07-2274 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
07-00002274
52090 AVENIDA CARRANZA
773-221-003-20 -000000-
REMODEL - RESIDENTIAL
COVE RESIDENTIAL
3000
c&ht'4 stP4"
Architect or Engineer:
AAMU,-
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
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
%n pplicant 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:.d ^ `
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:
LQPERMIT
Owner:
PEREZ LUIS E
52090 AVENIDA
LA QUINTA, CA
(
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/11/07
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 - Policy Number
_ I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and 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 provisions.
Date: Applicant:
WARNING: FAILURE TO SECURE WORKERS' 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 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 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 cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to build'ng construction, and hereby authori rep entatives
of 'coun�,� enter upon the above-mentioned propert or in ection purposes.
Date: , Sig ature (Applicant or Agent):
Application Number . . . . . 07-00002274
------ Structure Information RESIDENCE UNDER CONSTRUCTION -----
Other struct info . . . CODE EDITION O1BMP04E05EN
# BEDROOMS. 3.00
FLOOD ZONE NO
GARAGE SQ FTG .00
PATIO SQ FTG .00.
1ST FLOOR SQUARE FOOTAGE .00
2ND FLOOR SQUARE FOOTAGE .00
----------------------------------------------------------------------------
Permit . . . BUILDING PERMIT
Additional desc REMODEL TO RESIDENCE
Permit Fee 54.00 Plan Check Fee .
Issue Date . . . . Valuation . . . .
Expiration Date .3/09/08
35.10
3000
Qty Unit Charge Per Extension
BASE FEE 45.00
1.00 9.0000 THOU BLDG 2,001-25,000 9.00
-----------------------------------------------------------------=----------
Permit . . .
Additional desc .
Permit Fee
Issue Date . . . .
Expiration Date-. .
ELECT - ADD/ALT/REM
38.55 Plan Check Fee .
Valuation . . . .
3/09/08
9.64
0
Qty
Unit Charge Per
Extension
BASE FEE
15.00
20.00
.7500 PER
ELEC DEVICE/FIXTURE 1ST 20
15.00
19.00
----------------------------------------
.4500 EA
ELEC DEVICE/FIXTURE >20
:
8.55
. . .
Additional desc .
Permit Fee
Issue Date . . .
Expiration Date . .
PLUMBING
21.00
3/09/08
Plan Check Fee 5.25
Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00
1.00 3.0000 EA PLB FIXTURE DRAIN/VENT REP/ALT ,3.00
----------------------------------------------------------------------------
Special Notes and Comments .
REMODEL OF FAMILY ROOM TO MASTER
BEDROOM AT RESIDENCE UNDER
LQPE%NlIT
Application Number . . . . . 07-00002274
----------------------------------------------------------------------------
Special Notes and Comments
CONSTRUCTION. REVISE WINDOW AND DOOR
SIZES (REDUCE GLAZING AREA); MASTER
BEDROOM ELECTRICAL & LIGHTING;OUTDOOR
LIGHTING; RELOCATE WATER HEATER TO
GARAGE.2001 CBC,CMC,CPC, 2004 CEC, 2005
ENERGY CODES
----------------------------------------------------------------------------
Other Fees . . . . . . . . . ENERGY
REVIEW
FEE
3.51
STRONG
MOTION
(SMI) - RES
.50
Fee summary Charged Paid
------------------=----------=
Credited
Due
-----------------
Permit Fee Total 113.55
.00
----------
.00
113.55
Plan Check Total 49.99
.00
.00
49.99
Other Fee Total 4.01
.00
.00
4.01
Grand Total 167.55
.00
.00
167.55
LQPERAIIT