09-0229 (DEMO)4 P.O. BOX 1504 ^' VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/12/09
Application Number: 09'-00000229 Owner:
Property Address: 78050-CALLE_6,DIZ GALATI ANTHONY J '�-✓,
APN: 770-152-013- - - 45150 DESERT FOX DR
Application description: DEMO - COMML/OTHER LA QUINTA, CA 92253
t1 4p
Property Zoning: VILLAGE COMMERCIAL r\ [
Application valuation: 0
MQX 12
Contractor: 1��9
Applicant: Architect or Engineer: GALATI ENTERPRISES INC
78050 CALLE CADIZ (;1�`••ta V'''ry
LA QUINTA, CA 92253
�l,' P
(760)777-9994
`YLic. No.: 655861
----------------------- - ---------------------------
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 Busn antygofes�ionals Code, and my License is in full force and effect.
License Class: B C54 . 1License No.: 655861
Z.te:3— 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 (commencingwith Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom'a;' 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.).
(_) 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 performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier EVEREST INS Policy Number 76000056009
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 sho A d bec. a subject to the workers' compensation provisions of Section
�I3100 of the Labor ,O
�, IAiiall fo 2vith a ply with those provisions.
te: ��` Appli t:
WARNING: FAILU T WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER T 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 stale laws relating to bu' g co uctionffhereby authorize representatives
of ythis andcounty to enter upon the abteove-mentioedpr� sp ction
a{f te: ✓ Signature ppucant or Agen 6///
!-
Application Number .
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date .
. . . . 09-00000229
DEMO PERMIT
45.00 Plan Check Fee
Valuation
9/08/09
Qty Unit Charge Per Extension
BASE FEE 45.00
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Special Notes and Comments
DEMO EXISTING SWIMMING POOL
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 45.00 .00 .00 45.00
Plan Check Total .00 .00 .00 .00
Grand Total 45.00 .00 .00 45.00
LQPERMIT
TOTAL CONSTRUCTION
TOTALLY TILE
78.050 CALLE CADIZ
LA QUINTA, CA 92253
P: (760) 777-99N f: (760) 777-9995 GAwTI
Bin #
City of La Quinn
Building 8L Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #�
OR,
Project Address: ( C)5D t IP (
TRACKING PERMIT FEES
Owner's Name: Nr,+ 1 -t--
Plan Sets
_
A. P. Number:
'Plan
Address: 45
c
Legal Description:
City, ST, Zip:
2z(E:)`5
Contractor: 6Q la 4r-0(1
Truss Calcs.
Telephone.
Address: 7 �a'30 (--c-4tb Gad l
Project Description:
City, ST, Zip: L CA 9
Plans picked up Construction
efY-�o PonL
Flood plain plan
Telephon -177 7 99
Plans resubmitted Mechanical
: �J`"j lD City Lic. #:
State Lie. #2
Arch., Engr., Designer:
h
Address:
Subcontactor List
City, ST, Zip:
Grant Deed
"telephone:
,Mate Lic. #:
Plans picked up S.M.I.
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repar Demo
Name of Contact Person: t l
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: ) q9`,
Estimated Value of Project:
Review, ready for correctionslissue Developer Impact Fee
APPLICANT: DO NOT WRITE BELOW THIS LINE
it
Submittal
Req'd
Rcc'd
TRACKING PERMIT FEES
Plan Sets
'Plan
Check submitted Item Amount
Structural Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Calcs.
I
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
V Review, ready for correctionstissue 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 correctionslissue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees