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07-1449 (RER)s P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 07-000,01449 Owner: Property Address: 77.271 CALLE DURANGO ODAY ALAN E APN:. 773-211-030-22 -000000- 1507 MALCOLM AVE Application description: REMODEL - RESIDENTIAL LOS ANGELES, CA 90024 Property Zoning: COVE RESIDENTIAL Other, struct info Application valuation: 800 .Applicant- Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty'of perjury that I am licensed under provisions of Chapter (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: OWNER43UILDER DECLARATION I hereby.affirm under penalty of perjury that I am exempt from the Contractor's State:Ucense Law for the following reasoniSec. 7031.5, Business and'Professions Code: Any city or county that, requires a permit to construct, alter,improve, demolish, or repair any structure,, priortoits',issuance, also requires the applicant for the permit -,to files signed statement that he or she is licensed pursuant to the provisions of the Contractor's.State License Law,tChapter 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(8500).: (_) 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 lSec. 7044, Business and Professions Code: The Contractors' Stat(j:Ucense Lew does,not apply to:an owner of property who builds or improves thereon, and who does the work himself or herself through ,his•orPer own employees; provided thatthe improvements'ars 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 thet,he or she did not build or improveforthe purpose of sale.). (_ 1 1, as owner, of the property, am exclusively contracting with licensed contractors to construct the project (Sec. e, 7044, Businsssand 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 Licen_ :). ^ (_) I am exemjrt under Sec. B.&P . for th reasr ] Data:' Owner:(��� CONSTRUCTION LENDING AGENCY I hereby•offirm 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: .LQPSRMLT Contractor: Owner- DITION VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/15/07 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.. have and will maintain workers' compensetion'insurence; as required by Sectlon•3900 of the Labor I Code, for the performance of the work for which this permit is issued.. My workers' compensation insurance carrier and policynumber are: Carrier - - -- - -------- - — - -- Policy Number I certify that, in the performance of the work for which this permit isissued, I shall not employ any person in any manner so ome subj t workers' compensation laws of California, and agree that, if I sho beco)frthwi subje o: wor ars' compensation provisions of Section r37of the Labor e, I shall co wi those provisions. Date: �pplicam: WARNING:FAILUURE TO SECURE WORKERS' COMPENSATION C ERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE.HUNDRED THOUSAND DOLLARS (9100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THEYABOR 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 isnot commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permitto cancellation. I certify that I have read this application and state that thaconstru ation.ighereb agr- to comply with all city and county ordinances and state laws relating to builon, ahors a representatives of this cou to a err upon the -above-mentioned propertn pu Date: � I Signature.(Applicant or Agent):. Application Number . . . . . 07-00001449 Permit . . . .BUILDING PERMIT Additional desc . . Permit Fee . . . . 21.0.0_ Plan Check Fee_ 13.65 Issue Date . . . .Valuation . . 800 Expiration Date . . 11/11/07 Qty Unit Charge PerExtension .BASE FEE 15.0.0 3.00 2.0000 HND BLDG 501-2,000 6.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 18.75 Plan Check Fee 4.69 Issue Date Valuation . . . . 0 Expiration Date 11/11/07 Qty Unit Charge Per Extension BASE FEE 15.00 5.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 3.75 -------------- - . Special Notes and Comments EXTERIOR PLASTER REPAIR AND LANDSCAPE LIGHTING - O.ther Fees . . . . . . . . . ENERGY REVIEW FEE 1..37 Fee summary Charged Paid Credited Due Permit Fee Total 39:75 .00, .00 39.75 Plan Check Total 18.34 .00 .00 18.34. Other Fee Total 1.37 .00 .00 1.37 Grand Total 59.46 .00 .00 59,46 LQPERMIT Bin # City ofla Quints Building at 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:' 71-,2'7CA 14 f L 44n c o Owner's Name: At /i (4 0'0/1 A. P. Number: -T7 3 -2.11-003 Address: Legal Description: W) T 2 Z: 6LO Ck 5 W UN i T I Contractor: C,OA&T, (.0 , City; ST, Zip: Telephone: Address: 0 S 2.l t�,.tr . Project Description:::CCpIDL WA (L, I n P PA61 10, 60 6' 141# 6 Z ` L 9"H, PLgs City; ST, Zip: * 0V4A J veZis (,�} . Cj 2 z 10 Telephone: -160 57 4— 0 1 ct-7 State Lic. #: Q S City Lica•#: 4 6A res ( j6 � q ' 3' AND 3`. S b 49--p Arch., Engr., Designer 11t* . FrAr wole-IL 50 S - ?Pp # C N VL l,lf 13 + Address: City, ST, Zip: t at4ank ( Goo Telephone: State Lica#:' Name of Contact.Person: 444 &-w&b&_ Construction Type: Occupancy: Project type (circle.one):New Add'n. AI Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project:. APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Reed TRACING , PERMIT FEES Plan Sets Pian Check submitted Item, Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calces Called ContactPerson Plan Check.Balance Energy Cales. Plans bicked up Construction Flood plain,plan Plans resubmitted Mechanical Grading plan V Review, ready for corrections/issue Electrical Subcontactor List Called Contact.Person Plumbing Grant Deed Plans picked up SALL H.O.A. Approval Plans resubmitted Grading Eq HOUSE:- Review; ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees 17 Total Permit Fees Z 0/ 431 oWNE� : ALApj D nAY CW4Z P040904a / IA Q(4iNr,a CR, 9ZZs3 (� W "Q Mgr T LpeiT-m— GALLS M)U fl AN b O CITY OF LA QUINTA SUB -CONTRACTOR LIST JOB ADDRESS 11271 G49E 4DYt4#-'1r0 PERMIT NUMBER OWNER A�- --D � '- BUILDERS - �Ns� • C.c This form shall be posted on the lob_ with the Building Inspection Card at all times in a conspicuous place. Only persons .appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of. work. - Failure to comply will result in a stoppage of work. and/or the voidance of building permit. Fore ch applicable trade, all information requested, below must .be completed by a plicant. "On_ File" is not an acceptable response. Trade / Class,ficatiofl Contracttx ;atat:ConVactor's License . :.. ...: :- : Workaers.Com ensatiort;(nsuraeee City Busieexs License Company Name Classification (e.g. A. B, 0-8) License Number (xxx)txx) Exp. Date (x)i/xx/xx) Carrier Name (e.g. state Fund, CalComp) Policy Number (Format Varies) 'Exp. Date, (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK IL42) CONCRETE (C-8) :. D'a%jt. �NS'r• G"$ �f�$Oel'S" lr',TfCNfl>' FRAMING STRUCT:- MASONRY-(C 29) PLUMBING- (C7361 LATH. PLASTER (d' 5) � OCL - (.On 9` • V yr r DRYWALL (C-9),..> ... HVAC (p-20) ELECTRICAL (C 10) : ;.: C.dr✓Sr ,SHEET FLOORING (9615); - GLAZING IC 771 INSULATION' IC -21:.::. , SEWAGl DISP (G-42)' PAINTING (C=33) CERAMIC TILE (C=541 CABINETS IC -6) FENCING (C:13) LANDSCAPING 1,C-271. 'POOL (C-53) OWNER/BUILDER 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/Budder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work ..is 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 Government as 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 M. 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 contracts 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 95514. 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 untilthe verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Ouintar OW2253 / 1 f (760) OWNER'S SIGNATURE/DATE � 7'2-7 ( c:�4(_,,C- 6r4s� o PROPERTY ADDRESS PERMIT NUMBER(S)