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12-1389 (SOTB)4 ~ P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 11/29/12 Application Number: 12-000013 8 9. Owner: Property Address: 78195 CALLE NORTE LANDMARK LAND CO OF CALIF INC APN: 770-011-024-1 -18767 - P O BOX 1000 Application description: STRUCTURES OTHER THAN BUILDINGS LA QUINTA, CA 92253 D /1 Property Zoning: MEDIUM DENSITY RES Application valuation: 173 Contractor: Noy,? 9 2012 Applicant: Architect or Engineer: FRENCH CONSTRUCTION INC 7 0 5 SUNNYS IDE AVENUE CITY OF LA UUINTA REDLANDS, CA 92373 FINANCEDEpr (909)841-1379 Lic. No.: 667383 ---------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION 1 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. _ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: B -i n�o�; 667383 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. /te: 11 I Z ontractor: 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 0 ER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty.of perjury that I am xempt from the Contractor's State License Law for the Carrier STATE FUND INS Policy Number 1967263 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this.permit is issued, I shall not employ any construct, alter, 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 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I hall forthwith comply w' t those provisions.' 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).: Date: t/�Z plicant: (_ 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 WARNING: FAILURE TO SECURE WORKERS' COM—PE ATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ND CIVIL FINES UP TO ONE HUNDRED THOUSAND 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 ACKNOWLEDGEMENT (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions 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 made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_) I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City ff' d I f t r omission related to the work bein 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: ti kw LQPERMIT of La Qumta, is o kers, agents an emp oyees or any ac o g 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 cor ct. I aocof to co ply with all city and county ordinances and state laws relating to building constr ction-a\ d her by or ze rep esentatives o this county to enter u n the above-mentioned property foc: s ection purposes. Dated L ignature (Applicant or Agent)' _ Application Number . . . . . 12-00001389 Permit BUILDING PERMIT Additional desc . . Permit Fee . . 15.00 Plan Check Fee 9.75 Issue Date . . . . Valuation . . . . 173 Expiration Date 5/28/13 Qty Unit Charge Per Extension BASE FEE ---------------------------------------------------------------------------- 15.00 Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee . . . . 33.50 Plan Check Fee 8.38 Issue Date . . . . Valuation 0 Expiration Date 5/28/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 18.5000 EA ELEC SVC <=600V/<=200A 18.50 ---------------------------------------------------------------------------- Special Notes and Comments INSTALL 100 AMP PEDESTAL., 8 L.F. 5' GARDEN WALL STUCCO FINISH TO CONNECT - EXISTING PIECES, CITY STANDARD, 60 L.F. 18" GARDEN WALL. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE .98 Fee summary Charged Paid Credited --------------------------------------------------------- Due .Permit Fee Total 48.50 .00 .00 48.50 Plan Check Total 18.13 .00 .00 18.13 Other Fee Total 1.98 .00 .00 1.98 Grand Total 68.61 .00 .00 68.61 LQPERMIT r Bin .# A City of La Quinta Building a Silky DMObn P.O. Box (504,76-495 Calle Tamptco L4.Quinta, CA 92253 -:(760) 777V0I2 Building Permit Application'and.Tracking Sheet Perinit # li' Project.Address* -16 45 G� I It Nori-e- 'Owner's Name:. A. P. Number. )6-0 k 0 Address: AA1t) Legal Description: City, ST, Zip: Contractor. FreA)� cojv-qmu,&noA1 C Telephone: Address: '7)SStVQJ�kJS L& Project Description: City, ST, Zip: z-:3123 W AAA Telephone:,Fo�-gw-// —13-2 State Lic. 4: City Lie'. M. )0 0 Ct u'A Arch, Engr., Designer. S+L(L V 1Sk", to Address: I&F OF Aish csdLsklei-) City., ST, Zip: Telephone: Construction Type: Cype: Occupancy. State Lic. #: Project type (circle one): New Add'n. Alter Repair Demo Name of Conma Person: Sq. FL: 9 Stories: 0 univ: Telephone # of Contact Person: Estimated VaNe of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd 'RecId TRACK NG PERMIT FEES - Plan Sets Plan Check submitted item Amount Structural. Calm Reviewed, ready for corrections Plan Check Deposit. Truss C21cs. Called Contact Person Plan Check Balance. Tide 24 Calm Plans picked up Construction: Flood plain plan Plans resubmitted, Mechanical 7— Grading plan r' Review, ready for correctioustissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading* IN HOUSE-, 3d Review; ready for carrectianslissue Developer Impact Fee Planning Approval. Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees e DEMOLITION PLAN SCALE: 1B'= Al , . W � M C►Ty OF LA Ql1B Tq BUILDING & SAFETY EPT. 23'-0' rte► r -r stoat. rwt.. F0 p ROVED RUCTION DATE %� 14y 4 REVISIONS SHEET TITLE: ---------------- DEMOLITION, NEW ELEVATIO NEW FLOOR A m DRAWN RG. F.S.R. Mom, 2012 /`A1 C