07-0645 (SOTB)w
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tjht 4 4a Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: f! 07-00000645 = r Owner:
Property Address: 81215 LEGENDS WY WILL DAY
APN: 762-310-014- - 81215 LEGENDS
Application description: STRUCTURES OTHER THAN BUILDINGS LA QUINTA, CA
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 5000
Contractor :LAP
Applicant: Architect or Engineer: VICTORIA LANDS
53725 AVENIDA
LA QUINTA, CA 92253
(760)777-1417
fy� Lic. No.: 801813
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
MAR 0 21007 L�
Date: 3/01/07
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LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I 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
License Class: C27 C53 License No.: 801813
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
D O rector:
_ 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
OWNER-BUILDgeCon5acto'! RATON
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt fromsStateLicense Law for the
Carrier EXEMPT Policy Number EXEMPT
following reason (Sec. 7031.5, Business and Professions Codeity or county that requires a permit to
I certify that, in the performance of the work for which this 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 so as to become subject to the workers' 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 should become 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
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
3700 of the Labor , I sh fart comp) with those provisions.
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$5001.:
_
t
D plicant:
( 1 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
IS UNLAWFUL, AND SHALL
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIOKNSATI
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
'SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIONE 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 COMAMAGES 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 ATTO
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.l.
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,
(_ 1 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
_
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.
Date: Owner:
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
CONSTRUCTION LENDING AGENCY
permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that shave read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). •.
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this t to enter upon th ove-mentioned pro for' pecti rposes.
Lender's Name:
3 I v1
ate: Si cure (Applicant or Agent):
Lender's Address:
LQPERMIT _ - - - - - - _' - - -' _. 4
" Application Number .
. . . . 07-00000645
Permit . . . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
72.00 Plan Check Fee
46.80
Issue Date
Valuation . . .
. 5000
Expiration Date
8/28/07
Qty Unit Charge
Per
Extension
BASE FEE
45.00
3.00 9.0000
7 ---------------------------------------------------------------------------
THOU BLDG 2,001-25,000
27.00
Permit . . .
ELEC-MISCELLANEOUS
Additional desc .
Permit Fee . . .' .
17.25 Plan Check Fee
4.31
Issue Date . . . .
Valuation . . .
. .0
Expiration Date
8/28/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3.00 .7500
----------------------------------------------------------------------------
PER ELEC DEVICE/FIXTURE 1ST 20
2.25
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . .
18.00 Plan Check Fee
4.50
Issue Date
Valuation . . .
. . 0
Expiration Date
8/28/07
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
BBQ; PER APPROVED PLANS
---------------------------------------------------------_-------------------
_ Other Fees . . .
. . . . ENERGY REVIEW FEE
4.68
STRONG MOTION (SMI) - RES
.50''
Fee summary. Charged* Paid Credited
-------------------------------------
Due
Permit Fee Total
--------=-----------
107.25 .00 .00
107.25
Plan Check Total
55.61 .00 .00
55.61
Other Fee Total
5.18 .00 .,00
5.18
Grand Total
168.04 .00 .00
168.04
LQPERMIT
Bin #
Permit #��
Project Address:'
A. P. Number:
Legal Description:
Contractor:
Address: 5 3 7 A -y E
City, ST, Zip: c
Telephone:., (p p —/-77 q/ —7
State Lie. #
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name -of Contact Person: I
(?
Telephone # of Contact Person: 7/
# Submittal
Plan Sets
Structural Cala.
Truss Lica.
Energy Cala.
Flood plain plan
Grading plan
Subcootactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City of La Quinta
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
tiD S w Owner's Name: IN L
Address:
City, ST, Zip: j_ CA-
I
ZZs 3
I N e, Telephone:
►'h — Project Description:
ZS -
City Lic. #:
a.
Fees
Construction Type:
Occupancy:
Project hype (circle one):
New Add'n Alter Repair Demo
Sq. Ft.:
#Stories:
Units:
20 ! -7
Estimated Value of Project:
APPLICANT:
DO NOT WRITE BELOW
THIS UNE
9-7
TRACKING .
PERMIT FEES
eck submitted
Item Amount
eviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Pian Check Balance
Plans picked up
.
Construction
Plans resubmitted
Mechanical
2" Review, ready tions—
t�r!�m�ai
Called Contact Pe o
cA F ErPl�ra'i4g
I.
Plans picked upAMD
E I
Plans resubmitted COSI TRUG
. I
ing
Review, ready fo .corrcctionsrissue
Developer Impact Fee
Caned Contact Pe nDATE
U 0 NTA
I.Date
of permit issue
BUILDING & SA 1 DEPT.
Fees
RAISED BOX
PLANTER
P
L
A
N
T
E
R
U OLF COURSE
STEPS TO GRASS�- STEPS TO GRASS
LAWN AREA 19-10 0
J7+18"
LAWN AREA
DECK O
PLANTER BE PLANTER BED
-719 BENC14 ■ BENCH
:SPXA:
SCUPPER ENTRY STEPS
SCUPPER
FIREPLACE
41 POOL 31/2'
+12"
S
TAN SHELF +12"
O O ITY OF TA STEP UP L -.
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