05-1663 (GRES)41 ;
P.O. BOX 1504 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 05-00001663 Owner:
Property Address: 78712 VIA CARMEL KRUPINSKI JAMES H
APN: 646-430.-00.4- - - p 78-712 VIA CARMEL
Application description: GARAGE.- RESIDENTIAL D LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL '12005
Application valuation: 4567
,IV pF LA QUINTA Contractor:
Applicant: Architect or Engineer: FINANCEUSPARKS CONSTRUCTION, INC
P.O. BOX 1716
1IAn LA QUINTA, CA 92247
(760) 771-1941
I" Lic. No.: 674074
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: B Lic No.: 674074
�f �
Dat G S ntractor:
OWNER -BUILDER DECLAR ION
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 155001.:
(_ 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
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.l.
(_) 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 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:
LQPE%-,IIT
VOICE (760) 777-7012.
FAX (760) 777.7011
INSPECTIONS (760) 777-7153
Date: 7/05/05
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 00003482004
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner to as to become subject to the workers' compensation laws of California,
and agree that, if I shouu me subject to th s' compensation provisions of Section
3700 of the La 6e, I shat forthwith c ply with t ose provisions.
e0 1 plicant:
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.
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 ' ormaticZ correct. I agree to comply with all
city and county ordinances and state laws relati 'ding nstruction, an hereb for representatives
of this cou ty t enter upon the.a -m=nt):
d prope y r inspection purp
peree:o1 %% P�' ature (Applican
r' 40
Application Number . . . . . 05-00001663
Permit . . .
ELECTRICAL-CARPORT/GARAGE
Additional desc .
Permit Fee . . . .
19.66
Plan Check
Fee
4.92
Issue Date . . . .
Valuation
. . . .
0
Expiration Date
.1/01/06
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
233.00 .0200
----------------------------------------------------------------------------
ELEC
GARAGE OR NON-RESIDENTIAL
4.66
Permit . . .
CARPORT/.GARAGE
Additional desc .
'Permit Fee
72.00
Plan Check.Fee
46.80
Issue Date . . . .
Valuation
. . . .
4567
Expiration Date
1/01/06
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
3.00 9.0000
THOU BLDG
2,001-25,000
27.00
----------------------------------------------------------------------------
Special Notes and Comments
extend garage 233 sq..
tf.July 5,
2005
11:07:43 AM jjohnson
----------------------------------------------------------------------------
Other Fees •. . . . .
. . . . STRONG MOTION (SMI)
- RES
.50
Fee summary Charged
----------------- ----- - ---- ----------
Paid Credited
--=------- ----_-----
Due
Permit Fee Total
91.66
.00
00
91.66
Plan Check Total
51.72
.00
.00
51.72
Other Fee Total
.50
.00
.00
.50
Grand Total
143.88
.00
.00
143.88
LQPEINIIT
C,
City of La Quinta
Building &r 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: '78 71 Z- Vf,+ (`4lzA4,g7L-
Owner's Name:;
A. P. Number:
Address:W 7 -2 -
Legal Description.—m*et
City, ST, Zip:
Contractor:5p1CS c -D A
Telephone:
Address: -11 c,
Project Description:
City, ST, Zip: LR, C -i �; 7 L 4- 7
=72-33 S.
Tel —?Z�-=>
...... .......
State Lic. # 7 4115,
City Lic. #: 2. 7 510
Arch., Engr., Designer:
Address: -7 7 E3 IBp IQ si W% -JG A
City, ST, Zip: C4 2 2- (,,o
Telephone: -N-0 -7 P, S -'l .
............ ....
.... ....... .......
.............
... .............
......................
Construction Type: Occupancy:
State Lic. #:
Project type (circle one. New Alter Repair Demo
Name of Contact Person: 70 C,< A,- t -s
Sq. Ft.:
# Stories:
Telephone # of Contact Person: 7 '7 4t
Estimated Value of Project: Z 5c> 0 0 t10
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Plan Sets
Rcq'd
Rec1d
TRACKING
Plan Check submitted
PERMIT FEES
Item Amount
Structural Calcs.E'
e CA�4)
Reviewed, readyKr lc'olrections�) d�/ 4tros
Plan Check Deposit
Truss CaIcs.
Called Contact Person <e,,Acs,
an Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for correctio isbe
Electrical
Subcontactor List
Called Contact Person
�Plumbing
Grant Deed
Plans picked up
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
" Review, read), for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
kTotal
it Fees
JaK
do
J-0 bwwr- LAJV-
5' 5T"r. TZ 6^101-1Z OV -6, 7-7- (of
-71 u 4W row
WON—
RANCHO
`RANCHO LA •QUINTA
MASTER' ASSOCIATION
Architectural Committee
May 13, 2005
Mr. and. Mrs. Jim Krupinski
78-712 Via Carmel
La Quinta, CA 92253-
Re:
2253..Re: 78-712 Via Carmel J
Dear Mr. and Mrs. Krupinski,
The Rancho La Quinta Architectural Committee has reviewed and approved your
submittal of plans for your garage extension and entry portal at your residence, with the
following conditions:
1) All work is to *be done in accordance with all applicable requirements
of governmental entities, including the City of La Quinta, and in
accordance with'all Homeowners Association architectural/landscape
guidelines and governing documents
2) That a copy. of your permit be furnished to the Association prior to
commencement of work
When the -work Fias been finished, please fill out and return to the Notice of
Completion.
S' rely,
Mary E. Wal r,.CCAM, AMS, CMCA
Community Association. Manager for
The Architectural Committee
Rancho La Quinta Master Association
Cc: Architectural Comm.
73-550 ALESSANDRO, SUITE 5 ' PALM DESERT, CA 92260 • 760-346-1161 • FAX 760-346-9918