13-0757 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4
BUILDING'& SAFETY DEPARTMENT .
BUILDING PERMIT .
Application Number: 13-00000757 Owner:
Property Address: - 79475 TORONJA . ; {
APNi 772-340.-051•- - -
Application description: REMODEL - RESIDENTIAL
-Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 30dOO
Applicant: - Architect orgg, eer:
CURT ASKELSON
79-475 TORONJA
LA QUINTA, CA.92253
D- e
tractor:
JULAO�� RIVENS CONSTRUCTION INC, GL
L O. BOX 13302
M DESERT, CA 92255
CITY OF QUINT' 60) 837-9918
FINANCEDEPT `wT ic. No.. 807645 -
-
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/12/13
------------------------------------------------
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 Busines d 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 Class: B License No.:. 807645
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. '
Date: Contractor:
_ 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
- ' - OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 902363512
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
3700ofthe 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
It
�- � ��—i�
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).`. -
Date: �Z /!?Applicant: L i ✓t�s� `p._/
(_) 1, asownerof the,property, or my employees with wages as their sole compensation, will do the work, and •.
- - - - -
the structure is not intended or offeredfor sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 PENALTIES AND 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 ti
(_ 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 contractors) 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 am exempt under Sec. , B.&P.C. for this reason"
the own&, 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 1 have read this application and state that the above in ation is correct. I agree to comply with all '
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county or nances and state laws relating to building co truc n, and h y authorize representatives
•
of this cou y to ter upon the above-mentioned property for' spe' on S. '
Lender's Name:
y -
Date:. Signature (Applicant or Agent): ,
-Lender's Address:
— -
LQPERMIT
,
LQPERMIT
Application Number13-00000757 .
` Permit ELECTRICAL. 2013
Additional desc .
` Permit Fee 119.15 Plan. Check
Fee -:
.00
Issue Date. Valuation
0
Expiration Date .. 1/08/14
Qty .Unit Charge Per
Extension
5=.00 23.8300 LS ELEC DEVICES, FIRST 20
119.15
PermitMECHANICAL 2013
Additional' desc '.
Permit Fee . . . . 11.92 Plan -Check
Fee
.00
" Issue Date . . . Valuation
0
Expiration Date 1/08/14 v.
Qty- Unit Charge. Per
Extension_
I`. 1.00. ',"11.9200"EA MECH APPL REP/ALT
11.92
Permit REMODEL -2013-"
Additional desc
�.
Permit Fee 21.45 Plan.Check
Fee
.00
Issue Date . . Valuation
. .
0
Expiration Date 1/08/14
r Qty Unit Charge Per
Extension
J.
21.4500 EA MISC REMODEL,, ADDL 500
SF
21.45
Special Notes "and Comments
REPAIR FIRE DAMAGE IN GARAGE AND SMOKE
DAMAGE-IN,ATTIC SPACES. REPAIR AND
REPLACE TRUSSES.REPLACE DUCT .PER 2010.'
" CALIF,BUILDING CODES.
July,12, 2013 9:18:.22 AM jjohnson:-\
-------------
---------------------------------------------------------------
Other Fees : . . . . . BLDG STDS ADMIN (SB1473)
1.00
HOURLY PLAN CHECK
98_.00
' PLAN CHECK, REMODEL
17.16
STRONG MOTION (SMI)
- RES
3.00
Fee summary Charged Paid.: Credited
----------------- - ------
Due
Permit Fee Total 152.52 .00•
.00
152.52
Plan'Check Total, .00 .0.0
.00
.00
Other Fee Total 119.'16 .00
.00
119.16
Grand Total 271.68' .00
.00
271.68
LQPERMIT
Bin #
City of La Quinta 8r
Building Safety Division JUN 1 3 2 �;
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012 CITY OF LA QL II
Building Permit Application and Tracking Shee�tMMUNITY DEVE
Permit #
Project Address:LI-75 c w)
Owner's Name:Address:—Ask e L 07a ,tJ
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone:
``<5 ::`• €:i
Address: Lf qSc:>So N L
Project Description: Ar (:"t r C
City, ST, Zip: [> L A 4 2 .Z 6
C�
Telephone: 4
66 3
L
State Lic. # : g707 6-1 City Lic. #;
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
;w<:»;?<><:;<< ::::::#;::;:;;::;;.:•»,;:
v:z:::;<
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: � �� r i ✓e,J S-
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person: 6 7o, 3q
Estimated Value of Project:-' d
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING PERMIT FEES '
Plan Sets
S
Plao heck submitted
Item
Amount
Structural Calcs.
Reviewed, re y for,corrections Plan Check Deposit
Truss Calcs.
Called Contact Z Plan Check Balance
Title 24 Calcs.
Plans picked up 22 Construction
Flood plain plan
Grading plan
Plans resubmitted Mechanical AV
god Review, ready for corrections ss6e �l Electrical
C
Subcontactor List
Called Contact PersonPlumbing
'1
Grant Deed
Plans picked up S.M.I. 1'
H.O.A. Approval
Pians 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
cl�l�3 ifs �
*I13 ams
4— N Cf Co NI P_44e,1_ 1' S 1,V y-
lif (z, 60,6 C&P- , . �- 13 cry Pr2tty�
JTA
IPMEN.T