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07-2454 (AR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00002454 Property Address: 49805 VIA CONQUISTADOR APN: 649 -500 -018 -.- Application description: ADDITION - RESIDENTIAL . Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 27000 Applicant: Architect or Engineer: 1' ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 i ss and Professionals Code, and my License is in full force and effect. License Class: B .Licen a No.: 341036 ' OWNER -BUILDER LARATION I hereby affirm under penalty of perjury that I am exempt from the C tractor'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 ($500).: (_ 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 improvefor the purpose of sale.). (_) 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 contractor(s) licensed puisuant 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/26/07 Owner: STROHSAHL LYNN 49-805 VIA CONQUI LA QUINTA, CA 922 Contractor: JOHNSON, ROGER L. P.O. BOX 1648 PALM DESERT, CA 9 (760)56872208 Lic . -No 341036 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 3.700 of the Labor Code, for the performance of the work for which this permitis 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 permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND IPolicy Number 0008738-2007 I certify that, in the ormance of the work for which this permit is issued, I shall not employ any .person in any - anner as to become subject to the workers' compensation laws of California, and agree. that if I shout become subject to the workers' compensation .provisions of Section 3700 of the L or Code I shall forthwith co ly wi those provisions. Dante: f�t� .p nt: WARNING: FAILURE TO SECURE WORKERS' PENSATIO C VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL ES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001- 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 stat bove information is correct. I agree to comply with all city and county ordinances and state laws relati tat ato ui.ding construction, andlkereby(�uthorize representatives of this county to enter upon the above-mentione progegy f r inspectiop purpoVeN �\ Application Number . . . . 07-00002454 Permit . . .. BUILDING PERMIT Additional desc . Permit Fee . . . . 265.00 Plan Check Fee 172.25- 72.25Issue IssueDate Valuation 27000 Expiration Date 3/24/08 Qty Unit Charge Per Extension BASE FEE 252.00 2.00 6.5000 THOU BLDG 25,001-50,000 13.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . ., 18.26 P1an.Check Fee 4.51 Issue Date Valuation 0 Expiration Date 3/24/08 Qty Unit Charge Per Extension BASE FEE 15.00 93.00 .0350'" ELEC NEW RES - 1 OR 2 FAMILY .3.26' Permit MECHANICAL Additional desc . Permit Fee- 30:50 Plan Check Fee 7.63 -Issue Date . . . . Valuation 0,. Expiration Date 3/24/08 Qty Unit ,Charge Per. Extension BASE FEE 15..00 1..00 9.0000 EA MECH APPL REP/ALT/ADD 9.00 1.00'. 6.5000 EA MECH VENT. FAN 6.50 Permit . . . . . . PLUMBING Additional desc . Permit Fee .. 36.00 Plan Check Fee 9:00 Issue Date Valuation 0'. Expiration Date 3/24/08 Qty Unit Charge''Per Extension BASE FEE 15.00 3.00 6.0000 EA PLB FIXTURE 18.00 J 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ------------------------------------------- Special.Notes and Comments ------- bathroom addition and bedroom remodel. LQPERMIT Application.Number '. . . . . 07-00002454. s 7 ------------------------------------------------------------------------- Other'Fees . . . .. . . ENERGY REVIEW FEE 17.23 STRONG MOTION (SMI) - RES 2.70 Fee summary Charged Paid Credited Due Permit Fee Total 349.76 .00 .00. 349.76 Plan Check Total 193.45 .00 .00 193.45 Other Fee Total 19.93 .00 .0'0 19.93 Grand Total 563.14 .00 .00 .563.14 • LQPERMIT _ - --- - ---- - 4 111�407 f. N�5 RPR.o wa. t". 6 1 Bin # 4 ` City of ,La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760)'777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: �q .Yo 5 1k Wn (/jj r Owner's Name: A. P. Number: Address: �qs ?b S 04 Leh & f %WP.- ► Legal Description: f City, ST, Zip: Contractor: /f qj1 j /f / Telephone: Address: C Project'Deschption: 6(L /vOm City, ST, Zip: Telephone: State Lic. # : City Lic. #: 99 A. Al Arch:, Eng Designer: CufflJ .ShUe -r7., Address: /l6 Ga o/ City, ST, Zip: l%h Auekt (5,A o Telephone: 76 3V( 73S.? Z Construction Type: Occupancy: " State Lic. #: C/ 334fe Project type (circle one): New Add' Alter. Repair Demo Name of Contact Person: Co- —t- C4 (/ e Sq. Ft.:' g3 # Stories: / # Units: / Telephone # of Contact Person: 73 5' Estimated Value of Project: 2 7 aaO. 00 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING. PERMIT FEES Plan Sets Plan Check submitted b 4 Item v Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balancet Energy Calcs. Plans picked up Construction -. Flood plain plan Plans resubmitted Mechanical , Grading plan' 2nd Review, ready for correctio s/issue Electrical �• Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issu Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees cv�,I oma ajotq)