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04-4562 (RER)0� s 2 5 2004 -' BUILDING-& SAFETY DEPARTMENT OF LA QUINTA __. w IuANCP[(DfvBo I r%A4 (760).777-7012 ' C��►tOF9'c` 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA,•CALIFORNIA 92253 INSPECTION REQUESTS (760k7.77-71513- 4 BUILDING PERMIT Application Number �`04-00.004562 ! Date ',5/25/04 Property Address..,.-.. .57990 TROON WY APN:.. 762-360-014= - - -Application description REMODEL - RESIDENTIAL Property Zoning ..LOW DENSITY RESIDENTIAL Application Valuation 2000 . Owner 1,•1^,,,,1" Contractor _ .` . WEISKOPF PARTNERS I" ,SOUTHERN HILLS DEVELOPMENT INC. .55161 SOUTHERN HILLS 81070 CHANTICLEER DR, LA QUINTA. -CA 92253 LA QUINTA CA 92253 (760).771-3497 WCC: EXEMPT WC: EXEMPT 05/31/05 CSLB:. 8.38041 05./31/06 CCC.: B 'Other st'ruct info. CODE EDITION w2001 Permit BUILDING PERMIT Additional desc Permit -Fee 4'5 00 Plan Check Fee 29.25 Issue Date Valuation `2000 Qty... Unit Charge Per Extension BASE FEE .15.'00' 15.0,0 2. 0000 HND .. BLDG 501-2.,.000 " �• 30.00 Special. Notes and Comments ---...----- PER.APPROVED PLAN _----FIREPLACE Other Fees. ENERGY REVIEW 'FEE` 2.93.. STRONG MOTION (SMI).- RES .50 Fee summary Charged -----------------=---------- Paid Credited Due Permit Fee Total 45.00 -----------'--------- .0.0. .00' ---------- 45.00 Plan Check Total 29.25. .00. 29.25 Other Fee Total 3.43 .00 00• 3.43 Grand -Total 77.68 - .00 00 77.68 P.O. Box 1504 � 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 ' BUILDING & SAFETY DEPARTMENT Application Number: Applicant- Applicant's Mailing Address: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: .S- Zs Architect or Engi r: Architect or E gineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION j1hereby affirm under penalty of perjury that tam licensed under provisions of Chapter g (oominencing with Section 7000) of Division 3 of the Business and Professionals Code, and my Liceis in full force and effect fetif 04 License Class / • License No. Date 5 Z5 - 04 Contractor '�OliTlt�'=Li tt1L 3*—V OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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-exempton. Anyviolab of'Secb�03.1-5-by any applicant tare permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): U 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 or 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.). U 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.). U 1 am exempt under Sec. , BA P.C. for this reason. Date OWAef WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self4nsure for workers' compensation, as provided for by Section 3700 of the Labor Code, far the performance of the work for which this permit is issued. _ 1 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: Cartier Policy Number certify Ihat,.in the performance of t1work 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, d agree ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Pro ns. Date SfA!�-_ WARNING: FAILURE TO SECURE WORKERS' O ENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND OLLARS ($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. 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 IMPORTANT Application is hereby made to the Director of Building APPLICANT aCKNOWLEDGEMENT 9 Safety Apermit 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 theap kart each agrees to, and shall, defend, indemnify and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission rel d to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes rpil and voi is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to canc lation. I certify that I have read this application and state that the above in a6 s c agree to mply with all city and county ordinances and state laws relating. to building construction, and hereby authorize representatives of this county t er u on ve-mention roperty for inspection purposes. Date ik— Signature (Applicant or Agent): . Bin # Ci�� La Cit QUl nta Building at Safety Division P.O. Box 1504, 78.495 Cage Tampico La Quints, CA 92253 - (760) 777.7012 Building Permit Application and Tracking p Sheet permit 56 v 1tFA. ct Address: — )J, W Aq OHra's Name: //-- T G�S . Ntunba: Address: �l1Tl X x% Leal Descri7' ption: z �j city. ST. Zip: CXu i Cd, 9ZZS3 FTcicphonr -7 jl- - s _ a'f't. jea Description: Contractor. �j G Addren: -- " '70 C—L 1 �� X Ciry, ST, Zip: () .� tA . Telephone:? . f �s: ' • ::- ;•. Z - . 1� State tic. # : 04, City L, ic. I: Arch. Engr., Designer: Address . X City. ST.-Zip: Telephone: ; :•:.:.r.�,;K. .::;'. Lie. y ;�: f •,' =d:: G _^� 4 „ ; •.: -,� Type..�p�Y: Project type (circle one): New Add'n Ah Demo Alter 'Repair Name of Contac i'ersoa: Sq. Ft • N Stonier. / Units: iC Telephone it of Contact Person: Value of Project• APPLICANT: DO. NOT WRITE BELOW THIS UNE N' Submittal Req•d Recd TRACKING PERMIT FEES. Plan Sets Plan Check submitted "' Item Amount Structural Calcs. yt cwcd, ready for corrections Pias Check Deposit Trvw CalcL Called Contact Person Plan Cheek-Balance :. . Energy Cala. Plans Ncked up Construction Flood plain plan Pians resubmitted 1►rechanical Grading plan Y' Review, ready for eorrectiowassue Electrical Subcotitacor List Called Contact Person Plumbing Grant Deed Pians picked up S.M.I. H.O.A. Approval Plans resubmitted Grading Developer Impact Fee IN HOUSE:- Planning Approval 30 Review, ready for eorrcctioa o Called Contact Person Z,S A.I.P.P. . Pub Wks, Appr Date of permit issue School Fces Total Permit Fees Q � - a LEFT"LEJp-T�o�-1KE�alF ct� �G -� �4 EDATE a.. cod IyPt� ?lp► -.?©- o�Ri — 2QUINTA FETY DEPT. PPROVED RUCTION Y . LU LU 1 X W • �O 5 455 h5� FG�hV%C3 � 106.13' 'L ° • Illy ¢S 0.5%0.5q ' .. MIN. MIN. �, K5 1 o r39 0. 0' 137.0(' P 18.50' 1! .14.06' r CD _ CD 6;00' � 3B - co FF=455:30-: ` /4 17,28' A PAD=454.80 F, 10.0' Vol o .159.1 8.50' ASCO GF=454.80 �G 13` 13 oq ¢Sj=454.' e� FS 0 �Vol o 00 al 9j' 0'. - ..5,7 -g tSZ� 040o/ /