05-3478 (RER)N
P.O. BOX 1504
78-495 C'ALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property.Zoning:
Application valuation:
Applicant:
00034=78
78563 PEERLESS PL
770-250-002- - -
REMODEL - RESIDENTIAL
.LOW DENSITY RESIDENTIAL
20000
Architect or Engineer:
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
Dick Hannah
78563 PEERLESS PLACE
LA QUINTA, CA 92253
(760)322-8788
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
RAWLINGS CUSTOM CONTRACTING,
5000 E. CALLE SAN RAPHAEL, C-1
PALM SPRINGS, 'CA 92264
(760)322-8788 .
Lic. No.: 746930
Date: 9/22/05
-------------- - -- --- -----
----- - - - - -- ---- _ --------------------------------------------------—
LIC SED -CON -
D CONT CTOR'S ECLARATION WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury that am license derpro i' s` hapter 9 -(commencing with- I hereby affirm under penalty of perjury one of the following declarations:.
Section 7000) of Division 3 of the eusine and Prole" als License is.in full force and effect. . ' _ Ihave and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Cla Ba. "6930. for by Section 3700 of the Labor Code, for the perforrrmance of the work for which this permit is
/? .. issued.
. Date ' Contrattor: = �° _ I have and will maintain workers' co ensa�ton insurance, as required by Section 3700 of the labor
""''�� Code, for the performanceof t work f�r which this permit is issued. y. workers' compensation
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, alsorequiresthe applicant for the
permit to file a signed statement that he or she is licensed puisuant 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 oasis 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 is4not intended or offered forsale (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.).
(_ 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.).
(_) I am exempt under Sec. , B.&P.C. for this reason
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.).
LQPERMIT
is'- compensation provisions. of Section
those provisions.
'WARNING:. FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINALPENALTIES 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-AT.TORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
imDn DTAMT Annl;n ;� ;� I.nruh., .n �Au n •Mu fl:.urn. ni O. �IA�n,. e..A Crier.. {,.. a ...,.....:....,..,.,. ,..A,.
Application Number
. . . . 05-00003478
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee
207:00 Plan Check Fee
134.55
Issue Date . . . .
Valuation . . . .
20000
Expiration Date
3/21/06
Qty Unit Charge
Per
Extension
BASE. FEE
45..00
18.:00 9.0000
THOU BLDG 2,001-25,000
162:00*
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit.: Fee ,•.
5.0.25. Plan Check Fee..
7..50
Issue.Date . . .
Valuation
0
Expiration Date
3'/21/06
Qty Unit Charge
Per,.
Extension
BASE FEE
15.00
20.00. .7500
.PER ELEC.DEVICE/;FIXTURE 1ST 20
15.00
45:00 .4500
EA-ELEC.-DEVICE/FIXTURE >20
20..25
Permit MECHANICAL
Additional desc .
Permit..Fee
19.50. -Plan :Check 'Fee
Issue Date-
Valuation,
0
Expiration Date`..
3/21/06`
'Qty Unit Charge
Per
Extension
BASE FEE;.
15.00
1:00 4.5000
EA MECH.VENT INST/.DUCT ALT
4.50
..Permit
PLUMBING
Additional desc
Permit Fee ..
15.00. Plan Check Fee
3:75
Issue Date .
Valuation
0
Expiration Date..
3/21/06
Qty ; .Unit .Cha_ rge
Per._,.-> _
Extension -
BASE FEE
15.00
- 7 ------------------------
Special Notes and Comment's
Interior/exterior alteration including
electrical, plumbing,
window change.
outs, architectural elevations,
LQPERMIT
LQPERMIT
,Application Number
. . . . .
05-.00003478'
Special Notes and Comments
showers., fireplace -See
approved plans
and.narrative.scope
of work.
Other Fees ..
ENERGY REVIEW
FEE
13:46
-STRONG MOTION
(SMI) - RES
2.00.
Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
2.91.75
.00
.00
."2.91:75
Plan`:Check.Total
150.68""
.,00
.00
150.68,
Other: Fee, Total "
:15.46
.00
.00
15.46
`;Grand Total
.457:89
.00,•
.00.,.
457:89
LQPERMIT
-.Bin#
City of La: Quinta ;
Building 8l' Safety Division
P.O. Box .1504, 78-495-Calle .Tampico
La Quinta, CA 92253,-:(760);777-7012
Building. Permit Application and Tracking Sheet
Permit #
B
Project Address: ` 3 S
-------------
liOwner' s Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:��� s u7r�
�I I•� -
Telephone:
P 4 .......................
r,
Project Description; Z� C 1 • L �`
Address: 506o �G4u sou
City, ST, Zip:
Telephone:
P hone: Z -
2 X78'
State Lic. # : 746
City Lic. #;
Arch., Engr, Designer:
Address:
City, ST, Zip:
Telephone: <:
Statei
Lc.#:
- "
'Cn
0 structi on Type: .-Occupancy:
P
Pr J e
ct h'e �circl
eone New,
.Ne Add'n Alt Re air
er Demo
P
Name of Contact Person:��f5s
Sq. Ft.;
# Stori_es:.
#Units:
Telephone # of Contact Person: 3 Z.'L—� 76"1
Estimated Value of Project: QD�
APPLICANT: DO NOT WRITE BELOW.THIS LINE
#
Submittal ' .." . Req'd .
Rec'd .
f TRACKING i .. .
PERMIT FEES
-
Plan Sets h!! G
Plan Check submitted 7 Item
Amount
Structural Calcs.
Reviewed, ready for corrections /lo Plan Check Deposit
Truss Calcs.
Called Contact Person-
8�,(�-'. Plan Check Balance
Title 24 Cates.
Plans picked up ' "Construction
Floodplain plan
'Plans resubmitted Mechanical
Gradin plan
g P
.a "'" -
2" Review, ready for correc i s/issue i �� Electrical .
Subcontactor List
Called Contact Person j6s 1piumbing;
Grant Deed
Plans picked up S.M;L
H.O.A. Approval
Plans resubmitted Grading y
IN HOUSE:-
'"' Review, ready'for correction`s/issue Developerslmpact Fee
Planning Approval
Called Contact Person A.I:P.F.
Pub. Wks. Appr
'Date of permit issue
School Fees
W/� v� _ .G�J/.�. � . ,i2 /.tib d•Bif1.f�!O
I/ �
Total Permit Fees