11-1151 (PLBG). Q1 1
- P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-00001151
Property Address: 81115 GOLF VIEW DR
APN: 762-280-011- -
Application description:. PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 800
c&ty/ 4 4 a"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SABELLA DOUGLAS A
81115 GOLF VIEW DRIVE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/19/11
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:
LQPERAI IT
of La ouinta, its officers, agents and employees for an r omission related to the work being
performed under or fallowing issuance of this permi
2. Any permit issued as a result of this application be omes null a d void if work is not commenced
within 180 days from date of issuance of such rmit, or cess tion of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state Alhve informatio is correct. I agree to comply with all
city and cou�y orrd1dinanpes and state laws relatingconstruction, nd hereby authorize representatives
Ofthis wunty W 4itet peon the above-mentionedInspection p poses.,
1499 re (Applicant or Agent):
0/�
Contractor:
Applicant: Architect or Engineer:
DIAZ LANDSCAPE MAINT, FREDDIE
—_
80360 AVE. 43 {
INDIO, CA 92201
✓1,
0
(760) 342-8124 r Z7�
'^
I
I
Lic. No.: 781250i11fVrA
1'
----
F
--------------------
UC SED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I licen ed 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 d ofe sionals 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
Lic nse Class: 27 License No.: 781250
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
Date: lontractor:
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 per it is issued. My workers' compensation
• OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier GOLDEN EAGLE licy Number 400 219417
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance e w rk for which t ' 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 the
person in any manner s s t o subject to th orkers' 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 sh I be ject to the orkers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
f the Labor C d , I hwith co y with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
D
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
at A can
(_) I, as owner of'Lhe 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: FAILU E 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
(_ 1 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 Code: 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,
I—) I 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
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:
LQPERAI IT
of La ouinta, its officers, agents and employees for an r omission related to the work being
performed under or fallowing issuance of this permi
2. Any permit issued as a result of this application be omes null a d void if work is not commenced
within 180 days from date of issuance of such rmit, or cess tion of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state Alhve informatio is correct. I agree to comply with all
city and cou�y orrd1dinanpes and state laws relatingconstruction, nd hereby authorize representatives
Ofthis wunty W 4itet peon the above-mentionedInspection p poses.,
1499 re (Applicant or Agent):
0/�
LQPERMIT
r
- Application Number . . . . 11-00001151
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 18.00 Plan Check.Fee
4.50
Issue Date . . . . Valuation . . .
. 0
Expiration Date 4/16/12
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
INSTALL 98 L.F. 1' POLY GAS TO BBP AND
90 L.F. 3/4" CONDUIT.FOR ELECTRIC PLUG.
TO BBQ. 2010 CODES.
---------------- -----------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 18.00 .00 .00
18.00
Plan Check Total 4.50 .00 .00
4.50
Other Fee Total 1.00 .00 .00
1.00
Grand Total .23.50 .00 .00
23.50
LQPERMIT
H
m—as� —t (E) BARBEQUE
(E) CONCRETE
I
❑ (E) AC
RESIDENCE
8
O (E) POOL EQUIPMENT
I (N) 120 V ELECTRICAL. UNE
CONNECT TO EXISTING BBQ
—(N) 1-1/2" GAS UNE
CONNECT TO EXISTING BBQ
(E) DRIVEWAY
81115 GOLF VIEW DR.
(E) POOL
(E) COURTYARD
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVE®
FOR CONSTRUCTION
DATE��-/q/� gY 9
NEW GAS & ELEC LINE
Scale: 1 = 16 —0
SABELLA RESIDENCE
81115 GOLF VIEW DR.
LA QUINTA, CA. 92253
PGA WEST
of La Quina
Building ez Safety Division : r
Permit # P.O. Box 1504, 78-495 Calle Tamplco \
La.QAtU, CA 92253 - (760) 777-7012
Building Permit -Application and Tracking .Sheet
i Projca Address: - na's Name . �j
A P. Number dress:
Icity-STzip:
Vivi I DR
I,egaf Descrpdon: L / v ZZContractor.
p 2 r,Dephone:
Address: U 6— Project Description:
city. sl; zip: I 0 ZZc� l < [d
j
Telephone: O —6 i_
State Lie, # :
Arch, Fagr., Destgaer:
Address:
City, ST, Zip:
-i
Telephone: Construction T ype: • -0ccapancY- .
i
Steele Lic. #: Project type (c hde ane): Now Add'n Alter' Repair Demo
=
Name of Conict Person D , Z Sq Ft : # Stories - # UnitF.
Telephone # of Contact Person: Ewmawd vahm of Project: • (�
APPLICANT: DO NOT -WRITE BELOW -THIS LINE
8 -Submittal Req'd Reed.. TRACKM PER?= FEES'
Plan Seb
Pian Ch& submitted UM Amount
Mmctural i wc&
Reviewed, ready for eor ewons Plan Check Deposit,
11nas Caltr
caged Contact Person Plan Check Balance •
14fIe 24 Chlea.
Pians picked up Construction
Flood Ptah plan
Plans resubmitted MeehanW
Grading plan
r! Review, ready for eormetiousrasue Electrical
SnbeoutactDr last.
Called contact Peon Ftumbia
rsg
Grant Deed
Pians pidred up
H.O.A. Approval
Plans resubmitted Gradbxg
W $OUSB:-
"Reytew, ready for eorrectioaslLtsae Developer Impact Fee
Plannlug Appy'
Called Contact Pawn AJ.P-P.
Pub. Wks. Appr
Date of permit issue
Saw Fees
Total Permit Fees