11-0847 (PLBG)P.O. BOX 1504.
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-0 0_0__0 084 7- 7'
Property. Address: 61210"-TALEA DR
APN: 764-280-004-34 -35996 -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 300
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING. PERMIT _
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: . 8/08/11
Owner:
BAGAUS
61210 TALEA DRIVE
LA QUINTA, CA -92253
Contractor` ! q
DESERT LANDSCAPE ASSOCIAT $� r#''it: i,7 C 2� i `
LQPERMIT -
79405 HWY 111, STE #9, PM 4 7�.
LA QUINTA, CA 92253I (�If� F _iiiNTlA
(760) 399-9600 I r,•,iiA•5+e aFP
Lic. No.. 898417 -� -----
-----------
+- 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 Cl se s: C27 - License No.: 898417 -
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�(—
at�+ $ I( Cr Sctor. - -
issued.
Irhave 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
OWNER UILDER DECLARATION -
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I exemp from the Contractor's State License Law for the
Carrier NORGUARD INS Policy Number DEWC122591
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
700 of the Labor Code, I shall forthwith 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 a civil penalty of not more than five hundred dollars ($500).:
Date: -,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 WOR R ' COMPE SATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES A D CIVIL FINES UP TO ONE. HUNDRED THOUSAND .
and who does the work himself or herself through his or her own employees, provided 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,
_
I—) 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.
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.
Date: Owner: -
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
CONSTRUCTION LENDING AGENCY.. _ - . -
permit to cancellation. _
' - I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
- I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
r -
Lender's Name: _
of t ' co ty to enter upon above-mentioned property r i pection purposes.-
y .
/�
/�
Date: • / nature (Applicant or Agent):
Lender's Address:'
LQPERMIT -
Application Number . . . . .
f
11-00000847
Permit PLUMBING
Additional desc
_
Permit Fee 18.00
Plan Check Fee
4.50
' Issue•Date . . .
Valuation.
0
Expiration Date 2/04/12
.
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
INSTALL 80 L:F. 1" GAS LINE FOR
FUTURE
FIREPIT. 2010 CODES.
------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)�
--------------
1.00
Fee summary Charged
Paid Credited
Due
Permit Fee Total- 18.00
.00 .00
18.00
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
CL G u. 5
(.
OL
OW BRANCHING CDM
4ULTI I-15GA1
NO MOUND'
.CATION
;ALS
FOR
TSC -
_
I
ECTED I
-R .
•
. I
I
I
Bin #
.City of La Quinta
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Q!�
fit' U
Project Address: r
Owner's Name:f '
�ea'/ 4
A. P. Number:
Address:,
Legal Description: LIZ. So3y
City, ST, Zip: �� I �,t -t a 71 2V
Contractor' 1 I
s`M" ;:•>::z «
Telephone:
>i; +:%iliijv 4. :•: YLvY.4l:i: {ry!ii:%:
Address: LfDS How
Project Description:
City, ST; Zip:
Telephone: � G j 3 Fc6 o o
.Y•i'i.ti�i;i�Q::C�j�>ni�.t;'lFi;;C$rw,4:;jl:.
4:.at. ry:;• >.;; ;s::::..::::.:..nr.r r';:<;:;; . ,:.;£'
State Lic. # :97PI-177
City Lic. #•-
Arch., Engr., Designer: JDA 0-1) -�
Address:coo St V t ?
City., ST, Zip: ` S
Telephone: b 5 D ?Y
< >s s "s" r
N;;:; "»% %!`%> < <::<<
:r;:;�;:.: �>:r;;�r�::;::::,.,,4;:,,,.,: f.;, ;,,:;;,;.
Construction Type: ► le LJ Occupancy:
State Lic. #•
Project type (circle one): New . Add'n Alter Repair Demo .
Name of Contact Person: To e�-toqdb
Sq. Ft.: 0
# Stories:
# Units: -
Telephone # of Contact Person: 76o 714 0,2 7
Estimated Value of Project: X60. r
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections '
Plan Check Deposit
Truss Calcs.
A
Called Contact Person
Plan Check Balance
Title 24 Calcs.
,
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
'21' Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees