11-0180 (DEMO)1;
v
P.O. BOX 1504
78-495 CALL TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: i 1-1-0.0.0.0.0.180
Property Address: `�51--T0-0=CA 1; OBISPO
APN: 770-142-002-92 -000000-
Application description: DEMO - COMML/OTHER
Property Zoning: LOW DENSITY ' RESIDENTIAL
Application valuation:. 0
Applicant:
Architect or Engineer:
BUILDING & SAFETY. DEPARTMENT
BUILDING PERMIT
Owner:
DANIEL TORRES
51100 CALLE OBISPO
LA QUINTA, CA 922,53
--------------------
Contractor:
Owner
I
VOICE (760) 777-7,012
FAX (760) 77777011
INSPECTIONS (760) 7� 7-7153
%E.3 1 0'2011
Date: 2/18/11
4,WNTA
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` 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 orie,ofthe following, declarations:
Section 7000) of Division 3 of the Business and Professionals Code; and my License is ircfull force and effect. -'I have and wilrmaintain ecertificate of consent to self -insure for workers' compensation, as provided
License.Class: 4 License No.: - fo0by,Section 3700, of the' Labor Code, forthe performance -of the work for which this permit is•
issued.
Date: Contractor. I have and will maintain workers' compensation insurance,: as, required by Section;3700 oftheLabor '
OWNER-BUILDERDECLARATION
I hereby affirm under penalty of perjury that am exempt from the Contractor's State License Law for the
following reason (Sec. 7031:5, Business and 'Professions'Code:.Any cityorcounty 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(Chapter9 (commencing with Section. 7000)Division 3 of the Business and Professions Code) -or
that -he or she is exempt therefrom and the basis forthe alleged exemption: Any violation of Section 7031,.5 by
any applicant for permit subjects the applicant.to a civil penalty otnormore 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 isnot intended or offered for sale,(Sec.,7044, Business and Professions Codei� The
Contractors' State License Law does not apply to an,owner of pioperty who builds or. improves thereon,
and who does the,work himself or herself through hisor her own employees, provided.thatthe
improvements are not intended or offered for sale., If, however, the building or improvemenvis 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 purposecf'sale.).
(_) I, as owner, of the property, qrR exclusively contracting with.licensed contractors to conuct theproject (Sec.
7044, Business -and -Professions Code: The Contractors' str
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 Lawa.
(_ 1 I am exempt under Sec. , B.&P.C. for this -reason
Date:
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: Q
Lender's Address:
LQPERMIT
Code, -.for theperformanceof the'work for Which this permit isissued. My workers' compensation
insurance carrier and policy number -are:
Carrier '�Policy.Number.'
certify that, in the performanceof the',work for.whichthis permit is issued, I'shall not employ any
person in any manner so as'to become subject to the workers"compensation laws of C61ifornii,;
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the PborCode j shall forthwit j fomp�ith,thpse provisions.
WARNING: FAILURE TO SECURE WORKERS' CONIPENSATIONCOVERAGE IS UNLAWFUL, ANDSHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES.UP.TO ONE, HUNDRED'THOUSAND
DOLLARS 0100,0001. IN ADDITION TO:THECOST 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°restrictionsae{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/th}i 'cou/nt�y%too aanter upon t above-mentioned property for spection purpo
�Date:`'��[� �— S.
ru/pont
or Agent): 6�600
LQPERMIT
Application Number . . 11-00000180
Permit . . . DEMO PERMIT
• Additional desc .
Permit Fee 45.00
Plan Check
Fee
.00
Issue',Date . . . .
Valuation
:0
Expiration.Date 8/17/11
Qty Unit Charge._ Per
Extension
BASE FEE.
45.00
"Special Notes and Comments".
DEMO:;, -STUCCO FROM- FRONT &: BACK OF
RE8I•DENCE:;1IN, PREPARATION'•FOR' REMODEL.'
2010,:: CODES'..
Fee 'summary Charged-. Paid
Credited
Due
- -.---------------- -----
Permit Fee Total 45.00:.
----------
00
----------
.00
45.00.
Plan•Check Total :00
.00
00.
.00,
Grand Total 45:00
.00
.00
45.00
LQPERMIT
Bin #
'..ityof � Quinta
Building & Safety Division .
P.O. Box 1504, 78 495 Calle Tampico
La Q uintai CA 92253•-.(760)777-7012
Building -Permit Aoplidkion. and Tracking- Sheet
Permit #
Project Address:
Owner's Name: Y - e e
A. P. Number:
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..Address:JV
Legal Description:
City, ST, Zip:
Contractor
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Address:
Project:Descriptii n:
City, ST, Zip:
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Telephone:
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State Lica# :
.City Lic.4.
Arch., Engr., Designer:
Address:
City, ST, Zip:
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Telephone:,Construction
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Type: Occupancy:
',
State Lic. #:"i
' Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:.
# Units:
Telephone # of Contact Person: "
Estimated Value of Project:.
APPLICANT: DO NOT• WRITE BELOW :THIS •LINE {:
# -
Submittal
Req'd
Rec'drI-
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed;.ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cales.
---Plans picked up
Construction
Flood plain plan
`Plans resubmitted
Mechanical
Grading plan
2°".RevIcw, ready for corrections/ issue
a
Electrical
Subcootactor 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.correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.Y.P..
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permiffees