06-2299 (AR)c?
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: r 06-00002299
Property Address: 44330 CAMINO LAVANDA
APN: 604-193-022-18-25290—
Application description: ADDITION - RESIDENTIAL
Property Zoning:. LOW DENSITY RESIDENTIAL
Application valuation: 28485
"`&t!t 4'4 Qum&
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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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 License No.: 748685
Date: Contractor:
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.
( 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. f r this reason
Date: 7 - 2:2. 06 wne,:
STRUCTION Ln!XNG AGENCY
I hereby affirm under penalty of perjury that t is a constructiorMhding agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERDIIT
Owner:
WRIGHT ROBERT S
44-330 CAMINO LAVANDA
LA QUINTA,'CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
'TIONS (760) 777-7153
Contractor:
MARTINOVICH CONSTURCTION,
78165 MONTE SERENO CIRCLE
INDIAN WELLS,.CA 92210
(760)360-7061
Lic. No.: 748685
i/06-
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - —
WORKER'S
/06
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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.
_ Ihave 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 1795614
1 certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any man er so as to become subject to the workers' compensation laws of California,
/ and agree th I should become subject to the workers' compensation provisions of Section
3700 of a Labor Co shall forthwith comply with those provisions.
Date: Applicant:
WARNING: FAILURE TO SECURE RKERS. Co. SATION 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 build' co truction, and hereby authorize representatives
of oy county to enter upon.the above-mentioned props o spection purposes.
Date:? 2 % 406'Sig/nature (Applicant or Agent):
-R
i
Application Number . . . . . 106-00002299
Permit . . . . . . BUILDING PERMIT
Additional desc .
Permit Fee
. . . .
278.00; Plan Check Fee
1_80.70
Issue Date
. . . .
Valuation . . . .
28485
Expiration
Date
12/26/06; -
Qty Unit Charge
Per j
Extension
BASE FEE
252.00
4.00
'--------------------------
6.5000
THOU BLD,G-25,001-50,000
----------------------------------------
26.00
----------
Permit
. . .
ELECT - ADD/ALT/REM
Additional
desc .
I
Permit Fee
. . . .
32.711 Plan Check Fee
8.18
Issue Date
Valuation . . . .
0
Expiration
Date
12/26/061
Qty Unit Charge
Per '
Extension
BASE FEE
15.00
506.00
------------------------------------!------------------------------=----=----
.0350
ELEC NEW RES - 1. OR 2 FAMILY
17.71
Permit
i
. . . MECHANICAL'
Additional
desc.
Permit Fee
. . . .
52.50; Plan Check Fee
13.13
Issue Date
. . . .
! Valuation
0
Expiration
Date
12/26/061
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00
9.0000
EA MECH FURNACE <=100K
9.00
1.00
9.0000
EA MECH B/C <=3HP/100K BTU
9.00
3.00
------------------------------------
.6.5000
EA MECH VENT FAN
----------------------------------------
19.50
Permit .
. . . . . PLUMBING
Additional
desc .
Permit Fee
88.501
Plan Check Fee
22.13
Issue Date
. . . .
Valuation
0
Expiration
Date..
12/26/06!.
Qty Unit Charge
Per
Extension
BASE FEE
15.00
10.00
6.0000
EA PLB FIXTURE
60.00
1.00.
.7.5000
EA PLB WATER HEATER/VENT
7.50
1.00
3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00
3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
LQPERAIIT
Application Number . . . . .
06-00002299
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.Special Notes and.Comments
addition 498 sq..ft.June 21,
2006
6:55:54 AM jjohnson
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Other Fees . . . . . . . . .
ENERGY REVIEW
FEE
1.86
STRONG MOTION
(SMI) - RES
2.89
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
Permit Fee Total 451.71
.00
.00
451.71
Plan Check Total 224.14
.00
.00
224.14
Other Fee Total 4.75
.00
.00
4.75
Grand Total 680.60.
.00
.00
680.60
LQPERD4IT
r #Y.
00`�i�
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City of La Quin O�/ Q
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tamp
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit.#
o%- 2 2.9 q
Project Address: '14 33Q CAMI p LAt/A j,0A
Owner's Name: S.
A. P. Number: �O 4 I g 7, 0 2 2
Address: L4q I S D CA-m / xJ0 LA ./A N 0/4
Legal Description: L. I S J-'1.2pc_r L.Z 2q tV
City, ST, Zip: LA %A wYA 0.A 1711� 3
Contractor: "("'(� �� V �f
Telephone: ' (
Address: - S(
Project Description:
City, ST, Zip:
ADO ITi O eJ Lf g4
Telephone:
State Lic. # :
City Lic. #:
Arch., Engr., Designer: LJE 614 -
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New dd'n , ter Repair Demo
Sq. Ft.:. t6 U # Stories:'-( J # Units:
Telephone # of Contact Person: — g
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
2
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for correc ions Z
Plan Check Deposit
2
Truss Calcs.
/
Called Contact Person b / k
Plan Check Balance
2
Energy Calcs.
A _-
Plans picked up J L t. (
Construction
Flood plain plan
Plans resubmitted j
Mechanical
Grading. plan
2" Review, ready for correctiosPssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
'"' Review, ready for correction sueveloper
Impact Fee
Planning Approval
Called Contact Perso
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
ff
School Fees
v 6
a__
be 5,
Total Per it Fees
(o %7 0N Bo,920 ,� (
1 Cl,7 SGio,l �ce l,�