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07-2489 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, .CALIFORNIA 92253 - _Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 07-00002489 45280 DEBBIE DR 604-372-004-40 .-27899 - REMODEL —RESIDENTIAL LOW DENSITY RESIDENTIAL 350 T,`ht 4 4 Q" - Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT, -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby'-effirm 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 ].hereby affirm under penalty of perjury that.l 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 , n , pplicantfora permit subjects the applicant to a civil penalty of not more than five h undredd dollars,195001:: I, as owner of the'property, or my employees with wages as;their sole compensation, will do the work;.and the structure isnot intended or offered for sale (Sec. 70", Business and Professions Code:. The Contractors' State License Law does riot 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, 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 comractor(s) licensed pursuant to the Contractors' State License Law.). ( ) I am exempt under Sec. , 8.&P.C� for this reason Date: / V Ownef �../ 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: t,QFERM[T Owner: JOHN STULL- 45-280 DEBBIE DR LA QUINTA, CA 92253 Other struct Contractor: Owner DITION VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/10/07 WORKER'S' COMPENSATION DECLARATION I hereby+affirm under penalty of perjuryone of the following declarations: I have and will maintain a certificate of consent to self4risure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance:ofthe 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 ------:---- ---------Policy Number I certify that, in the performance oCthe 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 subiect to the workers' compensation provisions of: Section ,- -d3700 of the Labor Code, I sit 11 forthwith comply with those provisions. Date: !gh�pplicam: 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 (8100;000). IN ADDITION TO'THE C6ST OF COMPENSATION, DAMAGESIAS PROVIDED.FOR IN SECTION 3708 OF THE LABOR -CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT, ACKNOW LEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subjecttothe 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 Quints, 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 county ordinances and state laws relating to building construction, and hereby authorize representatives of thiscounty to enter upontheabove-mentioned property for in action purposes. Date: �Aignature (Applicant or Agent): Application Number . . . . . 07-00002489 .Permit . . . BUI-LDING PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee 9.75 Issue.Date Valuation 350 Expiration Date 3/08/08 Qty Unit Charge Per Extension . BASE FEE ------------------------------------------------------------------------------- 15.00 Permit . . . ELECT - ADD/ALT./REM Additional desc . Permit. Fee . . . . 19.5.0 Plan Check Fee 4.88 Issue Date . . . . Valuation 0 Expiration Date 3/08/08 Qty Unit Charge Per Extension BASE ,FEE 15..00 6.00 .7500 PER ELEC DEVICE/FIXTURE 1ST"20 4.50 ----------------------------------------------------------- Special Notes and Comments --=------ ENCLOSE EXISTING GARAGE LAUNDRY ROOM. A/C WILL NOT BE ADDED.September-10, 2007 9:00:57 AM jjohnson -------------------------------- ----------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE ---------- .98 STRONG MOTION (SMI)' - RES .50 Fee summary Charged Paid Credited Due ----------------------------------------------- Permit Fee Total 34.50 .00 ---------- .00 34.50 Plan Check Total 14.63 .0000 14.63 Other Fee Total 1.48 .00 .00 1.48 Grand Total 50.61 .00 .00 50.61 LQPERmrr TELEPHONE (760) 777-7012 FAX (760) 777-7011 OWNER/BUIIDDER INFORMATION Dear Property Owner: An application for a building permit, has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a permit. Budding permits are not required to be signed by property owners unless they are personally performing their own work. If your work Js being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City or County. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection. If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200.00 or more for the entire project, and such persons are not licensed. as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the State and Federal Governmentas an employer and you are subject to several obligations include State and Federal income tax withholding, federal social security taxes, worker's compensation insurance, disability insurance costs and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law,contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building permit, erroneously 'implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF IA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La,Quinta, CA 92253 (760) 777-7012 FAX: (760) 777-7011 9 6 OWNER'S SIGNNATURE/DATE PROPERTY ADDRESS a*? -a�lr�; PERMIT NUMBER(S) u►oa oFFlMP1<0 ►!9u?�dle�Is�Deur?ipeu�%NtiuW/ . — l�a0 dna/ r B wnkt5 6 J JA&Z 0 9' ro gee 'Me -1/S uuo:f- ve�rw To 0�5rvC N N Jo S Ni��'� Y ' � -7 JNA b Q r nV j:uogduasa4 aged :a;ea P ),011 i agbt F:; ,-��1 I -) US :DWBN z FLOOR. STR LAC-7'uQ2E Y2 #1 PLY wcx�D -Z/'K 4' 5 1-"D:5 zze��}f�T_c �'M ENT kl ALL SIRUGT'1.��,, . =AlItR I.OR VIA LLS: %L zLAY�s dfA:/z.t w ON UP M fit.. [.. �iNir _FAY �.. �:r. •lye!\. p.,.. � `r• 4 a CIC Lt n► L pq 3 fy r^Cm M pT 22' ilk d c� �►� zo, pq IT 6� < Z� IZ" „ oocK%c +D D c.ok Av Bin # City of La Quints Building & Safety. Division P.O. Box 1504, 78-495 Calle Tampico La Quints,, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # (DI- 7 Project Address: �2 O-De �� /h _.zo Owner's Name: o 4 f ' GL A. P. Number. Address: S'Z ( /',e� . Legal Description: City, ST, Zip: �,z CA ZZS3 Contractor: Address: Telephone: Project Description: V AtoN City, ST, Zip: Ek CC 05e4cE — C. 'L i .f �E.f Telephone: 19,4- - a State Lie. # : Arch., Engr., Desi er: M Ci Lic. #: x rS 3 CAR Address:7 o City, ST, Zip-.. Telephone: State Lica#:, Name of Contact Person: `J LL Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: #' Stories:. # units: Telephone # of Contact Person: _ - Estimated Value of Project: d APPLICANT: DO NOT WRITE BELOW THIS LINE Req'd Rec'd TRACKING PERMIT FEES rqSubmittal Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Cheek Deposit Truss Cal cs Called Contact Person Plan Cheek Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan Z'a Review, ready'foucorrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" Review, ready for correctionMssue. Developer Impact Fee Planning Approval Called Coutactferson A.I:P:P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Bin # City Of La Quints Building a 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:, 0 iF �, Owner's.Name: e LL A. P. Number: n Address: j Z S D j / JO& . Legal Description: City, ST,.Zip: �� i�rZ G'q 42J 3 Contractor:V Address: Telephone: Project:Description: ZA1JA1,1,eVE City, ST, Zip: / E/ i CC O5L[/C I% — *r- L I .¢ f fA Telephone: rR Q a Z OT State Lic. # : City Lic. #: C /°� CZ c - Arch., Engr., Designer: Address: City, ST,.Zip: . Telephone: State Lic:.#: Construction. Type: Occupancy: Project ype (circle one): New Add'n 6lD Repair Demo Name of Contact Person: `T LL Sq. Ft,: 1,22 # Stories: • # Units: Telephone# of Contact Person: - Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING. PERMIT FEES Plan Sets Plan Che& submitted Item Amount Structural Cities. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'' Review, ready for corrections/issue Electrical Subcontaetor List Called Contact Person Plumbing Grant'Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3w Review, ready, for correcddn&rmue Developer Impact Fee Planning Approval Called Contact•Person A.I.P.P. Pub. Wks. Appr Date of permif Issue School Fees Total Permit Fees 03i ole OOAO O