13-0328 (RER)f
�i
P.O. BOX 1504
78-495 CALLE TAMPICO
LA.QUINTA, CALIFORNIA 92253
Application Number: 13 -00000328 -
Property Address: 78106 CALLE NORTE
APN: 770-011-046- - -
Application description: REMODEL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 100000
Applicant:
Architect or Engineer:
M6
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lic�ensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Pr6fessi nals Code, and my License is in full force and effect.
License Class: 13-C36-C20Lice No:: 480121
KDate:2 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 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:
DEWVEALL.WILLARD/EDYTHE
78106 CALLE NORTE
LA QUINTA, CA 92253
Contractor:
DGH DEVELOPMENT CORPORATION
P.O. BOX 2982
PALM DESERT, 'CA 92261
(760)578-9429
Lic. No.: 480121
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/09/13
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 EX MPT 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 become sub'ct to the workers' compensation provisions of Section
3700 of the L r C e, I all forth it cith those provisions.
'Date.;,-2z'(S Applicant: 111
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 construction, and hereby authorize representatives
of this county to enter upon the above-mentioned pr or i/lnsq\�1cion pur es 1
Date- 24 -13 Signature (Applicant or Agenth \�.�1• /'
Application Number . . . . 13-00000328
------ Structure Information INTERIOR REMODEL
-----
Other struct info . .
---------------------------
. . . CODE EDITION
-------------------------------------------------
2010
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . .
639.50 Plan Check Fee
415.68
Issue Date . . . .
Valuation . .
. . 100000
Expiration Date
11/05/13
Qty Unit Charge
Per
Extension
BASE FEE
414.50
50.00 4.5000
----------------------------------------------------------------------------
THOU BLDG 50,001-100,000
225.00
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Permit Fee. . . . .
60.15 Plan Check Fee
15.04
Issue Date
Valuation . .
. ... 0
Expiration Date
11/05/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
20.00 .7500
PER ELEC DEVICE/FIXTURE 1ST 20
15.00
67.00 .4500
EA - ELEC DEVICE/FIXTURE >20
30.15
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . .
58.50 Plan Check Fee
14.63
Issue Date . . .
Valuation . .
. . 0
Expiration Date ,.
11/05/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 4.5000
EA MECH VENT INST/ ,DUCT ALT
.4.50
5.00 6:5000
EA MECH VENT FAN
32.50
1.00 6.5000
EA MECH EXHAUST HOOD
6.50
Permit . . .
PLUMBING
Additional" desc .
Permit Fee . . . .
75.00 Plan Check Fee
18.75
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
11/05/.13
Qty Unit Charge
Per
Extension
LQPERMIT
Application Number . . . . . 13-00000328
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
BASE FEE
15.00
9.00 6.0000 EA PLB FIXTURE
54.00
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
Special Notes and Comments
INTERIOR REMODEL THROUGHOUT ENTIRE
DWELLING [CONVENTIONAL] THIS PERMIT DOES
NOT INCLUDE CHANGE OUT OF GLAZING, HVAC
EQUIPMENT OR WATER.HEATER. 2010-
010CALIFORNIA
CALIFORNIABUILDING CODES.
May 9, 2013 2:43:32 PM AORTEGA
----------------------------------------------------------------------------
Other Fees. . . . . . . . . . BLDG STDS ADMIN (SB1473)
4.00
Fee summary 'Charged Paid Credited'
Due
Permit Fee Total 833.15 .00 .00
833.15
Plan Check Total 464.10 .00 .00
464.10
Other Fee Total 4.00 .00 .00
4.00
Grand Total 1301.25 .00 .00
1301.25
LQPERMIT
Bin .#
City 0f La Quinta
Buildtn &T Safe Division
.g ty
P.O. Box 1504,: 78-495 Calle Tampico
1a.Quinta, CA 92253 - (760) 777-7012
CY Lrt Building Permit Application and Tracking Sheet
Permit #
I
l
Project Address: Owner's Name:. t '
1 L�
A. P. Number. 7 O Q (v G4 Address: 0
Legal Description: b City, ST, Zip:
Con r Telephone: 4 �d2
AProject Description:® 6 tAl
ity, ST, Zip: v A C�
elephone:
State ic. # :
City Lie'.
Arch., ngr D�ig{teF
Address:
City.,ST,Zip: I'A& WE Q -t- 64R U_
Telephone:7� c�c ?jE^,�gZ Construction Type: Occupancy;^ �. V
State Lic. #:2� ?j Project type c' a one): Ne '
m
Nae of Contact Person: t! . Sq. Ft. # Stories: #Univ:
Telephone # of Contact Person: E V ue of Project
APPLICANT: DO NOT W BELO MQUNE
# Submittal Req'd Reed TRACIONG PERMUTE
Plan Set
Plan Check submitted Item Amount
Structural Calm
Reviewed, ready for corrections Plan Check Deposit. .
Truss Calcs.
Called Contact Person10140 Plan Check Balance
Tide 24 Cales.
Pians picked up Ca traction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2" Review, ready for correctionsfissue Electrical
Subcoatactor List
Called Contact PersonY1umbing
Grant Deed
Plans picked up S.M.L •
H.O.A. Approval-
Plans resubmitted Grading "
IPI HOUSE:-
3" Review; ready for corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person A LP.Y.
Pub. Wks. Appr
Date of permit issue
School Fees '
mit F
(p.W . oft,. �! I q�-
5`vl'L��'� MAR 18 2.013
L' n6o&j oo C%Lz u mit'cFa.+.�is+�ir�iao CITY OF �A QUINTA
COMMUNITY DEVELOPMENT