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05-5429 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 M. y Application Number: 05_00005429 # Property Address: 80928 BELLERIVE c! APN: 775-350-006- - - Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 100 Applicant: Architect or EnaineerllD BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: PAULA KOVACS 80928 BELLERIVE LA QUINTA, CA 92253 M Contractor: VICTORIA LANDSCAPES/WATERFALL 8236.5 HIGHWAY 111, SUITE #104 DEC 14 2005 INDIO, CA 92201 (760)775-0449 CIN,®F LA QUINTA L i c . No.: 801813 - -------------------------------------------------- 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. Licens Class: C27 C53 /License No.: 801813 Date //3/p -Contractor ,li�•�4/f./ 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 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).: (_) 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, 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.). 1 _ I 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 Date: Owner: 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/13/05 ----------------------------------------------- WORKER'S 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 workers' compensation insurance carrier and policy number are: Carrier EVEREST NTNL Policy Number 380002849 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. Date:-/ �`_ 6hiApplicant:- -e -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. 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 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 c unty to enter upon the above-mentioned propert for inspection purposes. / / Day€. �� 5 re_(Applicant or'Agentl: Application Number . . . . . OS -00005429 LQPERMIT Permit . . . BUILDING PERMIT Additional desc . . Permit Fee 15.00 Plan Check Fee 9.75 Issue Date . . . . Valuation . . . . 100 Expiration Date 6/11/06. Qty Unit Charge Per Extension BASE FEE ------------------ --------------------------------------------------------- 15.00 Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee . . 15.75 Plan Check Fee 3.75 Issue Date Valuation 0 Expiration Date 6/11/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 ---------------------------------------------------------------------------- .75' Permit . . .. PLUMBING INV FEE Additional desc . Cs Permit Fee . . . . 36.00 Plan Check Fee 4.50 Issue Date . . . . Valuation 0 Expiration Date 6/11/06 Qty Unit Charge Per Extension BASE FEE 30.00 1.00 6.0000 EA PLB GAS PIPE 1-4 OUTLETS 6.00. ---------------------------------------------------------------------------- Special Notes and Comments 65000 BTU BBQ/ 10 LF 3/4" GALVANIZED LINE WITH TRACER WIRE/ONE GFI PROTECTED OUTLET ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE .98 Fee summary' Charged Paid Credited ------------ Due - ---- ---------- ---------- ---------- ---------- Permit Fee Total 66.75 .00 .00 66.75 Plan Check Total 18.00 .00 .00 18.00 Other Fee Total .98 .00 .00 .98 Grand Total 85.73 .00 .00 85.73 LQPERMIT Bin # City of La Quinta Building U Safety Division P.O. Box.1504, 1504, 78-495 Calle Tampico La Quinta, CA 92253 -.(760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: kl/ - Owner's Name: kc V4 A. P. Number: Address: Legal Description: City, ST, Zip: (2-4 Contractor: 11,1e Telephone: ?-/ Address: Project Description: -7— City, ST, Zip-. _,_Po a6r1-,PW- C70,0 Telephone: Svs- & Oe�, State Lic. # City Lic. #: Arch., Engr., Designer. Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: 9Sq. Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Ft.: # Stories: #Units: Telephone #.of Contact Person: 4Pdf Jo , Estimated Value of Project: M511.P APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Reqld Rec.1d TRACKING. PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. 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"d Review, ready for corrections/issue Electrical 01 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 d