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05-3715 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 05-00003715 Property Address: 78187 INDIGO DR APN: 604-021-037- - - Application description: REMODEL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 600 Applicant: Architect or Engine Al A Tiht 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT o � F AUG 3 0 2005 CIT10 ►QUINTA -------------------------------------------------- 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: License No.: Date: 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 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 thepurposeof sale.). (_) 1, 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 Licens w.). ' ( ) I am exempt under Sec. , B.&P for his reason Date: Owner: •-COSUCTION 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: , 1 I♦� Lender's Address: i LQPERMIT CI VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/23/05 Owner: FOTI ANTHONY 78187 INDIGO DRIVE LA QUINTA, CA 92253 Other struct info . . . . . C Contractor: Owner DITION 2001 CBC ----------------------------------------------- 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: C rrier 2.00 Policy Number - - - - - - - - - - - - - -- 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, and agree that, if I should come subject to th workers' compensation provisions of Section 037 0 of the Labor Cod , I all forthwi h tho provisions. Date: Applicant: WARNING: AILURE TO SECURERKERMEN PSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P TIES 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 information is correct. I agree to comply with all city and co ty ordinances and state laws relating to buil ' g onstruction, a eby authorize representatives of thi ty to ter u n the above-mentioned pro y f insp n ose . Date Wu (Applicant or Agent ^ ` Q- Application Number . . . . . 05-00003715 Permit . . . . BUILDING PERMIT ' Additional desc . Permit Fee . . . . 17.00 Plan Check Fee 11.05 Issue Date . . . Valuation . . . . 600 Expiration Date . . 2/19/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 2.0000 HIND BLDG 501-2,000 ---------------------------------------------------------------------------- 2.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . . Permit Fee . . . . 18.00 Plan Check Fee 4.50 Issue Date . . Valuation . . . . 0 Expiration Date 2/19/06 Qty Unit Charge ,Per Extension BASE FEE 15.00 4.00 .7500 'PER ELEC DEVICE/FIXTURE 1ST 20 3.00 -------------------------------------------------------------=-------------- Special Notes and Comments INTERIOR RE -MODEL. TWO WALLS ADDED TO ENCLOSE DINING ROOM. ---------------------------------------------------------------------------- Other Fees . . . . . . . . ENERGY REVIEW FEE 1.11 Fee summary Charged Paid Credited Due Permit Fee Total 35.00 .00 .00 35.00 Plan -Check Total 15.55 .00 .00 15.55 Other Fee Total 1.11 .00 •.00 r 1-.11 Grand Total 51.66 .00 .00 0 51.66 r LQPMN11T t PATIO/DECK (SIZE MAY VARY) o Q 4 oeING� Coi✓1�7�" -tri a9a�o��'L ,�Oor�t, �� ,� v7�o� Ole � ��if?�c �`7�� 71:/Z/�J : • l l DINING wr F!z' i` - in [oil 0 in I a - . hu ._ DEN O 3 r7 n 011 NDN BATH 0 - MASTER D BEDROOM , .o