07-1361 (RER)' P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
07-00001361
79780 RANCHO LA QUINTA DR
649-550-019- - -
REMODEL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
6762
Architect or Engineer:
•
`�440"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of,perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business a d Professionals Code, and my License is in full force and effect.
license Class: 13 a No.: 792381
Date. "7 Contractor:
OWNER-BUILDERDE-510 ON
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 155001.:
• (_) 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.).
(_ 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.).
I—) 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.I.
Lender's Name:
Lender's Address:
LQPEILYIIT
Owner:
M/M PRAVORNE
79-780 RANCHO LA QUINTA
DR.
LA QUINTA, CA 92253
(760)771-3747
D
Contractor:
RISEN CONSTRUCTION
82175 CHARLESTOWN AVE
INDIO, CA 92201
(760)347-6399
Lic. No.: 792381
VOICE (760) 777-7012
FAX (760) 7777011
INSPECTIONS (760) 777-7153
Date: 6/07/07
noLull � •yI
JUNj
C17Y OLA ed, e
------------------
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 STATE FUND Policy Number 229-0025305
_ 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 to the workers' compensation provisions of Section
/. 300 of the Labor Code, I bra
hw' _ p y ith those provisions.
Date:. YJ v Applicant:
WARNING: FAILURE TO SECURE WK RS' COMPENSATION COVERAGE WFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 ISO days will subject
permit to cancellation.
I certify that I have read this application and state that the above,mation is correct. I agree to comply with all
city and county ordinances and state laws relating ID building c..ction, and hereb authorize representatives
of this county to enter upon the above-mentioned property for pec ' ;,Or s.
Date
/ Q Signature (Applicant or Agent,:
Application Number . . . . . 07-00001361
Permit BUILDING PERMIT
Additional desc .
Permit Fee . . . . 90.00 Plan Check
Fee
58.50
Issue Date . . . . Valuation
. . . .
6762
Expiration Date 12/04/07
Qty Unit Charge- Per
Extension
BASE FEE
45.00
5.00 9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
45..00.
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . 21.90 Plan Check
Fee..
5.48
Issue Date . . . . Valuation
. .
0
Expiration Date 12/04/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
345.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL
6.90
Special Notes and Comments
GARAGE EXTENTION ADDITIONAL 345 SQ. F.T.
----------------------------------------------------------------------------
Other Fees . . .. . . ENERGY REVIEW FEE,
5.85
STRONG -MOTION (SMI)
- RES
67
Fee summary. Charged Paid Credited
-----------------------------------------------
----------
Due
Permit Fee Total 111.90 .00
.00
111.90
Plan Check Total 63.98 .00
.00
63.98
Other Fee Total 6.52 .00
..00
6.52 '
Grand Total 182.40 .00
.00
182.40
LQPERAIIT
Bin #
4� V
City Of La Uinta
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Iv
Project Address: _ 790 L A-ZiA4* ur.
Owner's Name:..
A. P. Number:
Address: %9' Q ,.¢ q,o4
Legal Description:
Contractor: As e-.,
Address: O -7 7S- 0 J.r•r,e4J6wN edit
City, ST, zip: L,4 Q v,►U k4- CA 72-0S-,3
Telephone: (
Project Description:
City, ST, Zip:
$1 Cly
Telephone: (760) -347-6399
<.Z� Meea4
_ q fq-001144
State Lie. # : 7 Z 3 $ CityLic. #:4
Arch., Engr., Designer: 42u r`bs
Address:. 72; g o Rdd W +rl Al r. ' `
ihu ck6 w F C ,
City, ST, Zip: I- l a r'— Cl+ 912z
Telephone: 760) .3412.-735-4
State Lid. #:C 133 9'9
Name of Contact Person: t ( ik 1� a%t� I -'Z
Construction Type: Occupancy:
Project type (circle one): New Add'n . Alter Repair Demo.
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person: 7(�(j L� �� = S7 4C?
E�im� value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal,.
Req'd
Reed
TRACMG .
PERMIT FEES
Plan Sets
Plan Check submitt
Item
Amount
Structural Calcs.
Reviewed, ready r corrections
Plan. Check Deposit
Truss Calcs.
Called Contact Pe
Plan Check Balance
Energy Cales.
Plans picked up ilkConstruction
Mechanical
Flood plain plan.
Plans resubmitted
Grading. plan
2n° Review, ready for correcti 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:-
'Review, ready for correctionslissue
Developer impact Fee
a
Planning Approval
Called C ntact Person
A.I.P.P. ^
Pub. Wks. Appr
Date o[ er 't issue
��
t
School Fees
2
�!
Total Permit Fees
�v
7/-I--� VCAcDLLE Ej//lo
Ulf
i� ,
MAY -03-07 05:27 PM
E
GARY & MARY PRAVORNE 760 771 3119
R4,ANCHO LA Qui.l TTA
ArckjteC*tur.q1(_nnf
April 16, 2007
Mr. Gary Pravorne
79-780 Rarjcho La Quinta Drive
Quinta, ICA 92253
Re: 79-780' Rancho La Quinta Drive
P.01
The Architettural Committee reviewed your submission for a G
extension. the submission as presented is approved Garage
upon c 7nditlon of.-
The Cornmlitee requires the following:
All work Is to be done in accordance with all applicable requirements 'of
governmental entities, including the City of La: Qul6ta and in
apcorlance with all Homeowners Association Eirchliectjjral guidelines
and governing documents.
If, ap�llcable'
a City of La Quinta building. permit
b6 obtained and co
Nrnl�hed to1he Associatid n- prior to commencement o: work. copy
as been finished, please return "Notice LIQJI" to the
fffCe:- : The Ts"soc a ion c ura_Tconsultant wilt _perform �a
I after receipt of such notice; when verification of the approved
ions ' have been concluded, your Security DOposit will be
refund.
Thanking yo in advance and if any questions Please -do riot J
'e. t a. 00 -site office 777.8807,
ar-'y a er, ccAM, AMS
n ger
L 'a Ginti{
fax' %60.777.696
r -C: Arthitect�ral Comm.
RA�,:iw LA QI-INTA DR, • LA �)VIVVA. CA 92?53 760 -i'17 -880'i - FW
Itate to call
760,777-6961