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10-0231 (AR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 1 Application Number: 10-00000231 Property Address: 79230 TORONJA APN: 776-260-026- - - Application description: ADDITION - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 34906 Applicant: Architect or Engineer: . P(p BUILDING & SAFETY DEPARTMENT BUILDING PERMIT - Owner: KILGORE LAVERNE G 79230 TORONJA LA QUINTA, CA 92253 Contractor: HOME WORKS, TH�j 31 PENINSULA ¢E ROLLING HILL. F (310)377-9999 Lic. No.: 85769 VOICE (760) 777-7012 .FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/26/10 — — — — — — — — --- — — — - — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — 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: B License No.: 857693 Date: 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 (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).: 1 1 1, 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.). (_) I am exempt under Sec. , B.&P.C. for this reason Date: t� IJ C!<lNS1WUCTION 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 WORKER'S COMPENSATION DE RAT' 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, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -Y issued. , 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 1951107 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 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith co with those provisions. -Date: 7 e ,plicant: ' WARNING: FAILURE TO SECURE RKERS' 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 andrestrictions 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 my to enter upon the above-mentioned property for inspection purposes. te: 7 0 nature (Applicant or Agent): Application Number . . . . . 10-00000231 ------ Structure Information 432 SF ADDTN TO CASITA Construction Type . . . . . TYPE V, UNPROTECTED Occupancy Type . . • . DWELLG/LODGING/CONG <=10 Other struct info . . . . . CODE EDITION 2007/08 energy # BEDROOMS 1.00 FLOOD ZONE no GARAGE SQ FTG .00 PATIO SQ FTG .00 1ST FLOOR SQUARE FOOTAGE 432.00 ------------------------------------=--------------------------------------- 2ND FLOOR SQUARE FOOTAGE .00 Permit . . . BUILDING PERMIT Additional desc 432 SF ADDITION TO CASITA Permit Fee . . . 317.00 Plan Check Fee 206.05 Issue Date . . . Valuation 34906 Expiration Date 1/22/11 Qty Unit Charge Per Extension - BASE FEE 252.00 10.00 6.5000 ---------------------------------------------------------------------------- THOU BLDG 25,001-50,000 65.00 Permit ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . 30.12 Plan Check Fee 7.53 Issue Date . . . . Valuation 0 Expiration Date 1/22/11 Qty Unit Charge Per Extension BASE FEE 15.00 432.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 15.12 Permit GRADING PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date 1/22/11 Qty Unit Charge Per Extension ---------------------------:------------------------------------------------- BASE FEE 15.00 Permit . .'. MECHANICAL Additional desc . Permit Fee . . . . 39.50 Plan Check Fee 9.88 LQPERMIT Application Number . . . . . 10-00000231 Permit . . . . . . MECHANICAL Issue Date . . . . Valuation 0 Expiration Date . 1/22/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 1.00 6.500.0.EA ' MECH VENT FAN ---------------------------------------------------------------------------- 6.50 Permit . . . PLUMBING Additional desc . Permit Fee : 43.50 Plan Check Fee 10.88 Issue Date . . . . Valuation 0, Expiration Date 1/22/11 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 6.0000 EA PLB FIXTURE 18.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.5.0 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ---------------------------------------------------------------------------- Special Notes and Comments 432 SF ADDITION TO EXISTING CASITA IN FRONT YARD. R-3.00CUPANCY, TYPE V -B CONSTRUCTION. 2007 CODES / 2008 ENERGY. ---------------- ----------------------------------------------------------- Other Fees . . . . . . . .". BLDG STDS ADMIN•(SB1473). 2.00 ENERGY REVIEW FEE 20.61 STRONG MOTION (SMI) - RES 2.79 Fee summary Charged Paid. Credited Due Permit Fee Total 445.12 .00 .00 445.12 Plan Check Total 234.34 .00 .00 234.34 Other Fee Total 25.40 .00 .00 25.40 Grand Total 704.86 .00 .00 704.86 LQPERMIT CITY OF LA QUINTA* SUB -CONTRA TOR LIST JOB ADDRESS ?q- a3� PERMIT Ni1MBER /()- o?.� 1 OWNER . /1-60Ae BUILDER . �i51 E �D/�� �o,Ed'S 's shall be Oosted on tha'ob with ild' s c 'o 'C rd- at all times In a co ce. Only persons appearing on this list or their employees are authorized to worl 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 ermit. For each applicable trade, all information requested below must be 'completed by applicant. 'On File' is not an acceptable response. ::::. - Trade / Classrficatior► Contractor >.:. ?,:.;-;.:;:,::: S(ate€:ontrlcte�r's. Lkeltse... :..Pit . Biisineas Licens4;:.::: Company Name Classification License Number Exp. Date Carrier Name Policy Number Exp. Date License Number Exp, Date (e.g. A. B, C-8) (xxxxxx) (xx/xx/xx) (e.g. State Fund. CalComp) (Format Varies) (xx/xx/xx) (xxxx) (xxixx/xx) EARTHWORK (C-12) CONCRETE (C-8)* FRAMING (C-5) :. /�EOM� W o� 8►57 613 �v it e �-uvo. y'S!/ STRUCT. `STEEL- (Gt51) - MASONRY IC•291 PLUMBING (C-361 LATH; PLASTER (C-35) HVAC. (C -20r.::.:' ELECTRICAL. (C-10),:., ROOFING•(C-39)' SAEU .METAL FLO RING GLAZING (047 <> - INSULATION:'(C-21: v SEWAGE DISP& (6-421' PAINTING (6=33) CERAMIC TILE (C-54) CABINETS (C-6) ' FENCING (CA3) LANDSCAPING (C=27) ? POOL IC -S31 _