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07-0888 (SOTB)P.O. BOX 1504 7r.-495 CALLE TAMPICO . LA QUINTA, CALIFORNIA 92253 Tit!t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT (Application Number: 07-00000888 Property Address: 79390 BRIARWOOD APN: 772-020-007- - - Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 10000 Applicant: I hereby affirm under penalty of pe Section 7000) of Division 3 of the License Classy C8, C27 C29 Architect or Engineer: Wk CTOR'S DECLARATION ar provisions of Chapter 9 (commencing with Code, and my License is in full force and effect. ense No.: 656128 Dat Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury t at I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and rofessions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair y structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or sh is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Sec on 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).: 1 _) 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 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 _ 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 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 Owner: ESTANCIAS LOT 6 79-390 BRIARWOOD LA QUINTA, CA 922,9 Contractor: U TESERRA P.O. BOX 1280 COACHELLA, CA 92 36 (760)398-9222 Lic. No.: 656128 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 e MAR 3 0 2007 CITY OF LA QUINTA Date: 3/26/07 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 performancethe work for which this permit is issued. My workers' compensation insurance carrier and polic number are: Carrier SEABRIGHT I Policy Number BB1070510 I certify that, in the peCa7to the work for which this permit is issued, I shall not employ any person in any mannme subject to the workers' compensation laws of California, and agree that, if e s bject to the workers' compensation provisions of Section 3700 of the Laborort ith comply with those provisions. Date L Applicant: _ W NIN : FAILURE TO SECURE SUBJE AN EMPLOYER TO CRII DOLLARS ($100,000). IN ADDIT SECTION 3706 OF THE LABOR C (ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL NAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND N TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN )E, 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, an shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees r any act or omission related to the work being performed under or following issuance of this mit. 2. Any permit issued as a result of this app' ion a es null and void if work is not commenced within 180 days from date of i*nt): s or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and infor ation is correct. I agree to comply with all city and c my ordi nces and state laws restruct on, and hereby authorize representatives of this cou n, t n %r�upo the above-mentipropn purposes. Date, gn ure (Applicant or Application Number 07-00000888 Permit . . . BUILDING PERMIT Additional desc . Permit Fee117.00 Plan Check Fee 76.05 Issue Date . . . . Valuation 10000 Expiration Date 9/22/07 Qty Unit Charge Per Extension BASE FEE 45:00 8.00 9.0000 THOU BLDG 2,001-25,000 72.00 ---------------------------------------------------------------------------- Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee 17.25 Plan Check Fee 4.31 Issue Date' Valuation 0 Expiration Date 9/22/07 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 2.25 ---------------------------------------------------------------------------- Special Notes and Comments BBQ Z21-58-1995/FIREPIT AGAL 496 PER APPROVED PLAN Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 134.25 .00 .00 134.25 Plan Check Total 80.36 00 .00 80.36 Grand Total 214.61 .00 .00 214.61 LQPERMIT �QQtla t10,� L, 2— Bin# City of La Quinta Building 8i 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: - Owner's Name: C. A. P. Number: Address: Legal Description: Contractor: 5� -�� City, ST, Zip: Telephone: Address: ( Project Description: City, ST, Zip:,-0P-"r-E—:U z-- CIS A ��3 Cr-, -;? \A - -\Ct Telephone: �:)9 `9 12-2 Z Q�P l (�.C-�P�l_ L� Ct / State Lic. # City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: j� �� Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo #Stories: #Units: Sq. Ft.: I r Telephone # of Contact Person: SQ- ,Z Estimated Value of Project: - 6) G O APPLICANT: DO NOT WRITE BELOW THIS LINE $1 Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets ,y Lan Check submitted Item Amount Structural Cates. ad for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading, plan 2"" Review, ready for correctionslissue Electrical LX , Subcontactor List Called Contact Person Plumbing `� Grant Deed Plans picked up S.M.L. R.V •h, f1tl�l VYAI [ l"Q IIS ICJUUIII II\CU IN HOUSE:- ""Review, ready for correctionsli Planning Approval Called Contact Person uee ryc Pub. Wks. Appr Date of permit issue FORG Q School Fees DATE BY Total Permit Fees �Qo�to� -D1✓1o4cL 4GB,� Q2tciQf, 6QS-C"C r('*N po 41,7 �,ssv £ @ 7-e(5 71--v16