05-5587 (RER)rf .
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
05-00005587
81249 RED ROCK RD
764-270-999-64 -300233-
REMODEL - RESIDENTIAL
MEDIUM HIGH DENSITY RES.
. 15000
Architect or Engineer:
u�l'�Gv
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
i
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty 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: - - - - - - - - - - License No.: C27
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 (5500).:
(_) 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.).
(_) 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 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:
SHEA LA QUINTA.
C/O JEFF MCQUEEN
8800 N GAINEY CENTER 350
SCOTTSDALE, AZ 85258
Contractor:
CRAIGS LANDSCAPE INC.
42488 BYRON PL..
BERMUDA DUNES, CA 92201--0
WCC: ZENITH
Lic. No.: C27
VOICE -(76.0) 177-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/24/07
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 0067324602 0 6 / 0 1 / 0 Policy Number 734744
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
3700 of the Labor Code, I shall forthwith comply with those provisions.
Date: Applicant:
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 Ouinta, 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 construction, and hereby authorize representatives
of this county to entei upon the above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
LQPERMIT
Application Number .
. . . . 05-00005587
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
16.50 Plan Check Fee
.00
Issue Date . . . .
12/30/05 Valuation'
0
Expiration Date..
7/19/06.'
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
.00
Issue Date . .
12/30/05 Valuation . . .
. 0.
Expiration Date
7/19/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
---------------------------=----------------------------------
Special Notes and Comments
--------------
GAS LINE/ELECT. TO FUTURE APPROVED
'
•APPLIANCE
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
Permit Fee Total
:34.50 34.50 .00
.00
Plan Check Total
.00 .00 .00
00 .
Grand Total
34.50 34.50 00-
00
LQPERMIT
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Td4t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: "
pp X05-00�005'S-87
Property Address: 81112 RED ROCK RD
APN: 764-270-999-156 -300233-
Application description: REMODEL - RESIDENTIAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 15000
n �
Applicant: A Hi ct or En ineer� ZOOC
DEC J J
---------------------------------------------------
LICENSED C0 TRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lic ed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and 1 essionals Code, and my License is in full force and effect.
Licensee Cl a s: - - - - - - - - License No.: C27
D� ate:Lf,. �D C�n�ractoiiw�_ f
�+ OWNER -BUILD DECLARATION
I hereby affirm under penalty of perjury that I am exempt fr 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 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.).
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 ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
JUDY FRANKOVICH
81112 RED ROCK RD
LA QUINTA, CA 92253
Contractor:
CRAIGS LANDSCAPE INC.
42488 BYRON PL.
BERMUDA DUNES, CA 92201--0
WCC: ZENITH
Lic. No.: C27
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/29/05
-----------------------------------------------
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 F090ZO67324601 06/01/09olicy Number 734744
_ 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 law f California,
and agree that, if I should be a subject to the work ompensation pro v' s of Section
t 37PO of the Labor Code, all forthwith comply Vigtoffse provisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENAL AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 abov ormation is correct. I agree to comply with all
city and county ordinances and state laws relating to buitdi n tion, and hereby authD epresentatives
Of this county t0 enter upon the above-mentioned grope C, pyrpose
Application Number . . . . . 05-00005587
Permit ELECT - ADD/ALT/REM
Additional desc .
Permit Fee 16.50 Plan Check Fee
.00
Issue Date . . . Valuation . . .
. 0
Expiration Date 6/27/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
,S 2.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
------------------- --------------------------------------------------------
1.50
Permit PLUMBING
Additional desc .
Permit Fee. 18.00 Plan Check Fee
.00
Issue Date . . . . Valuation
0
- Expiration Date 6/27/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
------------------------------------------------------------------_----------
Special Notes and Comments
GAS LINE/ELECT. TO FUTURE APPROVED
APPLIANCE
Fee summary Charged Paid Credited
Due
Permit Fee Total 34.50 .00 .00
34.50
Plan Check Total .00 .00 .00
.00
Grand Total 34.50 .00 .00
34.50
LQPERMIT
Bin #
City of La Quinta
Building & Safety Division
P.O. Box. 1504, 78-495 Calle Tampico
La Quinta,.CA 92253 -.(760).777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: �1 ttl �� �G'�
Owner's Name: <
A. P. Number:
Address:
Legal Description:
Contractor:
City, ST, Zip:
Telephone:
Address: 6 71152 ho��&t G Z
Project Description:
City, ST, Zip:
Telephone:77Y f �
State Lic. # : 2
City Lic. #:
L, � yL
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
r.. '
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE-BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.
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
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2°d Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
17 --,