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06-4281 (GRES)P.O. BOX 1504 ' 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&ty/ nF °Y" 4" Application Number: 06-00004281. Property Address: 46680 CAMEO PALMS DR APN: 643-182-012-55 -2117 - Application description: GARAGE - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 12446 Applicant: Architect or Engineer: ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT .I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3of the Business and Professionals Code, and my License is in full force and effect. License Class: License No.: - - - - - - - - - - - - - - - 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 ppli cant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: .:( ) 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 1, 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.&PIC. for this reason If 4 ate:Wh CONSTRUCTION LENCKG 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: - LQPERDIIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/07/07 Owner: HOFFMAN KURT D 46680 CAMEO PALMS DR LA QUINTA, CA 92253 Other struct info . . . . . C Contractor: AOwner ----------------- - 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: CarrierNO Policy Number 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 00jof the Labor Cad s a 1 ll forth wirh c ly with those provisions. WARNING: FAILURE TO SECURE WORKERS' COMPEN ION 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 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 building construction, and h e authorize representatives of tthi�s o ty I enter upon t above-mentioned prer for i speecttiion p rpos Date: 7 ature (Applicant or Agent):¢e Application Number . . . . . 06-00004281 Permit ELECTRICAL-CARPORT/GARAGE Additional desc . Permit Fee . . . . 27.70 Plan Check Fee 6.93 Issue Date . . . Valuation . . . . 0 Expiration Date 8/06/07 Qty Unit Charge Per Extension BASE FEE . 15.00 635.00' .0200 ELEC GARAGE OR NON-RESIDENTIAL ---------------------------------------------------------------------------- 12.70 Permit . . . CARPORT/GARAGE Additional desc . Permit Fee 144.00 Plan Check Fee 93.60 Issue Date . . . . Valuation . . . . 12446 'Expiration Date 8/06/07'. Qty Unit Charge Per Extension BASE FEE 45.00 11.00 9.0000 THOU BLDG.2,001-25,000 99.00 ---------------------------------------------------------------------------- Special Notes and Comments 635 SF GARAGE ATTACHED TO EXISTING GARAGE. -------------------------------------------------- ------------------------- Other Fees . . . . ... . . STRONG MOTION (SMI) - RES 1.24 Fee summary Charged Paid Credited ----------------------------------------------- ---------- Due Permit Fee Total 171.70 .00. .00 171.70 Plan Check Total 100.53 .00 .00 100.53 Other Fee Total 1.24 .00 .00 1.24 Grand Total 273.47 .00 .00 273.47 LQPERDIIT City of La Quinta Building U Safety Division . . Permit # P.O. Box 1504, 78-495 Calle Tampico r / La Quinta, CA 92253 - (760) 777-7012 b Building Permit Application and Tracking Sheet Project Address: t` ip - 6%(D Ck, ,eCl Owner's Name: ` V 2 A, D C6 A- P. Number. Address: ' - C. CP, V, t o FA t Legal Description: City, ST, Zip: L ( v t � � A , C'p . C(2 2 'S Contractor: Qw,-a IE M_ 3 0 N L C rz Telephone: � Address: S `�`- �'�+Wd's ' � � Gs � Project Description: NE w V A (Z A C_ < City, ST, ZiP E X ST Telephone: • f State Lic. # : City Lic. #: Arch., Engr•, Designer: Address: NW City,. ST, Zip: Telephone: State Lic. #: Name of Contact Person: t/(Z,) Construction Type: WAD S7 v4c�pancy: Project type {circle one): New Add'n Alter Repair Demo Sq: FL: 635 # Stories: #Units: Telephone # of Contact Person: S- 3 9Y Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd , -- Reed TRACKING . PERMIT FEES Z Plan Sets Plan Check submitted Item Amount ZStructural Cates. Truss Calcs Reviewed, readyr corrections Plan Check Deposit Called Contact Peraon Plan Cheek Balance Energy Cates. Plans picked ap t7 Construction Flood plain plan Plans resubmitted Mechanical Grading.plan' 2"r Review, ready r cerrectio /' ue p Electrical Subcontactor List Called Contact Pe rso Plumbing Grant Deed Plans picked up S.bLL [i.OA. Approval Plans resubmitted . Grading 1N HOUSE:- "Review, ready for correctio issue p Developer ImpactFeh.. ; Planning ApprovAl Caned Contact Person A.I.P.P. .Pub. Wks. Appr Date of permit issuer. School Fees , 1,TqtaIPcrmitFcts : .. 12 14 0(� �VcA v(F12 2o/O(a I I31 0'1 5fKF1PPR[7JED l�la-gym—��CA IwE; 2A�0?