Loading...
11-0822 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Ap c&ht 4 4& Q",- - '' � Architect or Engineer: P1 P LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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:yE-(C20 License No.: 878070 te: (�Zt+ 1� ntractor. �c OWNER -BUILDER 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 asigned 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, 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 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- VOICE (760)'777-7012 FAX (760) 777-7011 INSPECTIONS (760)'777-7153 Date-.�1/28/11 Owner: t PEREZ MICHEAL 79408 CALLE SONRISA LA QUINTA CA 92253 t �tiS��� i Contractor: � ..., NICOL CONSTRUCTION COMFA""� 67851 OCOTILLO TRAIL DESERT HOT SPRINGS, CA 92241 (760)567-0397 Lic. No.: 878070 , ------------------------------------------------ WORKER'SCOMPENSATION DECLARATION 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 SCissued. ' 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 STATE FUND Policy Number 1960869 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 subject to the workers' compensation provisions of Section 3700 of the Labor Coo" I.shall forthwith comply with those provisions. ate: 11-4-1 A scant: [./e/ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTQRNF,Y'S FF,F,$. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building. and Safety for a permit'subiect 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 construction, and hereby authorize representatives of this county to enter up the above-mentioned pr pert for inspecti n purposes. ,Date: t~Z `�' ignature (Applicant or Agent): ,� Application Number:—_._11-00000822 Property Address: 79408 CALLE SONRISA APN: 604-392-014-55 -25953 - Application description: REMODEL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 10000 Ap c&ht 4 4& Q",- - '' � Architect or Engineer: P1 P LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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:yE-(C20 License No.: 878070 te: (�Zt+ 1� ntractor. �c OWNER -BUILDER 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 asigned 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, 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 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- VOICE (760)'777-7012 FAX (760) 777-7011 INSPECTIONS (760)'777-7153 Date-.�1/28/11 Owner: t PEREZ MICHEAL 79408 CALLE SONRISA LA QUINTA CA 92253 t �tiS��� i Contractor: � ..., NICOL CONSTRUCTION COMFA""� 67851 OCOTILLO TRAIL DESERT HOT SPRINGS, CA 92241 (760)567-0397 Lic. No.: 878070 , ------------------------------------------------ WORKER'SCOMPENSATION DECLARATION 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 SCissued. ' 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 STATE FUND Policy Number 1960869 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 subject to the workers' compensation provisions of Section 3700 of the Labor Coo" I.shall forthwith comply with those provisions. ate: 11-4-1 A scant: [./e/ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTQRNF,Y'S FF,F,$. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building. and Safety for a permit'subiect 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 construction, and hereby authorize representatives of this county to enter up the above-mentioned pr pert for inspecti n purposes. ,Date: t~Z `�' ignature (Applicant or Agent): ,� Application Number . . 11-00000822 ------ Structure Information 200SF`GARAGE CONVERSION/VB/RES-3 [ENG] ----- Other struct info . . . . . CODE EDITION 2010 # BEDROOMS 1.00 Permit ELECT = ADD/ALT/REM Additional desc . Permit Fee 22.00 Plan Check Fee Issue Date Valuation 0 Expiration Date 5/15/12.'. . Qty Unit Charge Per. Extension BASE FEE 15.00 200.00 .0350 ELEC NEW RES - 1 OR -2 FAMILY' 7.00 Permit BUILDING PERMIT Additional desc Permit Fee 117.00 Plan Check 'Fee 76:05 Issue Date Valuation 10000 Expiration Date 5/15/12 Qty Unit Charge Per Extension BASE FEE 45.00 8.00 .9. 0000 -------------------------------------=------------------------------------=- THOU BLDG '2; 0.01-25, 000 72..00 _ Permit MECHANICAL Additional desc . Permit Fee 26.00 Plan Check Fee 6.50 Issue Date Valuation 0 Expiration Date 5/15/12 Qty Unit Charge Per Extension BASE FEE 15:00 1.00 4.5000 EA. MECH VENT INST/ DUCT ALT 4.50 1.00 6.5000 EA MECH VENT FAN 6.50 Permit PLUMBING-, . Additional desc .. Permit Fee 36.00 Plan Check Fee 9.00 Issue Date Valuation 0 Expiration Date 5/15/12 y Qty Unit Charge Per Extension BASE. FEE 15.00 LQPERMIT ' LQPERMIT Application Number 11-00000822 Permit . . . . PLUMBING Qty Unit Charge Per Extension 3.00 6.0000 EA: PLB FIXTURE 18.00 1.00 3.0000 EA PLB WATER INST/ALT/REP. 3.00 Seciand Comments 200SFaGARAGESCONVERS ON/VB/RES-3/CLASS A -FR [ENGINEERED] PLANS APPROVED WITH COMMENTS - SEE OFFICE COPY FOR ANY DISCREPANCIES. THIS PERMIT DOES NOT INCLUDE ADDITIONAL HVAC EQUIPMENT. 2010 CALIFORNIA BUILDING CODES. November 17, 2011 4:14:24 PM AORTEGA --------------------------- ----------------------------------------------- Other Fees . . . . . . BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 7.61 STRONG MOTION (SMI) - RES 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 201.00 .00 .00 201.0.0 Plan Check Total 97.05 00. .00 97.05 Other Fee Total 9.61 .00 .00 9.61 Grand Total 307.66 .00 .00 307.66 LQPERMIT