RER (04-8014)54775 Avenida Madero
04-8014
P.O. BOX 1504
78-495 CALLE TAMPICO '
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number: 4 u ' 8.0
Applicant:
Appiicant's Mailing Address:
Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-7011 .
INSPECTIONS (760) 777-7153
Date: / 2
Architect or Engineer's Address:
Lic. No.:
tsUILUING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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 applicantfor the permit to file a signed
statement that he or she is licensed pursuant to he provisions of he 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 or 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).):
U 1, as owner of the property, or my employees with wages as their sole compensation, will do he 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 or 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.).
U 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 hereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. , BA P.C. for this reason
/1 T Owner
WORKERS' 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 he -performance of the work for which this permit is
issued. My workers' compensation insurance carrier and policy number are:
Carrier Policy Number
_ I certify that, in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date 1t>rjG Applicen / /,,t,4T/A
WARNING: 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.
CONSTRUCTION
LENDING
I hereby affirm under penalty of perjury that there is a construction lending ge cyor4the performance of he work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lenders Address
APPLICANT
ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Buildingand Safety or a
1. Each
person u Y Permit subject to he conditions and restrictions set forth on this application.
pe 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, he 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 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 permit to cancellation.
I certify that 1 have read his application and state that the above information is correct. I agree to.comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
Date 28 O Signature (Applicant or Agent : Sh
Application Number w'.f;0'00`0'8014
------ Structure Information. PARTITION OFF AREA FOR OFFICE:
-----
Construction Type TYPE V - NON RATED
Occupancy Type . . . . . . DWELLG/LODGING/LONG <=10
Flood Zone NON-AO,.FLOOD ZONE
Other struct info . . . CODE EDITION
-----------------------------------------------------------------------------
2001 CBC
Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee . . . . 21.00 Plan Check Fee..
13.65
Issue Date . . . . Valuation
750
Qty Unit Charge Per
Extension
BASE FEE
15.00
3.00. 2.0000 HND BLDG 501-2,000...
-------------------------------------------------------------
6.00
---------------
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 . . . . MECHANICAL
Additional desc
Permit Fee 24.00 Plan Check Fee
6.00
Issue Date Valuation
0
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 9.0000 EA MECH APPL REP/ALT/ADD
-- -- -
9.00
=-
----------------------------------------------------=--
Special Notes and Comments
--------------
partition off area for office in'
existing enclosed room. 12/27/042:18:32
PM jjohnson also add window to existing
bedroom
Other Fees . . . . . . . . ENERGY REVIEW FEE
1.37
STRONG MOTION (SMI) - RES
.50
Fee summary Charged Paid Credited
Due
----------------- ----------- ---------- ---------- ----------
Permit Fee Total 62.25 ..00 .00
62.25
Plan Check Total 23.96 .00 .00'
23.96
Other.Fee Total 1:87, .00 .00
1.87
Grand Total 88.08 .00 .00
88.08
Bin'#
City*of La ..
Quinta
,..
' Building aL Safety Division • '
P.O. Box 1504, 78-495 Calle Tampico'.
Permit #
La Quinta,.CA 92253 - (760) 777-7012
Building 'a'dan`
Permit AppliUon Trcking..Sheet,- -
Project Address: 16-R C),
O%%rcr's Name: p
A. P. Number
9Address.
Legal Description:
40ty. ST, Zip:
Contractor: .- ,
FTelepho ) SZ —
Address:/✓ "60- /
%/ -d,2o
Project Description: .. _
City; ST, Zip:L4 Pq
Telcphon- _,,...
State Lic. # : j e fSl /- Y
City Lic. #:
/J
7L 4 f
Arch., Engr., Designer.
Address: "
City, ST. Zip:
Telephone:
_
- •< "
C onstruction T YPe= Occupancy:..
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #: - f
Name of Contact Person: Em j 117 7AI
X Sq, FL: 11-4/7 N Stories: # Units:
stimatcd Value of Project:
Telephone # of Contact Perso / p
APPLICANT: DO NOT WRITE BELOW THIS LINE X
#
Submittal
Rtq'd
Rec'd
TRACKING . PERMIT FEES
Plan Sets
Plan Check submitted f Item t
IS . aunt
Reviewed, reador corrPlaa Check Deposit
Structural Cafes.
Truss Cates.
Called Contact Person Plan Check Balance
Plans picked up Construction
Energy Gales.'
Flood plain plan
Plans resubmitted M1lech2nic21
.+ I
2 Review, ready for correction issue Electrical
Gradin lane
Grading p
Subcontactor List
Called Contact Person
Plans picked up 1
Plans resubmitted -Grading
3" Review, ready for correctionsrissue Develo act
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Called Contact Person
r
Pub- N'ks. Appr '
Date of permit issue yA
School Fees
TOW Prr-it r.
Y
:i
:C 1
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http://in2osiv.0998.lowe,s.coin/ni2o/lowesQubte..jsp?prqjectld=5940726
. . . . .. . . .............. . ............... ... . ... . ... . ...................... .. . . ........... ...... ..... ..... . .............................. ... .. . ...... . ................... . . ... ... . .
LOWE'S HIW, INC. #208
78-865 HIGHWAY 111
LA OUINTA, CA 92253
(760) 771-5566
Project Name: ALMOND WINDOW:'
Project #: 80370331
Customer Name: ROBERT HAMILTON
Customer Phone: , (760) 564-4170
Customer Address: .54775 AVENIDA
MADERO
LA QUINTA CA 92253
Line Item
Frame Size
Product Code
Description
0001
Manufacturer: Therm §ar by Pella (TM) W
Size 713/4" W x 35
-- - ---- ----- . ... . . .. ...... . ........... - - - --------- - -- - - - — - ---- - --------------
..7
/4" H
Product: Windows
.Frame Size = 71 1/2" W x
Type: Sliding
5 1/2" H
Manufacturer: ThermaStar by Pella (TM) W.
Material: Vinyl
!Frame Type (Overall Width): Flush Fin (2 11/16"
AD)
..'series: 20 Series
Trame Profile: Flat
1,:Sill Orientation: Pocket (with Offset Drain Slots)
:Sash
Profile: Flat
C onfiguration: XO (Viewed from Exterior)
:Frame Size Width: 71 1/2"
if rame Size Height: 35 1/2"
;Vent Size: 1/2 Vent
Exterior Finish: Almond
interior Finish: Almond
lazing: Low -E (Recommended)
'Highfitu e: No
rgon Gas Filled IG: No
7empered Glass: No
!Grilles Between Glass Type: None
'11lardware: I Cam/Keeper Lock Set
Hardware Color: Almond
;Screen: Half Unit Fiberglass Screen
Lead Time: 14 Days
... . ................ . .... .. . ........... ....... ............ . ........ .... . .. ... ...............
Salesperson: GEORGE
ESQUIVEL(SO208(;El)
A ---+. A t,.,.
Unit
Quantity Total Price
Price
$209.33 1 $209.31
Project Total: $209.33
I of 2
12/11/200411:18 AM
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