11-1102 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:�I'1=00001102
Property Address: 478805_LEGACY_DR
APN: 658-130-011-7 -31379
Application description: REMODEL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 800
Applicant:
TUV/
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
Owner:
PAUL DOW
48805 LEGACY DRIVE
LA QUINTA•, CA 92253
Contractor:
WHITLEY'S CONSTRUCTION
77775 JACKAL DRIVE
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/06/11
D
OCT 0.7 2011
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
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 9d county ordinances and state laws relating to building construction, and hereby authorize representatives
of s county to enter u the above-mentioned pr pe y for inspection purposes.
Date:Signature (Applicant or Agent):
PALM DESERT, CA 92211 I -�
CITY OF 4—AOU NTA
(760) 341-9480
I
I
Lic. No.: 805021
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
Li an lass: B License No.: 805021
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ate: ontractor:.1
issued.
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 rjury that I am exempt from the Contractor's State License law for the
Carrier GRANITE STATE Policy Number 007200169
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
3700ofthe Labor Co e, I shall forthwith comply 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 ($500).:
nt:
ate:—�ET
1,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: FCU ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon.
SUBJECT AN EMPLOYER TO MINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work hirnseif 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'S FEES.
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 I, 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 contracts for 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, '
(_ ) 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 .
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
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 9d county ordinances and state laws relating to building construction, and hereby authorize representatives
of s county to enter u the above-mentioned pr pe y for inspection purposes.
Date:Signature (Applicant or Agent):
Application Number
11-00001102
Permit
PLUMBING
Additional desc .
Permit Fee . . . .
18.00 Plan Check Fee
4.50
Issue Date . . . .
Valuation
0
Expiration Date
4/03/12
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 . . . .
21.00 Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 800
Expiration Date
4/03/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3.00 2.0000
HND BLDG 501-2,000
6.00
----------------=--------------.---------------------------------------------
Special Notes and Comments
100 L.F. 1" GAS LINE
FOR FUTURE BBQ &
FIREPIT, 50 L.F. 3' BLOCK WALL, CITY
STANDARD.
----------------------------------------------------------------------------
Other.Fees . . . . .
. . . . BLDG STDS ADMIN (SB1473)
1.00
STRONG MOTION (SMI) - RES
.50
Fee summary Charged Paid. Credited
---------------------------------------------------------
Due
Permit Fee Total
39.00 .00 .00
39.00
Plan Check Total
4.50 .00 .00
4.50
Other Fee Total
1.50 .00 .00
1.50 -
Grand Total
45.00 .00 .00
45.00
LQPERMIT
Main Level
N
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED,
FOR CONSTRUCTION
DATFA-6 - Z BY %5 T•
Fr
1.
9-
1
Gas the nm from main meter
2011-08-19-0734
-+-- Water Brought from front malri line to new patio
Water spigot
7' .
7
1
Poi nii for futue wale
(Bubblers x5)
` Main Level
9/16/2011 Page:3
Bin fl
C*ty of La Quinta.
Building & Safety Division
P.O. Box 1504, 78-495 Calk- Tampico '
La Quinta, CA 92253 - (760) 777-7012. I
Building Permit Application and Tracking Sheet
Permit #
Project Address: — t2
Owner's Name: w
A. P. Number:
Address: C35
Legal Description:
City, ST, Zip:
, %A>TA C.4 1a6L
Contractor: .
Telephone:
W MIN
M: N
Address:79_^7 7G`J
Project Description:
City, ST, Zip: • 9oia
-4—i 1 EMr S
Telephone:",4,
state Lic. # : �Q�Oo2 (
City Lic. #":
n
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone: ° :� Construction Type: Occupancy:
State Lic. #:�"�>
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:ret, Sq. Ft_: �Cb SF # Stories: # Units:
Telephone # of Contact Person: 26,C3-3(48 _ yy/ Estimated Value of Project: Wd ,gyp
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Plea Sets
Req'd
Rec'd
TRACMG PERMIT FEES
Plan Check submitted Item Amount
Structural Cato
Reviewed, ready for corrections Plan Check Deposit
Truss Cales.
Called Contact Person Plan Check Balance
Title 24 Cala.
Plans picked cep Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2'! Review, ready for eorrectionsftme Electricst
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted 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 Fee
Total Permit Fees