12-0296 (RER)4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12-00000296
Property Address: 80620 VIA PORTOFINO
APN: 777-150-012- - -
Application description: REMODEL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 40000
T-iht °F 4 Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
-------------------------------------- - - - - -- - - - - --
LICENSED CONTRACTOR'S DECLARATION
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 Pr fessionals Code, and my License is in full force and effect.
License class:
BBy LiVe No.: 769229%
Y Date: Contractor: %A�afiyl
OWNER -8 ILDER 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 ($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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , BAP.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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:
BILL & SUE MURPHY
80620 VIA PORTOFINO
LA QUINTA,•CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
I1 °
Contractor: JU APR Q
ALBERS CONSTRUCTION CO, INC. / 112
P.O. BOX 238
LA QUINTA, CA 92253 CITY OF LAQUNTA
(760) 771-9954 FINANCEnEPT
Lic. No.: 769229
Date: 4/04/12
-----------------------------------------------
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 STATE FUND Policy Number 0004885-2011
_ 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 subjec to the workers' compensation laws of California,
and agree that, if I should become subject t e the
compensation provisions of Section
3700 of the Labor Code, I spall fo wit ply with those provisions.
CDate. f L Applicant:
WARNING: FAILURE TO SECURE WORKERS' COM ENSATION 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 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, a d hereby authorize representatives
of this cou ty to enter upon the above-mentioned property for inspe 'on pu s.
Date: Signature (Applicant or Agent):
7 71 irL
r -
r _ 1
Application Number .
. . . . 12-00000296
---- - Structure Information MASTER BATHROOM REMODEL
-----
Other struct info . .
----------------------------------------------------------------------------
. . . CODE EDITION
2010
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . .
349.50 Plan Check Fee
227.18
Issue Date . . . .
Valuation . .
. . 40000
Expiration Date . .
10/01/12
QLy UiilL Chatye
Pei
ExLeusluu
BASE FEE
252.00
15.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
97.50
Permit . . . ELECT - ADD/ALT/REM
Additional desc . .
Permit Fee . . . .
38.55 Plan Check Fee
9.64
Issue Date . . . .
Valuation . .
. . 0
Expiration Date
10/01/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
20.00 .7500
PER ELEC DEVICE/FIXTURE 1ST 20
15.00
19.00 .4500
------------------------------------------------"----------------------------
EA ELEC DEVICE/FIXTURE >20
8.55
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . .
26.00 Plan Check Fee
6.50
Issue Date . . . .
Valuation . .
. . 0
Expiration Date ".
10/01/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 4.5000
EA MECH VENT INST/ "DUCT ALT
4.50
1.00 6.5000
---------------------------------------------------
EA MECH VENT FAN
=------------------------
6.50
Permit . . . PLUMBING
Additional desc . .
Permit Fee . . 42.00
Issue Date
Expiration Date 10/01/12
Qty Unit Charge Per
BASE FEE
LQPERMIT
Plan Check Fee 10.50
Valuation 0
Extension
15.00
Application Number . . . . . 12-00000296
Permit . . . . . PLUMBING
Qty Unit Charge' Per
Extension
4.00 6.0000 EA PLB FIXTURE
24.00
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
----------------------------------------------------------------------------
Special Notes and Comments
MASTER BATHROOM REMODEL [CONVENTIONAL]
RELOCATION OF FIXTURES AT BATHROOM,
STORAGE AND CLOSET. THIS PERMIT DOES NOT
INCLUDE ALTERATION TO EXISTING FRAMING
OR ADDITIONAL SQUARE FOOTAGE. 2010
CALIFORNIA BUILDING CODES.
April 4, 2012 9:23:36 AM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS
ADMIN (SB1473)
3.00
Fee summary Charged Paid
----------
Credited
--------------------
Due
---------------------------
Permit Fee Total 456.05 .00
.00
456.05
Plan Check Total 253.82 .00
.00
253.82
Other Fee Total 3.00 .00
.00
3.00
Grand Total 712.87 .00
.00
712.87
v
LQPERMIT
Bin.#City414
1 . Of Qulntd
Bulling a Safety Division
P.O. Box 1504,78-495 Calte Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 2 b ' �()^j N D
Owner's Name:
A. P. Number
Address: y t t Pwfu nti
Legal Description:.
City, ST, Zip: urn
Contractor. tfters
Telephone: ,ON
�
Address: A(� S 4,UAV N„
ProjectDescription:
City, sT, zip: v,,, g22s3
MOVE E CW -+W &9
Telephone (�v 77V O % :�Z �€€
State Lic. # : U J/ ZZ �/ City Lia k
Cv Foo �- MCI(if
W � /✓tU w
Arch., Engr., Designer Y�tmr}
Address:
CAo n C a / %i �!
City, ST, zip: Cp(.t/rLMO
Telephone:v .Y : N .:'
State Lic. #:'-'
..>: �E;w �,_ :_'"» r�
Name of Contact Person:
Construction Type:. Ocupancy:
Project type (circle one): New Add'rLAlter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: �� f) LI &1
44
Estimated Value of Project: yQ OD
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Reed
TRACENG PERMIT FEES
Plan Sets
3
Plan Check submitted
ZZ Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check 3alance
Title 24 Cates.
Plans picked up
Construcdoh
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2`` Review, ready for correctionsrmue
Electrical
Subeontactor List
Called Contact Person
lumbing
Grant Deed
Plans picked up
Slyly
B.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review; ready for correctionsfissue
Developer Unpact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
4NIUM — *p