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)