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13-1459 (SPIN)s -i P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA; CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 13-00001459 50865 CALLE QUITO. 770-103-009-57 -000000- SPECIAL INSPECTION LOW DENSITY RESIDENTIAL 100 Tiht 4 4 " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect 1 or Engineer: \ p LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of pethat I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Di ision 3 of the lfsiness and Professionals Code, and my License is in full force and effect. ,.License. Class:. License No.: Date: - ntractpr: 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 permitto 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).: Gi9,f� 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.). 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 A�l pursuant to the Contractors' State License Law.). exempt under Sec. , B.&P.C. for this reason Date: Owner: \` e61uSTRUCTION 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 VOICE (760) 777-7012 % FAX (760) 777-7011 INSPECTIONS (760) 777-7153. Owner: NICK AND LINDA.ZUCCARO 50865 CALLE QUITO LA QUINTA, CA 92253 (760)289-7000 Contractor: Owner Date: 11/18/13 ----------------------------------------------- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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- - - - - - - - - - - - - - - - - - - - - - -- Policy Number rtify 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 ��,[��377%00 of the Labor Code, I sl 11 c r ith those provisions. -.Pate: ��'Applicant: WARNING: � WARNING: FAILURE TO SECURE WORK E MPENSATION*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 personat 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 building co s tion, and hereby authorize representatives ,of this county o en r upon the above-mentioned property i p tion ses. " Date: ignature (Applicant or Agent • J Application Number 13' -00001459 - Permit . . SPECIAL INSPECTION Additional desc Permit Fee- . . . .71.50 Plan Check Fee 00 Issue Date . . . . Valuation 100 Expiration Date 5/17/14 p Qty Unit Charge Per Extension , 1.00 71.5000 EA MISC SPECIAL INSPECTION 71.50 f - - - - - - - - - - - - - ------------------------------------------------ Special - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Special Notes and Comments SPECIAL INSPECTION FOR GAS RELEASE. 2010 CALIFORNIA BUILDING CODE. Fee summary Charged Paid Credited Due -------------------------------------------------------- Permit Fee Total 71.50 .00 .00 71.50 Plan Check Total .00 .00 .00 .00 Grand Total 71.50 .00 .00 71.50 APPLICANT`110 Nr1T WRITE RFI nW T441C 1 INF i # Submittal pity of La Quinta Building 8T Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Street Permit # Project Address: PZRMIT FEES Owner's Name: A. P. Number: Address:,Ij 9'4!;' Cf Legal Description: City, ST, Zip: ,¢ ` Contractors Telephone: 7�Q� — �o O F!is:A«>::><:s'>s>>.•r<;F.>:<#:: Address: Project Description: City, ST, Zip: Plan Check Deposit Telephone, Truss Caics. State Lic. # : City Lic. #•: Arch., Engr., Designer Title 24 Caics. Address: Plans picked up City., ST, Zip: . Telephone: Construction Type: Occupancy: - Project type (circle on ew Add'n _Iter Repair Demo State Lic. #. Mechanical :,:<r;:<;�:<�<:�,>r.;;�>:::>.<>.::>::::,<:;.;:;:::>.>.>-� %:<;! <>z:<<,;r:<.:s;>t'vsz Name of Contact Person: �(f �� Zu Sq. Ft.: 2,Zo.� # Stories: Units: / Telephone *,of Contact Person: d Oiq 0 -� p�# Estimated Value of Project: b��iLCG(�ylf APPLICANT`110 Nr1T WRITE RFI nW T441C 1 INF i # Submittal Rcq'd Rcc'd TRACMG PZRMIT FEES Plan Sets Plan Check submitted Item Amount Structural Caics. Reviewed, ready for corrections Plan Check Deposit Truss Caics. Called Contact Person Plan Check Balznce Title 24 Caics. Plans picked up Construction Floodplain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correctionsfissue 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 correctionsfissue Developer Impa•-.t Fee Planning Approval Called Contact Person • A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees X J • A. 1 •