06-1447 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO - F.
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT '
BUILDING PERMIT
Application Number: 06-00001447 Owner:
Property Address: 52990 AVENIDA VILLA DAN MARRUFO
APN: 773-334-013-14" —000000 * 52-990 AVENIDA VILLA . .
Application description: REMODEL -'RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL Other struct info . . .
Application valuation: 3500 '
Contractor:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/10/06*
C Li
APR 13.1006
Applicant: Architect or Engineer:' Owner CFn'Oj 1A QUI�y
NONCE D
- EprA_
LQPERMIT
DITION 2001 CBC'
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.:
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 3.00 Policy Number - - - - - - - - - - - ---- - -
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
d I 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 issuance, also requires the applicant for theT
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a 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 work rs' compensation provisions of Section '
- License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code�I shall forth'y' c with those ovisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
for five hundred
�,•_s,,,. '�,�� , Y
any applicant a permit subjects the applicant to a civil penalty of not more than dollars ($500).:
pplicant:
( ) 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
WARNING: FAILURE TO SECURE WORKERS' 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.). -
APPLICANT ACKNOWLEDGEMENT
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Cude: The Contractors' State License Law does not apply to an owner of -
conditions and restrictions set forth on this application. -
property who builds or improves thereon, and who contracts for.the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for '
- pursuant to the Contractors' State License Law.).
- whose benefit work is performed under or pursuant to any permit issued as a result of this application,
( 1 1 am exempt under Sec. , B.&P.C. for this reason -
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
11_ I
performed under or following issuance of this permit.
weer.
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
' CONSTRUCTION LENDING AGENCY -
permit to cancellation. -
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that.1 have read this application and state that the above information is correct. I agree to comply with all
.. work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state laws relating to building construction, and hereby a thorize representatives
„ - -
+. Lender's Name:
of thi county to enter upon the above-mentioned propert for inspectio ur e
+ i.
ate:Signature (Applicant or Agent):
Lender's Address:
'�.
LQPERMIT
Application Number . . . . 06-00001447
Permit . . . •BUILDING PERMIT
Additional desc .
Permit .Fee 63.00 Plan Check
Fee
40.95
Issue Date. . . . Valuation
3500
Expiration Date 10/07/06
Qty. Unit Charge Per
Extension
BASE FEE
45.00
2.00 9.0000 THOU BLDG' 2,001-25,000
18.00
Permit ... . PLUMBING.
Additional desc
„
Permit Fee 18.00 Plan Check
Fee .
4'.50
Issue Date . . . . Valuation
0.
Expiration Date 10/07/06
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
ADD FIREPLACE AND RE -MODEL •REPLACE 4
WINDOW PER PLAN
---------------------------------------------------------------------------=
Other Fees . . . . . . . ENERGY REVIEW FEE
4.10
STRONG MOTION. (SMI)
- RES
.50
Fee summary Charged Paid Credited
Due
----- ---------- ----------
Permit Fee Total 81.00 .00
----------
.00
81.00
Plan Check'Total 45.45 .00
.00
45.45
Other -Fee Total 4.60 :00
.00
4.60
Grand Total 131.05 .00
.00
131.05
" LQPERMIT _ -