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07-2357 (SOTB)y . t ..t > • I P.O. BOX 1504 78-495 CALLE TAMPICOa 4. LA QUINTA, CALIFORNIA 92253, BUILDING & SAFETY DEPARTMENT ' BUILDING PERMIT - - :Application Number: 07-0000.235'7 ; Owner: Property Address: 54555 SOUTHERN HILLS_ - 1 APNi ' 775 -101 -059 - Application description: • STRUCTURES OTHER THAN BUILDINGS 'Property Zoning: LOW DENSITY" RESIDENTIAL/ Application valuation: 30000 - JENKINS MATTHEW 20 13TH PL i LONGBEACH CA €ice LONG BEACH, CA 90802 it } _ Contractor: Applicant: Architect or Engineer: SUN WEST CONSTRUCTION, 7DR #3 PALM ALM DESERT, CA 92260. (760)773-4487 Lic. No.: 826995 ----------------------------- --- �"� LICENSED CONTRACTOR'S DECLARATION;•. . I hereby affirm under penalty of perjury that 1 am Ii nsed under provisions of Chapter 9'Icommencing with -Section7 00) -of Division 3 of the Business an ofessionals Code, and my License is in full force and effect. License ass: B ]i9ensAe.N'o.:/j826 5 Date Contractor.F-,I✓�(/ 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'orshe is:licensed pursuant to the provisions of the Contractor's State. License Law (Chapter 9 (commencingwiih 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 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 oneyear of completion, the owner -builder will have .the burden of proving that he or she didnot 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.). --, ( I 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: . LQPERMIT VOICE (760) 77777012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 CITY OF LA QUINTA' -INC FINANCE DEPT. 8/22/07 I 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. r 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 0023566-2006 _ 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, a d agree that, if] should becom ubject tot workers' compensation provisions of Section 00 of the Labor Code, I sh rt w' o y with those provisions. Dat Y, Applicant: ..J./ WAF NING: FAILURE TO SECURE W RKERS' COMP NS ON COVERAGE IS UNLAWFUL, AND SHALL " SUBJECT AN EMPLOYER TO CRIMINALPENALTIESAND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COSTOFCOMPENSATION, 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 isnot 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 informa ' is correct. I e to comply with all city and county ordinances and state laws relating to building constr on, and hereby orize representatives of -this ty t nter upon the above-mentioned pro fo ' ction p ' ` Date: a�Signature (Applicant or Agent): Application Number . . . . . 07-00002357 . Permit BUILDING PERMIT ` Additional desc -. Permit Fee.,..284.50 Plan Check Fee 184.93 ` Issue Date Valuation 29775 Expiration Date .2/18/08 Qty Unit Charge Per Extension _ BASE:FEE 252.00 . 5.00 6.5000 THOU BLDG 25-,001-50,000 ---------------------------------------------------------------------------- 32.50 Permit ELEC-MISCELLANEOUS Additional desc Permit Fee 18.00 Plan Check Fee'. 4.50 Issue Date Valuation . . 0 Expiration Date 2/1.8/08 Qty Unit Charge Per Extension BASE -FEE 15.00 -.4.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 -------------------------------------------------------------- 3.00 -------------- Permit PLUMBING Additional desc . Permit Fee 18.00 Plan Check'Fee 4.50 Issue Date . . . . Valuation 0 Expiration Date 2/18/08 Qty Unit Charge :Per Extension BASE—FEE 15.00 1.00 3.0000 EA PLB GAS PIPE -1-4 OUTLETS. 3.00 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee 15.00 Plan Check Fee .00 Issue Date Valuation 225 Expiration Date 2/18/08 - Qty Unit Charge Per. Extension ` BASE.FEE 15.00 ---------------------------------------------------------------------------- ------- Special Notes and.Comments Special ----------------- 9 L.F X G' CITY STANDARD BLOCK WALL, BBQ & SINK PER APPROVED PLAN ONLY. ----- - -- - ---- - - - - -- -------- Other Fees ENERGY REVIEW FEE -- - - - - -- 18.49 LQPERMIT Application Number . . . 07-'00002357 Fee summary.,.' Charged Paid Credited Due ----- Permit Fee Total 335.50 .00 - .00 ---- - - - - -- 335.50 Pian Check Total 193.93 .00 .00 193.93 r Other Fee Total,., 18.49 .00 .00 18.49• Grand Total 547.92 .00 .00 547.92 Bin # o City 6 La Quinti 4. ' Building U Safety Division 3 : � P.O.Box 1504 78-5.Calle Tampico -:� , p�. ' Permit #. � : - ',.49 La Quinti, CA_9.2253 - (7.60)777-7012`f` , Building Permit, Applicationand Tracking Sheet Project •Address: J -' SS �O� ! _AL) . l- Owner's Name: �� 6y A. P. Number' Address: 01 O 1 fi Legal'Descriptiona ' City., ST, -Zi P: n G , V_ 0 ` Contractor:, S S - Telephone: , ir „uifJ4&'i„ z Address: ' 111 ;;; •3 Project Description: ' 1 �: City, ST, Zip: t� , z U 1 z - , b-1kU, h Telephone: `I t`I.i W t 6 t3�S State Lic. #= $ City Lic. �� .. Arch., Engr., Designer: Address: City, ST, Zip: Telephone: • .. ' Construction Type: Occupancy: , - e Project type (circle�one): New` Add'n: Alter. .. Repair Demo State Lic. #: Name of Contact Person: .. I j S�'�� : " iSq Ft.: #Stories: #Units:. , Telephone # of Contact Person: _ �, •' �• '; .. '.Estimated Value.of Projec. APPLICANT: DO'NOT WRITE BELOW THIS LINE • r, # Submittal Rcq'd- Recd TRACKING ` ` PERMIT FEES Plan Sets Plan Check submitted 'Item Amount Structural Calcs. n' Reviewed, ready for corrections . Plan Check Deposit- eposit Truss Truss Cales: Called Contact Person Plan Check Balance Energy Calcs: Plans picked up Constriction Floodplain plan Plans resubmitted 'Mechanical-, si Grading -plan. .2. Reviewreadyfor corrections/issue" Electrical" q Subcontactor List '. k, - Called Contact Person Plumbing, Gds —14 aul£tS Grant Deed , ' Plans picked up -�L" 4 MO.A. Approval. PP jl , Plans resubmitted, 4 1 Grading , IN HOUSE �-Review, ready for corrections/issue, ' ' Developer Impact Fee „ Planning Approval �.., Called Contact Person ' ' 'A.I.P.P. e1 Pub: Wks. Appr ; Date of permit issue School Fees Total Permit Fees. F