10-0747 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
10-00000747
Property Address:
49826 COACHELLA DR .
APN:
646-250-013-13 -4275 -
Application description:
REMODEL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
3000
T,it!t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
JOHN OWEN
49-826 COACHELLA DRIVE
LA QUINTA, CA 92253
Contractor:
Applicant: Architect or Engineer: Owner .
dNyEQ T1�fE �fa14 $�1r-ri�+6ss
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that Iam 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: - License No.:
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 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 Lice6se 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, 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 ' n
Date:
Owner:
I hereby affirm under penalty of perjury that there is a construction lendine#ncy for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.). V
Lender's Name:
Lender's Address:
LQPERNIIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/16/10
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' cdmpensation, 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 Policy Number
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 t workers' compensation provisions of Section
��//'�
3700 of the Labor de, I shall forthwith co ly wit tho rovisions.
/mate: / -1/0Applicant.
WARNING: FAILURE TO SECU WORKERS' COMPEN - COV�IS WFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND IV FINENDRED THOUSAND
DOLLARS 1$100,000). IN ADDITION TO THE COST OFC PENSATION, 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.
1 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 building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
9 %2V a /°
Application Number . . . . . 10-00000747
------ Structure Information MASTER
BATH REMODEL/VB/RES-3/CL-A [ENG] -----
Other struct info . .
----------------------------------------------------------------------------
. . . CODE
EDITION
2007/2008
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
54.00
Plan Check Fee
35.10
Issue Date . . . .
Valuation . .
. . 3000
Expiration Date . .
3/15/11
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
1.00 9.0000
-----------------------------7----------------------------------------------
THOU BLDG
2,001-25,000
9.00
-. Permit . . .
ELECT - ADD/ALT/REM
_
Additional desc .
Permit Fee . . . .
31.35
Plan Check Fee
7.84
Issue Date . . .
"Valuation
0
Expiration Date
3/15/11
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
20.00 .7500
PER ELEC
DEVICE/FIXTURE 1ST 20
15.00
r 3.00 .4500
----------------------------------------------------------------------------
EA ELEC
DEVICE/FIXTURE >20
1.35
Permit . . .
MECHANICAL
Additional desc
BATHROOM VENTILATION ONLY
Permit Fee
21.50
Plan Check Fee
5.38
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
3/15/11
Qty Unit Charge
Per
Extension
.
BASE
FEE
15.00
1.00 6.5000
----------------------------------------------------------------------------
EA MECH
VENT FAN
6.50
Permit . . . . .
PLUMBING
- Additional desc .
Permit Fee . . . .
48.00
Plan Check Fee
12.00
Issue Date . . . .
Valuation . .
. . 0
Expiration Date . .
3/15/11
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
5.00 6.0000
EA PLB FIXTURE
30.00
LQPERNIIT
Application Number . . . . . 10-00000747
Permit . . . . . . PLUMBING
Qty Unit Charge Per Extension
1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00
----------------------------------------------------------------------------
Special Notes and Comments
MASTER BATH REMODEL/VB/RES-3/CL A -FR
[ENGINEERED] REVISED LAYOUT -OF PLUMBING
FIXTURES TO ACCOMMODATE LAUNDRY
MACHINES. THIS PERMIT DOES NOT INCLUDE
ALTERATIONS TO THE EXISTING MECHANICAL
SYSTEMS. 2007/2008 CALIFORNIA BUILDING
CODES.
September 16, 2010 2:30:32 PM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS.ADMIN (SB1473) 1.00
STRONG MOTION (SMI) - RES .50
Fee summary
-----------------
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
LQPERD7ff
Charged Paid
154.85 .00
60.32 .00
1.50 .00
216.67 .00
Credited - Due
.00 154.85
.00 60.32
.00 1.50
.00 216.67
Bin #
City of La Quinta
Building tat Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #P.O.
_Q,
Project Address: 0 GQ
Owner's Name:
A. P. Number: 64 2 �a 0(-3
Address:
Legal Description: tor- ( 44 Z77
City, ST, Zip:
Contractor: �J (� t (
Telephone:�
Address:
Project Description:
City, ST, Zip:.�j�
Telephone:
State Lic. # :
City Lic. #:
71
esignner:•
Address.—(�2ZL
City, ST, Zip: �( f:. �T- C
Telephone:-54 6 47,556
State Lic. #:
Name of Contact Person: ��
truction Type: Occupancy:
ct type (circle one): New Add'n Alter Repair Demo
fSq.t.: [� . # Stories: #Units:
Telephone # of Contact Person:
mated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
ReedI�C
BIVED
PERMIT FEES
Plan Sets
Plan Cheek submitted
Item
Amount
Structural Calces
Q
-f
Reviewed, ready for correctAUGi 11 0 o
Pian Check Deposit
Truss Calcs.
ky
Called Contact Person
Pian Check Balance
Energy. Coles.
Plans picked up BY:
Construction
Flood plain plan
Plans resubmitted 4 ,Z D
Mechanical
Grading plan
Y' Review, ready for corrects rssu
Electrical
Subcontactor List
Called Contact Person A
Plumbing
Grant Deed
Plans picked up
S.M.I.
N.O.A. Approval
Pians resubmitted
Grading
IN 110USE:-
'`' Review, ready for correctionsAssue
Developer Impact Fee
Planning Approval
Called Contact Person -IA.
P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
�tqImo'opfe' - t,P 4 t6 $Ow
SjV.xsit.>AA-(,
9-/�
0 *xf&
IVA . Mt0 O"