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08-1337 (CRES) Carport 3P.O. BOX. 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 0'8-00001337 Property Address: 47795 DUNE PALMS RD APN: 600-020-030-. - - Application description: CARPORT - RESIDENTIAL Property Zoning: REGIONAL COMMERCIAL Application valuation: 19,578 T4'!t 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: COACHELLA VALLEY 45701 MONROE ST INDIO, CA 9220.1 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/06/08 HOUSING COALI 1-G Contractor: V r Applicant: Architect or Engineer: BROWN CONSTRUCTION, INC,. \Ur ��j 2;5 PO BOX 960700 WEST- SARAMENTO, CA 95798 OF QWpSA (916)373-9300 G�F1NpNGEOle T. � A Lic. No.: 396120 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of, perjury that.l am licensed under provisions of Chapter's (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 haye.and'will maintain a:certificate:of consent to self -insure for workers' compensation,,as provided License Class: B License'No.: 396120 for by Section 3700.of the Labor Code, for the.performance.of the.work for which this permit is issued. Date: Contractor: _ I haveend'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: I hereby affirm under penalty of perjury that I am'exemptfrom the Contractor's State License Lew for the Carrier ZURICH AMERICAN Policy Number WC596614800 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a. permit to 1 certify that, in thee -performance of the work for which this permit is issued, I'shall nut employ any construct,after, improve,.demolish, or repair any structure, prior to its issuance, also.requires the applicant for the person in any manner a as to become subject to theworkers' compensation laws of California,, permit to file a,signed statement thathe or she is licensed pursuant to the provisions of the Contractor's State and agree that H' I should a subir to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 700 of the I shall foanyo wn t isions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fore permit subjects the applicant to a civil penalty of more than hundred dollars (8500).:�� plicent: 1,.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 saW(See. 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;ownerof 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 (S 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 3705 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.). (J164 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—) I am exempt under Sec. , B.&P.0=for this reason te: _ CONSTRUCTION. LENDING AGENCY I hereby, affirm under penalty of perjury that there is a construction lending agency for the performance of the work forwhich thispermitis issued (Sec. 3097, Civ. C.). Lender's Name:. Lender's Address: LQPERMIT APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for permit subject to the conditions and restrictions set forth onthis application. 1. Each person upon whose behalf !his 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 Quints, its officers, agents and employees for any act or omission related to the work, being performed under or following issuanceof this permit. 2. Any permit issued as a result of this application becomes null.and'void if work is�nct commenced within 180 days from date of issuance of,such permit, orcessation of work for 180 days will subject permit to cancellation. I certify that) haveread this application and stete.tha[ the above inform n is cerr - roe to comply with all city and ountyordinances and state laws relating to buil Ing con r ' , d herebyautho representatives oft ' my ter u7pone above-menti0 ro �e for i pection p rposes. v�� ate: 'nature (Applicant orAgent): Application Number . . . . . 08-00001337 Permit . . . ELECTRICAL-CARPORT/GARAGE Additional desc . . Permit Fee . . . . 44.44. Plan Check Fee 11.11 , Issue Date . . . . Valuation 0 .Expiration. Date . . 2/02/09 Qty Unit Charge Per Extension BASE FEE 15.00 1472.00 :0.200 ELEC GARAGE OR NON-RESIDENTIAL 29.44 Permit . . . CARPORT/GARAGE Additional desc . Permit Fee . . . . 207.00 Plan Check Fee 134.55 Issue Date . . . . Valuation . . . . 19578 Expiration Date . . 2/02/09 Qty Unit Charge. Per Extension BASE FEE 45.00 18.00 9.0000 THOU BLDG 2,00.1-25,000 162.00 ---------------------------------------------- ------------------------------ Special Notes and Comments 8 STALL TILE ROOF CARPORT #3, 1412 SF. BLDG. 830.0, PARALLEL TO DUNE PALMS ROAD Fee summary Charged Paid Credited Due Permit Fee :Total 251.44 .00 .00 251.44 Plan Check Total 145.66 .00 .00 14.5.66 Grand Total 3.97.10 .00 .00 397.10 LQrERMrr