11-0960 (RER)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO 414 QsAmFAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/14/11
Application Number: 7 11-00000960 T Owner:
Property Address: 79625 STAR FLOWER TR CORA HAWLEY
APN: 604-253-001-63 -24208 - 79652 STAR FLOWER TRAIL
Application description: REMODEL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 15000
Contractor:
Applicant: Architect or Engineer: DE GEARE BUILDERS INC D a
42335 WASHINGTON STE, F#344
PALM DESERT, CA 92211 ry
�wR'1/�gCsst��- (760) 345-1216 c'r'f 1, 5 2011qq
LiC. No.: 795830 J
UCENSED 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.: 795830
Date: IJ -IS��� 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, 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 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. , 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:
LQPERMIT
--------------- - --
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 STATE FUND Policy Number 0013415-2010
1 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 of the Labor Code, I shall forth ith com0 ply ith those provisions.
Date: /5 Applicant: i/
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. ,
APPUCANT 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 property for ' pection urposes.
;Date:-isii Signature (Applicant or Agent):
Application Number . . . . . 11-00000960
------ Structure Information BATHROOM REMODEL [CONVENTIONAL] -----
Other struct info . . . . . CODE EDITION 2010
----------------------------------------------------------------------------
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . 162.00 Plan Check Fee 105.30
Issue Date . . . Valuation . . . . 15000
Expiration Date 3/12/12
Qty Unit Charge Per Extension
BASE FEE 45.00
13.00 9.0000 THOU BLDG 2,001-25,000 117.00
----------------------------------------------------------------------------
Permit . . . MECHANICAL
Additional desc .
Permit Fee 21.50 Plan Check Fee 5.38
Issue Date Valuation . . . . 0
Expiration Date.. � 3/12/12
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 6.5000 EA MECH VENT FAN 6.50
L
Permit ELECT - ADD/ALT/REM
Additional desc
Permit Fee . . . . 24.00 Plan Check Fee 6.00
Issue Date . . . Valuation . . . . 0
Expiration Date 3/12/12
Qty Unit Charge Per Extension
BASE FEE 15.00
12.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 9.00
----------------------------------------------------------------------------
Permit PLUMBING
Additional desc
Permit Fee . . . . 42.00 Plan Check Fee 9.75
Issue Date . . . . Valuation . . . . 0
Expiration Date 3/12/12
Qty Unit Charge Per Extension
BASE FEE 15.00
4.00 6.0000 EA PLB FIXTURE 24.00
1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00
LQPERMIT
Application Number . . . . . 11-00000960'
--------------------------------------
Special Notes and Comments
`
MASTER BATHROOM REMODEL - REMOVE TUB TO
INSTALL SHOWER, RELOCATE WATER CLOSET
TO WHERE EXISTING SHOWER IS LOCATED TO
EXTEND COUNTER [CONVENTIONAL] THIS
PERMIT DOES NOT INCLUDE ALTERATIONS TO
LOAD BEARING OR LATERAL RESISTING
CONSTRUCTION. 2010 CALIFORNIA BUILDING
CODES.
September 14, 2011 3:40:46 PM AORTEGA
--------------------------------------------------------------------------=-
Other Fees . . . . . BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW
FEE
10.53
Fee summary Charged Paid
Credited
----------
Due
-----------------------------------------------
` Permit Fee Total 249.50 .00
•.00
249.50
Plan Check Total 126.43 .00
.00
126.43
Other Fee Total 11.53 .00
.00
11.53
Grand Total 387.46 .00
.00
387.46
LQPERMIT
CONSTRUCTION HOURS
_ October 1st - April 30
Construction is NOT PERNlIiiFD Monday - Friday: 7:00 a.m. to 5:30 p.m.
on the following Code Holidays: Sunda ay: s:oo a.m. to 5:0o p.m...:.
Sunday:
None
_ •. > > - - �• R _ _ _ _ Government Code Holidays:- ` None
y NewYear's Day \ E 11(ay 1st - September 30th
y' Dr. Martin Luther Krnglr. Day �1Vd'q'nday -Friday: 6:00 a.m. to 7:00 p.m.
Satnrda : 8:00 a.m. to 5:00 .n4
_ Presidents Day y . p .
Memorial Day _ Sikuday.:: ,,.1 None
t Independence Day ��.IG`ei"e�nt Code Holidays: None
t Labor Day
Veteran's: Day
t.. a A6E UATELY SIZED -DEBRIS CONTAINER
Thanksgiving Day ,
,~ Christmas Day L,` ,- IS REQUIRED ON THE JOB SITE DURING ALL
H 0PHA �1SES OF CONSTRUCTION AND: MUST BE
EMPTIED AS NECESSARY.`FAILURE TO DO SO
' 7 MAY CAUSE THE CITY TO HAVE THE CONTAINER .
-RE-INSPECTION FEE ;OF $30 Df1MPED AT THE EXPENSE OF -THE OWNER/, --
A'
WILL BE CHARGED IF THE APPROVED CONTRACTOR.
PLANS AND JOB CARD ARE. NOT. ON
U
THE SITE -FOR A SC -
INSPECTION. I �---
1 CITY OF LA-OU_INTA
NO F3(EPiIO
CNS. ,
_ BUILDING & SAFETY'DEPT.
- . FOR CONSTRUCTION
DATE °� !� %Ota gy�_'
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CITY OF LA QUINTA
BUILDING& SAFETY DEPT
APPROVED
FOR CONSTRUCTION
DATE BY
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Building 81' Safety Division
Permit #P.O. Box 1504, 78-495' Calle.Tamplco
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address. _ 2S' 5—Po, Owner's Name: Cod.HCL LAk e-
A. P. Number:
Address:. S
Legal Description:
City, ST, Zip: u � x%02.
Contractor:
Telephone: 76C Lq qL4
Address: �i 23 ?�
33
Project Description:
City, ST, Zip:
Telephone: %O
Vim. .ccx. >:::ez ;F
City Lic. #:
,,a✓ IAIILX
State Lic. # : 7off-0 316—
Arch., Engr., Designer.
v7
Address:
City, ST, Zip:
Telephone:
�
State Lic. #:
of Contact :
erson
vu; '
r� Constivaion Type: Occupancy:
-":;x ; = Project type (circle one): New Add'n Alter
RepJI)c-oName
,� Sq. Ft -�sTelephone#
of Contact Person:
(0-b �j �� CTS Estimated Value of Project: O �APPLICANT:
DO NOT WRITE BELOW THIS UNE
#
Submittal
Pisa Sets
Req'd
Rec'd
TRACMG PERMTT FE
Plan Check submitted Item ount
Structural Cala.
Reviewed, ready for correetioos Plan Check Deposit
Truss Calm
Called Contact Persou Plan Check Balance
Title 24 Calm
Plans picked ■p Construction
Flood plain plan
Plans resubmitted Mechanical
Grading pian
2'' Review, ready for correctionarrsue Electrical
Subcontactor List
Called Contact Person ` Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plana resubmitted Grading
IN HOUSE:-
Review, ready for correctionsf �" Developer Impact Fee
Planning Approval
Called Contact Person q i A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees 1
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