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07-1230 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00001230 Property Address: 55604 PINEHURST APN: 775-241-007- - - Application description: REMODEL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 40000 Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Lhereby affirm under penalty of perjury that) 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 Cl -.B - /J License No.: 815545' ,Date �Contmct�or*,� OWNER -BUILDER DECLARATION I hereby`affirm under penalty of perjury that I am.exenipt from;the Contractor's State License-Law,for the following reasonISec. 7031.5, Business and Professions Code. Any city.orcounty that requires a permit to .. consfruct, alter; improve, demolish, or •repair any structure, prior to its issuance, also requires'the applicant for the Permit to file a signed statement thathe or she is licensed pursuant to the provisions of the: Contractor's: State . License Law (Chapter 93commencing with Section 7066) of, Division 3 of the Business and Professio6t Code) or that tie 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 hundreddollars ($500).: (_) I, as owner of the property, or my employees withwages 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 in 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 oneyear of completion, the owner -builder. will have the burden of proving that heorshe did not build or improve for.the,purpose of sale.). 1 _ 1 1, as owner. ofthe.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 performanceof the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's.Name: Lender's Address: LQPERMn Owner: MR & MRS ASTOR 55-604 PINEHURST LA QUINTA, CA 92253 Contractor: -WILLIAMS,. ERIK.R.. 39.610 ENTREPENEUR,LANE, PALM DESERT, CA 92211 (.760) 200-5970. Lic. No.-: 815545 VOICE (760) 777=7012 ) FAX (760777-7011 INSPECTIONS (760) 777-7153 Date: 4/23/07. APR 2 3 2007 WORKER'S COMPENSATION�DECLARATION - I hereby affirm under penalty of perjury one of the following declarations I have•ana will maintain a certificateof consent to self.insure for workers' compensation, as provided for.by;Sectwn 3700:of the Labor -Code, for..the performance of the work for wvxh:this permit is issued !. _ I'have, and_will mamtainworkers' compensation insurance;�as required by Section 3700 of-ihe Labor Code, for the performance of the work for which'.this.permit is issued., My workers' compensation insurance carrier and policy number are: . ' - Carrier STATE FUND Policy Number 1788891 _ I certrfy_that, in the performance of'the work for which this,permivis issued; )shall not employ any person -in any manner so as to become'subject to;the:workers' compensation jaws 'ofCalifornia, _-.46d agree' thart,'if,I should _ e subjeciFto-the workers' compensation provisions,of Section 300 of the Labor Code s forthwith:complywith'thoseprovisions. Date` Applicant: WARNING: FAILURE TO SECURE WORKERS' MPENSATIONCOVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000).. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED ObR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. _ -APPLICANT ACKNOWLEDGEMENT . :IMPORTANT Application is hereby made to the'.Directorof Building. and Safety for a permit subject to they , conditions'and restrictions set forth on this application. 1. Eachpersonupon whose behalf this application is made, each person at whose request and for whose benefit work is performed.under or pursuant-toeny 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 buildin ' ruction, and hereby authorize representatives '. of this ccoou to nter upon the above-mentioned property r - pection-purposes. ;Date:-lq, Signature (Applicant or Agent): Application Number . . . . 07-0000.1230 Structure Information BATHROOM REMODEL Other struct info . . . . CODE. EDITION 2001/2005 Permit . . . BUILDING PERMIT Additional desc . Permit Fee 349.50 Plan Check Fee`: 227.18, Issue.Date Valuation 40000 Expiration .Date 10/20/07 Qty Unit Charge Per. Extension BASE FEE 252:00 15.00 6.5000 THOU BLDG.25,001-50,000 91.50 .:-Permit . . ELECT - ADD/ALT/REM Additional '-desc Permit Fee <.•, 24.75 -.Plan :Check Fee.... ' 6 19 Issue:, Date Valuation. 0 Expiration. Date 1:0'/20/07 Qty Unit Charge:' "Per Extension . BASE -FEE;. 15'.00; • 13.'00 .7500 PER ELEC DEVICE/FIXTURE ..1ST 20 9.75 Permit PLUMBING - . Additional des' Permit Fee. 39.00 Plan Check'Fee 9.75 Issue Date. Valuation~ 0 Expiration Date 10/20/07 Qty Unit Charge: Per Extension-::. `.. BASE FEE -. 15.00 .4. 0'0 6:,0.000 .EA PLB FIXTURE 24::00 --=-- - - - - - - - - - - - - -- Speptal.Notes and Comments ---- - ----- . BATHROOM-REMODEL•/ELECTRICAL/PLUMBING •CBC,""CPC; 2001 '2005 ENERGY: April 23; •'. 2007 3:04:42 PM AORTEGA ------------------------------- Other Fees' ... . . ENERGY.REVIEW FEE 22:72 Fee summary Charged Paid Credited Due ---------------------- Permit Fee Total 413.25 .00 .00 --- 413 25. Plan Check Total 243.12 .00 .00 243.`12 LQPERA TT Bin # ® City of La Quanta Building U Safety"pivision P,O..BOz 1504, 78=495"Calle Tampico CA 92253' (760).777-7012 Building Permit.Application and Tracking Sheet Permitfl. �toLa_Quinta, Project Address:' i N l0 6 —12l &JB 4L.�--Pxt- Owner's Name? 19Z S �6 A. P. Number: Address:., 66io— f. u 15'Au ers Legal Description: Contractor: ��, �, . �/`3 LC.t-6 �a S City, ST, Zip: - V ("{'1Gt Telephone: Address: �9F�V��J �. �L Project Description: City, ST, Zip (MK, 5G JOA 1 _ vl. z State Lic. # : 1 S� y City Lic. #: Arch., Engr.; Designer: Address: _A.. 'City, ST, Zip: Telephone: Constniotion•Type: ' , Occupancy: State Lic. #: Protect type (circle one): New. Add'n Alter Repair -Demo Name of Contact Person: ((� 1LL sem. f = Sq Ft^ ,;�p D # Stories:'. # Units: Telephone# of Contact. Person:-j-6Zg% "Estimated Value of Project: ba 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 V 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: 1nd Review, ready for correctio sue Developer Impact Fee Planning Approval ` Called Contact Person, A.I.P.P. Pub. Wks. Appr Date of permit issue: School Fees ,Total Permit Fees Owner/Address Mr & Mrs Astor 55604 Pinehurst PGA West La Quinta Contractor Erik R. Williams 760 275 0287 Lic. # 815545 55604 Pinehurst Bath Remodel SCALE 1/4" = 1 Foot ELECTRICAL SYMBALS Switch IFI GFI Outlet ® Fan Occupancy Motion Sensor