10-0424 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00000424
Property Address: 61545 TORO CANYON WY
APN: 764 -280 -999 -118 -300237 -
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 4500.
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
CENSE ONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury I am li sed under provisions of Chapter 9 (commencing with
. Section 000).of Division 3 of the Busi a and Pr essionals Code, and my License is in full force and effect.
License lass: C27 License No.: 379421
Date: d C actor:
OWNER -BUILDER DECLARATION
I here y 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 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.).
(_) 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
( ) 1 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: 5/17/10
Owner:
BARRY '
61645 TORO.CANYON W
LA QUINTA, CA 92253
MAY 17 tow
Contractor:
ARTISTIC LANDSCAP INC.C1 0
78206 VARNER RD, PYA LAQ .-i
PALM DESERT, CA 92211 �dE1Aj.
(760)3.60-1395
Lic. No.: 379421
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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 isissu . My orkers' compensation
insurance carrier and policy number are:
Carrier DELOS INS CO Policy Number 03 1 0 5 4
I certify that, in the p orm ce of the work fo?thers'
per tis' sue , I shall not employ any
person in any ma er so s to become su lerk ' c pe ation laws of California,
and agree that, ' I sho d become bje to om ensa �n provisions of Section
3 O➢%�of the L C , I shall f h h cose rovi ' s.
ate 7 s
WARNI G: FAILURE TOS CURE 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 aVew
less th City
of La Quinta, its officers, agents and employees f any act or omission relaork gperformed under or following issuance ofhispert.2. Any permit issued as a result of this applicatio I omes null and void if wm cewithin 180 days from date of issuance of s h rmit, or essation of woray ill bjectpermit to cancellation.
I certify that I have read this application and state the the bove inf a ' is corre .omply with allcity aYrAl_`7�'nature
un'state laws relating t bu' ing cons cti , and y aprese atives
oI 'myabove-mentioned y for in ti purpos
Applicant or
Application Number 10-00000424
Permit BUILDING PERMIT
Additional desc .
-Permit'Fee 15.00 Plan'Check Fee_.
9.75
Issue Date . . . . Valuation
400
Expiration Date 11/13/10
Qty Unit Charge Per
Extension
BASE FEE'
15.00
Permit ELEC-MISCELLANEOUS
Additional desc .
Permit,Fee . . . . 21.00 Plan Check Fee
5.25
Issue.Date . . . Valuation . . . .
0
Expiration Date 11/13/10
Qty Unit'Charge. Per
Extension"
BASE FEE
15.00
8.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
6.00
Permit PLUMBING
Additional desc .
'. Permit Fee 18.00 Plan Check Fee'
4.50
Issue Date Valuation
0
Expiration Date,11/13/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
-------------------
3.00
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Special Notes and Comments
16 L.F. X 6' WALL FOUNTAIN,CITY
STANDARD. -180 L.F. 11/2 " GAS LINE &
ELECTRICAL FOR FIREPIT AND BBQ INCLUDES
8 OUTLETS. 2007.CODES.
------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
.98
STRONG MOTION (SMI) - RES-
.50
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 54.00 .00 .00
54.00
Plan Check Total 19.50 .00 .00
19.50
Other Fee Total 2.48 .00 .00
2.48
Grand Total 75".98 .00 00
75.98
LQPERMIT
Bin #
Qty Of La Quin
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 #
Project Address: ; yl
Owner's Name: A
A. P. Number.
Address:
Legal Description:
Contractor:
Address:
City, ST, Zip: v
Telephone:'
Project Description: VZ�At
City, ST, Zip:.
0—
Telephone: `:' ,
K:
State Lic. #: City Lie. C
Arch., Engr., Designer ) ' 1 (. 'S
6, l
Address: % ZD 6 YAY- e tW �p h1l) s�
City., ST, Zip: L G r}`C 2Z1 I
Telephone: & p h 3 4
State Lic. #:
Name of Contact Person: l e
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:#Stories:
# Units:
Telephone # of Contact Person: !f195 /1/
Estimated Value of Project: 07
APPLICANT:,DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cities.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrcctionslissue
Electrical
Subcontoctor 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 correctionstiissue
Developer Impact Fee
Planning • Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
i
17-0 .., _--
(RAFTING FORM NO.: 101-63
`" I s+ A_ . N I APPROVED BY —
1 i s' CAr, DRAWN BY E/
�6 a1
SAFET
D E161,10 REVISED
FOR CONSTRU i o"' _ e./r
DATSZ-f -17-10 DRAWING NUMBER