08-1110 (PLBG)a1 •�
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,.CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property' Zoning:,
Application valuation:
Applicant:
ICA 7707 01110
5-4'4720 AVENIDA RAMIREZ
774-244-026-17 -000000-
PLUMBING
COVE RESIDENTIAL
500
Architect or Engineer:
/ "4-.
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
PETER SUAREZ
54420 AVENIDA RAMIREZ
LA QUINTA, CA 922.53
(760)578-2642
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/27/08
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of.perjury that I am exempt from 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
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and.Professions Code) or
Wepor she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
pcant for a permitsubjects the applicant to a civil penalty of notmore than five hundred dollars ($500).:
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 applyto an owner of property -who-builds:or improves thereon,
and who does the work himself or herself 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. oUcompletion; the owner -builder will have the burden of proving that he or she did not'build or
improve for the purpose of sale.).
(_ 1 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. , BAP.C. for this reason -
i/ 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:
LQPERAIIT
issued.
I have and will maintain workers' compensation ' a s required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier - - - - - - - - - - - - - - - - - - - - - -- Policy Number
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 be e s lect [ ewor rs' compensation provisions of Section
/ -7�773700 of the LaborCode, I all for with mpt h those provisions.
Date:)k- 2 -08' ppiic�ni:
WARNING: FAILURE TO SECURE ORKERS' 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.
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, 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 1 have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and slate laws relating to building co uction, and her by authorize representatives
of this county to enter upon the above-mentioned property f inspe tion p po
Date: v � � a ignature�Applicant-or�Agen'I)
'
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I amlicensed under provisions of Chapter 9 (commencing with
S� ION DECLARA ION
I hereby affirm under. penalty of perjury one of the follod�l rations:
WORKER'S COIfothe
Section 7000) of Division 3 of the Business and Professionals Code; and my License is in full force and etfe_ct.
-
_ I have and will maintain a certificate of coto se = mpensation, as -provided
License Class: License No.:
for by Section 3700 of the Labor Codeperform work for which this permit is
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of.perjury that I am exempt from 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
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and.Professions Code) or
Wepor she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
pcant for a permitsubjects the applicant to a civil penalty of notmore than five hundred dollars ($500).:
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 applyto an owner of property -who-builds:or improves thereon,
and who does the work himself or herself 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. oUcompletion; the owner -builder will have the burden of proving that he or she did not'build or
improve for the purpose of sale.).
(_ 1 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. , BAP.C. for this reason -
i/ 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:
LQPERAIIT
issued.
I have and will maintain workers' compensation ' a s required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier - - - - - - - - - - - - - - - - - - - - - -- Policy Number
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 be e s lect [ ewor rs' compensation provisions of Section
/ -7�773700 of the LaborCode, I all for with mpt h those provisions.
Date:)k- 2 -08' ppiic�ni:
WARNING: FAILURE TO SECURE ORKERS' 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.
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, 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 1 have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and slate laws relating to building co uction, and her by authorize representatives
of this county to enter upon the above-mentioned property f inspe tion p po
Date: v � � a ignature�Applicant-or�Agen'I)
LQPERAUT
Application Number . . . . . 08-00001110
Permit . . . . _ . PLUMBING
Additional desc .
Permit.Fee• 18.00
Plan
Check Fee
4.50
Issue:Date
Valuation
. . .
.
.0
Expiration Date 12/24/08
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
-----_-----
GAS LINES FOR .PROPANE TO KITCHEN
PER
APPROVED PLANS PER JJ
Fee summary Charged
Paid
Credited
Due
Permit Fee Total 18.00
.00
.00
18.00
Plan Check;Total 4_.50
.00
:00
4.50
Grand Total 22.50.
.00
.00
22.50
78-4.95CALLE TAMPICO — LA OU*lNTA, CALIF.ORNIA,�92253
TELEPHONE (760)" 777=7012 ,? FAX.=(760) 7774011 c
! t l
OWN "VILDER ,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 not.requi`red to. bye signed by property ownersunless
Ali are personally performing their
own work. If your:work is;:being:performed byaomeone other;than yourself; you may protect yourself from possible
liability if that person applies fort. proper.'permit'in'his or her name. d
Contractors, are, required byelaw to;be.licensed andsbonded.by the,State of:California and to have a business license
from the City or County. They are also'requim&by law to put,theic,license number on all permits for which they
apply'
If you plan to do your own work,'.with the a ception of,various. trades that you"plan to subcontract, you should be
aware:ofthe following information foryour�,benefit and, -protections '
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 I more, for the. entire 'project, and"such persons'. are;,. not licensed as contractors or
subcontractors, then you maybe an employer:
—If you are an employer, you must register.with:the StAe and. Federal,. Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, f6d6rah socialsecurity taxes, worker's
compensation insurance, disability insurance`costs: and. unemployment compensation contribufions.
There may be financial risks for you if you do. not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance. !
For more specific information about your obligations under Federal Law,, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration).T6rAmore specific information about your obligations under State
Law, contact the Department of Benefit Paymenm,And the'Division of Industrial Accidents.
If the structure is intended, for sale,•property. ownerswho, a e,.not licensed contractors are 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 t be contractors is to secure an.'"OwnerBuilder" building
permit, erroneously implying that'the= property ;owner is ro"viding his or: her.. own labor and material personally.
Building permits are not required' to fbe signed byjproperty owners`?unless they are performing their own work
personally.
Information about licensed,. contractors may bleuobtained by contacting the Contractors' State License Board in your
communityor at 1020 N.'S[reet, _Sacramento; California 95814
Please complete and returnxhe enclosed owner builder Verification form so'that,we tan -confirm that you are aware of
these matters: The buildmg`lpermtt.will no£be issued until the,verifcauon.is.returned#
Very truly yours, F
CITY OF LA'`QUINTA ,ry -
DEPT. -OF BUILDING AND SAFETY
78495 Calle Tampico
La Quinta, CA 92253'
(760) 777-7012
FAX: '(760) 777-7011
Perez -
y
OWNER'S SIGNATURE/DATE
PROPERTY ADDRESS
PERMIT NUMBER(S)' i
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City of Qf Luinta
Building, & Safety Division
P.O. Box 1504 78-495 Calle
, Tampico
La Quinta; CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:1�IE
Owner's Name: AQ�
A. P. Number:
Address: 11544ZQ 1
Legal Description:
Contractor:
City, ST, Zip: LA
Telephone:
Address:
< Project Description:
City, ST, Zip:
C-�S LAOerS
Telephone:
City Lic: #:
tTG
State Lic. # :
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction.Type: Occupancy:
State Lic. #:
Project type (circle one): New . Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stones:
# Units:
Telephone # of Contact Person:eo
Estimated Value of Project:
APPLICANT: b0'NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called ContactPerson
Plan Check Balance
Energy Calcs.
Plans picked:up
Construction
Flood plain plan
Plans resubmitted.
Mechanical
Grading plan
'2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
'Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
"d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A,I,P,P,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees