07-1068 (SOTB)P.O. BOX 1504-t 4
18-495 CALLEIAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY. DEPARTMENT
BUILDING PERMIT
Application Number:
07-00001068
Property Address:
61436 TOPAZ DR
APN:
764-280-999-149 -300237-
Application description:
STRUCTURES OTHER THAN BUILDINGS
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
5000
Applicant: Architect or Engineer:
Uk
-----------------
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 y License is in full force and effect.
LicenseClas: C27 -'C53 License No.: 847720
Dater Contractor:
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 ISec. 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_) 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 1, 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 contractor(s) licensed
pursuant to the Contractors' State License Law.). '
(_ 1 • 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:
LQPERN11T
s
Owner:
DALLAS &'DANELLE BAER
61-436 TOPAZ DR.
LA QUINTA,'CA 92253
(760)393-2690
Contractor:
GOLDEN FIREFLY ENDER
2.876 SPANISH BAY DRI'
BRENTWOOD, CA 94513
(925)918-0840
Lic. No.: 847720
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:. 4/06/07
1c w u
APR 10 2001
CITY OF LA QUINTA
WORKER'S COMPENSATION 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'
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
insurancecarrier and policy number are:
Carrier STATE FUND ' Policy Number 22900033243
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 became 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 Code, I s I or hwith comply with those provisions.
Date: "� / Applicant:
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 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. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county/o nter upon the above-mentioned property ec io" pu oses.
Date: `� Q Signature (Applicant or Agent):
..Application Number . . . . . 07-00001068
Permit BUILDING PERMIT
Additional desc .
Permit -Fee. 72.00. Plane Check Fee 46.80 .
Issue. Date Valuation 5000
Expiration -Date 10/03/07
Qty Unit Charge Per Extension
BASE FEE 45.00
3.00 9.0000 THOU BLDG 2,001-25,000 27.00
Permit ELEC-MISCELLANEOUS
3.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 2.25
-----------------------------------
Special Notes and Comments
FIREPIT & BBQ ISLAND PER APPROVED PLAN .
Fee summary. Charged Paid Credited Due
-- - - - ------ - - - - ------ - - -- ------ - - - - -- -- - - - - - -
Permit Fee Total 89.25 .00 .00 89.25
Plan Check Total 51.11• .00 .00 51.11
Grand Total 140.36 .00 .00 140.36.
LQPERMIT
B'° #
City of La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit .# /j,
r7.- 1vty:La
Project Address: 6(l49(p OP"9Z ��..
Owner's Name:..�{Qg
A. P. Number:
Address: (O! q 3(o 'lapfl z- Dg
Description:
�d�n�� re tC�eavvUrs�i G
r
City, ST, Zip: Lq�actor:
Telephone:.;koj 3% 3 z(0q Dess:
Project Description: sgo
City, ST, Zip: �t`Y.�wU�r) �4 ' 14*S 13
(Qn')
Telephone: _ q LS 91 9 09#0,
State Lie. # : q7 7 ZD
City Lic. #: 0,3
Arch., Engr., Designer:
Address: ,
City, ST, Zip:
,
Telephone: f �'
State Lic. #: ,� �• "' s i
Name of Contact Personjfz5 0 , Adds
Construction Type: Occupancy:
P cY:
Project type (circle one): •Add'n . Alter Repair Demo •
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 9ZS 9 t q 0 8 t{0
Estimated Value of ProjecO: , avv
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal .
Req'd
Recd
TRACKING. PERMTr FEES
Plan Sets
Plan Check submitted `' Item
Amount
Structural Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Calcs.
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up 'Constructiona
Flood plain plan. •
Plans resubmitted Mechanical
Grading, plan
2od Review, ready for corrections/issue Electrical
J 1?J40
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
Bull r)ihlr% GINTA
Aft CA" rin t Fees
f=ps CO[V,S T oN
SAT _BY 417'
CITY OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESS 6106 l df �Z PERMIT NUMBER. OWNEg �a s B4 of BUILDER �� �t '-
,x .
This form shall be posted on the job with the Building Inspection Card at all times in -a conspicuous place. Only persons appearing on this list .or their employees are authorized to work
on this job. -Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information. requested below must be completed by applicant. "On File" is not an acceptable response.
:::.:.:.:::.....:.. .. ...:.:..::.::..•....:; :. .:. ::.Cit .. Business LicenSe> ...
:: :::::::::.>:.;::;::;:::: rector s License
Trade I Classification Contractor :..::..:.: State..Cont .
Company Name Classification License Number Exp. Date Carrier Name Policy Number Exp. Date License Number Exp. Date
le.g. A, B, C-8) Ixxxxxx) (xx/xx/xx) (e.g. State Fund, CalComp) (Format Varies) (xx/xx/xx) (xxxx) (xx/xx/xx)
EARTHWORK IC -121 —
CONCRETE
TRUCT: `STEEL (G-51)
ASONRY (C-29)
"PLUMBING'(C-16f
K77 7 -
Ti
DRYWALL (C-9)
HVAC.
ELECTRICAL. (C=10)'
RO ' Fill G`
SHEET METAL'(C=431
FLOORING
C UINTA
GLAZING (C-171::: :>
DEPT.
INSULA(C-2) J 1 G
TION
SEWAGE OISP.IC-421. FOR ONSTRU TION
PAINTING (C=33) –
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (043). D
LANDSCAPING (C-27.1.:;:. C,R�li%1il�S , , . Ga�3 h (� 3l '�(Ul n ,1�1 �j a (ptooa
POOL (C-531 �..: cry �TE� E C53 �Z7Uot7�Z0 LIZ
3/ D rd 33Z'13-ZGG7 09 l��1S