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RER (05-4813)78100 Masters Cir 05-4813 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T-iht 4 4 Q" VBL DEPARTMENT D ERMIT Application Number: 05-00004813 D OOwner: 78100 MASTERS CIR O Property Address: CSWRIGH T FAMILY TRUST APN: 770-350-003- 78100 MASTERS CIRCLE Application description:REMODEL DENSITYRESIDENTIAL RESIDENTIAL yL"QIT, CA T(OF pEPTA 7)7- 92253 Property Zoning LOW Application valuation: 82725 C` 6562 F'NANG (6071 Applicant: Architect or Engineer: ----------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am Ii ed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business an rof sionals Code, and my Li ense is in full force and effect. License Class: B Lic se JNol•ractor: OWNER -BUILDER DION I hereby affirm under penalty of perjury that I am exempt from the '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 (Seo. 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 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.). 1 1 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: LQPER1111T Contractor: EDWARDS CONSTRUCTION, BOB 51455 DESERT CLUB DRIVE LA QUINTA, CA 92253 (760)777-8202 Lic. No.: 684857 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/27/05 ----------------------------------------------- WORKER'S 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' compensation insurance carrier and policy number are: Carrier VIRGINIA SURETY Policy Number 00500027012 I certify that, in the performance of th for which this permit is issued, I shall not employ any person in any manner so as to ome bject to the workers' compensation laws of California, and agree that, if I should comes lett to the work jf!s' compejj sation provisions of Section 3700 of the Labor Cod I shall thwith coyly aitlytho;ap pr,rGisiory5. -2 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVE A E IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINESkUP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001. 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 workis 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 that the above i ion is correct. I agree to comply with all city and county ordinances and state laws relating to buildinstru on, and hereby uthorize pres to 'ves of this/county to. enterthe above-mentioned t pertin.' n pusignature (Applicant or Agen i LQPERA1IT Application Number . . . . . 05-00004813 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 00 Plan Check Fee .00 Issue Date . . . . 10/27/05 Valuation . . . . 82725 Expiration Date . . 4/26/06 ---------------------------------------------------------------------------- Special Notes and Comments REMODEL TO EXISTING RESIDENCE. NEW STONE VENEER, CORNICE WORK, GATES & CHIMNEY CAPS. 2001 CODES. _ Other Fees . . . . . . . . . HOURLY PLAN CHECK 35.00 Fee summary Charged Permit Fee Total .00 Plan Check Total .00 Other Fee Total 35.00 Grand Total 35.00 Paid Credited Due .00 .00 .00 .00 .00 .00 .00 .00 35.00 .00 .00 35.00 r ',. • Cit,B-n•# ;- La - I Y of Quinta Building, UL Safety. Division Permit # P.O. Box 1504, 78-495 Calle Tampico b 4 La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: /— t, 2 Owner's Name --- ' A. 5-3 A. P. Number: p - • Address: 2L w . Legal Description: ' Q G SSG City, ST, Zip: ► Z a7 Contractor: !v Telephone: G Go` O 1s ...a. Address: '" - - Project Description: City, ST, Zip1z441J/,q ME Telephone 1) 1) State Lic. # : `j City Lic. #: Arch., Engr., Designer:- S 'Tc Address: City, ST, Zip: e g // Telephone:e51,p,) p V&, , g Construction Type: Occupancy: }/ ld State Lic. #: Project type (circle one): New Add'n Alter epair Demo I Name of Contact Person: Sq. Ft.: # St§ies: # Units: Telephone # of Contact Person: A Estimated Value of Proje . CS Z 6'0 1 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted IV/old/ Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction 'R - Flood plain plan Plans resubmitted Mechanical Grading plan 2"' Review, ready for correction issue 0/1,1 Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans 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 r School Fees Total Permit Fees in I., -109V r) _ L I /1