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
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