08-0953 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
tApplicant:
08;,000=009533
78007 )AGO
658-270-004-4 -3941 -
REMODEL -_RESIDENTIAL
LOW DENSITY RESIDENTIAL
500
Tu�v 4 4 Q"
Architect or Engineer:
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.
Licens lass: Bee-f0o:"-813897
Date: cntr.ct.r:
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 155001.:
(_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure isnot 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 (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
OFARRELL NANCY D
78007 LAGO DRIVE.
LA QUINTA, CA 922
Contractor:
K M SERVICE INC
41721 NEVIS PL
BERMUDA DUNES, CA
(760)861-2743
Lic.. No.: 813897
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
AIN Q 3 2000
cFN,O1`�Quin,r'
9220 �CEo�s_ A
Date: 6/02/08
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
-Y' Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 713-0022980
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if 1 should become subject to the workers' compensation provisions of Section
3700 of the LabIrco fo it t m with those provisions.
a'D te: �� A ant:
WARNING: FAI RE TO SECURE S' COMPENSATION COVERAGE IS UNLAWFUL, AND'SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 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 buildi construction, hereb authorize representatives
of this c)- ,n togpnter upon the ove-mentioned property mspectio oses.
e: It7 Z '�0 Si cure (Applicant or Agent)' `
Application Number '. . . . •08-00000953
Permit . . .
BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
15.00 Plan Check Fee
9.75
Issue Date . . . .
Valuation . . .
. 500
Expiration Date
11/29/08
Qty Unit Charge
Per
Extension
- ------------------------------------"----------------------------------------
BASE FEE
15.00
Permit . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee
15.75 Plan Check Fee
3.94
Issue Date . . . .
Valuation . .
0
.Expiration Date
11/29/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 .7500
-------'---------------------------------------------------------------------
PER ELEC DEVICE/FIXTURE 1ST.20
.75
Permit . . .
PLUMBING
Additional desc
Permit Fee . . . .
18.00 Plan Check Fee
5.25
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . .
11/29/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
RE -LOCATE ELECTRICAL
AND PLUMBING TO
ACCOMODATE NEW APPLIANCES
----------------------------------------------------7-----------------------
Other Fees . . . . .
. . . . ENERGY REVIEW FEE
.98
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
Permit Fee Total
48.75 .00 .00
48.75
Plan Check Total
18.94 .00 .00
18.94
Other Fee Total
.98 .00 .00
.98
Grand Total
68.67 .00 .00
68.67
LQPERMIT
,w:)
CITY OF LA QUINTA
BUILDING & SAFETY DEPT,
APPROVE®
FOR CONSTRUCTION
DATE
46-a-03, BY
^y.
5.4 3.5 1
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35.1 27 27
37 -1-27
118
137. --
1.5 0A 0.1 • 1.5
Precision Works _ KMS_E_ RVICES V_FARREL
—' 81-501 Indio Blvd Suite D-18 - - -- --
Indi)Ca. 92201 KITCHEN Roam 1
ii bone: 760-342-1133 Fax 76a775:.41 10 _----- — ----..
Current bate: Jan 29, 2008 1 Scale: NTS
No
uio;lo.
35.1 27 27
37 -1-27
118
137. --
1.5 0A 0.1 • 1.5
Precision Works _ KMS_E_ RVICES V_FARREL
—' 81-501 Indio Blvd Suite D-18 - - -- --
Indi)Ca. 92201 KITCHEN Roam 1
ii bone: 760-342-1133 Fax 76a775:.41 10 _----- — ----..
Current bate: Jan 29, 2008 1 Scale: NTS
rtivitl-ax ;�iJi.iroott •I:zv PAUL 001/001. Fax Server
0
FEI CATHEDRAL CITY #611
36.263 PLATA DRIVE Deliver To: KEN
CATHEDRAL CITY. CA 92234 From: Donn® Kinder
Wo Comments:
19:26:38 FEB 01 2008 FERGUSON ENTERPRISES. ItvC:.
FERGUSON ENTERPRISES, !NC:MC I 1
Price 6luoialion Purr.. 9 1,
Phare: 760-32M,561
Fax :76(}328-9859
Bid No.......: B 166328
Bid Date .... : 02/01/08
Quoted By.: DPK
Customer: KEN 0RiFGA.
--COD COD COD --
41721 NEVIS PLACE
ATTN: KEN ()RTE(':;A
BERMUDA DUNES. C.A. 9220.3
Cuss POS►...:
Mem
CBE 12539
FF.LU1:k16
B 12215
PFUOw 1
M7560St_
Bl2215S
8125165
WSW
FWb3426SN
KKBFS20ETWH
KKHMS20'L9W4
KKESK901SWH
Deacdo on
///BAR///
1HDL LEV 7 BAR FCT 'SOLtvMIN SS
13X 16 18 Ll C SS SIN
3.1 /2 LG BRS NCiST T`i PE 85;4 STR'v SN
///KITCHEN/
32X 17-3/4 UC: SS SINK
IHDL LEV KilC'. PO FCT 'EXTE•NS SS
3.1 /2 LG RPS POST TYNE BSKI STRN SN
HD SOAP / L(')1k:)N DISPN SN
SINK 1C)- AiR SWCH & 11?IM KIT
AIR %'V(,H •LI1BU1 SIJ
///APPLIANCES///
19.8 CU A SPLCLN SHLVSTMP
Ivl'h/AVE HOOD W101310 30
'CVR' RANGE Fi Fi: SI
CLIENT USING EXISTING
DISHWASHER
[HANKYOU..DC)NNA. KINDER
Cust Phone: 760-8611-2,43
rerms........ : CASH ON DFI [VERY
Ship To: KEN ORTEGA
- COD COD COD --
41; 2I NEVIS PLACE
A1TN: KEN ORTEGA
BERMUDA DUI' -IFS. CA 92201
Job Name: r4ANCY
Quantity
!
1
1
I
I
I
1
Quoted prices are based upC,n rF:cxipt of the: tofu! cli-Ki tItY for Immadlcrte shlpr.�enl (48 hours). St IIPMENTS BEYOND 4 riOURS SI TALL
BEAT 1 HE PRICE !N EFFECT AT TIME OF SHIPMENT. tTG et• aticns urz offerEd c0niinenl ._p:�r� me Bu/2r's acoeptrnce of Seller's terms
and :zndltlurs. SFIler objects to all other Iew-is c:nd condillorfi. Seller not resp:)wible f;:n' delays or k -x4: of product due iq causes
beyond our or»tro(. Purcnuser's solE v:r..rrcui'i,3s :f any, art tho4e provided by the man,16cturer, SE! LER DISCLAIMS ALL EXPPESSED
OR ItaIP! IED M/ARRANT'F.S, IPJCLUDINC;.AI I .IMP:.IFii JJARRANTIFS OF t0iFRC HAN1.461L•.TV .�r•!D FITNESS OR FITNESS FOR ,4 PART.( .)! AR
PURPOSE. iN N�j kVEtJT'ArILL S� R F 'ABLE FOI? A.id`! I! lCIDEtdTAL PUNIi IVB SPECIAL OR CONSEQUENTIAL DANAE� ES W4
ARI
DIRECTLY OR INDI(zECTLY .- ly) THE CAPE,' A1011 OR LI}E OF THE P?C)IjIJC T, SEI-IT:R'S Li.>BLIT/. IF ANY, SHALL BE LIMITfC THE Iy�T
SAI ES PRICE RECE!`/EG BY SFLLER. C.anoleir T,:;ms csnCi (;orditlotu are, avallabie u4xin request or uan be vlewe'd on rhe c;?
wVrn.fer>~luscm.acrrt/salerternts,fdn J.
Bin #
.
Cit of La
y Quints
Building ex Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
q
Project Address: 7 �j— 007 b.
Owner's Name: —73-.yti 077
A. P. Number:
Address:.- 007 /,+�O
Legal Description:
Contractor:
City, ST, Zip: Cc_
Telephone:
Address: /Y/- 72/ N�✓ I'S `1b
//
Project U
Description: '�( � � A A �og
City, ST, Zip: �Gtic�( ►� rEJGi�/,�s 3
S'��� /�/�Lw/►��75 �- ��
Telephone: 7&0-• !R4, (- 7 -TO
0 C -4-:i e €c.,T/Ll c- k +
R7 rcirLic
State Lic. # : gl 3 �f. #:
Arch., Engr., Designer:
lw+�t"-44
Address:
City, ST, Zip:
Telephone: I
State Lic. #:
Name of Contact Person: ��{V 1v� ��7G�o 1(
Construction Type: Occupancy:
Project type (circle one): New Add'n 4SDRepair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: '?GO^p 1- 27S�
Estimated Value of Project: p Qd ---'
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
2"d 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:-
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