The URL can be used to link to this page

05-2943 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 05-00002943 - 78460 COYOTE CANYON CT 770-240-012- - - STRUCTURES OTHER THAN BUILDINGS LOW DENSITY RESIDENTIAL 5400 aN mA c 1-0/c Architect or BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED 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: B Lice No.: 799449 ✓ Date: 7� 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.). (_ 1 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.). 1 _ 1 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: DEWEESE JOHN A 78-460 COYOTE CANYON COURT LA QUINTA, CA 92253 Contractor: JACOBS HOMES INC, PETER P.O. BOX 692 LA QUINTA, CA 92247 (760)777-9921 Lic. No.: 799449 VOICE (760) 777-7012 FAX (760) 777-7011 .i) INSPECTIONS (760) 777-7153 Date: 7/15/05 ----------------------------------------------— 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. 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 HRH INSUR Policy Number 176983305 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 work e 'compensation provisions of Section �.�/! 700 of the Labor Code, I shall forthwith mply 't hose provisions. ..Bate: �� 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 t above information is correct. I agree to comply with all city and county ordinances and state laws relating to ilding construction, and hereby authorize representatives of this county t enter upon the above-mentioned operty for inspection purpose D e: Signature (Applicant or Agent): Application Number . . . . . 05-00002943 Ij Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 81.00 Plan Check Fee 52.65 Issue Date . . . . Valuation . . . . 5400 Expiration Date 1/11/06 Qty Unit Charge Per Extension BASE FEE 45.00 4.00 9.0000 --------------- : THOU BLDG 2,001-25,000 36.00 . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee . . 17.70 Plan Check Fee 4.43 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/11/06 Qty Unit Charge Per Extension BASE FEE 15.00 6.00 .4500 ---------------------------------------------------------------------------- EA ELEC DEVICE/FIXTURE >20 2.70 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 24.00 Plan Check Fee 5.25 Issue Date . . . . Valuation 0 Expiration Date 1/11/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 , 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments BUILT-IN BBQ. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 5.27 Fee summary Charged Paid Credited ---------- Due'. --------------------------- Permit Fee Total -------------------- 122.70 .00 .00 122.70 Plan Check Total 62.33 .00 .00 62.33 Other Fee Total 5.27 .00 .00 - 5.27 Grand Total 190.30 .00 .00 190.30 LQPERMIT r Grant Dced Bin 11 Y - City Of La Quint' . Building U Safety Division IN ROUSE:- P.O. Box 1504, 78-495 Calle Tampico Permit # La Quinta, CA 92253 - (760) 777-7012 crStiYi"l�� Building Permit Application and Tracking Sheet ject Address: DN lJN Owner's Name: P. Number: 'Address:'Ig gal •Description: [A. City, ST, Zip: t r:cntrac oTele e• LhonMPSdress: Project Description: City, ST, Zip:was G� _164 I one: e Tch P 1 V State Lic. #: City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: . Telephone: ::::::<:; :;: _:::>::::>;;> ::: Occupancy Construction Type: Lic.Project Repairair Demo . c Iter Name of Contact Person: Sq. Ft.: # Stories: # Units: p� Telephone # of Contact Person: Estimated Value of Project: �— APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Rcq'd 'Rec'd TRACKING PERMIT FEFS Plan Sets Plan Check submitted Item Amount Structural Cates. IRtvitwed, read• for corrections Plan eek Deposit Trusr'Calcs. cd Contact Person Plan Che ' Balance Title 2'4 Calcs: Plans picked hp Constructi0 TA Flood plain plan Plans resu mitttd h tchanical Grading plan o "` orrec co a Electrical f 4 C44ru&_&S Subcontactor List UILAIN I'm Cj altcdQtt. c on Plumbin 1°1C8`i° Grant Dced II.O.A. ApprovalRUGT�� Grading IN ROUSE:- '"' Review adv for corrections/issuer Developer Impact Fee Planning Approval crStiYi"l�� A.i.P.P. Pub. INT's. Appr • Date or permit issue School Fees Total Permit Fees I TOP W/ INET - H PLASTERED /ALL 0. m III b co Gni 2.1 - . L- I -\ �` N PA -� t11 'FoCrTY ol � 4 �� APPROVED ■■• �1� • CONSTRUMION m Allkloilf PROVED ini JI ofession;,' Grill (All Grill) -')Sear burner 445 secondary) ed burners and cleaning' eeo motor and to ad 54 md,h Grill with Prep Center) !rjial of 50,000 BTU's 240 secondary) -'j sealed brass burners s-speedmotor and -I= Built-in Freestanding Description im Island shown for a., As shown ModeIL5430FR28 I im Island shown for a., As shown ModeIL5430FR28 I