08-1338 (CRES) Carport 4P.O. BOX 1504
78-495 CALLETAMPICO
LA QUINTA, CALIFORNIA 92253
c&ht 4 -4 Q"
Application Number: 08-00001338
Property Address: 47795 DUNE PALMS RD
APN: 600-020-030- - -
Application description: CARPORT - RESIDENTIAL
Property Zoning: :REGIONAL COMMERCIAL
Application valuation:. 9789
Applicant: Architect or Engineer:
BUILDING &. SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/06/08
Owner:
COACHELLA VALLEY HOUSING COALI
45701 MONROE ST 1-G
INDIO, CA 92201
Contractor:
BROWN CONSTRUCTION, I14 d
PO BOX 980700
WEST SARAMENTO, CA 95 8 A
(916)3'13-9300 A(/,G 2
Lic. No.: 396120 J ?008
Cn, _
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LICENSED CONTRACTOR'S DECLARATION
------------ ---------------- - - - --- -- - - -- - — -- —
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury that I.am licensed 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 and Professionals 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
Ucense,Class: B. License No.: 396120
for by Section 3700 of the Labor Code, for the performance ofthe work for which this permit is
issued.
Data: Contractor:
_ I have and will maintain workers' compensation insurance, as required by'Seotion 3700°of the.Labor
Code, for the performanceof the work for which this permit is issued. My workers' 6ompensation
OWNER -BUILDER DECLARATION
insurance carrier and policy number,are:
I herebyaffirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier WICH AMERICAN Policy Number, WC596614800
following reason fSec. 7031.5, Business and Professions Code: Any city or county,that requires_a permit to
I certify that, in the performance of the work:for which this permit is issuedi I shll not employ any
I
construct alter, improve, demolish; or repairany structure, prior to its issuance, also requires -the applicant for the
person in any manner so as to. become subject to the workers' compensation[ aws of. California,
permit to filea signed statement that he•or she isdicensed pursuant to the provisions of the Contractor's State,
and agree,that, if I shouojmmmUll subject,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
ZIl7OO of the Lvbartaderj shall fort with those' provisions.
thathe or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
�I t]�
any applicant fora permit subjects the applicant a civil penalty of noYmore than fivehundred-dollara (55001:ate:
Ile
plicant:
( 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 sale (Sec: 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C 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 15100,0001. 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 3708--OFTHE 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.).
( I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.,
TTT 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 contractors) licensed
pursuant to the Contractors" State Ucense.Law.).
(_) I am exempt under Sec. _ , B.&P.C. isreason
J.
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 (Sed. 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 on this application.
1. Each person upon whose behalf this application -is' made, each person at whose.requestand for
whose benefit work.is performed under or pursuant tweny permit issued as,a resuR of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and bold 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 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 statet at the above in o - i is correct:. I ag o comply with all
city and - My ordinances and laws relating to buildingconstructio hereby authorizer resematives
of IN y tpAnlpr'upon thea ntioned property,f inspection p rpose
ate: �(/ature (Ap - n
Application Number . . . . . 08-00001338
Permit . . . ELECTRICAL-CARPORT/GARAGE
Additional desc . .
Permit Fee . . . . 29.72 Plan Check Fee
7.43
Issue Date . . Valuation . . . .
0
Expiration Date . . 2/02/09
Qty Unit Charge Per
Extension
BASE FEE
15.00
736.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL
14.72
Permit . . CARPORT/GARAGE
Additional desc . .
.Permit .Fee . . . . 117.00 Plan Check Fee
76.05
Issue Date . . . . Valuation . . .
9789
Expiration Date 2:/02/09
Qty Unit Charge Per
Extension
BASE FEE
45.0.0
.8.00 9.0000 THOU BLDG 2,001-25,000
72.0'0
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Special Notes and Comments
4 STALL TILE ROOF CARPORT #4, 7.36 SF. @
BLDG. 8200, PARALLEL TO DUNE PALMS ROAD
Fee summary Charged Paid Credited
- -------- ---------- ----------
Due
Permit Fee .Total 146.72 .00 .00
--
146.72
Plan Check Total 83.48 .00 .00
83.48
Grand Total 230.20 .00 .00
230.20
LQPERMrr