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09-0270 (AR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 09-00000270 Property Address: 78531 TALKING ROCK TURN APN: 770-300-034- - .- Application description: ADDITION - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 72268 Applicant: Tdy/ " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or En ineer: c. AV 2-16 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: H I License No.: 213 74 Date: �`�G_Z/y ontracto C ����� 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).: (_ I 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 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 1 I 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: LQPERA11T Owner: PARIS CHARLES DIXON 1020 E COLOMBIA ST A14 WEATHERFORD, TX 76086 Contractor: LARSON, DAVID K. 77075 SANDPIPER DRIVE INDIAN WELLS, CA 92210 '(760)333-1935 Lic. No.: 213174 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/22/09 WORKER'S COMPENSATION DECLARATION 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 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 insurance carrier and policy number are: Carrier EXEMPT Policy Number EXEMPT 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 I should become subject to the workers' compensation provisions of Section 3700 oft a Lab Code, I shall forthwith omply w' those provisions. r ate: l pplicant: , WARNING: FAILURE TO SECURE WORKERS' C MPENSATION 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 to enter upon the above-mentioned.Rrep/eX�y for inspection p poses. �L I Date: �Zf VSignature (Applicant okAgepii�!'�/�'^'�7' LQPE&11IT / Application Number . . . . . 09-00000270 ------ Structure Information 887 SF CASITA ADDTION ----- Other struct info . . . . . CODE EDITION 2007 # BEDROOMS 2.00 FLOOD ZONE NO GARAGE SQ FTG .00 , PATIO SQ FTG 45.00 1ST FLOOR SQUARE FOOTAGE 887.00 ---------------------------------- 2ND FLOOR SQUARE FOOTAGE. ------------------------------- 00 Permit . . . BUILDING PERMIT Additional desc 887 SF CASITA ADDITION Permit Fee 518.00 Plan Check Fee 336•.70 Issue Date . . Valuation' . . 72268 Expiration Date 10/19/09 Qty Unit Charge Per Extension BASE FEE 414.50 23.00 4.5000 --------------------=------------------------- THOU BLDG 50,001-100,000 ------------------------------ 103.-50 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 46.05 Plan Check Fee 11.51 Issue Date Valuation . . . 0 Expiration Date 10/19/09 Qty Unit Charge Per Extension BASE FEE 15.00 887.00 .0350 ---------------------------------------------------------------------------- ELEC NEW RES - 1 OR 2 FAMILY 31.05 Permit .'. MECHANICAL Additional desc . .Permit Fee 53.50 Plan Check Fee 13.38 Issue Date -Valuation . . . . 0 Expiration Date 10/19/09 Qty Unit.Charge Per Extension BASE FEE 15.00 1.00 - 9.0000 EA MECH FURNACE <=100K 9.00 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 16.50 2.00 6.5000 EA MECH VENT FAN 13.00 Permit PLUMBING Additional desc . LQPE&11IT LQPERMIT Application Number . . . . . 09-00000270 Permit . . . . . . PLUMBING Permit Fee . . 91.50 Plan Check Fee 22.88 Issue Date Valuation . . . . 0 Expiration Date 10/19/09 Qty Unit Charge Per Extension BASE FEE 15.00 7.00 -6.0000 EA PLB FIXTURE 42.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 3.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS =-- 9.00 - ----------------------------------------------------------- Special Notes and Comments ------------- 887 SF CASITA (GUESTHOUSE) ADDITION W/- 45 SF TRELLIS CONNECTION TO EXISTING RESIDENCE. TYPE V -B CONSTR. R-3 OCC. 2007 CODES ----------------------------------- -------------------------------------- Other Fees . . .- . . . . BLDG STDS ADMIN (SB1473) 3.00 ENERGY REVIEW FEE 33.67 STRONG MOTION (SMI) - RES 7.22 Fee summary Charged Paid Credited Due Permit Fee Total 709.05 .00 .00 709.05 Plan Check Total 384.47 .00 .00 384.47 Other Fee Total 43.89 .00 .00 43.89 Grand Total 1137.41 .00 .00. 1137.41 LQPERMIT Bin #, R City of La Quinn Building & 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: 5 3 NCy. Kee Owner's Name: A. P. Number: Address: 28-S3/ A,4K/•v cc Ac- A'A.) Legal Description: Contractor: DAY f' b Ky • tA 950 City, ST, Zip: L , Telephone: Address: 7 7610 SE1�! �V D �- C R %i . Project Description: City, ST, Zip:IAJbll*AjcLL eA q%2-7-16 Telephone:7r-D 33 3 -/ c?3 g- City Lic. #: State Lic. # : Z t' 3 1.7 4 Arch., Engr., Designer: w; ONG _ -r nl Address: - S Lt:.E- E t 7; "-Ib. - City, ST, Zip: L Telephone: 760 S/ •'4 7 o State Lic. #: Construction Type: A.., Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: b Vi6 44k!;emi Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 76p 3 3 - (13 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd- TRACKING. PERMIT FEES Plan Sets Plan Check subm' � Item Amount Structural Calcs. Reviewed, ready f corrections 7 Plan Check Deposit Truss Calcs. Called Contact Pe Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted 0 Mechanical Grading plan 2i4 Review, ready for correction issue L Electrical Subcontactor List Called Contact Person L�Z?� Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" Review, ready for correctionsrssue Developer Impact Fee Planning Approval Called Contact Person A,I,P,P_ Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees �/ r wtw I/A!" A7