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RER (04-6126)51510 Avenida Martinez 04-6126 T-Ildf 4 4 a" P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT Application Number . . . . . Property Address . . . . . . APN: Application description . . . Property Zoning . Application valuation BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 04-00006126 ;51510 AVENIDA MARTINE 773-142-001-24 -0000 REMODEL - RESIDENTIAL COVE RESIDENTIAL 2335 Date 9/01/04 Owner -------------------- Contractor, \ u • NELSON ROYANN --------------------.- -r-; - SUNSET BUILDERS P O BOX 192 P.O. BOX 996 LA QUINTA CA 92253 APPLE VALLEY CA 92307 (760) 961-6454 WCC: STATE FUND WC: 1680870 08/01/05 CSLB: 286279 09/30/06 CCC: B ------ Structure Information REPAIR KITCHEN WALL ----- Constr.uction 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 . . . . 54.00 Plan Check Fee.. 35.10 Issue Date . . . . Valuation . . . . 2335 Qty Unit Charge Per Extension BASE FEE 45.00 1.00 9.0000 ---------------------------------------- THOU BLDG 2,001-25,000 ' = 9.00 Permit . . . . . ------------------------"----------- ELECT,- ADD/ALT/REM Additional desc Permit Fee . . . . 16.50 Plan Check Fee 4.13 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 .7500 ---------------------------------------------------------------------------- PER ELEC DEVICE/FIXTURE 1ST 20 1.50 Permit . . . . . . PLUMBING Additional desc Permit Fee . . .'. 18.00 Plan Check Fee 4.50 � - 1 P.O. BOX 1504 '��-V VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 4INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: t({ -- Applicant: Applicant's Mailing Address: I hereby affirm under penalty of perjury that I ari Code, and my License is in fu I for and effect. License Class Date—q — ! Contractors Date: Architect or Engineer: Architect or Engineer's Lic. No.. BUILDING PERMIT -DECLARATIONS LICENSED CONTRACTOR'S DECLARATION under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals License No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt fromThe 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 applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the 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 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).): U 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 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 thereon, 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 Date 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 the performance of the work for which this permit is issued. My workers' ompensation insurance carrier and olicy number are: Carder�i iy(►l Satfon Policy NumberUA _ I certify that, in the performance of ft 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, a agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi ns Date_qA — p `t Applicant WARNING: FAILURE TO SECURE WORKERS' COMPENS ON 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 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 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 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 canellation. I certify that I have read this application and state that the above info ion 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 en er on the above-mentioned property for inspection purposes. Date 0 ILI Signature (Applicant or Agent): c -h- Page 2 Application Number 04-00006126 Date 9/01/04 Issue Date . . . . .Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ---------------------------------------------------------------------------- Special Notes and Comments REPAIR DAMAGE TO KITCHEN WALL BY AUTO. INSURANCE --------------------7------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 3.51 Fee summary Charged --------------------------- Paid Credited Due Permit Fee Total 88.50 ---------- ---------- .00 .00 ---------- 88.50 Plan Check Total 43.73 .00 .00 43.73 Other Fee Total 3.51 .00 .00 3.51 Grand Total 135.74 ..00 .00 135.74 Bea Permit # o9- Project 9 - J [AP. ect Address: Number _ City of La Quinta Building a Safety Division P.O. Box 1 SO4, 78-49S Cape Tampico La Quinta, CA 922S3 - (760) 777.7012 Building Permit Application and Tracking Sheet O A9C MAP_-T(,UE2_40ncr'sNaznc: 'C D R D `'I A N AJ -/412 —C>01 —2-4 Address: — MAR TWE Z X Contractor. S V I City. ST. zip: Lq Total Address: 2 2 2- G q O A W 1 :R-3"Project Description: I( --- --- X city, ST, zip: Pp (E UA .E CA 3 D APPLICANT: DO NOT WRITE BELOW THIS LINE To k cl CI p X Telephone ' 6Q I S ^'rte " ' _ E- 13 A u o Plan Sets State Lic. N : Ciry Lic.: ^ D _ . Structural Calfs: - ..:..:_.:. _: _.......:..... ..:...:: _ . _ . AMA Review forcofrectioas - Linf PsoQ - C cAi Arch-, Engr,, Designer E a Pl Ch ck DeTruss Cafes Address:f-- Called CoPerson - Q Plan Check El( - LA Energy Cala City, ST. Zip: Balance Plans picked up (NSU ( A T(GN Telephone. Construction Flood plan pl:aPlans resubmitted ' Constivction Type U — Occupancy: 3 State Lic. Mechanical Pro cct j type (circle one): New Add'n Alter Rcpair Deme f% Name of Contact Pcrson: A.0 _ S1• Ft.: X Telephone # of Contact Person: ' d a _ N Stories: it Units: Total 5 unatcd Value of Project: 2 d APPLICANT: DO NOT WRITE BELOW THIS LINE ' p Submittal Req'd Rcc'd TRACKING Plan Sets PERNUT FE Plan Cheek submitted Item . Structural Calfs: - ..:..:_.:. _: _.......:..... ..:...:: _ . _ . AMA Review forcofrectioas - E a Pl Ch ck DeTruss Cafes Called CoPerson - Q Plan Check Energy Cala Balance Plans picked up Construction Flood plan pl:aPlans resubmitted ' Mechanical Grading plan 2'' Review, ready for eorrectionsrssue Electric Subeoataetor List • Called Contact Person 'I Gnat Deed bi Plans picked up S. 1. H.O.A. Approval Plans resubmitted r IN HOUSE: Gr In 3" Review, ready for eorrectionsrusuc Planning Approval De mpact Fee Called Contact Person Pub. - 'ks. Appr Date of permit issue School Foci Total