05-4487 (RER)V_
Io
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
05-00004487
Property Address:
5-4325 AVENIDA JUAREZ
APN:
774-232-015-4 -000000-
Application description:
REMODEL - RESIDENTIAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
2400
Applicant:
Architect or Engineei
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Pro essionals Code, and my License is in full force and effect.
License Class: B ense No.: 807363
Date: A ont
' ractor. 9
O NER-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 toits 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 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.).
(_) 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 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.&P.C. for this reason
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:
LQPERMIT
Owner:
PIERRE MONIQUE JEAN
54325 AVENIDA JUAREZ
LA QUINTA, CA 92253
Contractor:
ROHR CONSTRUCTION, KURT
45604 QUAILBRUSH
PALM DESERT, CA 92260
(760)409-3501
Lic. No.: 807363
VOICE (760) 777-7012
FAX (760) 777-7011.
INSPECTIONS (760) 777-7153
Date: 10/06/05
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:
Carrier EXEMPT Policy Number EXEMPT
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 beco subject he workers' compensation provisions of Section
370 of the Labor Code, I s I rthwit ply with those provisions.
Date: Applicant:
WARNIN AILURE TO SECURE RK RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
1A �IN
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 Ouinta, 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. 1 agree to comply with all
city and county ordinances and state laws relating to building constructiorr and hereb IF authorize representatives
of this cou y to enter n the above-mentioned property for inspe o urposes.
D
a,le. Signature (Applicant or Agent): ,r,
Application Number . . . . . 05-00004487
Permit . . . BUILDING PERMIT
Additional desc.
Permit Fee . . . . 23.00 Plan Check Fee
14.95
Issue Date . . . . Valuation . . .
. .866
Expiration Date 4/04/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
4.00 2.0000 HND BLDG 501-2,000
8.00
----------------------------------------------------------------------------
Permit . . . ELECT - ADD/ALT/REM
F_ Additional desc . .
Permit Fee . . . . 16.50 Plan Check Fee
4.13
Issue Date . . . . Valuation . . .
. 0
Expiration Date 4/04/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
2.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
=----------------------
1.50
-------------- 7 --------------------------------------
Special Notes and Comments
40 LF 5' BLOCK WALL PER ORCO
SPEC/REPAIR EXISTING DOOR/NEW ELECT
LIGHTS/REPLUMB SPRINKLERS.
---------------------------------------------------------
Other Fees . . . . . . . . . ENERGY REVIEW FEE
1.50
Fee summary Charged Paid Credited
-----------------
Due
-----------------------------------------
Permit Fee Total 39.50 .00 .00
39.50
Plan Check Total 19.08 .00 .00
19.08
Other Fee Total 1.50 .00 .00
1.50
Grand Total 60.08 .00 .00
60.08
19
LQPERMYr
Bin #
City of La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
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Project Address:
A. P. Number:
Owner's Name: e �
Address: S
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Legal Description:
City, ST, Zip: C(b
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Contractor: (a 7 h
Address: LfCj `
Telephone: a
Project Description: A
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Telephone
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State Lic. # : 0
City Lic. #:
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Arch., Engr., Designer:
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Address:
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City, ST, Zip:
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Telephone:
State Lic. #•:
Name of Contact Person:
Construction Type: L c ancy:
Project type (circle on. n terepair Demo
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project0kee rjg_
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
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
Energy Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"u Review, ready for corrections/issue
Electrical
Subcontactor 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 corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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Kurt Rohr Construction
45604 Quailbrush Ave
Palm Desert, CA 92260
1 Bill To I
JUAREZ JOB
MONIQUE JEAN PIERCE
54325 JUAREZ
LA QUINTA, CA 92253
P.O. No. I Terms
Invoice
Date Invoice #
L— 10/4/2005 54
Project
Quantity
Description I
Rate (
Amount
1
BLOCKWALLS ................................................install two 12" x 12" columns on north
i
0.00
east comer of garage, block -wall starting from the second column east 13ft , then
proceeding north 21ft, along front of said property , connecting with existing
blockwall on north side of property,using 6x8x16 dimensional block„ finish to be
plastered ,textured,and colorcoated to match existing if possible. (BLOCKWALL
BEING OF ORCO DESIGN AND FIVE FEET HIGH)
PLUMBING ......................................................cap or move sprinkler lines according to
I
0.00
the necessity of existing landscape.
ELECTRICALfrom existing exterior
lhtto
0.00
I
I 0.00
the to of each column and install lights
garage g p provided by customer.
DOORS............................................................ or remove exterior utility door (
( 0.00
0.00
total replacement of door if needed an additional $150.00 dollars) .
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TOTAL COST OF PROJECT $2400.00 DOLLARS (ALL PERMITS AND FEES
2,400.00
I
2,400.00
1
INCLUDED)PROJECT TO START IMMEDIATELY, PAYMENT SCHEDULE AS
I
AGREED.
I
Thank you for your
business.
J
Total
$2,400.00
JI
Bin #
City of La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
o
Permit #
Project Address: 2
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Owner's Name:
A. P. Number:
Address: :S
Legal Description:
City, ST, Zip: Ln Qs., 9 22
5 3
Contractor:
�u �-
Telephone:
Address: Lf.5 IOV
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Project Description:
C,-�a,
City, ST, Zip:
Q
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Telephone t��
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State Lic. # : (0
Arch., Engr., Designer:
. City Lic. #:i
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Address:
,
N
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City, ST, Zip:
I
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Telephone:
k t
Construction Type: c ancy:
State Lic. #:
Project type (circle on. n terepair
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'd
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 Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
-
School Fees
Total Permit Fees
evY�e
A RE—INSPECTION FEE
c WILL BE CHARGED IF THE APPROVED
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