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09-0818 (PLBG).P.O. BOX 1504 - 78-495 CALLE TAMPICO LA QUINTA; CALIFORNIA 92253. Application Number: s 09-00000818 - Property Address: 54479 SHOAL CREEK APN: 775-071-046- - Application description: PLUMBING Property Zoning; LOW DENSITY RESIDENTIAL Application valuation: 500 T-4ht 4 4aum& BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: GIL GAUTHIER 54479 SHOAL CREEK LA QUINTA, CA 92253 Contractor: D Applicant: Architect or -Engineer: R & R CONSTRUCTION 72710 HOMESTEAD ROAD PALM DESERT,.CA 92260 �I. (760)285-1308 Ole: Lio. No.: 853195 VOICE. (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/29/09 p a tit 4 o ring 04i,,'TA tYNf:? Ais?�1:.. ----------------------------------------------------------------------------------------------------- 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 Pro essionalsCode, 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 Cl a B . License No.: 853195 - _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is Q issued. ate: iJ 1 tractor: - _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor -O Code, for the performance of the work for which this permit is issued. My workers' compensation AER-BUILDER DECLARATION _ insurance carrier and policy number are: I hereby affirm under penalty of perjury4 at I am exempt from the Contractor's State License Law for the Carrier ' EM PT _ 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 0 of the Labor Code, I shat forthwith comply with those provisions. that he or she is exempt therefrom and the basis for the alleged oxcmption. 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 / ate: 0 A ;cant: 1 _ 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 WARNING: FAILURE TO SECURE RKERS' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, _ SUBJECT) EMPLOYER TO CRI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and whn Anes the work himself or herself through his or her own employees, piuvided 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 I, 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, indemnify 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 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 const tion, and reby authorize representatives of thi %ou ty to nter upo the above-mentioned pro for ins a on purp es. ate: ` C� ignature (Applicant or Agent): LQPERMIT Application Number . . 09-00000818 Permit . . . PLUMBING Additional desc . Permit Fee 18.00 Plan Check Fee 4.50 Issue Date Valuation p Expiration Date 1/25/10 Qty Unit Charge Per Extension BASE FEE 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS ------------------------------------------------------------ 15.00 3.00 Special Notes and Comments INSTALL 13 L.F. 3/4" GAS LINE FOR FUTURE APPROVED APPLIANCE. -LINE TO BE SLEEVED AND VENTED UNDER PATIO COVER. 2007 CODES. -------------------------------------------------- Other Fees BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited -------- ---------- Due ---------- Permit Fee Total 18.00 .00 .00 18.0.0 Plan Check Total •4.50 .00 .00 4.50 Other Fee Total 1.00 .00 .00 1.00 Grand Total 23.50 .00 .00 23.50 LQPERMIT 54 -Lvlq 150-, CItJErrG PC) A NTA7, ') "-,lam POW'S J 1a1�� Y B90 j ENG �ffo. PVC, CeAT't!D CITY OF LA UtNT,"�, BUILDING & SAFETY DEa "f. APPROVED FOR CONSTRUCTION DATE 9 " -a9 BY � A Bin .#• .7 Qty of La Quinta Building &r Safety Division P.O. Box 1564, 78-495-Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit# OR PrLof :_52j,—'4V SUL- 0;�T, '0wiieVs' Name: A. P. Number: ------- --- Ad Sq -419 S C98*, P4A 01 - Legal Description: City; _ST; Zip: Lxur)Q ju.q.-10,53 . C&-G76:e.f C091AV-11101) t-eldphone: r191-620* Address:- Sl to �-hdject Description:T D IJIN)G Flab M.a) ,SitEsl, zip: 7 wow, 1C4,5?gL,-'2,60 G01)4 OA)Wj- o COX46-MPAD 13'-rO !9U Telephone: up OF ,,,StateLic. #: FS3R5 -City Lic:#-, 0633 Arch., Engr., Designer: �Uu AD, 449-16 A fi6a)6 GIAWD OPPORM .VW0 LAD k/ kbAm, A U-,, Fwo j Address: 626 cowismro City., ST, Zip: Telephone: State Lie. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ��s Construction Type: 01,0 Occupancy: Project -New'. Add'n Alter Repair Demo type (circle one): Name of Contact Person: Sq. Ft.: Stori,es: #Unit . s: Telephone # of Contact Person: (Estim;*Ayalqe" _4Prqjqqt APPLICANT: DO NOT WRITE. BELOW THIS LINE # Submittal Req1d RWd TRACKING PERMIT FEES Plan Sets• Plan Check submitted item Amount' Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Titli 24 CaIcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 24d Review, ready for c 'r o rectionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up. S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- "d Reyiew,.ready'for corrections/issue' Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appi, Date of permit issue School Fees Total Permit Fees