07-3085 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 '
Application Number: 07-00003085
Property Address: -- 80500 WEISKOPF
APN: 762-100-015- - -
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 500
Applicant: Architect or Engineer:
a NIPS
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm 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: B C53 /� License No.: 552140
Dat !J c7 Contractor: (� �a�t � �1 S
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I 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
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 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 Lawdoes 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.).
(_ 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 witha contractorls) licensed
pursuant to the Contractors' State License Law.).
(.).'I amm exempt under Sec. B.&P.C. for this reason
Date: 1,"R-5:0 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
Owner:
AOYAMA RESIDENCE
80500 WEISKOPF
LA QUINTA, CA 92253
Contractor:
BRYAN INVESTMENTS GROUP INC
P.O. BOX 1804
PALM SPRINGS, CA 92263 .
(760)345-8483
Lic. No.: 552140
VOICE (760) 777-7012
FAX (760) 777-7011
WNS (760) 777-7153
�te: 12/05/07
Off' +77
C \_
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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.
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 CLARENDON NATL Policy Number OIDKRM21000978
I certify that, in the performance of the work for which this permit is issued, 1 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 subject to the workers' compensation provisions of Section
X3700 of the Labor Code,
I shall forthwith
�oo/me�pLl�ly(/with those provisions.
Date:; App APPlicant
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 1$100,0001. 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 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
permit to cancellation.
I certify that I have read this application and state that the above information is correct. 1 agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this/ county to enter upon the above-mentioned pro ty for inspection purpos
Signature (Applicant or Age
-Date1a s�-7 nt): 'G 1
1K
LQPERMIT
' li �� Number Application mz r .
. . . . 07-00003085
'
'Permit . - . . . .
BUILDING PERr4IT
Additional deec . .
Permit Fee ` . . .
15.00 Plan Check Fee .
. *.75
Issue Date . . . .
Valuation . . .
. sou
� Expiration Date - .
6/02/08
`
Qty Unit Charge
'Per
Extension
--------------------`----------
BASE FEE
-_----------------------------------_-------
lS.Ou
' permit . . . . . .
oLEc-MISCELLANEOUS
Additional deoo . .
Permit Fee . . . .
17.25 Plan Check Fee
4.31
zoaoe Date . . . .
Valuation . . .
. O
Expiration Date . .
6/02/08
Qty Unit Charge
Per
Extension
BASE FEE
zs.nn
3.00 .7500
PER ELEC DEVICE/FIXTURE 1ST aO
2.25
-----------------------_-------------------------------------------`---------
Speoial Notes and Comments-
ommeoto
BBQ
BBO omcLoonaE PER APPROVED PLAN ONLY.
Fee summary Charged
-----------------
Paid Credited
Due
----------
rernit Fee Total
---------- ---------- ----------
32.25 .00 .uo
32.2s
Plan Check Total
14.06 .ou .oO
14.06
Grand Total
46.3.1 .Oo .00
46.31
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and _Tracking Sheet
Permit #
v?b
Project Address:
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor: ��'�
City, ST, Zip: LA Q U 1
Telephone:
Address: TO
Project Description:
City, ST, Zip:
Telephone: _ �a
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person•
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Projec . ,�.C7r--)
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
(Z
Item
Amount
Structural Calcs.
or corrections
�jr
Plan Check Deposit
Truss Calcs.
rCalledContactrson
Plan Check Balance
EnergyCates.
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°d Review, ready for corrections/issue
Electrical
3 •
Subcontactor List
Called Contact Person
Plumbing 'VIA
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'`d 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
AiTylO
to ai� re
BuILAPPROVED
FOR CONSTRUICTIOIJ
mr, /L =S-0'7 BY 5 -7
LIGLL HT �
et
00 00
IIS
Q PRE -HUNG O O
S.S. DOORS
STAINLESS
STEEL
SINK PROVIDE VENT, WASTE, AND
STONE OR PLUMBING FOR SINK ON SEPARATE
TILE CONSTRUCTION DOCUMENT.
COUNTER
r GFI
REF. f L- -J OUTLET
CSTUCCO OR LIGHT
STONE
SWITCH
VENEER ) CWATERPROQF)
LENGTH VARIES
1
FREE-STANDING OUTDOOR KITCHEN - FRONT ELEVATION
BBQ:
I.C.B.0. # _
ANSI #Zal •SS Z00?3
BTU
U.L. APPROVED.
til
LIGHT l:
GRILL REF. SIPK
FREE-STANDING OUTDOOR KITCHEN - PLAN ADAPT DIMENSIONS
�E TO FIT APPLIANCES
6X8xI6 CMU; GROUT CELLS WITH STEEL I
#4 BARS VERT. AT 24" O.C. (TYP.)
i' � , _ ...