12-0293 (DEMO)P.O. BOX 1504
.78-495 CALLE TAMPICO ,
LA QUINTA, CALIFORNIA 92253
Application Number:12 00000.2.9~3 -
Property Address: 0.5 WASHINGTON ST
APN: 643-194-014-69.
Application description: DEMO - COMML/OTHER
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 0
c&t!t 4 4 w
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date
Owner:
FNMA
46705.WASHINGTON STREET
LA QUINTA, CA 92253
3/21/12
MAR 21 2012 c f tor:
Applicant: Architect or Engineer: O `
CITYAF LA�QUINTA
FINANCE IMPT. ---=. '-----------_----------------
LICENSED CONTRACTOR'S DECLARATION ' - WORKER'S COMPENSATION DECLARATION _ -
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: License No.: ` t' for by Section 3700 of the Labor Code, for the performance of the work for which this permit. is
• - issued.
Date: - Contractor: _ 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are: _
.1 hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the Carrier At - Policy Number
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its is also requires the applicant for the - person in any manner so as to become subject to the workers' compensation laws of California, ; -
permit to filen signed statement that he or she is licensed pursuant to the provisions of the Contractor's State -- and agree that, if I should become subject to the workers' compensation provisions of Section
•License Law (Chapter 9 (commencing with Section 7000) ofDivision 3 of the Business and Professions Code) or 3700 of the Labor Co , 1 shall forthwcomply with those provisions.
that he or she. is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by f �I��I
an applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Da t l plicant:• -
O 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 (Sec. 7044, Business and Professions'Code: The WARNING: FAILURE TO SECURE WORK S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL ,
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, - SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
• and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 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 contractor(s) licensed
. pursuant to the Contractors' State LiceLaw.l.
• (_ 1 I am exempt under Sec- , B.&P. or this reason
ate:
CONSTRU ION 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
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 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 above information is correct. I -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 property f r inspection p pos
le 2I Sign re (Applicant or Agentl:
LQPERMIT
Application Number . . . . . 12-00000293
Permit DEMO PERMIT
Additional desc .
Permit Fee . . . . 45.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. .
0
Expiration Date 9/17/12
Qty Unit Charge Per
Extension
BASE FEE
45.00
Special Notes and Comments
DEMO UNPERMITTED BACK PATIO INCLUDING
ENCLOSURE TO RESOLVE CODE CASE 11-2686
..Fee summary Charged Paid
Credited'
Due
Permit Fee Total- 45.00
.00
.00
45.00
Plan Check Total .00
.00
.00
.00
Grand Total., 45.00
.00
.00"
45:00 "
LQPERMIT
Bin.#
Gty 0 T Q u
Bulling a. Safety Division .
P.O. Box 1504,78-495-Calle Tampico,
La.Quinta, CA 92253 - (760) 777-7012 i" N
Mill Building Permit Application and Tracking Sheet
Permit #
Project Add=: �j �� W S N /(/
Owner's Name:. �r �Gares
if
A P. Number
Address: 0
Legal Description:..
Contractor.
City, ST, Zip: �jf — 5,2 -LI 0
Telephone: 760 '?Io _�_dd U •. >r''�x . �.�-'�'• -ksko; •
Address:
Project Description:
City, ST, Zip:
Telephone: •a�.'��• .:`C��..
State Lic. # : City Lie.. #;
Arch., Engr.; Designer.
rY/!l a C. i� 4� i l o
Address:
City., ST, Zip:
Telephone:a o
. ;r N .,
State Lic #:g%
Name of Contact Person: tr `4
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq.'FL:
# Stories: # Units:
Telephone # of Contact Person: ?6C . _ 2 (�(� % f' j 0
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Itec'd
TRACKNG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs•
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan-
Plans resubmitted..
Mechanical
Grading plan
2fd Review, ready for correctionsfissue
Electrical
Subcontactor 119
Called Contact Person
Plumbing
Grant Deed
Pians picked up
S M.L
&O-A. Approval
Plans resubmitted
Grading
IN 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
Total Permit Fees