Loading...
09-0202 (RR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 09-00000202 51765 AVENIDA CARRANZA 773-164-014-2 -000000- RE-ROOF COVE RESIDENTIAL . 1000 Tityl 4 4 a" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT ------------------ ------------------------------- ICENSED CONTRACTOR:$ DECLARATION 1 hereby affirm under penalty of perjury hat I am licensed u r provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Bus' ess and f rofessio als Code,/and my License is in full force and effect. License 2a=s: B ! Lic se/No.: 756174 A. Al / I hereby affirm under penalty of perjury that I am exeot from toe 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 the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 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 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 ISec. 3097, Civ. C.). Lender's Name: 6. Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/03/09 Owner: BRATTRUD MARK 51765 AVENIDA CARRANZA LA QUINTA, CA 92253 Contractor: o } GRAY, DON P O BOX 131 LA QUINTA, CA 2 47. (760) 574-3561 Q�U%tAT—A� Lic. No.: 7561 4 CITY„ ----------------------------------------------- WORKER'S COMPENSATION DECLARATION 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 for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier EXEMPT Policy Number EXEMPT I certify that, in the perfor ante of the work for which this permit is issued, I shall not employ any person it any manner so as t0 become subje trto the workers' compensation laws of California, and agree that, if I s ould become subiec o the workers' compensation provisions of Section 3700 of the Labor c4e, I shglll forthw' corpply with those provisions. WARNING: FAILURE TO SECURE WORKERS' COMPqfSATION WVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI ND CIVI NES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COM NSATION, 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 bejg 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 rmi , or cessation of work for 180 d ill subject permit to cancellation. certify that I have read this application and state that t above information is cor ct. I agree, o comply with all city and county ordinances and state laws relating to b Ilding construction, and ereby authorize representatives of this cpungho e0fer upon the above-mentioned prop rty for inspection pur ses. ,f (Applicant or Agent) Application Number . . . . 09-00000202 Permit . . . RE -ROOF Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/30/09 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes and Comments RE -ROOF WITH COMP. SHINGLES. CLASS "A" MATERIALS ---------------------------------------------------------------------------- Other Fees . . . . . ... . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary ----------------- Charged Paid Credited Due Permit Fee Total -------------------- 30.00 -------------------- .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 31.00 .00 .00 31.00 LQPERMIT Bi" # Submittal City of La Quinta Reed TRACKING PERMIT FEES Building & Safety Division Permit # Plan Check submitted Item Amount P.O. Box 1504, 78-495 Calle Tampico Zo L, La Quinta, CA 92253 - (760) 777-7012 (�q" Building Permit Application and Tracking Sheet Project Address:/—�%�� �/l� jZ Owner's Name: XWITP/0 A. P. Number: Plans picked up Construction Address: c` ` �% �' �j¢��j�.{� i:' Legal Description: City, ST, Zip: �Cl/tlf Contractor: Z)O,clg��%� Grading plan Telephone: }%� Address: 0-- 7f >/ry,, Project Description: City, ST, Zip: �l Q to 0,9— �6% Telephone: glel- Plans picked up S.M.I. State Lie. # : / % City Lie. #: Arch., Engr., Designer: Review, ready for corrections/issue Developer Impact Fee Address: Planning Approval City, ST, Zip: Pub. Wks. Appr Telephone: Date of permit issue Construction Type: Occupancy: State Lie. #: School Fees Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: '; Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: 11)©Q l APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Reed TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Caics. Called Contact Person Plan Check Balance Energy Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2`4 Review, ready for corrections/issue Electrical Subcoutactor 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 School Fees Total Permit Fees