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RER (08-0668)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA; CALIFORNIA 92253' Application Number: X08 00000668 Property Address: 52945 AVENIDA MENDOZA' APN: 773-332-024-11 -000000- Application. description: REMODEL - RESIDENTIAL Property Zoning: COVE RESIDENTIAL Application valuation: 50 Applicant: _t] Architect or Engineer: IA ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT' BUILDING PERMIT Owner: MENDOZA MISAELA 46302 MONTE VISTA 0, (760O777A706001 0040? -"'1�9 . ��,y Contractor: V .. Owner 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: OWNER -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 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 Cbop 'ng that he or she did not build or improvefor the purpose of sale.). ( 1 1, as owner of the property, am exclusively contracting contra ors to construct the project (Sec. 7044, Business and Professions Cad The Contraccense w does not apply to an owner of pr perty who builds or improves ther o d who che pro ith a contractor(s) licensed suant t the ontractors' State L' a aw.). a xempt ndef JSec. , B. .0 fo this rea (C te: IV u`y V' Owner' I hereby affirm under penalty of perjury that work for which this permit is issued (Sec. 3� Lender's Name: Lender's Address: LQPERMIT DNSTRUCTION LENDING AGENCY its a construction lending agency for the performance of the Civ. C.L. t VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 WORKER'S COMPENSATION DECLARATION Date: 4/23/08 I hereby affirm under penalty of perjury one of the following declarations: 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 f whit his permit is issued. My workers' compensation insurance carrier and policy number ar - Carrier ------ --- - - ---- - - - - -- Policy umber I certify that, in he pe N ormance of the rk for whic s permit is issued, I shall not employ any person in an mann r as to becom subject to orkers' compensation laws of California,. an agree ih t, if I s ul become subj t to the or rs' compensation provisions of Section 319 Ra pf the 4abor d I shall forthwit amp with se provision .W Date:-1pplican - `� ! WARNIN FAILURE TO SECURE RICERS' 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 benefitwork 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 relatJcomply work being performed under or following issuance is permit. 2. Any permit issued as a result of this a plicate n becomes null and void if wormmenced within 180 days from date of issua a of su permit, or cessation of workays will subject permit to cancellation. I certify that I have read this application and stat that the ov inf rmation is correct. I with all city and c J ina es and state laws relatin to buildi nst ction and hereby auesentatives of this c mpo pon the above-mentioned operty insp cti p ores.Signature.(Applicant or Agent): l Application Number . . . . . 08-00000668 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee 9.75 Issue Date,.-. Valuation . . . . 50' Expiration Date 10/20/08 Qty Unit Charge Per Extension ------------------------------------------------------------ BASE FEE 15.00 Special Notes and Comments ---------------- LATH WOOD COLUMNS - -------------------------------------------.---------------- Other Fees '. . . . . . . ENERGY REVIEW FEE .98 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total -------------------- 15.00 ---------- .00 ---------- .00 15.00 Plan Check Total 9.75 .00 .00 9.75 Other Fee Total .98 .00 .00 .98 Grand Total 25.73 .00 .00 25.73 LQPERMIT CITY OF LA QUINTA BUILDING & SAFETY DEPT. .-APPROVED P OVER CONS RUCTION !rrv''Sti1a`t . �`'",�.-_ r i' w.��iiy„�' .r .:r -1}H vy�. .- a.yK�C'.+",�.�'°F'ri'y'.�. � 1�`�in,-. •c: � _t- .,t�r�. �.i . ---'s... .r �.}t. OWNERBUILDER 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 propery 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. 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 truly yours, CITY OF LA QUINTA _ -- - - — •- .- ._.._ _,_ �,.� _ DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 ti J(760)-�77 7012 ( FAX: (760177-7011 n V Bin # City. of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 2-4?( S td L0wner's Name:m) c �(�� - m.e� O2� A. P. Number: Address: '5-2-q q ( Legal Description: Contractor: (, CA.1'Al -le �Z [. �� City, ST, Zip: l -a OJAI � 2Z Telephone: 17/pd -777-701a g, Address: >L Project Description: L ,a T14 6, c) o c� City, ST, Zip: G CJIc/' Telephone: State Lic. # : City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: r� State Lic. #: Name of Contact Person: Construction Type: Occupancy- Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Storie : # Units: Telephone # of Contact Person: p Estimated Value of Project: C) 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 Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''d 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 C