05-1823 (AR)11 i
qw��
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T419� 4.4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: \_ 05-00001823
Property Address: 5_4T5_17KVENIDJA VELASCO
APN: 774-251-017-6 _000000 -
Application description: ADDITION - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 79853
I hereby affirm under penalty of perjury that I
Section 7000� of Division 3 of the Business Z
License Class: 13
e:11&ey64Co ct.
Architect or Engineer:
- - - - - - - - - - - - - - - - - - - - - - - - - - - -
ITRACTOR'S DECLARATION
6 provisions of Chapter 9 (commencing with
u 'Crode, and my License is in full force and effect.
nse No.: 833738 .
0 N?!-BULDEFeDECLARAT'ON
m �
I hereby affirm under penalty of perjury that I a 3 pt rom th Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Prof ions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair � ;strSucture, 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
I hat 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, 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, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec
Y044, 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.).
I 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: 1 P<
LQPERMrT
Owner:
CHARLES KLIERE
54353 AVE VELASCO
UNKNOWN, CA 99999
Contractor:
JONES ELITE HOMES, GARY
30665 BAY HILL CT
CATHEDRAL CITY, CA 9223'
(760)641�3765
Lic. No.: 833738 lib�
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/28/05
-LM U__
NOV 23 2005 11
---------------------- - - - - - - - - —
WORKER S COMPENSATION DECLA���
I hereby affirm under penalty of perjury one of the foil N
owing cleclaralto"ns^INCE DEPt
- f6r —worke-rs—Co—mpensa 6-js provided
I have and will maintain a certificate of conseWtt_o_se`1r—insure ti
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 a -re,
Carrier STATE FUND — Policy m4r 00017752006
I certify that, in the performan e of the ork f I W hil this is; issued, I shall not employ any
c f
person in any manner so as to beco e su lec, I a wo=itcompensation laws of California,
su I I
and agree that,.if I should become ' bi t to orkers' compensation provisions of Section
I f It
p,I
3700 of the Libor Code, I Shal or itrki co: with those P&Pvisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENrIVN COVERAGE IS UNLAWFUL, AND SHALL
PENALTIES
'I
SUBJECT AN EMPLOYER TO CRIMINAL I A IL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,000). IN ADDITION TO THE COSTJA COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, 49!ND 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 nd voi . d if work is not commenced
a a 'a '
within 180 days from date of issuance of such permit, a as ation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the abov is I
e I rm ion is or ct. I agree to comply with all
2 ut nz
city and county ordinances and state laws relating to building con truc i n, a h eby authorize representatives
, 't
of this cou� t t �t'above-mentioned property for ins n pu as s.
g a n er upon
Date: gn.tur. (Applicant or Agent):
LQPERMIT
Application Number .
. . . . 05-0000182.3
Permit 'BUILDING
PERMIT
Additional desc
Permit Fee . . . . .
549.50
Plan Check Fee
357.18
Iss�ie Date . . . .
Valuation
79853
Expiration Date
5/27/06
Unit Charge
Per
Extension
�Qty
BASE
FEE
414.50
30.00 4.5000
- - - - - - - - - - - - - - - - - - - - - - - - - -
THOU BLDG
- - - 7 - - - - - - -
50,001-100,000
- - - - - - - - - - - - - - - - - - - - - - - - - - -
135.00
- - - - - - - - - - - -
Permit . . . . . .
ELECT ADD/ALT/REM
Additional desc'.
Permit Fee . . . .
65.94
Plan Check Fee
16.94
Issue Date . . . .
Valuation . . . .
0
Expiration Date
5/27/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1188.00 .0350
ELEC
NEW RES 1 OR 2 FAMILY
41.58'
468.00 .0200
- ------------------------------------------------------
ELEC
GARAGE OR NON-RESIDENTIAL
-----------------------
9.36
Permit . . . . .
MECHANICAL
Additional desc
Permit Fee ; . .
77.00
Plan Check Fee
19.25
Issue Date . . . .
Valuation
0
Expiration Date
5/27/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
2.00 9.0000'EA
MECH
FURNACE <=100K
18.00
2.00 9.0000
EA MECH
B/C <=3HP/100K BTU
18.00
3.00 .6.5000
EA MECH
VENT FAN
19.50
1.00 6.5000
----------------------------------------------------------------------------
EA MECH
EXHAUST HOOD
6.50
Permit . . . . . . .
PLUMBING
Additional desc . .
Permit Fee . . . .
133.50
Plan Check Fee
.33.38
Issue Date
Valuation . . . .
0
Expiration Date
5/27/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
8.00 6.0000
EA PLB FIXTURE
48.00
9.00 6.0000
EA PLB ROOF DRAIN
54.00
LQPERMIT
LQPERMIT
Application Number .
. . . . 0'5'-00001823
Permit . . . . . .
PLUMBING
Qty Unit Charge
Per
-Extension
1.00 7.5000
EA PLB WATER
HEATER/VENT
7.50
1.00 3.0000
EA ' PLB WATER
INST/ALT/REP
3.00
2.00 3.0000
EA PLB GAS PIPE
1-4 OUTLETS
6.00
7 ------------------------------------------------------------------------
Special Notes and Comments
remodel addition 1188
new , garage 468
patio 205.code case.see JACKIE
MISURAEA.November 14,
2005 8:03:43 AM
jjohnson
------------------------------------------------
Other Fees'
ENERGY
7- 7 ------ 7 ------------------
REVIEW FEE
35.72
STRONG
MOTION (SMI) RES
8.281,
Fee summary Charged Paid
--------------- ---------- I
Credited
Due
--
Permit Fee Total
----------
825.94
---------- --------
.00 .00
825.94
Plan Check Total
426.75
.00 .00.
426.75
Other Fee Total
44.00
.00 .00
44.00
Grand Total
1296.69
.00. .00
1296.69
LQPERMIT