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06-0511 (SOTB)P.O. BOX 1504. ^� +'.•; VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011' LA QUINTA,:CALIFORNIA 92253 F BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153,- BUILDING 77-7153. BUILDING PERMIT 1 . y- Date: 2/0.1/06 Application Number: y 06-00000511 r.� Owner., ~ 4.3 Property Address: " 5.7_0.37�MERION M/M .JOHN PFAFFL , APN: z^ 762-031-007- - - " `• 57037 MERION a Application description: STRUCTURES OTHER THAN BUILDINGS LA QUINTA; `CA 92253 •-1 D ' -,Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1500 _ �= ' Contractor: _ C ' FEB 02 2006 Applicant: Architect or Engineer: FLORES . BLDRS CONSTR, OF WA • ' w .` r + 61125 PIERSON CITY ��C �I�TQUINTA r •� _ WHITE WATER,>,CA- 92282 (760)251-7957 r• Lic. No. ,516625 - LICENSED CONTRACTOR'S DECLARATION- ' WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with �• I hereby affirm under penalty of perjury one of the following declarations: ` ` . Section 7000) of Division 3 of the Business and Professionals Code,`and my License is in full force and effect._ I have and will maintain a certificate of consent to self -insure for workers' compensation, as.provided 'License Class: B '� AL License No.: 516625 for by Section 3700 of the Labor Code, for the performance of.the work for which this permit is ' ' i l - _ — issued. I Dat Contractor: o - have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor - _ ti Code, for the performance of the work for which this permit is issued. My workers' compensation OWNER -BUILDER DECLARATION - ' - insurance carrier and policy number are: - *. ' I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the • Carrier STATE FUND : Policy Number - 1640796-2006 _,�. • - following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to- _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any , r " t construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the • person in any manner so as to become subject to the workers' compensation laws of California, t� permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State • • and agree that, if I should become subject to the workers' compensation provisions of Section „ License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall fo hwith comply with those provisions.' _� 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 1$5001.: Date:_ tZ Applicant: (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, ander the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL `- Contractors' State License Law does not apply to an owner of property who builds or improves thereon, - SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND ' ' and who does the work himself or herself through his or her own employees, provided that the - DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN t. - improvements are not intended or offered for sale. If, however, the building or improvement is sold within - SECTION 3706 OF THE LABOR CODE, INTEREST, ANDATTORNEY'S FEES. - 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.). - y - APPLICANT ACKNOWLEDGEMENT. -• �_ ,, 1—) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. ' property who builds or improves thereon, and who contracts for the projects with a contractorls) licensed , 1. Each person upon whose behalf this application is made, each person at whose request and for . pursuant to the Contractors' State License Law.).- • whose benefit work is performed under or pursuant to any permit issued as a result of this application, 1 _ 1 I am exempt under Sec. - B.&P.C. for this reason 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 actor omission related to the work being _ performed under or following issuance of this permit. ' ° - I' •_ J Date: j Owner: i 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 CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the + I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). 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 insp�ectil �o/rLy/��urposes. - + _Lender's Name: t •O`'� • _ _ _ - �r Date: �� .Signature (Applicant or Agent): .L ' • N s, Lender's Address: - • �J _ T - a LQPERMIT _ n .:� .+ �• * - ' .�% _ - - - Application Number 06-00000511 ..Permit . : . -BUILDING PERMIT Additional desc . Permit Fee 35.00 Plan Check Fee 22.75 Issue Date Valuation 1500- Expiration Date .. 7/31/06 Qty .Unit Charge Per Extension ` BASE ,FEE 15.00 10.00 2.0000 HND BLDG 501-2,000 20.00 Permit ELEC-MISCELLANEOUS Additional desc .;: Permit Fee 18.00 Plan Check Fee 4.50 Issue Date Valuation . . . . 0 Expiration Date:: 7/31/06 Qty: Unit Charge Per Extension BASE FEE 15.00 4.00 -`` .7500 .PER ELEC DEVICE/FIXTURE 1ST'20 3.00 Permit PLUMBING Additional desc . Permit Fee . . : 18:00 Plan Check Fee 4.50 Issue Date Valuation 0 Expiration Date 7/31/'06 Qty Unit Charge Per Extension BASE FEE 1.5.00 1.00 3.0000 EA" PLB GAS PIPE 1-4 OUTLETS 3.•00 ------------------------------------------------------------- Special Notes .and .Comments BBQ/ELECTRIC FOR MISTERS(GFI)/2 GFI PLUGS/GAS LINE FOR BBQ(ANSI Z21:58B/CGA 1.6) . -------------------------------------------------_- Other Fees . . . . . . ENERGY REVIEW FEE 2.28 Fee summary Charged Paid Credited ----------------- Due ---------- ---------- --------- ---------- ---------- Permit Permt Fee Total 71.00 .00 .00 71.00 . Plan Check Total. 31.75 .00 .00 31.75 Other Fee Total 2.28 .00 .00 2.28 Grand Total 105.03 .00 .00 105.03 LQPERMIT RIM RM qgoffaEg 'X RRI us y>.�yZ• .. * �}j3 ., ,}•� s�•'A.= h�jrr,;"�wa;,rgixs� x�r� .. , ' � �� yeti '"� " 'a'q'•pi,�.�/{'b �� '1/°! - s'�'� . _. . 7w kv N� BI fiF 1)►H� 10 ARJACEIIf OOII EE � lOP IRBf uy 2 slo Fs®s Am'!�aac dF w+ msice�xr , of mhr ie nos sloE3 ANo�swEx 2 �� P �� OUIOObR t6E NaY ff 570N@'R�. DtTAG1 Atm !�E C11DmFR d11�OQl� GAS