07-2248 (SPIN)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: �0':7":00002248� .
Property Address: 78780 SANITA DR.
APN: 604=.163-003-103 -23269
Application description: SPECIAL INSPECTION
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 0
r4d BMW, � 0 R I
r
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING *PERMIT
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LICENSED-CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that Iam licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of 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 s e is exempt therefrom and thebasisfor.the alleged exemption. Any violation of Section 7031.5. by
any !ppKant for a permit subjects the applicant to a civil penalty, of -not more than five hundred dollars ($5001.:
( _uol)I, as owner of the property, or my, employees with wages as their sole compensation, will do the work, and '
thestructureisnot 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 doesthe work himself or herself through'6is or her,owri 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 impro , and who contracts for the projects with a contractor(s).licensed
pursuant to the Contract State Liceris aw.).
( 1 I am exempt under $ec. , BAP.C. o this reas -
Date: _ / ner: i
NSTRUCTION LENDING AGENCY
I hereby affirm under penal y of perjury that t ere is a construction lending agency for the performance of the
work for which this permit i issued (Sec. 30P7, Civ. C.).
Lender's Name:
Lender's Address: -
LQPERMIT
Owner:
REBECCA ARMENDARIZ
78780 SANITA DRIVE
LA QUINTA; CA 92253
--------------------
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/07/07
----�-
- -11
AUG 07 2007 � U
�
CITY g: I e car Eas��rs
------------------
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
man
Code, for the perforceof'the,work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier Policy'Number -
I certify that, inI.
once of the work f r which this permit is issued, Lshall not employ any
person in .y manner so a ecome s tec to the workers' compensation laws of California,.
'ands a that,`if (should eco subje t wor ensation provisions of Section33770 of the Labor Code; I ha w' h h prove ' ns. -
ate. • 1 icanr
WARNING: FAILU E TO SECURE WOR OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPL YER TO,CRIMINA ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000 IN ADDITION-- THE COST OF COMPENSATION, -DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE OR COD 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. I ' `" -
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 ' ation becomes null and void if work is not commenced
within 180 days m date of issuance of suc, rmi[, or cessation of work for 180 days will subject
permit to can lotion:
I certify that I have read is application and state that thea ove i fo ation is c I agree omply. with all
city and county ordina es and state lawsrelating to buildi g co tr n, and e y authorize r ntatives
of county to enter Pon the above-mentionecLpropert for' s i rpo a /f,� , / / /
Date: U PV �jSikn.ture (Applicant or Agent):
Application Number . . . . . 07-00002248
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 234.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
22806
Expiration Date 2/03/08
Qty Unit Charge Per
Extension
BASE FEE
45.00
21.00 9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
189.00
Permit . . . ELECT - ADD/ALT/REM
Additional desc . .
Permit Fee . . . . 29.70 Plan Check
Fee
.00
Issue Date . . . . Valuation
0
Expiration Date 2/03/08
Qty Unit Charge Per
Extension
BASE FEE
15.00
420.00 .0350 ELEC NEW RES - 1 OR 2
----------------------------------------------------------------------------
FAMILY
14.70
Permit . . . . . . MECHANICAL
Additional desc `
Permit Fee 26.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 0
Expiration Date 2/03/08
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 11.0000 EA MECH FURNACE >100K
11.00
----------7-----------------------------------------------------------------
Special Notes and Comments
PERMIT TO FINAL OFF PREVIOUSLY
PERMITTED ADDITIONS (BUILDER'S SQUARE
#'S 0304-286 & 0005-124)
IN PREPARATION FOR SALE OF RESIDENCE
Fee summary Charged Paid Credited
-----------------
Due
------------------------------
Permit Fee Total 289.70 .00
----------
.00
289.70
Plan Check Total .00 .00
.00
.00
Grand Total 289.70 .00
.00
289.70
LQPERMIT
Bin #
City Of U Quinta
Building.0 Safety;Division
Box4504, 78-495-.,Calle Tampico
La Quints, CA 92253 -,(760), 777-7012
BulldingPermit Application and Tracking Sheet
Permit:#KG.
0.,l , mho
Project Address:
A. P. Number:
Legal Description:
Contractor:
*Owner's Name:
Address:. C
c�
City, ST, Zip:
c,n e
Telephori :
Project.Descriphon: C- � 0b. D ;5�o —
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.
9aQLI�13
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Address:
City, ST, Zip:
-
Telephone:.
State Lie. # :
City Lie. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
:?. Construction Type:. Occupancy:
Project type (circle one): New 'Add '.n Alter Repair Demo.
Ft.:
e
#Uni ts:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE •.
#
Submittal
RegW
Reed
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
2°" Review, ready for corrections/issue .
Electrical
Subcontactor List
Called Contact PersonPlumbing
Grant Deed
Plans picked up
II.O.A. ApprovalPlans
resubmitted
Grading
INHOUSE:-
Review, ready for correctionsrssne
Developer lmpact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
CITY OF LA OUINTA
BUILDING & SAFETY DEPT.
APPROVED .UrMP!IAI v2%?
FOR CONSTRUCTION
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