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04-6505 (RER)Taf 414QU&M BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . 04 0-0-0-0-6-5-05 Date 9/29/04 Property Address . . . . .. . 79822 BARCELONA DR APN: 609-380-998-14 -293232- Application description . . . REMODEL - RESIDENTIAL Property Zoning . . . . . . LOW DENSITY RESIDENTIAL Application valuation 300 Owner. Contractor AGIN RAKIPI OWNER 79822 BARCELONA DRIVE LA QUINTA CA 92253�- ----------------------=---------------C7i':L =/y Permit . . . - ELECT ADD/ALT/REM _ Additional desc CITYUFUQUINTA Permit Fee 26.00 Plan Cc-F��re�ECEDE 6.50 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE '15.00 1.00 11.0000 EA ELEC MISC 11.00 Permit. . . . . . . PLUMBING Additional desc .Permit Fee . . . . 21.00 Plan Check Fee 5.25 Issue Date . . . . Valuation . . . . 0 Qty Unit Charge Per Extension, .BASE FEE 15.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 3.0000 EA PLB GAS PIPE 174 OUTLETS 3.00 Special Notes and Comments PLUMBING, GAS, & ELECTRIC.STUB-OUTS FOR FUTURE POOL AND FUTURE APPROVED APPLIANCES Fee summary Charged Permit Fee Total 47.00 Plan Check Total 11.75 Grand Total 58.75 Paid Credited Due ---------- ---------- ---------- .00 .00 47.00 .00 .00 11.75 •.00 .00 58.75 P.O. BOX 1504O4V ICE 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: Date: �4 I Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: L�JL5 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 is in full force and effect. License Class License No. Date 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 �iQapplicant to a civil penalty of not more than five hundred dollars ($500).): AF1'�l 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. It, 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 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contn3ctore 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. . , B.8 P.C. for this reason Date / °� wner �. WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1 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 workers' compensation insurance carrier and policy number are: Cartier 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 become o the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ate plicant 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 r ' 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 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 co I egr o comp y wr all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter�perRhe above meaLero arty for inspection purposes. n ate a -o 1 0 S/ ignature (Applicant or Agent): 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 not required 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 City or 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 benefit and 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 for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. Ifyou are an employer, you must register with the State and Federal Government as an employer and you are subject to several obligations including State and Federal income tax withholding, federal social security taxes, worker's compensation insurance, disability insurance costs and unemployment compensation contributions. 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 Adminstration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are 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 to be contractors is to secure an "Owner/ Builder" building permit, erroneously implying that the 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 Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. 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 will not be issued 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) 777-7012 FAX: (760) 777-7011 O R'S SI 'TURE/DATE PROPERTY ADDRESS o4- (011:�o 5 PERMIT NUMBER(s) L. I IF SPECIRCA'1 IONS l � DBE... • ��M�+ � r►x �i A r 6+ S. I q 1 fr CONSTRUCTION SAILS FIEF PRE -Gl `Nll•i E [INIXPGROUND 1=LASO N RY P Dl:' K MWACE AM pr rope, 4;� ('0` .� ,PA IPATIONS j7itE sm x ' 7 sa rr. %r rr�e SPA DAii ULL WIH VA"F LPrt P401 or rc TV --..-�— L04T OuAT m K SPA AT i' ► Rai ILE suVAr Tr E WO& :. _ EXCAYAT1014 / STEEL DIVMTM ode m W" UD&MAT OONOWR PEWMAL 2M MMu voo►Tr)w rrQ+AY PRAS_ If Rid, le OXX rr,WI - - coca" - - PLUMBING DOC97M P1 W ADD). riR 37 AWL PUMP *�[ aA" - - - ox TE Clot r X* F&44 A --�� Ili IJE �T "I LIB � WAM _ mcm WPM PI PCXX _ Rr SPA GVrTE g�I DO RAWP ordm 2,w va . JL LDVMAT 99UP►Y TvX _ 6Sll il{iL� I)ECKJNG sk CAKTWOM OnX DRAM on= aww GAS post siv rAx "m An vlomm No*" — n rw [ �0 -"K AS+ fAcm PMaR. ili R/M.k! PLANU U14 RETA� aw" Mw rV4Ms - - - UGWM POCi — WHIN I" ' *X= vw wm r5M r# r'ds ii FENCING ruvix rft M M7hT 6kiR CAN NVUMA pwffm i NwAn WL X"ww �.�: 000 ?0 (1) I "WK 8E ""4ZlkATt•EAVATPM 4r K% CA SPA AT IA)Wr Qk DAY tX DCAWAX (%I INC MO#6E THAt PJL 40 "NOT LOCATOM AM VALA tf iD AtT PT+Mra OV (3) W DWO aOwo" *§!LL AT LLAV ftM OALT POP XNM a[An AFM fG�L 9 MTV AJM (4) M 1MlT CAIJSLGA. POOLS M MOT WrOMU FOR UNDMMM Gr70104 CM CL C?L NO AVY PAMAGE V OAK M1kA Pwv[wYk uft a* voO r%w M W AMw AWA (f) = Wt ALL "M{ K aura, 00 WAfM W= IW Loci r= RN A FM rOMM rMrk 10 Avyw T>p T� {p MLL Pom Ab4DAVExY +►fir PL"w {r Low &SnkClcb4 -- no w ue6 k4I mm) (r) tW NO *MT '%* oRAU* 4 WE 50Li PW014 Or CM0%ft" POM3 APO *K? DIE ff?P f JN rra Pltdjw OF CN rOW F4MU W. ri "We a ST LAlt MW WM'WAZ KJOL POIM. AM Mir L4CAMD 4 ►Ma MM 09AD %% W AID 0040 470L A+wi$3 sm SWUMINC POOL PLAN FQR: NAME FA I ! RESIDENCE 4rarcr RHONI* OFFICE FEES -07 tH TRACT PAGE MAP 800K PACE NO. ICITY CON7MUC7E0N 07RCE PHONE N0. SCALE DATE DRAWN BY SOLD BY CHECKED BY J013 # I REVISIONS DATE SELECTIONS I STONE TILE BOULDERS ` DE CK COCOR JAN() !y/ r SGNATURE DRA14AGE NOTE: Drainage and irrigotlon fbr plonterm and pots, by other*,urTle*e of rwise noted, lk