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06-0315 (RR)P.O. BOX 1504 78495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 06 -00000315 - Property Address: 78675 SAGEBRUSH AVE APN: 646-311-017-17 -000000- Application description: RE -ROOF Property ZoniY MEDIUM DENSITY RES ApplicatiQSI?j y00n: 5000 I hereby affirm ur Section 7000) of License Class: Date: Contractor: T"y/ . 4.44" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING -PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: HARVEY R ANTHONY 130 VISTA VALLE PALM DESERT, CA 92260 --------------------------------- Contractor: Owner Date: 1/19/06 --------------------------------------------------------------= LICENSED CONTRACTOR'S DECLARATION .WORKER'S COMPENSATION DECLARATION rjury that I am licensed under provisions of Chapter 9 (commencing withI I hereby affirm under penalty of perjury one of the following declarations: Business and Professionals Code, and my License is in full force and effect. - _ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided - License No.: for by Section 3760 of the Labor Code, for the performance of the'work for which this permit is ' OWNER -BUILDER DECLARATION - - 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 ($500).: (_ 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 Contractors' State License Law does hot 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, s.owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, business and Professions (:ride: The Contractors' State License Law does not apply to an owner of U --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 am exempt under Sec. , B.&3,e7or this reason Date: l t t" It f alp ! Owne 1 Y - _ t f 3 �- CONSTRUCTION LENDING A CY _ 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 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 Policy Number I�certtify 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 s become subject to the workers' compensation provisions of Section 3700 of the La ode/I shall forthwith comply with those provisions. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COV.ERrAGE 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 hereby authorize representatives of this�couply to enter upon the above-mentioned proper r inspection purposes. 61e[e: t \`►q fl� Signature (ApTplicant'gorAgennit -. _ r �. Application Number . . . . 06-00000315 Permit . . . RE -ROOF Additional desc . Permit Fee 30.00 Plan Check Fee .0"0 Issue Date Valuation 0 Expiration Date 7/18/06. Qty Unit Charge Per Extension BASE FEE' 30.00. Special Notes and'Comments REROOF Fee summary Charged Paid Credited Due --- Permit Fee Total 30.00 - ---- ---------- .00 ---------- .00, 30.00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 .00. .00 30.00 LQPERMIT 1 .. PERMIT APPLICATION County of Riverside t, Department of Building and Safety i. 4080 Lemon St. 2nd Floor 135 N. Alessandro Rd. Am. 203 880 N. Slate Street 227 North "D` Street 46209 Oasis 3t. Am. 310 160 N. Oro Jway lI Riverside. CA 92501 Banning, CA 92220 Hemet. CA 92343 Perris. CA 92370 Indio, CA 92201 Blythe. CA 92225 E'• Ph: 787.6146 Ph: 849.7312 Ph: 658.4464 - Ph: 657.3898 Ph: 342.827 Ph: 922.2670 F? This permit becomes void it work nor commenced within 180 days Jrom date of issuance. OR. it work has been suspended or abandoned Ior a period of 180 days. : ) �i CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need rim be com- LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 ( comment- pleted it The permit is for one hundred ($100) or less. I certify Thai in The performance 01 the work for which this, Ing with Sectioh.7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. permit is issued. I shall not employ any person in any ma I net so as to become subject to the Workers' Compensa-' Zion Laws of California. ' Date Apflicanl eNOTICE OWNER -BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractor's License Law for the TO APPLICANT: If, after making this Certificate ciExemption. you should become subject to the Workers' ' Compensation provisions Of The Labor Code. you must foil-iwith comply with such provisions or this permit shall be' i following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to con- deemed revoked. • slruct, alter, improve. demolish, or repair any structure, prior to its issuance, also requires the applicant for such ' permit to file a signed statement that he is licensed pursuant to the provisions of The Contractor's License Law DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prolessions Code) or that he is ex- ex- 1 ❑I hereby that live feel into and the basis for the alleged exemption. Any violation of Section 7031.5 by 0)any applicant for aper- ' empt subjects the ., mil subjects the applicant to a civil penalty of not more than five hunderd dollars ($500).): certify no excavation (5) or more in depth which a person is required to descend. will, be made in connection with work authorized by This perm , and that no building structure. scaffolding, falsework, �• ❑ T, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the or demolition or dismantling thereof. will be more than Ihir y -six (36) feet high. (Chap. 3.2. Grp 2. Art 2. Sec 341.. Title 8. C.A.C. ). structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License OAS owner -builder. I will not employ anyone to do war- which would require a permit Tom the Division of In - Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or dustrial Safety. as noted above. unless such person ha=_ a permit to do such work from the division. through his own employees. provided that such 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 prov. ❑Division of Industrial Safety Permit No. Y ing that he did not build or improve for the purpose of sale.) � SS9S iF ❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the CONSTRUCTION LENDING AGENCY: I hereby affirm ME there is a construction lending agency for the perfor- project (Sec. ,t 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who mance of The work for which this permit is issued (Sec. 3097. Civ. C.). builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant To The Con- Lender's Name reactor's License Law.) Lender's Address j ❑I am exempt under Sec. . B.d P.C. (Attach Certificate). _. Dale Owner CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have read this application and stale that the information given is correct. I agree to compl- with all slate laws and county ordinances relating to ' WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure, or a building construction, and authorize a representative of the County of Riverside. Department of Building and Safety '-cerlilicale of Workers' Compensation Insurance, or a certified copy Thereof (Sec. 3800. Lab. C.). to enler upon the properly for -which I have applied for,biis permit for the purpose of making inspections'/ r„`� Y �"� r /�� •�� �,❑Certified copy is hereby furnished. " '' ��'� `�'~` ❑Certilied copy is filed with the County Building Inspection Department or County Department. " fSignalure of Applicant or Agent - Dale " —.:.PilR1 'APPLICANT NAME (L, F, MI) ' HARMON . ISUZANNE MNO MARTINIQUE &.C'.P�►`ISTAONES CTA 922010000 t1�7/�Y�9SJJr�R��yRy7EyS�S(gIIS�pP•ACE SAGEBRUSH AVE. SAGEBRUSH STPAC �ISICjj�J°.�U,JAi'I CA 922530000 9O.A'I .4V 1 u A-7 1 O T1 06,60TWIN P E R M1-55484 to S WWTa a a 0 Vit 17 °� Se 0MIIt' CLUB -.MANOR 01 pjF alB (`,MI)SUZANNE PHONEp CONTRACTOR -FIRM NAME LICNC If ADDRESS CITYICOMMUN ITYISTATEIZIP PHONE # BLD NSPE OR FINAL DATE yyL ARCIENG FIRM NAME 'Ile LICNC # ADDRESS �D CITYICOMMUN ITYISTATEIZI P PLAN# _ PLANS EXAMINER APPROVE DATE WdUL INSP-,SE TI , SYS. Do % fN FSB � SS9S COUNTER L.U.T. D.. ZONE:ORD'# LOT SZ END/� V V V V' _ 1 8 .P E C I A' t.• APPLIPRMT p PS DATE 55484 1 N S P E O T1 0 N P E R M1-55484 t. SPECIAL ANS"'M FEE $30100 TOTAL. FEE $30,00 CA CrX, NC •C UNT COUNTER L.U.T. •rc TAL PERMXT COST IS $30.00 `ORM 284.208 (11.81) INSPECTOR. 1 N S P E O T1 0 N P E R M1-55484 •rc TAL PERMXT COST IS $30.00 `ORM 284.208 (11.81) INSPECTOR. NO. OPERATION DATE INSPECTOR NO. OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS 1 Set Back 33 Ventilation System 2 Ftgs 8 Frms 34 Plenums & Ducts 2A Slab Grade 35 Furnace Comport. 3 Steel 36 Inlets & Outlets 4 Grout Blocks 37 Combustion Air 5 Bond Beams 38 Compressor 6 Roof Deck 39 Appl. Clearance 7 Framing 40 Fire Damper 8 Vents 41 Smoke Detection Device 9 -Garage Fire Wall 42 Commercial Hood 1 10 Fireplace P. L. E] 43 Final 10A Fireplace T. 0. OP"N NO _ ADDITIONAL INFORMATION _ _ SEWAGE SYSTEM SIZE & LOCATION 11 Exterior Lath 12 Internal Lath 12A Drywall 13.—Finish.Grade. — — - • . • — _ INSULATION Thick R Value 7A Walls (Batts) 12B Ceiling (Batts) 12C Ceiling (Blown) 14 Final _PLUMBING APPROVALS 15 Ground Plumb 16 Water Piping 17 Rough Plumb 18 Vents 19 Sewage Disposal L 20 Sewer r 21 Water Heoter 22 Water Softener 23 Water Service 24 Gas Test 25 Final 2 `L Tank Pit L.Line REAR OF PROPERTY LINE p PSLp l P) ff f X 0 yy- VV ELECTRICAL APPROVALS 26 Power Pole 27 Conduit 28 Service Entrance 29 Wiring 29A Grounding Wire 29B Bonding 30 Fixtures 31 Service 32 Final STREET NAME I— — — — — — — — — — — — — — — — — — — — — — — — — — — -- — — — — — — — — — — — — a I . DEPARTMENT OF BUILDING AND SAFETY . COUNTY OF RIVERSIDE OFFICE DATE " TIME -7" PERMIT NUMBER INSPECTION /REUUESTED ADDRESS 1 SPACE N0. FOR: ;7e�— A. M. OWNER OMMUNITY P.M. BUILDING PLUMBING ELECTRICAL MECHANICAL a PION I / TUES. WED j REMARKS: TH W L FRi OWNER/CONTRACTOR TEL.NO.