07-2052 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
O-;-7 0 5 2
53'8'8.0 AVENIDA RAMIREZ
774-162-008-17 7000000 -
REMODEL - RESIDENTIAL
COVE RESIDENTIAL
823
Architect or Engineer:
-----------------
LICENSEDCONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
hereby affirm under penalty of perjury that 1 am licensed under, provisions of .Chapter 9 (commencing with, .
Section'7000) of Division 3 of the Business and.ProfessionalsICode, and my License is in full'force and effect.' -
License Class,. B ' . ':License No:: 847937' -
Date: Contractor:
OWNER-BUILDER,DECLARATION -
Thereby affirm under penalty of perjury that,l am exempt6om 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 _
LicenseLaw (Chapter 9 (commencing with Section 7000)-of..Division 3 of the Business and,Professioiis 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 fora permitsubjects'the applicant to a civil penalty of not more than five hundreddollars ($500).:
(_ 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.
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, pro4ided.that the '
improvements are. not intended or offeredfor sale. If, however; the building or improvement is sold within
:ane ,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.). _ -9
( ,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
ate:
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:
RAMOS ROBERT E
50855 WASHINGTON ST STE
LA QUINTA, CA 92253"
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/13/07
Contractor. D
RC GROUP "Zl
66309 PIERSON BLVD
DESERT HOT183RINGS,. CA 92 40 ilk 1 3
Lic. No.: 847937
-------------- ---------------'---------------�.f--
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one ofthe following declarations: _
have and willmaintain certificate of consent to self -insure for workers' compensation,las provided`
for by"Section 3700;of the Labor Code, for the performance of'the work for which this.permitis
issued.
_' I have and will maintain workers' -compensation insurance, as required by Section 3700 of the1iibor
Codejor the performance of the work for which this permit is issued. My workers"compensation
insurance carrier and policy number are:
Carrier EXEMPT' Policy Number EXEMPT.
certify that, in'dhe 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 l'should become subjecrto the workers' compensation provisions of Section
3700 of. the LaborCode, lI shall:forthwith cow with those 'ions.
' cant:
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 60ST-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 toany 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 andc my ordinances and state laws relating to building construction, hereby authorize representatives
of thi ounty to enter upon above-mentioned property for inspection pu
�� rposes.
ate: nature (Applicant or Agent):
r�
Application Number . . . . . 07-00002052
Permit . . . . . .
BUILDING PERMIT
Additional desc .
Permit Fee
23.00 Plan Check Fee
14.95
Issue Date . . . .
Valuation
823
Expiration Date
1/09/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
4.00 2.0000.HND
------------------------------
BLDG 501-2,000
----------------------------------------------
8.00
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
17.25 Plan Check Fee
4.31
Issue Date . . . .
Valuation .
. 0
Expiration Date
1/09/08
Qty Unit Charge,
Per
Extension
BASE FEE
15.00
3.00 .7500
PER ELEC DEVICE/FIXTURE 1ST 20
2.25
----------------------------------------------------------------------------
Special Notes and Comments
38 L.F. 5' COURTYARD
WALL WITH DOORBELL
AND LIGHTING ON 8' WOOD FRAMED ARCH
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . ENERGY REVIEW FEE
1.50
Fee summary Charged
----------------- ------
Paid Credited
- --- ---------- ---------- ----------
Due
Permit Fee Total
40.25 .00 .00
40.25 -
Plan Check Total
19.26 .00 .00
19.26
Other Fee Total
1.50 .00 .00
1.50
Grand Total
61.01 .00 .00
61.01
LQPERMIT
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware. that as "Owner/Builder you are the responsible party of record on such a
permit. Building permits are notrequired'to be signed by property owners unless'they are personally performing their
own work. If your work is being performed by someone other than.yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded .by the State of California, and to have a business license
from the Cityor. County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the, exception of. -various trades that you'plan to subcontract, you should be
aware of the following°information.for your`benefihand protection.
If you employ or otherwise engage any persons other than your immediate family; ,and the work (including materials
and other costs) is $200.00. or: more fof:*4he entire project, and such ,persons are no't licensed as contractors or
subcontractors, then you maybe, an; employer..
If you are an employer, you•must register with the. State and Federal Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment -compensation contributions.
There maybe financial1hsks for yotii7,if'y'ou`do not eairy flhese obligations, and these risks are especially serious with
respect to worker's compensation -insurance..
For more specific information 'ab ' out your obligations under Federal Law, contact the Int nal Revenue Service (and, if
you wish, the U.S. Small Business Administration). For more specif'Cinforri anon about your obligations under State
Law, contact the Department of Benefit Pay nems and the'Division of -Industrial Accidents{
s
If the structure is intended for sale, property owners."who are' not licensed contractors ar&allowed to perform their
work personally or through their own employees, without a`�licensed contractor.or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing .to be contractors is .to secure an "Owner/Builder" building
permit, erroneously implying thatthe .property owner is providing his or her own labor and material personally.
Building permits are not required -to be signed by property owners unless they' are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the- ContractonO State License Board in your
community or at 1:020 N. Street,';Sacramento; California;95814. t
Please complete and, return, the enclosed owner. -builder verification form so that we can confirm that you are aware of
these matters. The building permit;wiIl not bels'sued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253'
(760)t777 7.;012:Hai
FAX `(760) 777 7011
t rr,4r j X,}
PROPERTY ADDRESS
r :ts
PERMIT NUMBER(S)
Bin #
41 City,, fkLa Quints
Building 8i Safety Dlvis'ion, ,
P.'Box .1-5Q4, 78-495 Calle Tainpfto
La:Quinta, CA'9.2253'- (.760)'77-7--70.12
Building Pgrmit'Appilcation*and Tracking Sheet
Permit #
.
Project Address:. 5 `� g g� Av �l�G� �.�; c eZ " l�
1- -
` Owner's Name: t R -u �-�- .1 1 fM 1 I
A. P. Number: ^l; ► _ 1 _� -_5
Address: 5 asN\n S+
Legal Description: .Lo E 1-1 (3 d -K 3Lp. m� bb pa
Ci ST Zi c'(
h', p . L as
Contractor:
Telephone1(-Q())
Address:
Pro'ect Descri U
City, ST, zip:
Telephone: -fLPP ` a-I`a
State Lic. # : O q
City Lic: #: ,
X 1 S r -"c,
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:.
+
`ConstructionType s, Occupancy:
State Lic. #:
' Protect type (circle'onej: New ' Add'n Alter Repair Demo
Name of Contact Person: Fr70. nccD Sa 1'
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:t;9"O' JO � �_ q G
Estimated Value of Project: .
APPLICANT DO NOT WRITE BELOW,THIS:LINE
#
Submittal
Req'dr ,:.
Rec'dRACKING.
i
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"" Review, ready, 6r,-corrections/issue
,Electrical
Subcontactor List
'Called Contact.Person .
Plumbing
Grant Deed
f,
Plans;pickeds.up
S.M.I.
H.O.A. Approval'
Plansresubmitted
Grading
IN HOUSE:-
''d Review, ready for eorrections/issue
Developer.Impact Fee
Planning Approval
Called Cont*&Person
! A.I.P.P.
Pub. Wks. Appr
Date of permiGissue,
School -Fees
i
Total Permit Fees
C4
3.5
I�
J
CES OF Lp, QUINTA
LDING & SAFETY D P
13Ui
i APPROVE
' FOR CONSTRUCTION
ria