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08-0567 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 08-00000567 Property Address: 61634 TULARE LN APN: 764-280-999-111 -300237— Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 19000 Applicant: 4t a&W111 Architect or Engineer: n � N BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: DIXON RESIDENCE 61-634 TULARE LA QUINTA, CA 92253 Contractor: WESTLAKE LANDSCAPE P.O. BOX 5175 LA QUINTA, CA 92248 (760)258-9684 Lic. No.: 857801 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/07/08 -----------------------------------------------------------------------7------------------------- 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 Clas C27 License No.: 857801 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is c9 ,gyp issued. Dale:Contrac[o�r: �l. WvCl _ I have and will maintain workers' compensation insurance, as required by Section 3700 of•the Labor 4 - ' . ` 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 fromthe'Contractor's State License Law for the Carrier NAVIGATORS INS Policy Number WEN004285-01 ' 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 twpecome subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licerised;pursuantao the provisions of the Contractor's,5tate arid, 6gree that, if I should become subject to the workers"compensation provisions of Section License Law (Chapter 9 (commencing. with Section'7006)r6f Division 3 of the Business and Professions Code) or 3700 of the Labor Cod�all foghwith comply with those provisions. - 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 acivil penalty of'not more than five hundred dollars ($500).: (_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intendedor 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 1, 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 town owner of property who builds or improves thereon, and who contracts for the projects with a contractors) 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 l WARNING. FAILURE TO RE WORKE 'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT.AN EMPLOYER TO CRIMINAL P ALTIES'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 forthon 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 cour�ty t9 enter upon the above-mentioned property for inspeclo purposes. r) 1 Application Number . . . . . 08-00000567 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 198.00 Plan Check Fee 128.70 Issue Date . . . . Valuation . . . . 19000 Expiration Date 10/04/08 Qty Unit Charge Per Extension BASE FEE 45.00 17.00 9.0000 THOU BLDG 2,001-25,000 153.00 ---------------------------------------------------------------------------- Permit . . . ELEC-MISCELLANEOUS Additional desc . . Permit Fee . . . . 17.25 Plan Check Fee 4.31 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/04/08 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 2.25 ---------------------------------------------------------------------------- Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 18.00 Plan Check Fee 4.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/04/08 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments FIREPIT,' BBQ PER APPROVED PLAN Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 233.25 .00 .00 233.25 Plan Check Total 137.51 .00' .00 137.51 Grand Total 370.76 .00 .00 370.76 LQPERn1IT 3 r' 3 Bin # • C<<tY of [:a .Quinta BuildingW Safety Division P.O Box 004,.18-495 Calle Tampico La.Qulnta, .CA 92253 - (76Q•): 777-7012 Building Permlt Application and. Tracking Sheet Permit # Project Address:�20 L 6' U�C�, . Owner.'s Name:. A. P. Number:4. Legal Description: City, ST, Zi :: ' P L Contractor: 'DS C Address: = D City, ST,Zip:/�Q :S Cit Tele h - . p . one:. roject Description: Telephone: State. Lie. # : C ^ i 7 .� 57 8 0.. I.. City «: #: Arch:, Engr. , _ esigner: Address: . City, 'ST, zip: Telephone:Cotistruchon State Lit. #: Name of Contact -Person: Q — ---- Type; Occupancy: Pro;ect,type (circle one): -New Add'n_ Alter Repair Demo SgTFt._.. __. #Stones_..---_ -Units:. . Estimated Value;o�Project Telephone # of ContactPerson: �C� " Z C( Z _ APPLICANT: DO NOT,WRITE BELOW THISIINE'... # Submittal Req'd_ Recd :: . • TRACKING". PERMIT FEES Plan Sets Plan Check submitted / Item Amount Structural Calcs. Reviewed; ready for corrections / Plan Check Deposit Truss Calc§. Called Contact Person rlan Check Balance Energy Cales. :Plans picked up Construction a Floodplain plan,, Plans resubmitted Mechanical Grading. plan 2°'Review, ready for.correctiorisAssue Electrical 3 �gCTORf.± Subcontactor. List 'Called*Contact Person. -plumbing 1 m�zC GranfDeed Plans.picked up S.M.I: H.O.A. Approval Plans resubmitted Grading INHOUSE:- Review, ready for correctionsfis)6 'Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees