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07-1201 (GRES)} A F � � ® " -. � - • ... 1.14" VO. BOX 1504. VOICE (760) 777-7012. 78-495 CALLE TAMPICO '� FAX (760) 7.77-7011. LA QUINTA,I'CALIFORNIA'92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777=7153 t BUILDING PERMIT ' Date:' 7/26/07 Application Number.0_7 '00.0.012D1� + , Owner: 'Property Address: 79735. RANCHO LA •QUINTA DR, MR. ANDREWS r APN:_ •'." 649-550-027- - - 79-735 RANCHO LA QUINTA�DR. D r Application description:GARAGE - RESIDENTIAL LA QUINTA, CA 92253 d - ;Property Zoning: 'LOW . DENSITY RESIDENTIAL _ Application valuation: 1'5000 Contractor: Jvk 2 6 2007 Applicant:. _ Architect or Engineer: AMERICAN BUILDING CONTRACT RS 499.50 JEFFERSON ST STE, 130 i 5 COFLA INDIOCA 92201 F/N�CF , . Euw�rA (760)342-8458 LiC. No.:*839472 LICENSED CONTRACTOR'S DECLARATION _ _ - WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: , Section 7000) of Division 3 o the Business and Professionals Code, and my License. is in full force and effect. _ _• I have and will maintain a certificate of consent to self -insure for workers' compensation; as provided . License Class. B License No.: 839472 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is f _ issued. Dater 4 Contractor. _ 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 - OWNER -BUILDER DECLARATION' insurance carrier and policy number are: ' I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number ' 0014644-2006 following reason (Sec. -7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any. construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if 1 should become subject to the workers' compensation provisions of Section ' License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with those provisions. 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).: _ Date:? Applicant_:- ' _ (_ 1 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL - . Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND - and who does the work himself or herself through his or her own employees, provided that the ' DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION,,DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If,'however„the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ' 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.)-- APPLICANT ACKNOWLEDGEMENT (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. ' property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed - 1 . Each person upon whose behalf this application is made, each person at whose request and for, . .. pursuant to the Contractors' State License Low.). _ - - whose benefit work is performed under or pursuant to any permit issued as a result of this application, - (_ I I amn _ exempt pricier Sec. , 8.&P.C. for this reason 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 foi`any actor omission related to the work being - • performed under or following. issuance of this permit. Date: Owner: - - - 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 - CONSTRUCTION LENDING AGENCY permit to cancellation.- ` - - I hereby affirm under penalty of perjury that thereis a construction lendingagency for the performance of the - I certify that I have read this application and state that the above information is correct. I agree to comply with all - work for which this permit is issued (Sec. 3097, Civ. C.). - city and county ordinances and state laws relating to building construction; and hereby authorize representatives . - - of this county to enter upon the above-mentioned property for ins ti pur- Lender's Name: - //(� - - ~Date:7signature )Applicant-or,Agent): Lender's Address: �— - LQPERMIT .. t Application Number 07-00001201, -Information -184SF-ADDITION/V-NR/RES-3:-, [ENGINEERED] Other st.ruct info . ... . . %; CODE EDITION 2001/2005,,' FLOOD ZONE NO J .GAIRAGESQ FTG -7 - - - - - - - - --- - - - - - - - - - - --- - - - - --- 77 - - - - - - - - - - - - - - - - - - - - - - - - - 184.'00 - - - - - - - - - - - - - Permit.,- ... . . . . . ELECTRICAL-CARPORT/GARAGE Additional desc Permit, Fee::. 18.68', Plan Check Fee,-. 4.6-7 Issue -Date-, Valuation . . . . 0 Expiration Date 1-/22/08 Qty. Unit Charge Per Extension BASE' FEE 15 :00 184.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL'' - - - - --- - - - - --- - I - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - 7 - - - - 3.68 - - - - - - - - - - - - - Permit CARPORT/GARAGE Additional desc Permit Fee 162.00 Plan Check Fee 105.30 Issue Date . . . . Valuation 15000 Expiration Date 1/22/08 Qty Unit'Charge Per Extension BASE.FEE 45.00 131.00 9.0000 THOU BLDG 2,001-25,000 117.00 -------------------- ------------------------ ---------------------------------_- a ' Speci1 Notes and Comments 184SF ADDITION TO GARAGE/V-NR/RES-3 [ENGINEERED]. 2001. CBC, 2004 CEC, 2005 005 ENERGY. July 26, 2007.10:31:45 AM' AORTEGA - - - - - - - - - - - - - - - - - - - - - - - - --------------------7------------------------7------ -------------------7----------- OtherFees . . . . . .. .. . * ENERGY REVIEW FEE ------------7------Other 10.53 STRONG.MOTION (SMI) - RES 1.50 Fee summary. Charged Paid- Credited, - ----------------- Due ---------- ---------- ----------- Permit Fee Total .180.68 ..00 ---------- 00 180.68 Plan Check Total 109.91 .00 .00 109.97 Other*Fee'Total, .12.03 .00 ..00 12.03 ..Grand Total 302.68 ..00, .00 302..68 LQPERr%IIT D. City of La Quanta fD Building 8I Safety Division 07 1 P.O. Box 1504, 78-495 Calle Tampico VVV U Quinta, CN 92253 - (760) 777-7012 ..Building Permit Application and Tracking Sheet.,- heet.,Project Per&t.# .. ProjectAddress: %q ^ 735' 0417CG,d 44 Owner's Name: . n r A. P. Number: t n Address: ,S R % a,7 cL d za Q Legal Description: City, ST, Zip: �G 62Z 51 I Contractor:A�,y�Lrl�n CGfi fn nfr Or Telephoner ' a e �s Address: -g,SQ �effBs'S n s4-. " ! 3 ' �.3 Project Description: O �� City, ST, Zip: T pCj'D ZZ D I ok ANe Telephone: State Lic. # : 0 39 `7 �% City Lic. #: ouv Arch., Engr., Designer: w r4 S 12, s Address: ZATIO Fred VAt-'n b, si h'.,_S' City., ST, Zip: T R �1''+ GtZZ Q . _ Telephone: _,3+ 7 S State Lic. #: Name of Contact Person: Do r) T](f KZ rJC •. Construction Type: Oecupancy: Project type,(circle one): New dd'r .Alter Repair Demo; Sq. Ft.: ' . #Stories: • #Units: Telephone # of Contact Person: 7(eo -a%� - 7'J,S0 Estimated Value of Project:Z/S' 000 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING . PERMIT FEES 2 Plan Sets Plan Check submitte tem Amount 2 Structural Calcs. Reviewed, ready or•corre tions Plan Check Deposit 2 Truss Calcs. Called Contact so Plan Check Balance Energy Calcs. Plans picked up Constructioa Floodplain plan Plans resubmitted Mechanical Grading plan' 2" Review, ready for correcti issue Electrical Subcontactor List Called Contact Person Plumbing j Grant Deed Plans picked up ' ' S.M.I. H.O.A. Approval-• Plans resubmitted ' Grading 'IN HOUSE:- ''" Review, ready for corrections/issue Developer Lnpact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees ! Total Permzt Fees 6 -`14 t'119 I �% � BRor.)Z pyE' 5/I �O'] . ��"': S 0st 7; .��i.�v5. R �C� • . 5�2 �O? � RFC : • .. , �\��S (� iQ �l� �� P/S -Y UVat. -;60 07