13-0651 (RER)i.
0
P.O. BOX 1504
u�W
78-495 CALLE TAMPICO 4
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
13-00000651
79000 CALLE BRISA
649-450-009- - -
REMODEL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
10000
Architect or Engineer:
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: B �+�,Liice�nseeNNoJ:, 577776/_ / T
Da[�� / �3 Contracto��//r� �Y.S g ��/►' �pyy�
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).:
1 _ 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, 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.l.
(_ 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 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: Y
LQPERMIT
Owner:
KNUDSON
79000 CALLE BRISA
LA QUINTA, CA 92253
Contractor:
STARK CONSTRUCTION
39725 GARAND LANE,
PALM DESERT, CA 922
(760)345-9711
Lic. No.: 577776
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/17/13
------------------
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
f,�Cocle, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 0507351-12
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 me subject to the workers' compensation provisions of Section
700 of the Labor Code, a forthwitl _wit hose provisions.
DatZ7_,�Applicant:
WAFAILURE TO SECURE WORK COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES 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 cru
o ction, and hereby authorize representatives
of this cou ty to nter upon the above-mentioned property. f p tion purpo
Date/?// )//-12;Sig nature (Applicant or Agent)i .�
Application Number . . . . . 13-00000651
Permit . . . . .
PLUMBING 2013
Additional desc . .
Permit Fee . . . .
11.92 Plan Check Fee
.00
Issue Date . . . .
Valuation . . . .
0
Expiration Date
1/13/14
Qty Unit Charge
Per
Extension
1.00 11.9200
----------------------------------------------------------------------------
LS PLBG GAS SYS, 1-4 OUTLETS
11.92
Permit . .
REMODEL 2013
Additional desc . .
Permit Fee . . . .
191.62 Plan Check Fee
.00
Issue Date . . . .
Valuation . . . .
0
Expiration Date . .
1/13/14
Qty Unit Charge
Per
Extension
1.00 143.0000
EA MISC FIREPLACE
143.00
1.00 48.6200
LS MISC REMODEL, 1ST 100 SF
48.62
----------------------------------------------------------------------------
Special Notes and Comments
EXTEND PATIO COVER 96
SQ. FT. AND ADD
GAS FIRE -PIT. PER 2010
CALIF BUILDING
CODE.
July 9, 2013 2:17:51
PM jjohnson.
---------------------------------------------------------------
Other Fees . . . . .
. . . . BLDG STDS ADMIN (SB1473)
------------
1.00
PLAN CHECK, REMODEL
347.49
PLAN CHECK, PLUMBING
23.83
STRONG MOTION (SMI) - RES
1.00
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
Permit Fee Total
203.54 .00 .00
203.54
Plan Check Total
.00 .00 .00
.00
Other Fee Total
373:32 .00 .00
373.32
Grand Total
576.86 .00 .00
576.86
LQPERMIT
RErEIVED
Bin.#
D
Y Z;.01
City of.U Quint
Building sC Safety Division CITY TLA QUI TA
P.O. Box 1504, C78-495 Calle Tampico OMMUfNRY DEVEL PMEI
La..Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet
Permit #
/3
Project Address: 9��(� LL 6s'� f��
Owner`s Name:.
A. P. Number.
Address: e�5fz/s"
Legal Description:
City, ST, Zip: Z-;eg �/� �� 9 �/zJ�✓7
Contractor c j j9 �Q G� �j;
Telephone:
Address: 9Z2 44441%
Project Description:
�/� 5�11
City, ST, Zip: �� fi'J� �l
l /
lsj2�
Telepho
State Lic. 4: rC!tyLic-.ff,
Arch., Engr., Designer. LSD n/ �Sl�i
Address:�l�9
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.:
# Stories: # Units:
Telephone # of Contact Person: %(pO S�.S 97� Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMG PERMUVEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs
Reviewed, ready for corrections 3
Plan Check Dtposit, .
Truss Calcs.
Called Contact Person Plan Check Balance •
Title 24 Calci.
Plana picked up to Construction
Plans resubmitted Mechanical
Flood plain plan
Grading plan
Z'' Review, ready for correctiio rssu l,6 Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Pians picked up S.M.L
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
'" Rtvlew, ready for correctionstmue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
A
Total Permit Fees
- bub K
IT
b.i/'Ly/'Lull UU: J4 1 /bUJ41 /4d / I AYLUN t AUL U1101
PANCHO L.A ' QUIN'
MASTER ASSOCIATION
Architcctura-1 Corttro� ornmittce
March 28, 2013
Mr.:and Mrs, Rich Knudson
79000 Calle BHsa
U Qulnta; CA 92253
Re: 79.-000 Calle Bnsa
Architectural Sub'rnission 9 �I of 5tibm 4 ton
The Architectural Committee reviewed your submission for an addition
rogfflne over the Master bedroom area,,install a fire pit and replace.rear patio con your
• /extension of.
pavers: The submission as presented is oppra.upoo»ditfon ote creme warn
The Committee requires the following:
• All work Is to be done in accordance with all applicable requirements of governmental
entities, Including the. City of La Quinta and in accordance
Association architectural guidelines with all Homeowners
and governing documents.
• A City of La Qulhta bulidin
B permit to be obtained and copy furnished to the
Association for to v n e en
• Q at' YI s asked t� rhe es;. . --
Ur as Ice Olt e ro e
When the work has been finished, please return "Notice of Completion"
Office. The Association's architectural consultant will perform a final inspection a
to the Association
such- notice; when verification-ofthe approved plan modiflcations have been concluded, ,yourof
.
Security Deposit will be processed for refund.
your.
Thanking you in advance and N any questions please do not hesitate to call me at the on -
office 777,8807, site
Slnc
CCAMO .
association General Manager FRECEIVED
760-777-$807 fax 760.777,8961
'' mwalker drminte net.com
cc: Architectural Comm.
MAY 2.1 2013
C®M.�'�i`:.}�ri.-N DIE.
P.O. BOX 6419 • LA QUINTA, CA 92248-6419 • 760-777.8807 • FAX 760_777-8961