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04-3734 (GRES)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING PERMIT BUILDING & SAFETY DEPARTMENT (760).777-7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 Application Number 04-00003734 Date 4/28/04 Property Address . . . . . . 542-73- AVENIDA RUBIO APN: 774-234-035-24 -000000- Tenant nbr,.name . . . 759. FREE STANDING GARAGE Application description . . . GARAGE - RESIDENTIAL Property Zoning . . . . . . . COVE RESIDENTIAL Application valuation . . . 14876 Owner Contractor ------------------------ ------------------------ ART LAMBROIS LAMBROIS DGH DEVELOPMENT CORPORATION 54273 AVE RUBIO P.O. BOX 2982 LA QUINTA CA 92253 PALM DESERT CA 92261 (760) 360-8706 WCC: STATE FUND -WC: 1640909 02/01/05 L� CSLB: 480121 09/30/05 CCC: B -C36 -C20 ------ Structure Information 759 SQ. FT. FREE STANDING GARAGE ----- Construction Type . . . . TYPE V - NON RATED Occupancy Type . . . . . . GAR, CARPORT, SHED, AG Flood Zone . . . . . . . . NON -AO FLOOD ZONE Other struct info . . . . . CODE EDITION 2001 CBC FLOOD ZONE NO GARAGE SQ FTG 759.00 - --------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL-•CARPORT/GARAGE Additional desc . . Permit Fee 30.18 Plan Check Fee 7.55 Issue Date . . . Valuation 0 Expiration Date 10/28/04 Qty Unit Charge Per Extension BASE FEE 15.00 759.00 .0200 ELEC-GARAGE OR NON-RESIDENTIAL 15.18 ---------------------------------------------------------------------------- Permit . . . . . . CARPORT/GARAGE Additional desc _ Permit Fee . . . . 162.00 ,1 Plan Check Fee 105.30 Issue Date . . . . ,AValu-ation 14876 Expiration Date 10/28/04 �' Qty Unit Charge Per �' Extension BASE FE'E��,,_ 45.00 �w�1A P.O. BOX 1504 • VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 0 1 - 373 Y I Date: 01 -OZ -al' Applicant: CoN%Tcv2 Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Address: A1.0 / FL 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 Code, and my.License i full force and effect. ` /License Class `��S License No. Date- o Contractor 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 1, 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 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 issued. My wnrs' c pensation insurance carrier anc�pglicy numbg4are: Carrier 1, st�¢� /—a.., Policy Number /fie O O 9 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 I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 01 `Date r Y 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. 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.). Lenders -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 Ouinta, 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 a e 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 thea ;entioned p for inspection purposes. Date %Signature (Applicant or Agent):- Application Number . 04-00003734 Page 2 'Date 4/28/04 Qty Unit Charge Per Extension 13.0.0 9.0000 THOU BLDG 2,001-25,000 117.00 ---------------------------------------------------------------------------- Special Notes and Comments 759 SQ. FT. FREE STANDING GARAGE. w ------------------ Fees . . . . . . . . . STRONG MOTION (SMI) - RES 1.48 Fee summary Charged ----------------- Paid Credited Due' -------------------- Permit Fee.Total 192.18 ---------- .00 ---------- .00 192.18 Plan Check Total 112.85 .00 .00 112.85 Other Fee Total 1.48 .00 .00 1.48 Grand Total 306.51 .00 .00 306.51 if A x BrnT� V City of La Quinta Building aE Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Dye -dd'� Project Address: 7 O%mcr's Name: / bio A. P. Number: Address: s9 v� r Legal Description: Contractor. City. ST. Zip: u l ✓� 2L );Telephone: , - ' Address: r rte) 11,4 Project Description: City, ST, Zip: G `.✓ .� Telephone: 3 =?• niLY State Lie. # Arch., Engr., Designer: N City Lic. #: C0 t► Address: • City, ST, Zip: Telephone: State Lic. #: �. -•:. - =.... ..�'^ . K i : w_ . .: •.: r�Y_ :,:. nstru 1 ? Coction Type: V Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: �� Sq. FL: #Stories: #Units: Telephone # of Contact Person: �) � -21- stimatcd Value of Project: L APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Reed TRACKING PERMCT FEES Plan Sets 2 Plan Check submitted y Item Amount Structural Cala. Reviewed, ready for corrections <I Plan Check Deposit Truss Cala. Called Contact Person f Plan Check Balance Energy Cala. Plans picked up Construction Flood plain plan Plans resubmitted Y12,71 Mechanical Grading plan Y' Review, ready for eorreetio assn Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.I►t.l. H.O.A. Approval Plans resubmitted ' Grading IN HOUSE:- ''' Review, ready for corrcctionsrtssue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue ' School Fees . �� SS o otal Permit Fees if6't'QUcY- eRLK RFC- 5e, FL 5e �oN2