07-1047 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4'tt 4 4 Q" -
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 07-00001047 Owner:
Property Address: 60856 FIRE BARREL DR JOEL & LILLIAN GAFNI
APN: 764-280-999-56 -300235- 60856 -FIRE BARREL DRIVE
Application description: STRUCTURES OTHER THAN BUILDINGS LA QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 400
Contractor:
Applicant: Architect or Engineer: ARTISTIC LANDSCAPE INC.
.78206 VARNER RD, #D PMD2
PALM DESERT, CA 92211
(760)360-1395
LiC. No.: 379421
I hereby affirm under penalty of perjyrfy/that I am licens�6 under Prov' ions,o Chaptr 9 Icommencing with
Section 70001 of1bivision 3 of the ;Bu mess and 0ofe ionals Q6, and, Licen4a is in full force and effect.
OWNER -BUILDER DECLARATION
I hereby affirm under penal y of perjury that I am exempt from the Contractor's State License Law for the
following reason ISec. 7031.5, Business and Professions Code: Any city or county thatrequiresa 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 (5500).:
(_) 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.).
1 _ 1 1, 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. , 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
Date: . 4/05/07
e.
APR c 0 6007
4
CI I°Y OF LA QUINTA
FINANCE C " .PT.
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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 700 of the Labor'
Code, for the performance o he work for which this permit is issued. MY' rk 'compensation
insurance carrier and polic mber are:
Carrier SIRIUS AMERICA Policy Number '01KD 1000.5
_ I certify that, in the performa a of the or for w ich this p r' it is iss d, I all not employ any
person in any he nnerr to become ject o the wo s' �o ensati n laws of California,
L.9nd agree that, if I shout become sub' t to, a worke comp sation p ovisions of Section
f ! /3700 of the Labor_.Cod . I shall forth ith co olv wit ose o visions.
WARNIVG: FAILURE TO SERE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER T 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 ny act or omission related to the work being
performed under or following issuance of this p it
2. Any permit issued as a result of this applmati be mes null and v0'5if work is not commer} e
within 180 days from date of issuance of ch emit, or cessatio f work for 0 days will ubje
permit to cancellation.
I certify that 1 -have read this application and state tha the ove infor ation ' correct. I e to� com wit all
City and coun ordinances and state laws relating,to bui ing constru tion, d hereby orize Aepr entativ s
of t 's to ter upon the above-mentione/d/pro y for inspe ion rposes.
D t% Si cure (Applicant or Age 0
j
Application Number . . . . . 07-00001047
Permit
BUILDING PERMIT
Additional desc . ..
Permit Fee . . . .
15.00
Plan Check
Fee
9.75
Issue Date . . . .
Valuation
. . .
. 400
Expiration Date
10/02/07
Qty Unit Charge
'Per
Extension
----------------------------------------------------------------------------
BASE FEE
15.00
Permit . . .
PLUMBING
Additional desc .
Permit Fee.
. 18.00
Plan Check
Fee
4.50
Issue Date . . . .
Valuation
0
Expiration Date
10/02/07
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
--------------------------------
--
FIREPIT, PER APPROVED
PLANS
----------------------------------------------------------------------------
Other Fees . . . .
. . . . ENERGY
REVIEW FEE
.98
STRONG
MOTION (SMI)
- RES
.50
Fee summary Charged
-----------------
Paid Credited
Due
----------
Permit Fee Total
----------
33.00
----------
.00
----------
.00
33.00
Plan Check Total
14.25
.00
.00
14.25
Other -Fee Total
1.48
.00
.00
1.48
Grand Total
48.73
.00
.00
48.73
LQPERA11T
- No pas entneposer ni utiliser d'essence, W
d'subw vapeurs ou liquides inflammables, pros
de cat appareil ou de tout autre appareil.
- S1 vous d6Wctez une odeur de gaz
• n'essaYazpas d'aftuner quelgue appareti que
ce soft
- no tout hez A aucun interrupteur, n'utilisez
aucun t86phone dans votre mice ou maison
- tM6phonezimmediabement;bvotref r
de gaz depuls I'appareil d'un voisin. Suivez
les directives du foumisseur de gaz-
- si vous ne pouvez pas joindre votre
fournisseur de gaz, contactez Is service des
incendies.
- t_'inshallation et 1'entretien doivent btre assur6s
par un irstallateur ou un service quaM6 ou par to
foumisseur de gaz.
PATIO
CAMPFIRE
Instructions
de montage et
mode d'emploi
IMPOWMM l.isez attentivement toutes les instructions avant
de commencer t'i mUlation. Unobservation de ces instructions
peat entrather un risque d'inoendie et annulera la garantie.
Ce rn nuel dolt servir 8 l'instaliation et Is propri taire Is
conservera pour faire fonctionner et entretenir son appareil.
Gardez4e pour Is consulter uit6rieurement
Si nous avez des questions ou d6sirez nous faire part de points
qui vouspr6occuperrt, veuiliez contacter la division des ser-
vices techniques de Hearth & Home Technologies Inc. au
numero suivant :1(800) 927-6841 ou 1(888) 4273973.
Ce prodult est profth par un des brevets suWants ou plus: (aux EtaWUNs : 4;112,913; 4.40%594. 4.422.426; 4,424.792; 4,529,791; 4,793.322; 4.852.548;
4.875.464; 5.0170.162; 5.016.609; 5.076.254 5,191,877; 5.218.953; 5.328,356; 5.429.485; 5,452,708; 5,542,407; 5.613.487: (an Austt81i9) 54379&; 586383; (au
Canada) 1.123.2N, 1.297.746; 2,195.264; (au Mexique) 97-0457; (en Nouvelle-Uhu de) 200265: ou d'auMw bmvels en UmWce atm 6fats-unls ou 9 r6tranger.
08/04 t
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # `t�
V�
Project Address: �1 t YY�
Owner's Name: �� f!
A. P. Number:
Address: 0 S f� 6 11 C, L
Legal Description:
City, ST, Zip:
Contractor:
Telephone:
Address:v 2 0
Project Description:
City, ST, Zip:
Telephone:�60 1Y61
State Lic. # : 7 Y1,
City Lic. #: 6 % Y
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: ii
p � i
State Lic. #:
Name of Contact Person:Ina lz�
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of.Project: LIN �
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
.Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3 d Review, ready for correctis/issue
�(b
Developer Impact Fee
A.I.P.P.
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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