06-0786 (AR)P.O. BOX 1504, VOICE (760) 777-7012
78-495 CALLE'TAMPICO FAX (760) 777-7011
LA QUINTA, CALIF.ORNI_A 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/05/06
Application Number: 06-'00000_7.8.6 4 Owner:
Property Address: 79 0 STONEGATE CUMMINGS C T
APN: 772-020-022- - - 79400 STONEGATE
'Application description: ADDITION - RESIDENTIAL . LA QUINTA, CA 92253
c Property Zoning: LOW DENSITY RESIDENTIAL -
Application valuation: 83529 6 9
Contractor: -
Applicant: Architect or Engineer: CLASSIC BUILDERS, 0
INC. ��� 4� 2006
45-475 CLUB DRIVE R.
-- -INDIAN WELLS, CA 92210 _
(760) 772-1991 TA
�t �FLAgUIN
Lic. No.: ----------- Lic. No.: 691405 '-"-~ NCEIpEpf
-------------------------------------
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 Business and 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 ense No.: 691405 for by Section 3700 of the Labor Code, for the performance of the work for which this permit.is
��// //L�c issued.
Date: '. '` 6-.0 --Contractor' - = Y !i(. _ 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 0006519-2006
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 3700 of the Lab�ode,,wrt h o ply with those provisions. -
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 (5500).: 1Date:{� 67151 ApplcantK
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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
i 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'SFEES.
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
1, 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 contractsfor the projects with a contractor(s) 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,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason 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 relaied 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 I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). - - city and county ordinances and state laws relating to building construction, and hereby authorize representatives
. of this county to enter upon the above-mentioned rop11V for inspection pins.
Lender's Name: _ ���6 `
Date ignatute (Applicantor,Agentl"'
Lender's Address:
' ' LY
LQPERMIT - .
" Application Number
. . 06-00000786
Permit . . .
BUILDING PERMIT
Additional desc'.
Permit Fee
567.50 Plan Check Fee
_'.368:88 "
Issue Date
Valuation . . . .
83529
Expiration Date
11/29/06
Qty Unit Charge"
Per
Extension
-
BASE FEE
414.50
34.00 4.5000
THOU BLDG 50,001-100,000.
153.00
Permit'•. . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
41.63 Plan Check Fee
10.28
Issue Date . . . .
Valuation
0
Expiration Date ".
11/29/06.
Qty Unit Charge
Per
Extension
BASE FEE
15.00
746.00 .0350
ELEC NEW RES - 1 OR 2 FAMILY
26.11
26.00 .0200
-----------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
.52 "
Permit . . .
MECHANICAL
Additional desc .
Permit Fee
59.00 Plan Check Fee
14.75
Issue Date
Valuation . . . .
01
Expiration Date
11/29/06
Qty Unit Charge
Per
Extension
BASE"FEE
15.00
1.00 9.0000
EA MECH FURNACE <=100K
9.00
1.00 9.00.00
EA MECH B/C <=3HP/100K BTU
9.00
4.00 6.5000
EA MECH VENT FAN
26.00
Permit . . .
PLUMBING
Additional desc .
Permit Fee
106.50 Plan :Check Fee
26.63
Issue Date . . .
Valuation
0'
Expiration Date
11/29/06
- Qty Unit .Charge
Per -
Extension
BASE FEE
15.00'
10.00 6.0000.
EA PLB FIXTURE
60.00
3.00 6.0000
EA PLB ROOF DRAIN
18.00
1.00 7.5000.EA
PLB WATER HEATER/VENT
7.50
LQPERMIT
Application Number . . . . Q6-00000786 "
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
1.00: 3.0000 EA PLB WATER INST/ALT/REP
3.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
-------------------------------
Special Notes and Comments
--------------
" "746 SQ.FT. GUEST HOUSE.- PERMIT DOES
-NOT I-NCLUDE BLOCK WALLS, POOL/SPA OR
DRIVEWAY APPROACH.June 2,-2006 9:10:26
AM SRUBIO
--------------.--------------------------------------- ---
Other Fees . . . . . . . ENERGY REVIEW FEE
------
36.89
` STRONG MOTION (SMI) = RES
8.35
Fee summary Charged Paid Credited
Due
i----------------- ---------- ---------- ---------- ---
-------
Permit Fee Total 774.63 .00 .00
774.63
Plan Check Total .420.54 .00 .00
420.54
Other,Fee Total 45.24 .00 .00
45.24
Grand Total 1240.41 .00 .00
x240:4
LQPERMIT - •.
Bin #/,
ass.
City of. La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit'#Y �,r
IuCO
Project Address: 77'
A. P. Number: 77 Z O Zm O Z Z
Owner's Name:.
Address: 9
Legal Description: ' iZ 2� S�L� (_ �7 3 Z
Contractor:Sjf S �o QST �. e L ti,Tel
Qj
Address: #M
City, ST, Zip: � �� a�-� � q' z Z (-3
hone: S� 7�- S'-/ 2- f
Project Description:
City, ST, Zip: i 2 2-
Telephone:
Telephone:
State Lic. # : 4, 7Y0 7
City Lic. # S C
Arch., Engr., Designer: /� r
Address:
City, ST, Zip:
d .-
Telephone: ?j p-o-
State Lic. #:
Name of Contact Person: , S
C struction Type: Occupancy:
Project type (circle one): Add'n Alter Repair Demo
Sq. Ft.: ? # Stories: # Units:
Telephone # of Contact Person: /
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted 2"�
Item
Amount
Structural Calcs.
Reviewed, ready for corrections S 3 . /3
Plan Check Deposit
Truss Calcs.
Called Contact Person /3
plan Check Balance
Energy Calcs.
Plans picked up 3/
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading, plan
2°" Review, ready for corrections/issue S y
Electrical
Subcontactor List
Called Contact Person _c 'Y/,->7
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted I?i
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
I
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