13-1571 (SPIN)P.O. BOX 1504
78-495 CALLE-TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00001571
Property Address: 79342 NUEVO DR -
APN: 604-382-002-93 -25953 -
Application description: SPECIAL INSPECTION —
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 0
Applicant: Architect or Engineer:
obfflIZ4.917,
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
4LICENSED 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 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 1.6v (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
,,i�epor she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
p
pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
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.).
V/&J, 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 contractorls) licensed
r0 pursuant to the Contractors' State License Law.).
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 JSec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
EDWARDS ALBERT & DEIRDRE
79342 NUEVO DRIVE
LA QUINTA, CA 92253
(760)777 -09.71 -
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/05/13
10
2013
C17Y opr
�YOFLAOIIIarr
QUINTA
FINANCE Dgp-r
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
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 - - - - - - - - - - - - - - - - - - - - - - - Policy Number
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 become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
Date: ' Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 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 constructiorl, and hereby authorize representatives
of;th�*P�count t ter upo;;Pe-above-mentioned property for inspection purpos
DatE Signature (Applicant or Agent):
Application Number . . . . . 13-00001571
Permit . . . . . . SPECIAL INSPECTION
Additional desc
Permit Fee . . . . 71.50 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 61/03/14,
Qty Unit'.Charge Per
Extension
1.00. 71.5000 -EA MISC SPECIAL INSPECTION
71.50
7 ----------------------------------------------------------------------
Special Notes and -Comments
SPECIAL INSPECTION FOR ELECRTICAL
SERVICE. 2010 CALIFORNIA BUILDING CODES.
Fee summary Charged Paid 'Credited
---------- ---------- ---------- ----------
Due.'.
-----------------
Permit Fee Total 71.50 .00 .00
71.50
Plan Check Total .00 .00 .00
.00
Grand Total 71.'50 .60, .00
71.50
LQPERMIT
I
4
41�
Bin #
Qky of La Quinta
Building &r Safety'Division
P.O. Box 1504, 787495 Calle Tampico.
La Quinta, CA 92253 - (760) 777-7012
�p ligation and Trackin Sheet
Building Permit,,60 _p
Permit #
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1'0 wrier's Name:
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A. P. Number:
Legal Description:
iddress: 7 q,-'� 4Lj-, A/ u v o 2) rl�
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Contractor:
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Address:
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City, ST, Zip:
Telephone:
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State Lie. #
City Lie.
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone:
State Lic. #:
..... .........
t,[ame-o_fContact Person- e j rd r (�. Eo- (A)d
Construction Type: Occupincy:
Project type (circle one): New Add'n Alter Repair
Demo
Sq. Ft.:
# Stories:
TelephopeA,of Contact Person:-'
D, '77 7-,19 47 7
Estimated Value of P *ect:
r0i
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
Req'd
Rcc1d
TRA�K'ING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural CaIcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance.
TitIc24Calcs.
Plans pick eid up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionslissue
Electrical
Subcontactor List
Called ContactPers.on
Plumbing
Grant Deed
Plans picked up
S.M.l.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE--
3rd Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fe6
T6tal Permit Fees
'-5-. V '