05-4993 (RER)P.O. BOX .1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:..
Property Zoning:
Application valuation:
Applicant:
05-0.0004993
53605 AVENIDA CORTEZ
774-101-004-4 -000.0100-
REMODEL - RESIDENTIAL
COVE RESIDENTIAL
15000
Architect or
Tit!t444"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjurythat'], am licensed under provisionsof Chapter 9 (commencing with
Section 7000) of Division of the Businass`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. exempt from the Contractor's:State License Law for the
following reason (Sec. 7031.6, 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
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
tha she is.exempt therefrom and the basis for the alleged.exemption. Any violaiion,of Section 7031.5 by
any plican,
fora permit subjects the:epplicartt to a civil penalty, of not more than five hundreddollars (8600).:
(_) I, as owner of the, property, or my employees withwagesas 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
improvemenware not intended or offered for, sale. if, however, the building or impiovemertt 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 construcrthe,project iSec.
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 contractors) licensed
pursuant toAhe Contractors' State License Law.).
(_) I am exempt under Sec. - ; 8:&P.C. for -this reason ,
Date:.
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:
LQPERnfrr
Owner:
MACMILLAN RICHARD H
*NOT ON.FILE
UNKNOWN, CA 99999
Other struct info . . .
Contractor:
Owner
DITION
2001 CBC
VOICE (760) 777-7012
FAX (760) 777-7011
.INSPECTIONS (760) 777-7153
C
------------------
WORKER'S COMPENSATION DECLARATION
Date: 11/1.0/05
I.hereby affirm under penalty of perjury one of the following declarations:
_ I have and mill 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.
Lheve,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 isissued. My workers' compensation
insurance.. carrier and -policy number are:
Carrier ------=------------Policy Number
t certify that; in the performance of'the .work for which this: permitis`issued, Ishall 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 is o e workers' compensation provisions; of Section
3700 of the Labor" e; I shall w o ply.with those provisions.
Date: %� �� Applicant: -f
WARNING: AILURE TO SECURE WORKERS' COMPENSAT10OVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVI INES 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 underovpursuantto 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 Quints, its,officarsi 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 resultofthis application' becomes null and void if work is not commenced
within 180 days from date of lssuaneeW-such permit, or cessation of'work.for180 days will subject
permit to cancellation.
I'certify that,I have read this application and statethatthe above information is co recta I, agree to comply with all
city and county ordinances'andstate laws relating `to ildingconstr tion, h reby authorize:represemedves
of this county to enter upon the above-mentioned Irrop for,insp n rp S.
Date: Signature (Applicant or Agent):
Application Number 05:-00004993
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . . 162.00 Plan Check
Fee
105.30
Issue Date . . Valuation
150.00
Expiration Date 5/09/06
Qty Unit Charge Per
Extension
BASE FEE
45.00
13.00 9.0000 THOU BLDG 2-,001-25,000
117.00
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . 22.50 Plan Check
Fee
5.63
Issue Date . . . . Valuation
. . .
. 0
Expiration Date 5,/09/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
10.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
-------------------------------------------------------------------------
7.50
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . . 24.00 Plan Check
Fee
6.00
Issue Date . . Valuation
. .
0
Expiration Date 5/09/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 9.0000 EA MECH APPL REP/ALT/ADD
9.00
Permit PLUMBING_
Additional desc .
Permit Fee . . . . 48.00 Plan Check
Fee
12.00
Issue Date . . Valuation
0
Expiration Date 5/09/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
5.00 6.0000 EA PLB FIXTURE
30.00
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
--------------------- -----------------------------------------
Special Notes and Comments
-----------
remodel bathroom, convert one bath to
two.November 10, 2005 9:56:24 AM
LQPERMIT
4-
LQPERMTT
Application Number . . . . . 05-00004993
----------------------------------------------------------------------------
Special Notes and
Comments
jjohnson
Other Fees . . .
. . . . . .
ENERGY REVIEW
FEE
10.53
Fee summary
Charged
Paid
Credited
Due
Permit Fee Total
256.50
.00
.0.0
256.50
Plan Check Total
128.93
.00
.00
12.8..93
Other Fee Total
10.53
:00
.00
10..53
Grand Total.
395.96
.00
.00
395.96
Bin # /
ro
City of La Quinta.
Building U Safety Division
P.O. Box 1504, 78-495 Calle; Tampico.
1.a Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: S ytwn Z
O.wner'sName: �CNAC ANC
A. P. Number:
Address:536 , E
Legal Description:
City, ST, Zip:L0 cA 1a -K-3
Contractor: �.
Address:
Telephone:
Project Description: 8,8 6Y%A, ( jry Q
City, ST, Zip:
•
Telephone:dL
•
State Lie. #
City Lit. #:
Ah AL le
Arch., Engr., Designer:
`
Address:
City, ST, Zip:
Telephoner
State Lic. #:
Name of Contact Person: ri%/LJ
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
F#St6ri es: # Units:
Telephone # of Contact Person: Sij
Estimated Value of Project: t)
APPLICANT: DO NOT WRITE :BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
/0z1J
Item Amount
Structural Calcs.
Reviewed, ready fo corrections
(i
Plan Check,Deposit
Truss Calcs.
-Called Contact Person
11 a
Plan Check Balance
Energy Calcs.
Plans picked up
�r l lO J
Construction
Flood plain plan
Plans -resubmitted
,,
Mechanical
Grading plan
2" Review, ready for correctioissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
I I Grant Deed I I I Plans, picked up i I S.M.L
I H.O.A.-Approval I I I Plans resubmitted • I I Grading ' I
IN HOUSE:- 3' Review,ready for correctionstissue Developer Impact Fee
Planning Approval Called Contact Person
I Pub. Wks. Appr I I I Date of permit issue I I I I
Scbool. Fees
Total Permit Fees
on the following Code Holidays:
New Yea y--- 57" -
Dr. Marti i Luther Kingjr. Day
Labor
2 " pip
19"— • 4
cold water
hot water
2" vent
Drain
2 "pipe
3" pipe
Toilet
I"
9". _ CONSTRUCTION HOURS
A RE INSPECTION October 1st - April 30
Wil 6EN CWGED 1F'tHE APPROVED • 0 p.m.
JOB CARD ARE NOT ON
FOR A SCHEDULED
NO D4CEP'TtONS1
pipe
48"
366
2 " pipe
" pipe
All construction shall comply wiht the 2001 CA Building, Plumbing, Mechanical, 2004
Electrical, and 2005 Energy Codes and all othe local codes and ordinances
All current carrying conductors shall be copper
All electrical recepticals on o4jADiii�� DEBRIS CONTAINER
IS REQUIRED ON THE JOB SITE D MUST BE
There are no light fixtures in MmcramI
DO SO
There are no hot mopping areEM�� AS NECESSARY. FAILURE CONTAINER
pp g .AY CAUSE THE CITY TO
New wall will be bolted DUMPED AT THE EXPENSE OF THE OWNER/
CONTRACTOR:
."day: 8:00 a.m. to 5:00
ay: None
rpment Code Holidays: ,
lot - September 30th
I" - Friday: 6:00 a.m. to 9
r&r. 8:00 a.m. to 5:00
ay: None
rament Code Holidays:.
V ` -- pipe w
42'—
1"
OF LA Q,UINTA
►LDWG & SAFEV
DEPT.
ED
AP P R® CT ION
FOR CONSTfkt
Owners: Michael vezo and Nancy Loar
53605 Avenida Cortez
La Quinta, CA 92253
U
pm.
57"
48"
19"
cold water
129"
185"
CITY OF LA OU aq
BUILDING & SAFEPT.
APP
FOR CONSTRUCTION
DATE_,BY.
hot water
2" vent
0 Drain Current Bathroom Plumbing
2 "pipe Owners: Michael Veto and Nancy Loar
3" pipe 53605 Avenida Cortez
La Quinta, CA 92253
Toilet
0
ClILOF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION,
n/\,TF- BY
88" 95"
-v-�• Wiririg
Light
D GFI
0 *Shower Curtain
OExhaust Fan
Lighting / Swithches
New Walls
All construction shall comply wiht the 2001 CA Building, Plumbing, Mechanical, 2004
Electrical, and 2005 Energy Codes and all othe local codes and ordinances
All current carrying conductors shall be copper
All electrical recepticals on one -20 apm circuit
There are no light fixtures in any tub or shower enclosures
There are no hot mopping areas
?%T {— -;II ka MI*OA
Proposed Plan
Owners: Michael Vezo and Nancy Loar
53605 Avenida Cortez
La Quinta, CA 92253
dow
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their'
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the ,proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They Tare also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:.
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal. Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disabdity'insurance costs and unemployment ,compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these. risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of. Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contracts are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons. professing to be contractors is to secure an "Owner/Budder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The. building permit will not be issued until the verification is returned.
Very truly yours;
CITY OF LA QUINTA
DEPT, OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253 i
(760) 777-7012
FAX: (760) 777-70.11
ER'S SIGNATURE/DA
fy
,s�, (Lr AyeAllm
�Tt
PROPERTY ADDRESS
of 4!'93
PERMIT NUMBER(S)