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04-7794 (RER)BUILDING & SAFETY DEPARTMENT c b ,P.O.-Box 1504: (760)-777-7012 'OF `� ��7`8 495 CALLE TAMPICO , " FAX (760) 777-7011 �LA `QutNTA;" CALIFORNIA 92253 INSPECTION. REQUESTS (760)'777-7153 BUILDING PERMIT AppzlSi;cr .tion -.Number 04 00007794 Date 12/15/04 Pro, rt y Address ;�52995TOF A I !3-12 026=13 -0-0'0-000- 77'Y! -3-1:270,2-6-=r3--=0-0,0-0 0 0 - pplication description _REMODEL:=".RESIDENTIAL pplicatio Property Zoning COVE RESIDENTIAL Application valu'ation.. 1431 Owner Contractor TUCKER RICHARD DANROY CORP 52995 AVENIDA RUBIO *, 928.;�VELLA ROAD LA QUINTA CA 92253. PALM -,SPRINGS CA 92264 (76'0) 320.-2.-128 WCC': VIRGINIA INS 005000177101 01/01/05. CSLB-: 5811.49 11/30/05 CCC:... B -C9 -C15 -C33, -------------------------- Structure Information ---- --------------------- Construction Type '• . . . TYPE V NON. RATED .:. , Occupancy Type.DWELLG/LODGING/CONE <=10 Flood Zone NON -AO ,FLOOD ZONE Other struct info . . . . CODE EDITION:, 2001 CBC ----------------- -------------.---- Permit . ... . . . ------------ ----------- ---------------------- --------------- BUILDING -.PERMIT ---Permit Additional desc Permit Fee 35 00 Plan Cheek Fee ;, 2.2.75, Issue Date k Valuation. 1431 Qty Unit Charge Per Extension BASE ,,FEE '15 . 00 10.00 2.0000 HND BLDG 5'01 2;000 20.00 Permit ,`ELECT,-.ADD/ALT/REM' Additional desc Permit Fee 15:75 Plan.,Check Fee 3.94 Issue Date . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE' FEE . 15.00 1.00'. 7500. PER: ELEC DEV=ICE/FIXTURE 1ST 20 .75 Special Notes'an(i:.d6mments REPAIR FIRE DAMAGED TRUSS-- AND_=DRYWALL -IN DINING .ROOM .CEILING-. REPLACE,.INSULATION'' AT REPAIR .AREA..REPAIR FIRE` -DAMAGED', ELECTRICAL 'WIRING•TO. DINING. ROOM CEILING•,.. FAN. REPLACE DRYWALL, TEXTURE£°'AND .PAINT:-, y Other Fees STRONG :MOTION ` .(SMI) - RES .50 P.O. BOX 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: �' — ?'7 Date: Applicant: C I Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 Cod e„and ;my-myfull force and effect. License"Cl'a'ss ALJ _ ._License No._ �j �i( _ q OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' 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 1 _Issued. My workers' aomnencafinn incnron— I—A.. —A ..,.r.,... _.._ --_. erfify 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 I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisioD6•— 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. 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 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, indemnity 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 building construction, and hereby authorize representatives of this county to ent pp the above-menfoned pr perty for inspection purposes. -Signature (AFPFcant or Age .�� Page 2 Application Number.' 04`-00.007794 Date 12/15/04 Fee summary Charged ,Paid. Credited Due Permit. Fee Total 50.75 00. .00 50.75 Plan.Check Total 26.:69 00. 00 26.69 Other Fee''Total 50 .-00 .00 .50 Grand.Total 77.94 .0'0 .00 77.94 I Uib LI ULU LLIC'bUucuuw am%xmp snau IN amugat w ute an=o dw 9MMUiral amnw. and dw mven= build dmwtm cq nsE'.r,,cLu.vcmaccoraa=vm.0 'UtuAg V'WJ=UA16-UwUe am zVor deviations".-ftch't rt mwm ". thm aftim a UGbqSU UULI wasn"m -or `Pff" div I AAA60 zww ? 5M 7'�`q� t ~ �C��4� "qd � WI -7- 07 - ju.c=w am%mp snau oe arougni vo me an.emc msim.wT and dii pvming hWding'de* mm ite shoring and bracing to support all loads durim shall be in 2=rdance with the barest adonted edi I 0 0 ^^'' Qcd �= z _9 �o .. xC14 - v da_j =y u LLJ U.1 UJ -�- . LU CIA lu ju 21. O �p� Fes-- J V_" � p R ` ;s °J.9 C4 -Eo-' OLC\ p o > LU 2QAC) W • e . o �O UJ LU IL si- �-r- :� I-�- LU Lj CN oc .o F - O �- (— o cn Jdt oJl\:w �w o .. > J L w �N Al Um o 4 Ux X7 M - �= � T-- J w w � o -7-1 lti o �y S t -- o ILI L t,o •pp• V , � � W CN ILI r� SIL' w> OCIL fA_ w