10-1262 (PLBG)— i .
P.O. BOX 1504 ..
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00001262
Property Address: 51425 CALLE PALOMA
APN: 7.70-174-011-185 -000000-
Application description: PLUMBING .
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2500
BUILDING &,SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ROMMEL CARLOS
51425-CALLE PALOMA
LA QUINTA, CA 92253
VOICE (760)'777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/18/10
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.).
Lender's Name: _
Lender's Address:
LQPERAIIT
performed under or following issuance of thiermi nn
2. Any permit issued as a result of this applic an beco s null ph6id if work t comri
within 180 days from date of issuance of s permi essatron pi••ytigk for 1 days
permit to cancellation. �c v
I certify that I have read this application and stale chat the abov 1 a{ correcte to co -
city and county ordinances and state laws relating to building cons eby aUtr(�ze repr
of this county to enter upon the above-mentioned property fo inspec i
n�.o_�l•163�0 c��r;�r, o'rn�,:r��n.:�.,n� ori t! ' U
Contractor:
Applicant: Architect or Engineer:
EGGAN; ' RICK EDWARD
/
73680 HIGHWAY 111; STE 4123
DESERT HOT .SPRINGS, CA 92241,
(760)404=6325
Lic- No.:. 950244
" 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 of the Business and Professionals Code, and my License is'in full force and effect.
I.have and.will maintain a ceriificate of consent to self -insure for workers' compensation, as provided
License Class: C4 2 - - License No.: 950244
for by'Section 3700 of the Labor,Code; for the performance of the work for which'this permit is
6Daie:: L✓ C,�onirac[or.'
issued:.. ..
_ I have and wiltmaintain workers' compensation insurance, as required by Section 3700 of. the Labor
4
Code, for the performance of the work forwhich this permit is issued. My. workers' compensation
' OWNER- UILDER 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 EXEMPT' Policy Number EXEMPT
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
I ceitify that, in the performance of the work for which this permit is issued, I sha11�not employ any
construct, aper, 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 I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9'(commencing'With Section 7060) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, Lshall forthwith comply with those provisions.' ( _
.that he or she is. exempt therefrom and the basis. for the alleged exemption: Any violation of Section 7.031.5 by
%
any applicant for a permit subjects the applicant to a civil penalty of not more than. five hundred dollars ($500).:
Date Applicant, lag
( ) 1, 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' C_ ,EP ATIONCOVERAGE-IS UNLAWFUL, AND SHALL
Contractors'State License. Law does not apply to an owner of property who. builds or thereon,'
PENAL IAND CIVIL FINES P TO-ONCHUNDRED THOUSAND
SUBJECT -AN EMPLOYER TO CRIMINAL IESII
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 ACKNOWLED MENT
1 _ 1 I, as owner.of,the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT. Application is hereby made [o,the Director.of Building.5 a for a permit subject:to;t_he,
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditionsandrestrictions 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 meison at ose request and for
pursuant to the Contractors' State License Law.)..
whose benefit work is performed under or pursuan an er issue esultof this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees [o, an 11 fend, in nd h IQ harmless the City
of La Quinta, its officers, agents and employee fora act or omissio aced to `the work being
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.).
Lender's Name: _
Lender's Address:
LQPERAIIT
performed under or following issuance of thiermi nn
2. Any permit issued as a result of this applic an beco s null ph6id if work t comri
within 180 days from date of issuance of s permi essatron pi••ytigk for 1 days
permit to cancellation. �c v
I certify that I have read this application and stale chat the abov 1 a{ correcte to co -
city and county ordinances and state laws relating to building cons eby aUtr(�ze repr
of this county to enter upon the above-mentioned property fo inspec i
n�.o_�l•163�0 c��r;�r, o'rn�,:r��n.:�.,n� ori t! ' U
LQPERMIT
Application Number
. . . . . 10-00001262
Permit . .
. PLUMBING SEWER
Additional desc .
Permit Fee
30.00 Plan Check Fee
.00
Issue.Date . . .
. Valuation . .
. 2500
Expiration Date ..
5/17/1.1
Qty Unit Charge
Per
Extension
BASE FEE
.30.00
------------------------------------------------------------------------------
Special Notes and
Comments .
SEWER CONNECTION./
SEPTIC.ABANDONMENT..
•-------------------------------
:Other Fees
-----
BLDG STDS.ADMIN.(SB1473)
-----
1.00 .
Fee'summary
Charged Paid = Credited•"
Due 4
"Permit Fee, Total
30.00 .00 .00
•30 00 '° a
Plan" Check.,,Tota`l
. 0 0-.00 -.00
0.0.
>. Other .Fee Total
1 .:0.0 . 00 ` .00
1. 00
Grand "
-31.'0,0 .00 ..00
31': 00 *-
-Total.
•
y
LQPERMIT
CARLOS,: ROMMEL Project:
10-2647
51425 CALLE PALOMA
Project.Date:
11/16/20.10
.Amount Due: `
$4,231.00
LA QUINTA, CA 92253 GEO.
060706-4
...Planner:
CAROL PFANNKUCHE
TO INSURE PROPER CREDIT, PLEASE_ RETURN THI&PORTION WITH
REMITTANCE -AND. INCLUDE THE PROJECT,ONYOUR CMECK
_��
Bin #
City Of. La ,.Quinta .
Building 8z Safety. •Divislon .
Box 1504, 78-495 Calle Tampico
La Qulnta; CA 92253 -.(760)777-7012
.-.Building- Permit ApplicationRand Tracking Sheet
Permit #P.O.
i�lOr'✓
0 "
Project Address: 5—)'.LfZj : �
"Owner's Name: Gj¢eL05 X46 LsL
A. P. Number:
Address: l
Legal Description:
Contractor: V ix -GOA
City; ST, Zip: j.
Telephone: ' �:: ` " `` r
f>'
Address: 7j 6 JAv 711
Project Description: L5L�,e
City, ST, Zip: 1f71"L _C�
Telephone: 71, D 46) q (
City Lie. #:'
State Lie. # G : {
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:} . ' • 3
•
State Lie. #: .sw.K .,: a:,
. , ''��''�'''",Gf;%'`
Name of Contact Person:
Construction Type: Occupancy:
. Project type (circle one): New Add'n Alter Repan 'Demo
:Sq. Ft.:
#Stories: (
#Units:
Telephone # of Contact Person: (o3-ZT
Estimated Value_of Project:
APPLICANT. DO NOT;WRITE:'BELOW THIS LINE.
N
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Chectc Deposit
Truss Calcs•
Called, Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked uP
Construction
Flood plain plan
Plans•resubmitted
Mechanical
Grading plea
2°' Review, ready for corrections/issue
Electrical .
Subcontactor last
Called Contact Person
-Plumbing ,
Grant Deed
Plans picked up
S.M.I:
H.O.A. Approval
Plans resubinitted
Grading
IN HOUSE:-
34 Revlew, ready for eorrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P. :
Pub. Wks. Appr
Date of permit issue•
School Fees
Total Permit Fees
V