SOTB (10-0510)Application Number: 10-0000510
Property Address: 61194 Living Stone Dr
10-0510
Owner: SHEVCHUCK
APN: 764-280-999-200 -300236-. 61194 LIVI
Application description: STRUCTURES OTHER THAN BUILDINGS LA QUINTA,
•Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 320.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
a --�
•
Date: 6/11/10
2010
OF IA OUni-P. +
_ Contractor:
ARTISTIC LANDSCAPE INC.
78206 VARNER RD, #D PMD244
PALM DESERT, CA 92211
(760)360-1395
Lic. No.: 379421 ,
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WORKER'S COMPENSATION DECLARATION
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
wvncn- UM.C. ur:� --i wn insurance carrier ano poncy numoer are: .
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the - Carrier DELOS INS CO - Policy Number 03DKRM12 5 4
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the peLato
the work for which per m'
s ' s d, 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 mancome s ject to t rker ' c p nsation 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 e s je • to the o ers' m ens tionprovisions.of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 700 of the Labor o i � compl ith th a rovi ions.that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 byany applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).: a0 plicant:
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 WARNING: FAIL ETO SECURE WORKERS'. COMPE SATION 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 ($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
( 1 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. -
property who builds or improves thereon, and who contracts for the projects with a contractors) 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 benefitwork is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. , B.&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.
Date: Owner: 2. Any permit issued as a result of this application omes null and void if work is.not om enced
within 180 days from date of issuance of such p mit, or cess tion of wo for 18 d s will subject
CONSTRUCTION LENDING AGENCY permit to cancellation.
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the, I certify that I have read this application and state that the a ve info a on iscor I agr t comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances an state laws relating to buildi constr eti and h e auth ize epresentatives
of this c un to ter upo eabove-mentioned probe for insp do purpos
Lender's Name: ) % -
D / / gnature (Applicant or Agenpl/
Lender's Address:
LQPERMIT
Bin #.
City of La Quinta
Btdlding ff Safety Division
P.O. Box 1504, 78495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Penult # �
Project Address: Li S aneOwner's
Name: tt
Address: tyl
City, ST, zip:
A P. Number
Legal Description:
Contractor.
Telephone:
Project Description: t3(o L
Address:
City,,zip:
aGt LtrlI J3
Telephone:
State Lie. #: City Lie. C
Arch., Engr., Designer:
L fi
Address:
City., ST, Zip:
Telephone: Construction Type: Occupancy:
State Lic. #: %% 9Z,1 Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: 'T7
K_ 1 Sq. Ft: #Stories: # Units:
Telephone # of Contact Person: Estimated Value of Project: ZUU !—
APPLICANT: DO NOT WRITE BELOW THIS UNE
tl
Submittal
Plan Sets
Req'd
Recd'
TRACX3NG
Plan Check submitted
PERMIT FEES
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Pon Check Deposit
Trass Coles.
Called Contact Person
Plan Cheek Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'! Review, ready for correctionvissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3'4 Review, ready [or corrcctloasJissae
Developer Impact Fee
Planning Approval
Called Coutset Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Application Number 10-00000510
Permit . . . . BUILDING PERMIT
Additional desc .
Permit Fee 15.00 Plan Check Fee
9.75
Issue Date Valuation . .
. 320
Expiration Date 12/08/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
-- --- ---- --�- ---Permit-Fee.-- : - -- . __ ---18:75 . _..- - - Plari -Check Fee
.... 4'. 69 ... ... .__:. ,..
Issue Date . . . . - Valuation . .
. 0
Expiration Date 12/08/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
:. .:;5.00. .7500 PER ELEC DEVICE/FIXTURE 1ST 20
----------------------------------------------------------------------------
3.75
Permit . . . PLUMBING
Additional desc .
Permit Fee 18.00 Plan Check Fee
4.50
Issue Date . . . . Valuation
0
Expiration Date 12/08/10
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
INSTALL GAS LINE TO BBQ & FIREPIT; 5
ELECTRICAL OUTLETS FOR PATIO AREA & BBQ
WALL FOUNTAIN (20 L.F. 3' WALL HEIGHT,'
-
CITY STANDARD). 2007•CODES.
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Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
--------------
1.00
ENERGY REVIEW FEE
.98
Fee summary. Charged Paid Credited
Due
Permit Fee Total 51.75 .00 .00
51.75
Plan Check Total 18.94 •.00 .00
18.94
Other Fee Total 1.98 .00 .00
1.98
Grand Total 72.67 .00 .00
72.67
LQPERAIIT
.I-"
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVE®
FOR CONSTRUCTION
DATE 40 '%("/D BY 40
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DATE Z REVISED
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.DRAWING NUMBER
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