09-0152 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:09-00000152
Property Address: ��81445�RUSTIC CANYON DR
APN: 764-280-999-47 -300236-
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: MEDIUM HIGH DENSITY RES.
Appljcatlon valuation: 2000
Applicant: Architect or Engineer:
.4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
JIM & LYNDA CALDER
81445 RUSTIC CANYON
LA QUINTA, CA 92253
Contractor:
BRYAN INVESTMENTS
P.O. BOX 1804
PALM SPRINGS, CA
(760)345-8483-
Lic. No.: 552140
VOICE (760) 777-7012
FAX (760) 777-7011
INO CTIONS (760) 777-7153
•ate: 2/18/09
4
DRIVE
GROUP INC
92263
ICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of per' th 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 th Busine 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 C53 License No.: 552140
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
r ntractor:
IRt
J
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 workerscompensation
OWNER -8 ILDER DE RATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt tom the Contr ctor's State License Law for the
Carrier NORTHERN INS NY Policy Number WCO281765000 '
following reason (Sec. 7031 .5, Business and Professions or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shalt not employ any
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,
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) or700
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
of the Labor , I shall forthwith comply with those provisions.
`A
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
e: L ` �ant:
(_ 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
WARNING: FAILURE TO SECURE WORKERS' COMPEN �TION COVE AGE 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 PENALTIESAN FI UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS 1$100,000). IN ADDITION TO THE COST OF C NSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'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.).
APPLICANT ACKNOWLEDGEMENT
(_ 1 I, 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 contractor(s) 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,
(_ I 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
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
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 building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned prope for inspection urposes.
ggnature (Applicant or Agent)'if
Application Number
09-00000152
Permit
BUILDING PERMIT
Additional desc .
Permit'Fee . . . .
45.00 Plan Check Fee
29.25
Issue Date.
Valuation
2000 .
Expiration Date
8/17/09
Qty Unit Charge
Per
Extension. .
BASE FEE
15.00
15.00 2.0000
HND BLDG 501-2,000
30.00
Permit
ELEC-MISCELLANEOUS
Additional desc .
Permit Fee
17.25 Plan Check Fee
4.31
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
8/17/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3.00 .7500
----------------- ----------------------------------------------------------
PER ELEC DEVICE/FIXTURE IST 20
2.25
Permit . . .
PLUMBING
Additional desc .
X18.00
Permit Fee . . .,.
Plan Check Fee-
4.50
Issue Date . . . .
Valuation . .
. 0
Expiration Date
8/17/09
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
BBQ .(A21.58 2003) & FIREPIT
(A223.1). 75
L.F. TOTAL OF 3/4" GAS
LINE. T'D OFF
FROM HEATER TO BBQ, AND RUN FROM HOUSE
STUB OUT TO FIREPIT,
NO, SINK.
----------------------------------------------------------------------------
Other Fees • . . . .
. . . . BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
2.93
Fee summary Charged
Paid Credited
Due
Permit Fee Total
80.25 .00 .00
80.25
Plan Check Total
38.06 .00 .00
38.OG
Other Fee Total
3.93 .00 .00
3.93
Grand Total
122.24 .00 .00
122.24
LQPERMIT
LQPERMIT - .
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CITY OF LA QUINIT,
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Bin #
City of La Quinta
Building U. Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:' 19 y 5 wsfi c l, Gl A dh Owner's Name: r m�c 1 OLI nd q Ca, I d e n
A. P. Number: Address: I y 1-4 S P, U S 1 C �a >1 Ll rM
Legal Description: City, ST, Zip: u lh__T_k�
Contractor: C Q I f C. C l Fl C POO 1S Telephone:
Address: P Q, aQ I� 0 y
City, ST, Zip: �a (m Sprin s
Telephone: 3p� g.6 q q
State Lic. # : S a I q r;h
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal
Plan Sets
Structural Calcs.
Truss Cates.
Energy Calcs.
Flood plain plan
Grading. plan
Subcoutactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
Recd
Project Description:
Lic. #:
7— al.
7-'4- r!�V
M-1
Total Permit Fees
Construction Type: Occe panty:
Project hype (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: #Units:
Estimated Value of Project: 6z>lz�
IUCANT: DO NOT WRITE BELOW THIS UNE
TRACKING.
EERMTT FEES
Plan Check submitted
Item
Amount
Reviewed, ready for corrections
Plan Check Deposit
Plan Check Balance
Called Contact Person
Plans picked up
Construction
Plans resubmitted
Mechanical
2" Review, ready for corrections/rssue
Electrical
Called Contact Person
Plumbing
S.M.I.
Plans picked up
Plans resubmitted
Grading
Developer Impact Fee
A.I.P.P.
3A Review, ready for. corrections/issue
Called Contact Person
Date of permit issue
Total Permit Fees