06-3247 (AR)• P.O. BOX 1504 Qum' -
78 -495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253- BUILDING & SAFETY DEPARTMENT
�- BUILDING PERMIT
t
r: ` Application Number: / 06-00003247
lkProperty Address: 51980 AVENIDA VILLA 1
APN: 773-183-011-13 -000000-
Application description: ADDITION - RESIDENTIAL
Property Zoning: COVD RDOIDEN TIAL '
Application valuation: 2172
Applicant:
0u1#er 1
-
Architect or Engineer:
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 Professionals Code, and my License is in full force and effect.
License Class: License No.:
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that Iam 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).:
(_) 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 propeny,.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.).
A _ 1 I am exempt under Sec. B.&P.C. f th' ason
Date:0`7-07— 10c Owner:
• ONSTRUCTION LENDINGArA
C
1 -hereby affirm under penalty of perjury that there is a construction lendi agency or the performance of -the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/06/06
Owner:
RAMIREZ FAMILY LIVING TRUST
7704 LONGS PEAK DRIVE -
RIVERSIDE, CA 92509
(951)661'L13/
Contractor: D
Owner
SEP 0.8 2005
CITY OF LA QUINTA
FINANCE DEPT
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 have and will maintain a certificate of consent to self -insure for workers' compensation, a -s 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
t - insurance carrier and policy number are:
Carrier Policy Number '
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 subject to the workers' compensation laws of California,
and agree that, if I should qbm jest to the workers' compensation provisions of Section
3700 of the Labor C II o Yh comply with those provisions.
Date: Applicant:
WARNING: FAILURE TO SECURE ORKCOMPENSAT N COVER GE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIV 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 of 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 informs •on is correct.' I agree to comply with all
- city and county ordinances and state laws relating to building co tru on, nd hereby authorize representatives
of this county to enter upon the above-mentioned prop or " ec on rposes.1N
Date: —07_U6 Signature (Applicant or Agent)
LQPERMIT - .
Application Number 06-00003241,
,
-- Structure Information ADDITION TO EXISTING RESIDENCE
,.
Other struct info CODE EDITION
01BMP04E05EN
a..
# BEDROOMS'
.00
FLOOD ZONE
NO
GARAGE SQ FTG
.00 i
PATIO SQ FTG, _
40'.00
1ST FLOOR SQUARE FOOTAGE
.00 ,
2ND FLOOR SQUARE FOOTAGE
-----------------------------------------------------------
.00
------------
Permit . . .. BUILDING PERMIT
Additional desc
Permit Fee 54.00 Plan Check Fee
35.10
Issue Date Valuation
2172 y
Expiration Date 3/05/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU BLDG 2,001-25,000
9.00
----------------=----------------------------
-----------
Special Notes and Comments
40 SF FRONT ENTRY PORCH COVER ADDITION.
y
TO RESIDENCE UNDER.CONSTRUCTION,(PERMIT
#05-4227). 2001 CBC.
----------------------------------------------------------------------------
Other Fees ... . . . . . . STRONG MOTION (SMI) - RES
.50
Fee summary, Charged-, Paid Credited
Due
------------------------------------------=--------------
Permit Fee Total- 54.00 00 00
54.00 _
Plan Check Total 35.10 .00 .00
35.10
Other Fee Total .50 .00 .00
_50
Grand Total •89.60 .00 .00
89.60
LQPERMIT
. .:. • r.