10-0800 (BLCK)Bin #
City of LA Quint'a
Building 8i' Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta,.CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
V
Project Address: -j 1 b $O 'IrC,: 'Por-. ((�r� dQ.
Owner's Name: �� tem 2 ► o r'o o
A. P. Number:
Address: 1 6gQ ,`r m4 /�f7rv2.
Legal Description:
City, ST, Zip: tj �91Z211 3
Contractor: k.
Telephone: 1
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Address: -1 o Q
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PQ Sto �¢,r R,Q
Project Description:
City, ST, Zip:P Qom; f CA- QZzs"3
tc �
�ne:
Telephone: o �i 6 l
ftow f
State Lie. #
Arch., Engr., Designer:
9t C! City Lie. #..
( _C,4Y JC-_Q_ p� Q _
Address:
City., ST, Zip:
Telephone:
Con tr
s ucti n T e:
o yp Occupancy:
Lie. #:
PStato roJe ct type (circle one): New Ad ' o Alter Repair
Demo
Name of Contact Person:
,
[4
. .
#Stories:
#Units:LqFC.;01
Telephone # of Contact Person: -16 o i 6 -12-0
Estimated Value of Project:. i.700
I APPLICANT: DO NOT WRITE BELOW THIS LINE
4
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
I '
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
(
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue
Electrical
„F?�e�
Subcontactor List
I
Called Contact Person
Plumbing
. Grant Deed
I
Plans picked up
S.M.I.
H.O.A. Approval
i r
Plans resubmitted
Grading
IN HOUSE:-
I
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
j
Date of permit issue
to
School Fees
"
Total Permit Fees
u��,r,ved,tcua,
, _ 4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
c 0 0` 9 6 00800
Property Address:
77680 TRADITION DR
APN:
658-130-011-12 -31379 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1500 ,
Applicant:
Architect or gineer:
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 Lic a No.: 942804
Date: s 2r'10.Eontractor.._
Cr.. NER- UILDER 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 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 _ I 1 am exempt under Sec. , BAP.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:
LAVARATO RESIDENCE
77680 TRADITION DRIVE
LA QUINTA, CA 92253
(403)827-2140
Contractor:
KOMPLETE INC
79409 PASEO DEL REY
LA QUINTA, CA 92253
(760)625-6720
Lic. No.: 942804
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/25/10 .
D �
.AUG 2 2010
CITY OF LA QUINTA
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 GUARD INS Policy Number KOWC110176
_ 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 to the wo cers' compensation provisions of Section
3700 of the Labor Code, I shall for it comp) ith those provisions.
Date: ��- Applicant:
WARNING: FAILURE TO SECURE W KERS' OMPENSATION 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 constructio ^d hereby authorize representatives
of this county to enter upon the above-mentioned property for inspecti purposes.
,RDate :6�0 Signature (Applicant or Aggnt):
'Application Number 10-00000800
Permit . . . ELEC-MISCELLANEOUS „
Additional desc'.
Permit Fee 15.75 Plan Check Fee
3.94
Issue Date Valuation
0
Expiration Date 2/21/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 .7500 PER ELEC.DEVICE/FIXTURE 1ST 20
.75
Permit . . PLUMBING
Additional desc .
Permit Fee . . 21.00 Plan Check Fee
5.25
Issue Date Valuation,
0
Expiration Date -2/21/11
Qty _ Unit Charge. Per
Extension
. BASE FEE
15.00
1.00 6.0000 EA PLB FIXTURE
6.00
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee 15.00 Plan Check Fee
.00
Issue Date . . . . Valuation... . .
. 480
Expiration Date 2/21/11
Qty 'Unit Charge Per
Extension'
BASE FEE
15.00
Special Notes and Comments
30 LN X,4 FT•HT BLOCK WALL CITY STANDARD
(1) ELECTRICAL FIXTURE & (1) PLUMBING
FIXTURE PER APPROVED PLANSA & S.T.
-----------------------------------------------------------------------------
Other Fees . . . . BLDG SIDS ADMIN (SB1473)
1.00.
Fee summary Charged Paid Credited
Due
Permit 'Fee Total 51.75 00 .00
51.75
Plan Check Total 9.19 .00 .00
9.19
Other Fee Total 1.00 .00 .00
1.00
Grand Total. 61.94 .00 .00,
61.94
LQPERMIT
EXISTING. PATIO WALL EXISTING PILASTER
TO REMAIN
' 12'-6" 4 1 T.-3 1/2"
--,i
- EXISTING PATIO WALL
TO BE DEMOLISHED
NEW PATIO WALL
0
N
. OUTDOOR POWER OUTLET (GFI) •
/. NEW PILASTER
7, SIZE.& STUCCO
TO MATCH EXISTING
Existing open patio to remain 144 SQ.FT.
Proposed) open patio to enlarge 254 SQ.FT'
TOTAL openpatio 398 SQ.FT.
OUTDOOR TAF]CITY OF LA QUINTA .
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DA - S' (C9 .
®, object:
TEAM
wrk no. 07-10 Drown by: Madis Karo
KOMPLETE
Date: 8/1912010 alent:
KOMPLETE INC. La Quinta, 92253 CA Drawing name: Drawing scale: 3H s" = r -o•
teamkomplete@gmail.com. • Phone: (760) 625 6720
www.teamkomplete.com Fax : (760) 645 6225. Partial .fl00r plat1 Page q: 112