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07-0672 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T -i -ht 4 .fwQ" Application Number: 07-00000672 Property Address: 79120 KAYE CT APN: 604-371-004-96 -27899 - Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1200 Applicant: �P, Architect or Engineer: N/A BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Cod nd my License is in full force and effect. License Class: D06 L i c� s o.: 836488 Date: Contractor: • OWNER -BUIL 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 155001: (_) 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.). 1 _ 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 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.I. Lender's Name: _ Lender's Address: LQPERMIT Owner: FLAGG DARREN E 79120 KAYE COURT LA QUINTA, CA 92253 Contractor: - J'S GUNITE COMP 4664 CHALLEN AVE RIVERSIDE, CA 925 (951)313-7301 Lic. No.: 836488 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/05/07 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 FLTND Policy Number 0034440-2006 _ 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, and agree that, if I should become subject to the wo ters' compensation provisions of Section 3700 of the Labor Code, I s II forthwith 'Com09ofth those provisions. L WARNING: FAILURE TO SECURE WORK S' COMPENSA ON 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 information is corre I agree to comply with all city and county ordinances and -state laws relating to building construction, a y authorize representatives of this count to enter upon the above-mentioned property inspecti n p s. Date: p Signature (Applicant or Age r Application Number . . . . . 07-00000672 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 29.00 Plan Check Fee 18.85 Issue Date . . . . Valuation . . . . 1200 Expiration Date 9/01/07 Qty Unit Charge Per Extension BASE FEE 15.00 7.00 2.0000 ---------------------------------------------------------------------------- HND BLDG 501-2,000 .14.00 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 18.00 Plan Check Fee 4.50 . Issue Date Valuation 0 Expiration Date 9/01/07 Qty. Unit Charge Per Extension BASE FEE 15.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments OUTDOOR FIREPIT PER APPROVED PLAN ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 1.89 STRONG MOTION (SMT) - RES. ...50 Fee summary Charged --------------------------- Paid Credited ------------------------------ Due Permit Fee Total 47.00 .00 .00 47.00 Plan Check Total 23.35 .00 .00 23.35 Other Fee Total 2.39 .00 .00 2.39 Grand Total 72.74 .00 .00 72.74 LQPERMIT Total Permit Fees r Bin # City of U Quints Building U Safety Division Petmit # P.O. Box 1504, 78-495 Calle Tampico' La :. Quinta, CA 92253 - (760) 777-7012 -7 Building Permit Application and Tracking Sheet - Project Address: A. P. Number: Owner's Name: Legal Description: — Address: Contractor: City, ST, Zip; L Z Telephoa Address: �p-�� Q GCS /J ✓ tom/ Project Desaiption: d City, ST, Zip: .. O/Z /ZE Telepho �� A State Lie. # : 3 City Lic. #- Arch., Engr., Designer ' Address: r� City, ST, Zip: '. Telephone: State Lie. #: Construction Type: pocupaac,. • Name of Contact Person: >��jtype (circle one): New Add'n Alter Repair Demo . . Telephone # of Contact Perso Jr" 3 _ Q Sq. Ft : #Stories: 777--- Estimated #Units: lue 01Project: 2,6 ,�— APPUCANT: DO NOT WRiTEBELOW THIS UNE # Submittal Re9'd ReC+d . TRACING Plan Sets Check submitted PERMIT FEESPlan Stractaral Calcs. . Reviewed, raidy for corrections Item Amount Truss Coles. Called Contact person Pfau Check Deposit Energy Cale. Plans Picked. up Plan Check Balance Flood plain plan Plans resubmitted • Construction Grading. plia 2" Review, ready for correedowusue Mechanical SubcoutaetorUst . Called Contact Person Electrical Grant Deed Plans picked up Plumbing H.O.A. Approval Plaas resubmitted SALL IN [iOUSE:= Review, ready for.correctlons/,ssae Grading Planning Approval Called Contact Person Developer Impact Fee Pab. Wks. Appr .Date of permit issue A.I.P.P. School Fees Total Permit Fees OW H t,,,r, _ 91 � w,� m .. _ r a * N f i1, " � , : , : I " ggy�p jam - t M1 + j �f�� {[ / 17 qp�� ;� r � j f! - a.. 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