09-0915 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09-00000915
Property Address: 50385 EL DORADO DR
APN: 772-250-999-162 -30357 -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2200
T-i&t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 ($5001.:
1 _ 1 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.).
(_) 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 contractorls) licensed
pursuant to the Contractors' State License Law.l.
1 _ ) 1 am exempt under Sec. , BAP.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: P I A
LQPERMIT
Owner:
BECKER
50385 EL DORADO DRIVE
LA QUINTA, CA 92253
Contractor:
MORRIS CONSTRUCTION INC,
51200 CALLE PALOMA
LA QUINTA, CA 92253
(760)272-9292
Lic. No.: 867583
VOICE (760) 777-7012
FAX (760) 7.77-7011
INSPECTIONS (760) 777-7153
Date: 8/27/09
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ 1 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 ruired by Section 3700 of the Labor
Code, for the performance of the work for which this p i is issued. My workers' compensation
insurance carrier and policy number are:
Carrier MPT Policy Numb e "X PT
I certify that, in the performance a work fo ich yfis permit is issued, I shall not employ any
person in any manner so o be me sub' . t to t 4 workers' compensation laws of California,
and agree that, if I sh bec a subjec the or ensation provisions of Section
^` / 737 o the La e, I all forthwi co with t provisions.
Ytl1e. / �/ plicanC
WARNING: FAILURE TO SECU E WORKERS' COMPENSATION 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 kifrknot commenced
within 180 days from date of issuance of such permit, or ces180 days will subject
permit to cancellation.
1 certify that I have read this application and state that the above ' or tie comply with all
city and unty ordinances and state laws relating to building ns coonze representatives
oft ' county to enter po he above-mentioned property pec 'on p
Date: � 7 d ignature (Applicant or Agent):
Application Number . . . . . 09-00000915
Permit . .
. PLUMBING
Additional desc .
Permit Fee . . .
. 18.00 Plan Check Fee
4.50
Issue Date . . .
. Valuation . . .
. 0
Expiration Date
2/23/10
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
INSTALL 45 L.F. 3/4"
GAS LINE FOR FUTURE
APPROVED APPLIANCE
(FIREPIT).2007 CODES
----------------------------------------------------------------------------
Other Fees . . .
. . I . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
Charged Paid Credited
----------------------------------------
Due..
-----------------
Permit Fee Total
18.00 .00 .00
18.00
Plan Check Total
4.50 .00 .00
4.50
Other Fee Total
1.00 .00 .00
1.00
Grand Total
23.50 .00 .00
23.50
LQPERMIT
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Uty of La Quinta
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
5036S- 67 DoY/r> rOwner'sName: e— }'
A. P. Number: Address:�� 503� 4!V P_>0f111:'d
Legal Description: "City, ST, Zip: Ga A_ /1ws
Contractor: Telephone: "?( -' :>:x•'>"?:� , d �` / ` / �07-/
Address: . lj 111,00 exq'l ft; PQlo� o P ect Description:
City, ST, Zip: Z-4 62u ..t 1'r, ( G/� �.� o - 31Y Al -
Telephone:
A5 Lt lk� 114 G S• �r
state Lic. # : City Lic. #: 109331 1:5:� IQ,L_ rl
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
, ,° tea°` Construction Type: Occupancy:
ject (circle one): Pro New Add'n Alter Repair Demo
r-�. ..
State Lic. #:type
Name of Contact Person: /i Sq. Ft.: # Stories: #Units:
Telephone # of ..Contact Person: ,:, Estimated- Value of Project:
APPLICANT: DO NOT WRITE, BELOW THIS LINE
# Submittal Req'd Recd TRACMG PERMIT FEES
Plan Sets Plan Check submitted Item Amount
Structural Cates.
Reviewed, ready for corrections Plan Check Deposit
Truss Cates.
Called Contact Person Plan Check Balance.
Title 24 Cates.
Plans picked up Construction
Flood plain plan
Pians resubmitted Mechanical
Grading plan
2"" Review, ready for correctionslissue Electrical
Subcontactor fist
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 Fees
Total Permit Fees