owner's Name: I 1t)c— Vvssso A. P. Number: Address: &0 7S5 LS� Legal Description: City, ST, Zip: Contractor: Telephone: Address: Project Description: City, ST, Zip:./�/t� �p Telephone: . .............:......:.......................... lceqpA State Lic. # : City Lic^,#: Arch., Engr., Designer: , V Address: City., ST, Zip: Telephone:. �>::<`.'«.::•::::..::::::...::<:::;:!•::.;:;:.. :: J::i•l:i"•.'!v�:vr.i �:: iii:'.i'>4tiJ:'r'v' .......;>;..;; :<:.:::;.; ; Construction Type: Occupancy. State Lic. #:............ .V Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: #Stories: #Units: Telephone #,of Contact Person: Estimated Value of Project: 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 Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" 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 correctionsrssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees 8 16— Total Permit Fees CITY OF LA QUINTA COMMUNITY DEVELOPMENT.