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12-0346 (RER)P.O,. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000346 PFoperty Address: 4944-5—AV'ENIDA CLUB LA QUINTA APN: 658-320-016- - - Application description: REMODEL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4000 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: IVAN & DARLENE LEE P.O. BOX 1518 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/06/12 LA QUINTA, CA 92247 Contractor: MC KINNEY CONSTR CO, DONALD E. �''+fs jj R_ !� PO BOX 1165 MORONGO VALLEY, CA 92256, CRY OF I (760)363-9110 �1'r';gi�:1;�jT Lic. No.: 536992 • ------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION - ----------------------------------------------— WORKER'S COMPENSATION DECLARATION I 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. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: B cense No.: 536992 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. fateCantractor• _ 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EXEMPT Policy Number EXEMPT 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 Cod shall forthwith om ly with those provisi ns. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by z .� h _b_ 1 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Data? I Applicant: ( ) 1, 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' COMPENSATIO!COVERAGE D ALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND 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 1, 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, (_ 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnity and hold harmless the City 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 of La Quetta, 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 this county to enter upon the above-mentioned property c inspection purpos S. r Date: I ignature (Applicant or Agent): Application Number Permit . Additional desc . . Permit Fee . . . . Issue Date . . . . Expiration Date . . . . . . 12-00000346 BUILDING PERMIT 63.00 Plan Check Fee 40.95 Valuation . . . . 4000 10/03/12 Qty Unit Charge Per Extension BASE FEE 45.00 2.00 9.0000 THOU BLDG w 2,001-25,000 18.00 ------------------------------ Notes and Comments REPAIR OF EXISTING CHIMNEY TO CONDOMINIUM UNIT. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged ---------- Paid Credited -------------------- Due --------------------------- Permit Fee Total 63.00 .00 .00 63:00 Plan Check Total 40.95 .00 .00 40.95 Other Fee Total 1.00 .00 .00 1.00 Grand Total 104.95 .00 .00 104.95 LQPERMIT CITY OF LA QUANTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTIQIV . �bD_�X�Nt��x� To RA��T�RS► F'�JR, ��d�'D �� GAc-comxw-) -ra powe"fc'WALC. WRAP wITIA T'1LE8A D-RCPLA(-6EX1$Tj&J6r r EA(:5T KYWool> IEVP66 .5-cRe W -S I 3e- t(E , ATtG f t orr TO .-54A O- ' mETAL S FLA541 tAllI 3TANDi-FALLEfq-a4.j"r=V ;994SAWNIIE CLUB I.AQu1NT,0. Bin. #f La Q[d1n Bu11d1ng 8z Safety Division P.O. Box 1504,78-495 Calle Tampico, La.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # '' 11 3�C �- Project Address:. r �- �)� G�Ut3 t j NamK leo Pita} Owner's e:d A. P. NumberAddress: G ScGli� av , Legal Description::. City, ST, Zip: L i U I rc 1 4 Contractor. � , itJ�e ��sr- �� O'y t mCj�L L1C / Telephone: 2p 2QQ> D y23 7 K j Address:%� DS �j E-d CZ 1 lid. ProjectDescnpaon: t 5t£ % Cr(f t RJ S City. ST, Zip: /V-0 ro 0060 1 Ch I P22s6 'L Telephone: '7i6 6 3 6 3 g' j j Q rr?Y� y State Lie. # : 53 City Lie. 9,,/0 702 Arch., Engr., Designer. Address: City, ST. Zip: Telephone: `� _ State Lic. #: w �wrl , Name of Contact Person: Construction Type:. Occupancy: Project type (circle one): New Add'n Al R air Demo Sq. Ft.: L(3 # Stories: #Units: Telephone # of Contact Person:D7r, o • �o ! Estimated Value of Project J70, 0 0 APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calm Reviewed, ready for corrections Plan Check Deposit, . Truss Catcs. Called Contact Person Pian Check Balance. Tide 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted.-. Mechanical Grading plan 2T'! Review, ready for correctionissue Electrical Subcontactor List Called Contact Person Plumbing Gmut Deed Plans picked up S.M.I. H.O.A. Approval Pians resubmitted Grading N HOUSE:- 'o° Review; ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person &LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees • g