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12-1329 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 TW!t 4 4 a" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 'TIONS (760) 777-7153 Application Number: 12-00001329' Owner:I" J Property Address: 52530 EISENHOWER DR THE NORRIS GROUP L APN: 773-301-002-22 -000000- 1845 CHICAGO AVE SEC Application description: REMODEL - RESIDENTIAL RIVERSIDE, CA 9250 Property Zoning: COVE RESIDENTIAL Application valuation: 500 Contractor: Applicant: Architect or Engineer: GRISA ENTERPRISES INC 44695 SAN BENITO CIRCLE PALM DESERT, CA 92260 (760) 341-0555 Lic. No.: 921518 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Bus' ss and Professionals Code, and 'eensie'is in full force and effect. Lic e C ss: C ss: B: Lic .:Lic .: 921518 Date: ontractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).: 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 contractors) 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 11/09/12 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. 1F 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 permit is issued. My workers' compensation insurance carrier and policy number are: Carrier NORGUARD INS Policy Number GRWC222985 I certify that, in the performance of the work for which 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 Id become subject to the workers' compensa . mprovisions of Section 3700 of th Labo Co e, I shall fo h comply with tl wsians. <te: '1-2 pplicant: WARNIN _TTT TO SECU ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO 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 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 city and county ordinances and state laws relating to b ilding construction, and hereby authorize representatives this c unty to enter upo the above-mentione pe y for inspection s. Date:v, Q 2 nature (Applicant or Agent). Application Number Permit . . . Additional desc . . Permit Fee . . . . Issue Date . . . . Expiration Date . . . . . . 12-00001329 BUILDING PERMIT INV FEE 30.00 Plan Check Fee . . 9.75 Valuation . . . . 500 5/08/13 Qty Unit Charge Per Extension BASE FEE -------------------------------------------------7-------------------------- 30.00 Permit PLUMBING INV FEE Additional desc . . Permit Fee . . . . 45.00 Plan Check Fee 5.63 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/08/13 Qty Unit Charge Per Extension BASE FEE 30.00 1.00 15.0000 EA PLB WATER HEATER/VENT 15.00 ---------------------------------------------------------------------------- Special Notes and Comments INSTALL 40 GALLON PROPANE FUELED WATER HEATER AND WALL A/C UNIT IN GARAGE. INVESTIGATION FEE ASSESSED PER 1997 UNIFORM ADMINISTRATIVE CODE §304.5 FOR WORK BEGUN WITHOUT BUILDING PERMIT. ---------------------------------------------------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE .98 STRONG MOTION (SMI) - RES .50 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 75.0.0 .00 .00 75.00 Plan Check Total 15.38 .00 .00 15.38 Other Fee Total 2:48 .00 .00 2.48 Grand Total 92.86 .00 .00 92.86 LQPERMIT a 5253 40. (:::;,yu•, It '� ' (, —k" -400V )cl xq, ,, x t4 x3o A CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATqM/a BY I I Prescri fly Residential. Pm ect Name: General Infon Site Address: of Compliance: Residential 1 Climate Torte: ❑ Multi Enforcement CF71R-ALT-DH Page I of 2 Permit N: Date: or Charter, Out of Water.Heater WATER HEATING List neww• installed.waar heaters and boilers for both domestic hot water heaters (DWH) and lndralic space heating. Ne%• v installed DWH heaters and boilers mast be gas., prWane. or use the existing el Wates Hater ! Typdlw Type Distribution Type (Stydard. Numbs In Tank E—By Factor Ree System Capacity (gal) . Thermal Effw micy 6,nemal Tank insulation R-Value' • 1 certify dint the energy features and pesf0munce specifications for the building design identified on this Certificate of Compliance conform to the requirettuents of Title 24. Part I and 6 of the California Cock of Regulations. • The building design features identified on this Certificate of Compliance arc consistent with the information provided to document this building design on the other applicable compliance forms, worltslwem calculations. plans and specifications subtruixed to the enfotecment agency for approval with this building. permit kwon - Man= Oap (9) r1�� �: I l g ZAdd: 14 1. Indicate Type (Storage Gas. Heat Pump: Inrtantaneous. etc.) I Recirculating systems serving multiple dwelling units stall. Hatt the recirrulation requirements of §1ARX rlegrrirrments do awe allow the installation of a recirculating water heating system for single dwtelling units. i. The external water heat' rank and ' s shall be iuuulated_to nae[ the require►nents off l The Prescriptive C mtractor or Homeowner (Documentation Author's/ResponsgAe Building Designer's Declarad" Statement) • 1 certify [fiat this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • 1 certify dint the energy features and pesf0munce specifications for the building design identified on this Certificate of Compliance conform to the requirettuents of Title 24. Part I and 6 of the California Cock of Regulations. • The building design features identified on this Certificate of Compliance arc consistent with the information provided to document this building design on the other applicable compliance forms, worltslwem calculations. plans and specifications subtruixed to the enfotecment agency for approval with this building. permit kwon - Man= Oap (9) r1�� �: I l g ZAdd: 14 .� l.o<�e�21 o Pb PA VM .� r Bin .# Qt% Of La Quinta Building 8i' Safety Division P.O. Box 1504,78-495 Calle Tampico P.Quinta, CA 92253 - (760) 7777012 Building Permit Application"and Tracking Sheet Perinit # Project Address:Owner's Name: . A. P. Number. Address: Legal Description: City, ST, Zip: Si Contractor. L �� 0(). Telephone: Address: �(�PIT Project Description: City, ST, Zip: - TeleP hon e: i D a !•.. .ii�o " State Lie. #: V I ��^^ owl City Lie.. #; 1 C Arch, Engr., Designer: Address: City, ST, Zip: Telephone: ' !��-/� State Lia #: ,,;r;.;�aw�J,�� Name of Contact Person: Construction Type:. Occupancy: Project type (circle one): New Add'a Alter Repair Demo Sq. Ft : #Stories t# Units. Telephone # of Contact Person: Estimated Value of Project APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd'Rec'd TRACENG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Pian Check Balance Tide 24 Calcs. Plans picked up Construction ' Flood plain plan Pians resubmitted Mechanical Grading plan tad Review, ready for correctionsfiissue Electrical Subeontactor List Called Contact Person Plumbing Grant Deed Plans picked up SALL H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 7i° Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees