RER (10-0265)61665 Living Stone Dr
10-0265
Date: 4/01/10
Application Number: ` 10-00000265 > Owner:
Property Address: 61665 LIVING `STONE DR HARRISON
APN: 764-280-999-21 -,300236- 61665 LIVING STONE DRIVE
Application description: REMODEL - RESIDENTIAL LA. QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 5000 D
Contractor: i
Applicant: g� Architect or Engineer: ARTISTIC LANDSCAPE INC
V— 78206 VARNER RD,. #D P 2 4 ^�� O� 2D�3
U PALM DESERT, CA 92211
(760) 360-1395 C17 OFLA4UTAJ
�( Lic. No.: 379421 tNA1VCLv �PP
� ———-----
L
CENSED ONTRA
I hereby affirm underpenalty of perjury hat I arg,lic nsed un
Section 7000) of Division 3 of the' Bu ess a r essional
r 9 (commencing with
is in full force and effect.
' f / - OWNER -BUILDER DECLARATION
I hereby affirm under penalty Yf perjury that I am exempt from the Contractor's 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 Contractor's 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).:
(_ 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.).
(_ 1 1, 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.).
(_) 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:
LQPERMIT
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
1 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 polis umber are:
Carrier DELOS INS CO ' Policy Number 0315KM14OA84
I certify that, in the perfor ce of the work for which i pV.peynafion
ued, I shall not employ any
person in any manners as [o becomes jest tot orkensation laws of California,
Q and agree that, if I Id become ubj to [he o ers' provisions of Section
3700 of the Labor C de, I shall f hcompl ith ons.
WAI,XNIN¢: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
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.
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 applic on becomes null and void if work is not om nced
within 180 days from date of issuance sus permit, or ssation of w k for�18 da ,will subject
permit to cancellation.
I certify that I have read this application and state at t above fo ation is cor I g e to omply with all
city and co ty o dinances and state laws relatin to/b ding co tr coon, and h y t rize epresentatives
of t c y to er upon the above -men tione pro rty for i pe tion purpo
ateSig- nature (Applicant or e
Application Number . . . . . 10-00000265 -
Permit . . . ELECT,- ADD/ALT/REM
Additional desc .
Permit Fee 18.00 Plan Check
Fee
4.50
Issue Date . . .". Valuation
0
Expiration Date 9/28/10.
Qty Unit Charge Per
Extension
BASE FEE
15.00
4.00 .7500 PER ..ELEC DEVICE/FIXTURE 1ST
20
3.00
Permit . . BUILDING PERMIT
Additional desc—
esc .Permit
PermitFee 72.00 Plan Check
Fee
46.80
Issue bate Valuation
. . .
. 5000
Expiration Date 9/28/10
Qty Unit Charge Per
Extension
BASE FEE
45.00
3.00 9.0000 THOU BLDG 2,001-25,000
27.00
Permit, PLUMBING
Additional desc .
Permit Fee . . 22.50 Plan Check
Fee
5.63
Issue Date Valuation
. . .
0
Expiration Date 9/28/10
Qty Unit Charge Per
Extension -
BASE FEE
15.00
1.00 7.5000 EA PLB VACUUM BRKR FIRST 5
----------------------------------------------------------------------------
7.50
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . 21.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 750
Expiration Date 9/28/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
3.00. 2.0000 HND BLDG 501-2,000
6.00
7 ------------------------------------------------
Notes and Comments .
30 L.F: 6' COURTYARD WALL,CITY STANDARD.
INSTALL•PRE-FABRICATED BBQ WITH 4.
OUTLETS & ELECTRICAL CONDUIT TO SPA &
LQPERMIT
Application Number
. . . . .
10-00000265
Special Notes and
Comments
BBQ, FIREPIT.
INCLUDES 120 L.F.
1 1/2" GAS
LINE. 2007
CODES.
---------------------------------.----------------------
Other Fees
. . .. . .
ENERGY REVIEW
---------------------
FEE
4.68
Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
133.50
.00
.00
133.50
Plan Check Total
56:93
.00
.00
56.93.
Other Fee*Total
4.68
.00
.00
4.68
Grand Total
195.11
.00
.00
195..11
LQPERMIT,.. _
-
Bin #
City Of La Quints
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # `^ (�
l D , dr..-✓
Project Address:�n 7F,
wner's Name: S
A. P. Number:
Address: s J r► 1 yl Uj? [�-
Legal Description:
City, ST, Zip:
Contractor: LStelephone:
C—
.
Address: 26 Zo6
Project Description: 8
City, ST, Zip:
i t i
Tele hone:
yQl:4iith-:{.:++�:ii;ii:ib:i�ii�i:4i:y: ��:;:ti:"?"':i'
„:<;;:.::N ::;.:x;;;:;::
30
State Lic. # : City Lie. #:
Arch., Engr., Designer:
1 L
G �
.Address:
City., ST, Zip:
:.;..•.;::.?:;:;<;�:�;�:»?:<::::s;:st<t::? psi;:
Telephone: c.:z.;?> ;<<;: ' �•rion
";:;: :;?{•:4;:$;'•;. '?r :.:>Y;: . -.fix:, -.tet." .;�:,+.
State Lic. #::: .. ;;...<,.;:•::..?>s
Name of, Contact Person:
COIIStrllCt• p an cy•
Type: Occup
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person: 6
Estimated Value of Proj4 6Q
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIQNG
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°d Review, ready for correctionsAssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Pians 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. Appr
Date of permit issue
School Fees
Total Permit Fees
HEAT -N- Lf®
LifeStyle Products
Models:
PCFL-HNG
PCF-HNG
Patio Campfire
Decorative Gas Log Set
Owner's Manual
Installation and Operation
CAUTION
GAS-FIRED
C
UL US
LISTED
DO NOT DISCARD THIS MANUAL
• Important operating and • Read, understand and follow . • Leave this manual with
maintenance instructions these instructions for safe party responsible for
included. installation and operation. use and operation.
A WARNING i
If the information in these instruc-
tions is not followed exactly, a.
fire may result causing property
damage, personal injury, or death.
• Do not store or use gasoline or other flam-
mable vapors and liquids1in the vicinity of
this or any other appliance.
• What to do if you smell gas: '
- Do not try to light any appliance.
- Do not touch any electrical switch. Do not
use any phone in your building.
- Immediately call your gas supplier from
a..neighbor's phone. Follow the gas
supplier's instructions.
- If you cannot reach your gas supplier, call
the fire department.
• Installation and service must be performed
by a qualified installer, service agency, or
the gas supplier. '
[ I, A WARNING
HOTI DO NOT TOUCH.
SEVERE BURNS MAY RESULT.
CLOTHING IGNITION MAY RESULT.
Glass and other surfaces are hot during
operation and cool down.
• Keep children away.
• CAREFULLY SUPERVISE children in same room as
appliance.
• Alert children and adults .to hazards of high
temperatures.
• Keep clothing, furniture, draperies and other
combustibles away.
s Installation and service of this appliance should be performed
by qualified personnel. Hearth & Home Technologies
suggests NFI certified or factory -trained o
professionals, or technicians supervised
by an NFI certified professional
=' Heat-N-Glo Lifestyles • Patio Campfire • 4004-001 Rev D • 07105
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