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07-0084 (AR)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 1/18/07 Application Number: 07-00000084 Owner: Property Address: 79390 'BROOKVILLE LA QUINTA ORCHARDS P$ TNERS APN: 772-040-020- - - C/O LA QUINTA ORCHA ART Application description: ADDITION - RESIDENTIAL P O BOX 1716 Q Property Zoning: LOW DENSITY RESIDENTIAL LA QUINTA, CA 92253 Application valuation: 6232 Contractor: JAN 232007 Applicant: Architect or ' eer: SPARKS CONSTRUCTIO , Eng'NC17YoF !�`Q!!% P.O.P . O . BOX 1716IftNgNCE pE Iyrq LA QUINTA, CA 92247 (760) 771-1941 Lic. No.: 674074 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. Li ense cla B License No.: 674074 r Date: r ontractor: 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.). (_ 1 I, as owner of the property, am exclusively contracting with licensedcontractors 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.). (_) Lam 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 ------------------------ ---------------------- 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 STATE FUND Policy Number 0000348-2006 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 /D 3700 ;of;the L or Code, I shall forthwith comply with those provisions. ate: i� o cant:' ✓"� WARNING: FA RE TO SECURE WORKERS' 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 actor 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 co y to enter upon the ove-mentioned property f� ectian putposej , 9a' � Si ture (Applicant or Agent): vT`1-` 1 Application Number . . . . . 07-00000084 ------- Structure Information 80 SF PWDR RM ADDTN ----- Other struct info . . . . . CODE EDITION 2001 CBC # BEDROOMS .00 FLOOD ZONE NA ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 80.00 Permit . . . BUILDING PERMIT Additional desc . . 80 SF POWDER RM ADDITION Permit Fee . . . . 90.00 Plan Check Fee 58.50 Issue Date . . . . Valuation . . . . 6232 Expiration Date 7/17/07 Qty Unit Charge Per Extension BASE FEE 45.00 5.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 45.00 Permit . . . ELECT - ADD/ALT/REM . Additional desc . . Permit Fee 19.30 Plan Check Fee 4.83 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/17/07 Qty Unit Charge Per Extension BASE FEE 15.00 80.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 2.80 2.00 .7500 ---------------------------------------------------------------------------- PER ELEC DEVICE/FIXTURE 1ST 20 1.50 Permit MECHANICAL Additional desc . Permit Fee . . . . 21.50 Plan Check Fee 5.38 Issue Date . . . . Valuation 0 Expiration Date 7/17/07 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.5000 ---------------------------------------------------------------------------- EA MECH VENT FAN 6.50 Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 27:00 Plan Check Fee 6.75 Issue Date . . . . Valuation . . . . 0 Expiration Date 7/17/07 Qty Unit Charge Per Extension LQPERAIIT Application Number . . . . . 07-00000084 Permit . . . . .PLUMBING Qty Unit Charge Per Extension BASE FEE 15:00 2.00 6.0000.EA PLB FIXTURE 12.00 ---------------------------------------------------------------------------- Special Notes and Comments 80 SF POWDER ROOM ADDITION TO RESIDENCE UNDER CONSTRUCTION."unconditioned space" SUPPLEMENT TO PERMIT 05-23933. CBC 2001 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 5.85 STRONG MOTION (SMI) - RES .62 Fee summary Charged Paid Credited ------------------------------ Due -------=------------------- Permit Fee Total 157.80 .00 .00 157.80 Plan Check Total 75.46 .00 .00 75.46 Other Fee Total 6.47 .00 .00 6.47 Grand Total 239.73 .00 .00 239.73 LQPE&\IIT iL