06-4007 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&t�/ 4 etPa"
Application Number:
06-00004007
Property Address:
79755 FIESTA DR
APN:
649-063-001-70 -2180 -
Application description:
STRUCTURES OTHER THAN BUILDINGS
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2000
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
1 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.:
t` agate- & 6 n( .,;tor: �r�-
./� OWNER -BUILDER DECLARATION
I hereby affirm under penalty o rjury that 1 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 pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
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.).
(_ 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 License Law.).
1 1 I am exempt under Sec. , B.&P.C. for this reason
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perju 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:
HARDIN JAMES M
79755 FIESTA DR
LA QUINTA, CA 92253
(
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/16/06
----------------------------------------------—
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.
_ 1 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 2001 CBC Policy Number - - - - - - - - - - - - - --
' certify that, in the performance of the workforwhich 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 ould become subject to the workers' compensation provisions of Section
a�/�0 of the Labo ode, I shall forth comply with those Provisions.
e: /G 6 icon
WARNING: FAILURE TO S RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER T CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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
c�ate
ty ordinances and state laws relating building construction, and hereby authorize representatives
ter upon the ve-mentioned //perty forinspectss�G 6�i ure (Applicant or e 4
Application Number . . . . . 06-00004007
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . . 26.00
Plan Check
Fee
6.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date 5/15/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 11.0000 EA MECH FURNACt >100K
----------------------------------------------------------------------------
11.00
Permit . . . ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . . 45.00
Plan Check
Fee
11.25
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date 5/15/07
Qty Unit Charge Per
'Extension
BASE FEE
15.00
1.00 30.0000 EA ELEC PRIVATE SWIMMING
----------------------------------------------------------------------------
POOL
30.00
Permit . . . PLUMBING
Additional desc .
.Permit Fee . . . . 21.00
Plan Check
Fee
5.25
Issue Date . . . .
Valuation
0
Expiration Date .. 5/15/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 3.0000 EA PLB WATER
INST/ALT/REP
3.00
1.00 3.0000 EA PLB GAS PIPE
1-4 OUTLETS
3.00
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Special Notes and Comments
.RELOCATE POOL EQUIPMENT PER APROVED
PLAN, PRIOR TO RESIDENTIAL ADDITION.
Fee summary Charged Paid
-------------------------------------
Credited
--------------------
Due
Permit Fee Total 92.00
.00
.00
92.00
Plan Check Total 23.00
.00
.00
23.00
Grand Total 115.00
.00
.00
115.00
LQPERMIT
Ulty of La Qulnta .
Building et Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: �� j l e ( j c� Owner's Name: -
A. P. Number. Address: '� �.5" es'E� �� tJ'Q
Legal Description: City, ST, Zip �3
s
Contractor: (i'LU (V -e � Telephone: '�
Address: �� ss C S �? Project Description:
City, ST, Zip: L) qz z,;- � 0V -,h4 KGOL F,?
Telephone: Construction Type: Occupancy:
State Lic. #: Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: e,
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LIkE
H
Submittal
Req'd.: Recd TRACKING . PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Calcs.
Reviewed, ready for corrections PlanCheck Deposit
Truss Calcs.
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading.plau
2`! Review, ready for corrections/issue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up SALL
II.O.A. Approval
Plans resubmitted . Grading
IN IKOUSE:-
" Review, ready for correctionstissue Developer Impact Fee.
Planning Approval
t Person A,K.P.Y.
.Pub. Wks. Appr
issue..
School Fees
E.f
Total.Permit Fees : ..
17-