08-0172 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA; .CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 08 000.0172
Property Address: 79980 TANGELO
APN: 772-230-024-
Application desceiption: STRUCTURES OTHER THAN BUILDINGS.
Property Zoning: LOW 'DENSITY RESIDENTIAL- .
Application valuation: 500
• Applicant: - ` Architect or Engineer:
Cb
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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: BB�icense novo.: 873958
Date: �-9'G .Contractor.
NER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I arA 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 fora 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.).
(_ ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, BusinessandProfessions Code: The Contractors' State License Law does not apply to an owner of - -
prope-rty. who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
I._ 1 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 fSec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERA1IT
Owner:
BENOWITZ BARRY A
79980 TANGELO
LA QUINTA, CA 92253
(310)619-1831
Contractor: D
TMC COMPANY INC
23382 MADERO STREET #F
MISSION VIEJO, CA 92691
(949)600-7020
Li'c. No.: 873958
C
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/23/08
JAN 29 2008
L
OF LA QUINTA .
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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, asprovided
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 STATE FUND Policy Number 0000904-2006. -
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
fy 3700 of the Labor Code, I shall forthw'th comply withthose provisions. -
Date:. ti'' r•0-% Applicant
WARNING: FAILURE TO SECUR WORK COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI 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. 1 agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby a orize representatives
of this county to enter upon the above-mentioned property for inspectio pos S. -
Date:— tag' Signature (Applicant or Agent):
Application Number 08-00000172
Permit . . . BUILDING PERMIT
Additional desc .
°' •.. Permit:_Fee.: 15.00 Plan Check Fee
9.75
Issue Dates ... Valuation
500
Expiration Date ., 7/21/08
Qty Unit.Charge. Per
Extension
BASE FEE
15.00
Permit . . . ELEC-MISCELLANEOUS
Additional desc .
Permit Fee 17.25 Plan Check -Fee
4.31
Issue -Date Valuation . .
0
Expiration Date 7/21/08
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 . 7/21/08
' 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
STEEL STUD BBQ ISLAND PER APPROVED PLANS
Fee summary. Charged.- Paid Credited
Due '
- - ------ - - - - ------ - - - - --
Permit Fee Total 50.25 .00 .00
---- - - - - - -
50.25
Plan Check Total 18.56 .00 .00
18.56
Grand Total 68.81 .00 .00
68.81
LQPERMIT' - -
.
Bin #
_ City of La 'Quinta '
Building & Safety Division -
P.O.' Box 1504,, 78-495 Calle Tampico), _
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking -Sheet
Permit .#
Project Address:` '71 -kA—tlFL
Owner's Name: G�7i� .ai�2 `13f3T1Ow'IT2
A. P. Number: -7 -J �P ' �- 3 D p 2 = 3 `
Address: —7 9 — 15 d. 1z1 Q
Legal De's'cription: `Lo t- Z Nl$_ al "
Contractor: _DV/ C- CoMA", :1� G
City; ST, Zip: L Qv/.;� CA- f z Z S 3
Telephone:'3 I C) ` lcl 1831
Address -,-2_ ?j a -2VY1� SvrrtZ
,3 r4D �A,ST
Project Description: ST�li�LL S 7 U1�
t'
n
City, ST, Zip: %.S S
Telephone: 1 I - &00 -7OZ
State Lic; # : LLQ City Lic #: I b 213
Arch.,'Engr., Designer: C✓-�2a 0S,' LI �S
Address: 3662,S7- 0I,PO TLLMS L.10i -Qk192
City, ST, Zip: CA- �i Gid:. tLZ3
. " r
Telephone: 32 -7 2-7 I
Construction Type`. Occupancy:
State Lic: #:.
Project type (circle one New ' Add'n� Alter Repair Demo
'Name of Contact Pelson: Sj-}1� 1,J. LO L
Sq. Ft.:
# Stories:'
# .Units:
Telephone # of Contact Person: { 3S ' 39
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW.THIS LINE •
#
Submittal
Req'd -
Rec'd .. TRACKING .
y PERMIT FEES
Plan Sets
Plan Check submitted
Item .
Amount
Structural Coles.
Reviewed; ready for corrections.,
Plan Check Deposit
Truss Calcs.
Called Contact Person
-Plan Check Balance
Energy ,Calcs.
Plans picked up
-Construction `
Q
Flood plain plan ,
Plans resubmitted
Mechanical
Grading plan
26d Review, ready for corrections/issue :
Electrical,
Subcontactor List
Called *Contact Person.
Plumbing
_
Grant Deed
Plans. picked up
S.M.I. r'
-
H.O.A. Approval
Plans resubmitted I.
G�,diggi.
IN HOUSE:-
''' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue-
ssueSchool
SchoolFees
OF ►+ °
RL ILt)ING &
Total Permit Fees *
`
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CONSTRUCTION
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