06-0264 (SOTB)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: 1/18/06
Application Number: 06-00000264 Owner:
Property Address: 81440 CARBONERAS 1, DOWNIE
APN: 764-200-006-38 -316 - — ''— 81-440 CARBONERAS
Application description: STRUCTURES OTHER T i ILDINGS g LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENT L JAN 2 206
Application valuation:. 5000
CIN OF LXQU"rA Contractor:
Applicant: Architect INANCEDEPrr CALIFORNIA POOLS & SPAS
P.O. BOX 1280
COACHELLA, CA 92236
(760)398-9222
Lic. No.: 656128
-----------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Sectio -n,7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
LicenseClass: C8 C27 C29 License No.: 656128
�C ate: Contractors
/ O NER-BUILDER DECLARATION
1 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 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 _ 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 performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier HRH INS Policy Number BB1060510
_ 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 bec a subject to the workers' compensation provisions of Section
370000� of the Labor Code, I s II orthwith comply with those provisions.
a��TApplic n'a t:
WARNING: FAILURE TO SECURE WORKERS' OMPENSATION 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 unty ordinances and state laws relating to building co ruction, and hereby authorize representatives
oft ' county to enter upon the above-mentioned grope, y f urposes.
Date:I'��l0 Signature (Applicant or Agent):
Application Number . . . . . 06-00000264
Permit
BUILDING PERMIT
Additional desc .
Permit -Fee . . . .
72.00
Plan Check Fee
46.80
Issue Date . . . .
Valuation . . .
. '5000
Expiration Date . .
7/17/06
Qty Unit Charge
Per
Extension
BASE FEE
3.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
27.00
Permit . . .
ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . . .
17.25
Plan Check Fee
4.31
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
7/17/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3.00 .7500
----------------------------------------------------------------------------
PER ELEC DEVICE/FIXTURE
1ST 20.
2.25
Permit . . .
PLUMBING
Additional desc . .
-
Permit Fee . . . .
18.00
Plan Check Fee
4.50
Issue -Date . . . .
Valuation . . .
. 0
Expiration Date
7/17/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 3.0000
EA PLB GAS PIPE
1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
BARBEQUE AND FIREPIT ONLY PER APPROVED
PLAN.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . ENERGY
REVIEW FEE
4.68
Fee summary Charged Paid
-----------------
Credited
Due
----------
Permit Fee Total
----------
107.25
--------------------
.00 .00
107.25
Plan Check Total
55.61
.00 .00
.55.61
Other Fee Total
4.68
.00 .00
4.68
Grand Total
167.54
.00 .00
167.54
LQPERMIT
M
Bin #
La Quinta
Building a Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Addres4(—y 0 Owner's Name:
A. P. Number:
Address: g `—Lj4 C �.
Legal Description:
City, ST, Zip:
Contractor
Telephone:
Telephone:
^�: x'�r., �•'' x��.f ;
Address: _o Zo 2—,go
Project Description:
City, ST, Zip:
/ 2
PEA aft
Telephone: 7&0 3?? -01222—
r
State Lic. # : (O5 -CO (2
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
r
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: t%GV��/ �ee�J�
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:tj O -<%y2 S,Z-�� y
Estimated Value of Project: pp O
APPLICANT: DO NOT WRITE BELOW THIS LINE
9
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 r$
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d Review, ready for corrections/issue
Electrical 3 _ rri><7vRES
Subcontactor List
Called Contact Person
Plumbin
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"` Review, ready for corrections/issue
evelogc'llmpp ct Fee
Planning Approval
Called Contact Per r
•A".l'.�.P.�
Pub. Wks. Appr
Date of permit issue to n�AvG &
'
s�♦
t
School Fees��
FOR CU
Y
o iYFe'es
DAA
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GAS SHUTOFF
VALVE GRAVEL
LOCATED
WITHIN 36" GAS LOG
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(TYP.)
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GAS 'LINES. SHALL BE INSTALLED
PER CPC FOR DEPTH,
WATER PROOF COVERAGE, AND PLACEMENT.
MEMBRANE !
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#4 TIE STEEL;
#4 BAR: VERT. AT. 32" O.C.
8x8x8 CMU.; SOLID GROUT
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L
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FREE-STANDING OUTDOOR KITCHEN - FRONTELEVATION BTU `L
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GRILL
FREE-STANDING OUTDOOR- K I TCH - PLAN ADAPT DIMENSIONS.
� TO FIT APPLIANCES
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I 4 •I PHINE OFFICE 4>r% ' Ili l RES ? i Lf
f SIMMS 11,111 , LOT 38-F TRACT _�'PAGE BOOK 1
• MAP BOOKPAGE ND, ii;ITY
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_ ' SCALE DATE BRAWN BY SULD BY rGNECKLD BY
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REVISIFNIS 1---
DATE
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