12-1344 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application :valuation:
TAI
f�'ftiGv
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
C.12=000,013.44 _�
A8110-PASO'TIEMPO LN
646-350-005- - -
STRUCTURES OTHER THAN BUILDINGS
LOW DENSITY RESIDENTIAL
3000
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
DIANNE HONIG
48110 PASO TIEMPO LANE'
LA QUINTA,- CA' 92253
Contractor: Alfa/ 13 iniq
Applicant: Architect or Engineer: PAYNE, RICHARD ALL ItlUV t31
52565 AVENIDA BE A
LA QUINTA, 'CA 9225 CITYOFIJAQUINTA
(760) 578-6149 FINANCE DEPT.
Lic. No.: 947805
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 Business a d Professionals Code, and my License is in full force and effect.
Lice "e Class: 13 2 e No.: 947805
Date: \ 1 C ttractor _
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).:
(_) I, as ovvner 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 ISec. 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 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
Date: 11/13/12
WORKER'S COMPENSATION DECLARATION
1 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 numbe.r are:
Carrier STATE FUND Policy Number 9016599-12
_ 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 be a subject tot or &s' compensation provisions of Section
3700 oft he Labor , I sh I forthwith o ply wi those provisions.
Zat e:�Date:11!�plicant•
WARNING: FAIL RE TO SECURE WORKERS' COMPENS a, JON OVERAGE 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 county ordinances and state laws relating to buildinNonstructioAn.a hereby authorize representatives
of this count to ng ter upon the above-mentioned p perty ctioes.
Date: ��Inature (Applicant or Agent
Application.Number
12-000.01344
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . .
54.00 Plan Check Fee
35.10
Issue Date . .
Valuation
3.000
Expiration Date
5/12/13
Qty Unit Charge
Per
Extension
BASE FEE,
45.00
1.00 9.0000
THOU BLDG 2,001L25,000
9.00
Permit . . . ELEC-MISCELLANEOUS.
Additional desc .
Permit Fee16.50
Plan Check Fee
4.13
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
5/12/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 .7500
PER ELEC DEVICE/FIXTURE 1ST 20
1.50
Permit, PLUMBING
Additional desc .
Permit Fee . . . .
18.00 Plan Check Fee
4.50
Issue Date . . . .
Valuation
0
Expiration Date
5/12/13
Qty Unit Charge
Per
Extension
J
BASE FEE
15:00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS"
3.00
--------------------
Special Notes and Comments
BBQ ISLAND - STEEL,FRAMED, STUCCO
FINISH. 2 RECEPTACLES,
27 L.F. 3/4" GAS
LINE. 2010 CODES.
-----------------_----------
Other Fees . . .
------------------
. BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
3.51
STRONG MOTION (SMI) - RES
.50
Fee summary Charged Paid Credited
Due
Permit Fee Total
88_50 .00 .00
88.50
Plan Check Total
43.73 00 .00
43.73
Other Fee Total
5.01 .00 '.00
5.01
Grand Total
137.24 .00 .00
137.24
LQPERMIT'•
Smooth Stucco Finish (Rancho La Quinta texture) I -Electrical Outlet (2 receptacles; Single -Gang) I -
4iS11U YdSU I M111PU LdIIC - t • I' ' _
La Quinta, CA 92253
dphonig@gmail.com
720-480-4793 \ 30 FireMagic NG Grill w/Rot
flex ANSI # Z21.58 (National Gas
light Safety Number) ;
r
Island will be constructed
from Riverside County- ¢ , i ¢ Solid Granite Top _
approved building w/Mitred Edges
materials, per the ,
Uniform Building Code.
Galvanized Steel, genuine
Hardi-backer
backer/cement board,
AGA -approved gas grill,
304 -grade stainless steel, _
UL -approved lighting, etc.
Fl
❑❑�
M �r �D
r �ZM.00Mme.
_MM < �
r� o 0 0 M M
Z� T
. _ ..
• r .. - _ ,7 Feet i• _ C)M'� m O(� ,
� " n Cn
.ALL VALLEY BBQ, SPA.&* FIREPLACE, w D 0
i
1 - a
Property Line'
And Block Wall...
Gas
Stub
vered Overhang Off of. Home Gas line
N epi
-IARDSCAPE' 27 Ft. r
HERE SPA I
1
The Wall Is 5' 10" On.
this side...
• BBQ . _--��
And 4' Tall On This
HERE N�Ng Qt�T' Side...
7 Ft.
POOL
Application For Gas !
To BBQ; 10.22.12
i
deephaventom@gmail
Bin.#
•
City. of La Quinta
Bui�ng $r Safety Division
P.O. Box 1504,78-495 Calle Tampico
Ia.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
�
Project Address: / q
� 1 " / ,50 -r-) CM P7
Owner's Name .
A. P. Number.
// �
Address:
Legal Description:
Contractor. �CZT
6
City, ST, Zip: %'U77
."`
Telephone: �z -•'`sem+.:�m�•ay
Address:
Project Description: ( S
City, ST, Zip:/
'
! ZZ
I V 5�
)
Telephone: KN J 1 3
61 G�l
6111-
State Lia #
City Lia #;
Arch., Engr., Designer.
Address:
City, ST, Zip:
Tele hone:
P
State Lic. #:�
Name of Contact Person:
�`
2 • ;
i �- s : �.
^E „ %ice»�%
Construction Type: Occupancy: .
Project type (circle one): New Add'n After Repair Demo
Sq. FL: # Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: 3W d.
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACK.IING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2`d Review, ready for correctionsfcssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.XL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'^' Review; ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees