13-0165 (PLBG)_4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: '13-6&000165____)
Property Address: 47715 WIND SPIRIT DR
APN: 623 -520 -010 -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 800
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I Ii se der provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business a d of s on s Code, and my License is in full force and effect. -
License Class: C27-053 icense No.: 964474
late 12 t� Contractor:
'Uepa'
WNER-BUILDER DECLARATION
I hereby affirm under penalty of periexempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Busiessions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, 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 (5500).:
(_ 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.).
(_) I am exempt under Sec. , B.&P.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.).
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
D G e: 2/12/13
RONALD DIFELICE
47715 WIND SPIRI D . FEB 2013
LA QUINTA, CA 92 3
(760)275-7359
CITY OF WINTA
FINANCE DEPT.
Contractor:
DESERT OUTDOORS INC
78065 MAIN ST STE #205
LA QUINTA, CA 92253
(760)399-9600
Lic. No.: 964474
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.
�0_1 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 NORGUARD INS Policy Number DEWC338066
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become su ' t to the workers' compensation laws of California,
and agree that, if I should a e ub' ct to he workers' compensation provisions of Section
3700 of the Labor Code, sh I h 'th c mply with those provisions.
Date;(z 1 3 1 . Applicant:
WARNING: FAILURE TO SEC E WORK S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO RIMINAL NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,000). IN AD;ikTION TQ/THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR GQDE, )NTEREST, 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 Guinta, 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 abMiurp
agree to comply with all
city and county ordinances and state laws relating to buildingthorize representatives
of this county
t toenterupon the above-mentioned property fo
Date: ' It r (/ Signature (Applicant or Ag
Application Number . . . . . 13-00000165
Permit
ELEC-MISCELLANEOUS
Additional desc . .
Permit Fee . . . .
15.75 Plan Check Fee
3.94
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
8/11/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 .7500
----------------------------------------------------------------------------
PER ELEC DEVICE/FIXTURE 1ST 20
.75
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
18.00 Plan Check Fee
4.50
Issue Date . . . .
Valuation . . .
. 0
Expiration Date . .
8/11/13
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
320 FT. 1" GAS LINE TO FUTURE FIREPIT,
BBQ AND TORCHES IN REAR YARD. (1) GFI
OUTLET. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
----------
Paid Credited
------------------------------
Due
-----------------
Permit Fee Total
33.75 .00 .00
33.75
Plan Check Total
8.44 .00 .00
8.44
Other Fee Total
1.00 .00 .00
1.00
Grand Total
43.19 .00 .00
43.19
LQPERMIT
Bin. #
QtY Of La Quin to
wicripg st Safety Division
P.O. Box 1504, *78-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 7777012
Building Permit -Application and Tracking Sheet
Permit #
(/
Project Address: —1 f 1 -D s I R1
Owner's Name:. D NJ
A. P. Number
Address: .7-71 S CJI I S I Z
Legal Description:
Contractor. Desert Outdoors
City, ST, Zip: (, A v is C ZZs 3
Telephone: ( �.
Project Description:
Address: 78-065 Main St. Ste. 205
City, sT, zip: La Quinta, Ca. 92253
Telephone: 760-399-9600 ; -'
;,� 2 r 3�
N� - 2C}i
A» b CG, —LST
state Lic. # : --c-53 964474 City Lic #;
Arch., Engr., Designer: Flying Buttress
Address: - 77725,Enfield Ln. Ste. 130
city, sT, zip: Palm Desert, CA. 92211
Telephone: 760-772-4411
State Lia #: 33446 e =
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: -%(Ml ' - (03(.0 ' a9 4
Estimated Value of Project -
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACENG
PERMI'FFEES-
Plan Sets
Plan Cheek submitted-
Item Amount
Structural Cahn.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cala.
Called Contact Person
Plan Check Balance
Title 24 Coles.
Pians picked up
Construction
Flood plain plan
Pians resubmitted..
Mechanical
Giading plan
V Review, ready for correc6ons/issue
Electrical
Subcontaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
Ill HOUSE:-
'"' Review; ready for corrections/�ae
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
FOR
CONSTRUCTION
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CITY OF LA QUINTA
BUILDING & SAFE T Y DEPT.
APPROVED
FOR CONSTRUCTION
DATE U Nb BY
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4. PVC SCHEDULE 40 STREET ELL
S. PVC SCHEDULE 40 TEE AND ELL
B. CLASS 200 PVC LATERAL
7. 4" A,D.S. PERFORATED PIPE
42' LONG W/ ONE BUBBLER
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