07-0394 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253.
C&hf 4 4.Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
07-00000394
Property Address:
79390 BROOKVILLE
APN:
772-040-020- - -
Application description:
STRUCTURES OTHER THAN BUILDINGS
Property Zoning:
LOW DENSITY RESIDENTIALApplication
rrR
valuation:
8000
Applicant:
0 a0
Architect or Engineer:
N1a
FEB 0 c 2007
Owner:
THE ESTANCIAS
79-390 BROOKVILLE
M QUINTA, CA 92253
J
O. BOX 1280
ACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/05/•07
e L — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — -
- — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
I hereby affirm under penalty of perjury
I Section 7000) of Division 3 of the B
t.%. License Class: C8 C27 C29 t
Da :Contractor:
CONTRACTOR'S DECLARATION
nsed under provisions of Chapter 9 (commencing with
essionals Code, and my License is in full force and effect.
License No.: 656128
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury tkKr":
am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, BusinessProfessions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or reny structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he 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 Codel 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 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 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
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 performan4omubje
k for which this permit is issued. My workers' compensation
insurance carrier and polre:
Carrier SEABRIGHT y Number BB1070510
I certify that, in the performork for which this permit is issued, I shall not employ any
person in any manner soubject to the workers' compensation laws of California,
and agree that, if I shoulbje to the workers' compensation provisions of Section
3700 of the Labor Codewit comply with those provisions.
Dat Applicant:
WARNING: FAILURE TO SECURE WORK ' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO T COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INT EST, AND ATTORNEY'S FEES.
I 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, nd shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employe for any act or omission related to the work being
performed under or following issuance of this ermit. '
2. Any permit issued as a result of this applicatio becomes null and void if work is not commenced
within 180 days from date of issuance of suc it, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that a ove in rmation is correct. I agree to comply with all
city and county ordinances and state laws relating t ild constr ction, and hereby authorize representatives
of this county to ent Pon the above-mentioned pr rty o ins tion purposes.
Date: 9 Signature (Applicant or Agent):
1
Application Number . . . . . 07-00000394
Permit . . . BUILDING PERMIT.
Additional desc . .
Permit Fee 99.00
Plan Check Fee
64.35
Issue Date
Valuation . . .
. 8000
Expiration Date 8/04/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00
6.00 9.0000 THOU BLDG
----------------------------------------------------------------------------
2,001-25,000
54.00
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . . 17.25
Plan Check Fee
4.31
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . . 8/04/07
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 116.25
--------------------
.00 .00
116.25
Plan Check Total 68.66
.00 .00
68.66
Grand Total 184.91
.00 .00
184.91
LQPERMIT
Bin # Citi .of `La Quints
Building 8t Safety Division
Permit # /), P.O. Box 1504, 78-495 Calle Tampico
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: Owner's Name: c \Ft!., +
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: k F—: J 7=�
Telephone: Y
Address: (2
Project Description:
City, ST, Zip:z1-0PC ClZ --1R
Telephone: 2 --
State Lie. #
State
City Lic. #:
Truss Cales.
Arch., Engr., Designer:
Address:
�"L
City, ST, Zip:
Telephone:
Plans picked up Construction
Construction Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n Alter RepairdDemo
Name of Contact Person: �, ��
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: Estimated Value of Project: ,
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING. PERMIT FEES
Plan Sets
Plan.Check submitted Item Amount
Structural Calcs.
Reviewed; ready for corrections Plan Check Deposit
Truss Cales.
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading.plan
V Review, ready for correctionsfissue Electrical _1'.yl,-ua5
Subcontactor List
Called Contact Person Plumbing
a
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resub Grading
IN HOUSE:-
Planning Approval
`Review,ea c ret/i u e eloper Impact Fee
Called Co tact Perso r G & SqFr. P.r.
Pub. Wks. Appr
Date of p rmit iss L! V,
School Fees
UC ION
A. B
otal Permit Fees