11-0948 (SPIN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-000.0'0948
Property Address: 52-975 AVENIDA RUBIO
APN: 773-312-025712 -000000-
Application description: SPECIAL INSPECTION
Property Zoning: COVE RESIDENTIAL
Application valuation: 100
Applicant:
c&ty/ 4 4 4, w
Architect or Engineer:.
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
FNMA
14221 DALLAS PKWY, STE. 1000
DALLAS, TX 75254
Contractor:
SMITH & SONS CONSTRUCTION
I,NC
245 E. DRAKE STREET, UNIT I
- SAN•BERNARDINO, CA 92408
(909)885-2220
j
Lic. No.: 810322
-
------------ -- ------------------------------
. . LICENSED. CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION -
herebyaffirmunder penalty of perjuryahatI am licensed under provisions of Chapter -9 (commencing with I hereby affirm under penalty of perjury one of the following declaration's:
Section 7000);of Division 3 of the Business and Profess' nals•Code, and my License is in.full .force and effect. _ I have and will maintain:a certifica4of consent to self -insure for. workers' compensation, as provided
Licens Class:"B License No.: ��810322 for by Section 3700 ;of,the Labor Code, for the performance of tfie work for which this permitis
t [' ' - .. issued. . f: ' - 1 -
ate . - . I '-Contractor• ' • - - - ; y,•I have and will mantain workers' compensation msurance,-asrequvedby Section 3700 ofthe
- - Code,,for the performance o . the work forwhmch,this per
insurance
issued My workers' compensation
OWNER -BUILDER DECLARATION,.. _ - insurance carrier and. policy nurn6er are.
. I hereby affirm under.penaltyof perjury,thatlam exempt from the'Contractor'sState.License Law for'thei„ Carrier STATE: FUND'.- "r" Policy Number 4970001007
following reason (Sec. 7031.5,-Busin6s'and Professions Code: Any, city oecounty'Ahat requires a. permit to. .'I certify that, in the performance.of the.work for which this permit is. issued; I -shall not employ any
construct, alter, impitiveldemolish, or; rep aii. any. siructure,- prior, to its ,issuance,:also requires the applicant for the person in ary mariner so as to become-subject,t ;,—! workers' compensation laws of California,
permit to file a signed.stateriment thathe!or she.is licensed pursuant to the provisions of the Contractor's State' „ and agree that, if, I sho becom bje tJo the workers':compensation provisions of Section
License Law (Chapter 9f(commencing with Section 7000) of DivIision Sof the Business and Professions. Code) or., 3700 of the Lab o ode; I, shall" or yyi y comply with those provisions.
that he she,is-exempt therefrom and the, basis for the alleged ex emption. Any violation of Section .7031.5 by Q • -�" ; = - -
any applicant fora permit subjects�the.applicant toa.civil penalty of not more than five. hundred dollars (5500)•: ate pplica
( ') `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'. COMPENSATION COVERAGE IS UNLAWFUL,, AND SHALL.
Contractors'State. License Law does not.apply;to an owner of property Who builds 6; 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,$rovided that the 'DOLLARS1$100,000):-,IN ADDITION TO THECOST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN
improvements a renot.intended or'offered fo' •sale :'If, however, the building or.improyement is sold within - r SECTION 3706 OF THE LABOR CODE INTEREST, AND .ATTORNEY'S FEES.
'one,yeai 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 )•;.-, c'• ;' - - " y' 'APPIJCANT ACKNOWLEDGEMENT _
(_ 1 I, as owner, of the property, am exclusively contracting with licensed contractors�toconstructlheprojea (Sec. IMPORTANT. -Application is hereby made to=the Director of Building and Safety'for a permit subject to the
7044, Business a'nd Profession -s Code:' -the Contractors' State License Law does not apply town owner of conditions and restrictions set forth on'.this application.
,property who builds or improves thereon, and who contracts for the projects with a contractorlsl 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 I am exempt under Sec. , BAP.C. for this reason the owner, and the applicant,'each'agrees to, and shall defend, indemnify and hold harmless the City
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/01/11
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 o•r following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work isnot commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation. - - r
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�buiildinqRconst, idn, an hereby authorize representatives
offtthis county to enter upo theabove-mentioned pron oses.
Date / nature (Applicant or Agent
t
,e _.
P.O. 'BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
'Applicant:
11-00000948
52975 AVENIDA RUBIO
773-312-025-12 -000000-
SPECIAL INSPECTION
COVE RESIDENTIAL
100
Architect or Engineer:
4
BUILDING & SAFETY DEPARTMENT'
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153.
Date: 9/01/11
Owner:
FNMA
14221 DALLAS PKWY, STE. 1000
DALLAS, TX 75254
Contractor' "
SMITH & SONS CONSTRUCTION .INC.
245 E..DRAKE'STREET, UNIT I
SAN BERNARDINO.,.CA 92408 '
(.909);885-2220
Lic.=•No.. 810322
--------------------------------------
LICENSED CONT RACTOR'S'DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that 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 - License No.: 810322 for by-Section3700 of;the Labor.Code, for the performance of the work for which this.permit is
.. issued.
Date:. • Contractor. _.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
OWNER -BUILDER DECLARATION - insurance carrier and policy number are:. ' -
I hereby;'affirm under,penalty of perjurv�that Lam exemptfrom the Contractors Staie License Law' 4or the - Carrier STATE FUND Policy Number 497.0001007 .
'following reason (Sec.- 7031 .5, Business 'and ProfessionslCode Any city or county that requires a permit to _ I certify that, in the. performance of the work for which this permit, is issued, 1 shall not employ any
coristruct, 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 becomesubject 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 $700 of the labor Code, I `shall forthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged.exemption. Anywolation.of Section 7031.5 by
any applicant for a permit. subjects the applicamto-a civil penaltyofnot more than five hundred dollars ($500)::
1 _ 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 andProfessionsCode: The
Contractors' State License Law does not apply to an owner'of property, who builds or. improves thereon,
and who -does the workhimself or herself through his or her own employees, provided that the• Z •
improvements are not `intended or offered for sale. If; however, thebuilding.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 forahepurpose of sale.)- - - -
O 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 contrac'tor(s) licensed
pursuant to the Contractors' State Licenselaw.).
(_ 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
Date: Applicant:
WARNING: FAILURE TO SECUREwORKERS'.COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES:UP TOXONE HUNDRED THOUSAND
DOLLARS ($100;000)- IN ADDITION TO THE COST -OF COMPENSATION, -DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABORCODE, 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 personat-whoserequest 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;:agentsand 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 property for inspection purposes.
Date: Signature (Applicant or Agent):
Application Number . . . . . 11-00000948
Permit ... .. SPECIAL INSPECTION
Additional desc
Permit Fee . . . . 100.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 100
Expiration Date 2/28/12
Qty Unit Charge Per
Extension
BASE FEE
100.00
----------------- -----------------------------------------------------------
Special Notes .and Comments, ,
SPECIAL INSPECTION TO CORRECT..PLUMBING &
,. _: .. .- .. :: •-:: ELECTRI'GAL'-,-WORK �AT-.'OR,� NEAR°:'PATIO.. _.
STRUCTURE -.-STRAP WATER HEATER, CAP .OFF
1'/2",COPPER.=ABS•. AT WASHER AND DRYER,
REMOVE�FLOURESCENT LIGHT:•FIXTURES'AND.
ROMEX,:REMOVE.RIGID .CONDUIT°AND SECURITY.
-LIGHTS..- AL`L''A PART OF CODE' CASE
411=1402_:
Fee summary Charged: Paid,- Credited
,,.
Due'
Permit Fee Total 100:00. ,00
.00
100.00 F
Plan Check. Total 00 00'
.0.0.
00
Grand Total. 100.00 00
00
100.00 ;II
LQPERMIT
t.
.•Bin #. .. . ,.... ..
... ..
City of La .'Quints
Building a Safety ;Diyision: R
P.O. Box1504, 78-495 Calle.Tampico, .
.. La Quints, CA 92253,- (760) 777-70 [2
Building Perm►tTApplicath h and. Tracking Sheet
Permit #
(j�Kv
\�
Project Address: tJ'J
'•� al -.��Yµ .
Owner'sName: r M
A. P_ Number:
+Address: )�•yd •'.; ' • . /�S /� w Sam
Legal Description: '
Contractor: �L
A. f� '
City, ST, Zip. cv,1] 5 -7 5a5.y
Telephone:'
Address: �'S N . ti-NGl 1 iLOG+O'.
Project Description: C J vM i E
City, ST, Zip: to
Al W YCii2 >L
Telephone:
City'Lic "cit)
tT�
State Lic. # : �%Q 3
Arch., Engr., Designer:
`
l�
Address:
�% 0
City, ST, Zip: r
W O D d L
Telephone:.
'
.•n :r...
A� A ..
ConslrudiomT an
yPe Occupancy:
State Lic. #:^
Project type (circle one): ' New Add'n Alter epau Demo
Sq. Ft./ Stories: #Units:
Name of Contact Person:,
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO; ;NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACKING PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Cala.
Reviewed, ready.for corrections Plan Cheek Deposit
Truss Cales.
Called Contact Person Plan Check Balance
Title 24 Cales.
Plans, picked up, Construction
Flood plain plan
Plans'resubmitted - Mechanical
Grading plan
tr Review; ready'for oo�rrectionslissue Electrical
Subcoutaetor Inst
Called Contact Person Plumbing
Grant Deed
Plans picked.up . S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
3" Review, ready for core ctionshatic Developer Impact Fee
Planning Approval
Called.Contact Person . A.I.P.P.
Pub. Wks. Appr.
Date of permit issue
School Fees
Total Permit Fees
i h•
Bin #
City Of b . Quina
Building 8z' Safety Division.
P.O. Box. I SO4, 78-495 Calle Tampico
La Quinta, CA. 92253 -,,(760).777-7012
Building Permit Application and -Tracking Sheet
Per ' #
' g
Project Address: 5/ E ' '�
Owner's Name:
A. P. Number:
Address: / JE ;
Legal Description: i n! �.(� j
City, ST, Zi . 1 14 - ' -I 5 `r
Contractor: SGS, ry 4? G ^1
telephone:/
— — r}r;o•:v qi,. ; }~ .,
Address: �! %ZCl
ProjectOescription:
City, ST; Zip: P.C / a...7
i i d— C, D
TeleP hone• 9� 3aa yap
•��:r<:::z•::.,.` .. ;:. s;ur•,,.z:....
State Lic. # : Jd 3;
City Lic.
Arch., Engr., Desi gner:,°
Address:
:' GIT i Q Lk> D
City., ST, Zip:
az Pe-
eTelephone:
Telephone:
State Lic. #:
Name of Contact Person:S A
Construction' Type: Occupancy: b
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #'Stories: #.Units:
Telephone # of Contact Person: 96 2. 3 as —
Estimated Value of Project::'
APPLICANT:.
DO: NOTWRITE'BELOW THIS LINE
#
Submittal
Req'd
Recd '
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Pian Check Deposit
Truss Calcs.
Called Contact Person
�fe
PlanCtieck Balance,
Title 24 Calcs.
Plans picked up jK
Construction
Flood plain plan
Plans resubmitted.
Mechanical
Grading plan
2°"Review, ready for corrcctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval ..
Plans resubmitted
I/r'
..Grading
IN HOUSE:-
'^' Review, ready for correctionsrsWe
Developer Impact Fee
Planning Approval
Called Contact Person
I
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
U &92A44.-95 F04
.,.•tc+ate �i�tv�5 -». s� 14i�lte,Mez t�t�.w►e'kc�i--
F
• ��IVIf�'IN
P.O. Box 1504 BUILDING & SAFETY DEPARTMENT
78-495 CALLE TAMPICO - (760) 777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
To: Greg•Butler, Building & Safety Director To PD: August 11, 2011
From: Les Johnson, Planning -Director Due Date: 'August 17, 2011
Permit* 11-869 Status: 1 St
Building Plans Approval
(This is an approval to issue a Building Permit)
The Planning Department has reviewed the Building _ Plans ' for the following
project:
Description: Patio/Carport
Address or General Location: 52-975 Avenida Rubio
Applicant Contact: Scott Smith (909)322-4219
The Planning Department finds that:
❑ ...these Building Plans do not require Planning Department approval.
...these Building Plans are approved by the Planning Department.
.❑ ...th se Building Plans requir corrections. Please forward a copy of the
alta ed corrections to the applicant. When the corrections are made
pleas return them to the P nning Department for review.
X\ 1.
Les hnson, D t Planni g
r
•
l r
rcWd
AUG 15 2011
City of La Quinta
Planning Dapor4ment