06-2421 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00002421
Property Address: 49796 COACHELLA DR
APN: 646-240-007- - -
Application description: REMODEL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 7500
Applicant:
Tiht 4 4 Q"
Architect or Engineer:
P (A
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm underpenalty of perjury that 1 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.: 868571
Date: 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 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
Owner:
TOM & NANCY BRASFIELD
49-796 COACHELLA DRIVE
LA QUINTA, CA 92253•
( .
VOICE (760) 777-1012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/28/06
Contractor: %p- a `I
D E GENERAL CONTRACTO . V INC (rte l
P O BOX 1814 U Q �oOC
LA QUINTA, CA 92-)47 JUN 2 U
(760)777-1910 1,
Lic. No.: 868571 QUINTA
CIT`( OF,Lc nEPT.
------------------
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 0032912-2005
_ 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
�p 3700 of the Labor Code-, IIsshhall forthwith coin ly with those provisions.
at_
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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.
certify that 1, 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 ty to enter upon the above-mentioned property f r inspection purposes.
ate: 01, Si um (Applicant or Agent):
Application Number . . . . . 06-00002421
------ Structure Information REMODEL TO EXISTING RESIDENCE
-----
.Other struct info . .
. . . CODE EDITION 01BMP04E05EN
----------------------------------------------------------------------------
# BEDROOMS
.00
Permit . . . BUILDING PERMIT
Additional desc . .
Permit Fee.
99.00 Plan Check Fee
64.35
Issue Date
Valuation . . . .
7500
Expiration Date
12/25/06
Qty Unit Charge
Per
Extension
BASE FEE
45.00
6.00. 9.0000
---------------------------
THOU BLDG 2,001-25,.000.
-------------------------------------------------
54.00
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Permit Fee
53.00 Plan Check Fee
13.25
Issue Date . . .
Valuation . . . .
0
Expiration Date
12/25/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
20.00 .7500
PER ELEC DEVICE/FIXTURE 1ST 20
15.00
4.00 3.0000
EA ELEC APPLIANCES
12.00
1.00 11.0000
----------------------------------------------------------------------------
EA ELEC MISC
11.00
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . .
24.00 Plan Check Fee ..
6.00
Issue Date . . . .
Valuation
0
Expiration Date
12/25/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 3.0000
EA PLB FIXTURE DRAIN/VENT REP/ALT
3.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
RESIDENTIAL REMODEL TO EXISTING
KITCHEN, BATH & OUTDOOR SHOWER AREA.
ADDITION OF (1) ABOVE
GROUND SPA TUB.
2001 CBC,CMC,CPC, 2004
CEC,
2005 ENERGY CODES
LQPERMIT
Application Number . . . . . 06-00002421
----------------------------------------------------------------------------
Other Fees . . .
. . . . ...
ENERGY REVIEW
FEE
6.44
Fee summary
Charged
Paid
--------------------
Credited
----------
Due
-----------------
Permit Fee Total
----------
176.00
.00
.00
176.00
Plan Check Total
83.60
.00
.00
83.60
Other Fee Total
6.44
.00
.00
6.44
Grand Total
266.04
.00
.00
266.04
M
LQPERMIT
Bin # -
City of. La Quinta
Building 8Z Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinti, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
it+
Project. Address:2aw" -
Owner's Name:
A. P. Number: 440, 240 -"7
Address:
Legal Description:
City, ST, Zip: G3 A4
.4
Contractor: 6'+x,Q, fpL r4247410etrOOMS
Telephone: �
Address: g, Ao g ¢
Project Description: e A
City, ST, Zip: L9 u t24,
State Lic. # : s
city Lic. #: /a 1,5'S S'
Arch., Engr., Designer:
y
C - t!S
Address:
Af
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair � Demo
Name of Contact Person: C✓
Sq. Ft :
# Stories:
# Units:
Telephone # of Contact Person: 7 7.7
Estimated Value of Project: 7_S -a o
Z . APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd •
Rec'd
TRACEING
PERMIT FEES
2
Plan Sets
2
Plan Check submitted
Item Amount
Structural Cates.
Reviewed; ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person hnPlan
Check Balance
Energy Calcs.uYL
(N
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical •
Grading.plan`
V Review, ready for correction) a
Electrical
Subcontactor List
Called Contact Person ZY
Plumbing
Grant Deed
Plans picked up
S.M.I.
H O:A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Review, ready for torrectionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
��57aveoAzF') Do6 (0 060
0
RESIDENTI.,AL KITCHEN LIC'sHTI G"r WORKSHEET WS -5R
pTN/i6!{•iT1fIP. _ _ w _ _ _ _ . _ _ � ft Date
0
'Ob - a4e%l
At least 50*1 1� of the total rated watraUe of permanently installed luminaires in the kitchen must be in luminaires that are high
efficacy luminaires as defined in Table t 5^.C. Luminaires that are not high efficacy mutt be switched separately.
Kitchen Lighting Schedule. Provide the following infbrmation for all luminaires to be installed in kitchens.
Luminaire Tvpe Hi h E icac ? Watts x Quantity = —High Etiicac Watts or
YeN Non ti 06 _� or
b _
Yes
Nor x _. or
_ w Yes o N.9'a .; _- - __� or
Yes o No o_ —� x __— o;
Yes o ,Ve e x - or
CITY OF LA QUINTA
BUILDING & SAFETY DEPT,
APPROVED
FOR CONSTRUCTION
Residential CAmpliance For,
March 2005
41 - 71 (, Goa,A.e lac pr-