SOTB (05-3703)44030 Mariposa Ct
05-3703
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
05-000037.03
44030 MARIPOSA CT
604-091-007-7 -22982 -
STRUCTURES OTHER THAN BUILDINGS
LOW DENSITY RESIDENTIAL
800
Architect or Engineer
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/20/05
Owner:
MORAN JAMES
*NOT:ON FILE
UNKNOWN, CA 99999
L---------------------------------
c or:
D°
SEP 0'7 2005 = - -------------------------
----
CITY OF LA QUINTA
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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:
OWN51R-BUILDER DECLARATION
I hereby. affirm under penalty of perjury that I am exempt from.the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Cdde:j'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 1, 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.). •e
(._ 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 L' se'Lw
.L -
( ) I am exempt under Sec. P. for this reason
ONSTRUCTION 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:
LQPER111IT
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WORKER'S COMPENSATION DECLARATION _
I hereby affirm under penalty of perjury one of the following declarations:
I have.and will maintaina 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 policy number are:
Carrier Policy Number
1f1 I certify that, in the performance of the work for which this permit is issued, I shall not employ any
C person in any manner so as to become subject to the workers' compensation laws of California,
a agree that, if I s become subject to the workers' compensation provisions of Section
00 of the Labo ode,) shall fo i comply with those provisions.
_
a e: pp icanr. y
WARNING: FAILURE TO SECURE RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI AL 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 Quinta, 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 I have read this application and state thItoformation is correct. I agree to comply with all
city and county ordinances and state laws relating toruction, and hereby authorize representatives
ofthis co t t /einter upon the above-mentioned prec4i py oyes.
26et- e:/ yr rgnature (Applicant or Agent):
Application Number . . . . . 05-00003703
Permit . . . . . BUILDING PERMIT
Additional desc .
4 Permit.Fee . . . . 21.00 Plan Check Fee
13.65
Issue Date Valuation . . .
. 800
Expiration Date 2/16/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
3.00 2.0000 HND BLDG 501-2,000
6.00
Permit . . ELEC-MISCELLANEOUS
;- Additional desc .
Permit Fee, 19.50 Plan Check Fee
4.88
Issue Date- Valuation
0
Expiration Date 2/16/06
Qty _..Unit Charge Per
Extension
BASE FEE
15.00
6.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
---------------------------------------------------------------------------
4.50
Permit PLUMBING
Additional desc .
Permit Fee . . . . 18.00 Plan Check Fee
4.50
Issue Date . . . . Valuation .. . .
. 0
Expiration Date 2/16/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 3.0000 EA PLB'GAS PIPE 1-4 OUTLETS
3.00
r -------------------------------------------------------------
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Special Notes and Comments
CONSTRUCT BBQ & FIREPIT PER PLAN
(ANSI#Z223,1A-1998 & Z21.58-1995/CGA
1.6-N95)
----------------------------------------------------------------------------
Other Fees . . ENERGY REVIEW FEE
1'.37
Fee summary Charged Paid Credited
Due
Permit Fee Total 58.50 .00 ..00
58.50
Plan Check Total 23.03 .00 .00
23.03
Other. Fee Total 1.37 .00 .00
1.37
Grand Total 82.90 Ob .00
'
82.90
r
LQPERMIT
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and,to have a business'license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware .of the following information for your benefit, and protection:.
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs)' is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contracts are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work ' ,
personally. r
Information about licensed contractors may be obtained by contacting=the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the'verification is returned.-
Very
eturned:Very truly yours, s
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY -
78-495 Calle Tampico
La Quinta, CA 92253 _
(760) 777-7012
QF(760) 777-7011
ER'S SIGNATURE/DATE
y -G3a Ce
PROPERTY ADDRESS
PERMIT NUMBER(S)
Bin #
City of La Quinta
Building & Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
06, La Quinta, CA 92253 - (760) 777-7012
_3 0 Building Permit Application pp on and Tracking Sheet
Project Address: cl,C) Mit r) ' G'S4 4 Owner's Name:
Ti v1 A) Ura te
A. P. Number: Address: `T q0 •3 '
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Legal Description: a Ci ST Zi ' , 4 j
City, P G ` l 111
& SAFETY [DEPT.
Permit Fees
Contractor:
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Project Description: its
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City, ST, Zip:
Te lephone:
State Lic. # :
CityLic. #;
Arch., Engr., Designer:
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C on stru ctt on Type: Occu anc Y•
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Telephone:
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Name of Contact Person: ev\ C F:
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Sq. Ft.: # Stories: # Units:
Estimated Value of Project:
Telephone # of Contact Person: ,C, im f C `; c J ' ° M— P
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd .
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections l91106Plan
Check Deposit
Plan Check Balance
Truss Calcs.
Title 24 Calcs:
Flood plain plan
Called Contact Person r
Plans picked up
Plans resubmitted g
Construction
6OT6
Mechanical
Electrical
F 1Ntt
Grading plan
Subcontactor List
Grant Deed
2n° Review, ready for correcti-o—nsm sue
Called Contact Person
Plans picked up
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H.O.A. Approval
Plans resubmitted
Grading
Developer Impact Fee
IN HOUSE:-
'`" Review, ready for corrections/issue
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
& SAFETY [DEPT.
Permit Fees
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