05-2839 (AR)p
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P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
97.
44470 VIA CORONADO
604-211-040-47 -23971 -
ADDITION - RESIDENTIAL_
LOW DENSITY RESIDENTIAL
6768
Architect or Enqineer.
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
DRAGON DARYL F
!N Q' 11726 SAN VICENTE STE 360
LOS ANGELES, CA 90049
SEP 2 3 2005
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 Business and Professionals Code, and my License is in full force and effect.
License class: A-13 Lice a No.: 833207
Date: 7/ —Contractor. sop:_
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 ($5001:
1 _ 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
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 intendgd 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 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
Contractor:
RWITT(, RTTTT,r)FR.q
77885 LAS MONTANAS, SUITE A
PALM -DESERT, CA 92211
(760)564-6833
Lic. No.: 833207
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/22/05
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.
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 EXEMPT Policy Number EXEMPT
).certify that, in the performance of the workfor 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 should become subject to the workers' compensation provisions of Section
700 of the Labor Code I s�h/ap7 forth th co ly with those provisions.
-Date: Q �Applicani:
WARNING: FAILURE TO SECURE WORKERS' 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 building construction, and hereby authorize representatives
of this coyty to upon the above-mentioned property for i9spect. n ptygoses�
.-. s ./ //tel
Or
LQPERMrr
Application Number . . . . . 05-00002839
Permit BUILDING PERMIT INV FEE
Additional desc,.
Permit.Fee 180.00 Plan Check Fee
58.50
Issue Date Valuation
6768
'Expiration Date 3/20/06
Qty Unit Charge Per
Extension.
BASE FEE
90.00
5.00 18.0000 .THOU BLDG 2;001-25,000
90.00
Permit . . . ELECT'- ADD/ALT/REM
Additional desc .
Permit Fee . . . . 21.30 Plan Check- -Fee _:
--5.33-
-5..33
Issue Date Valuation
Issue
0
Expiration.Date 3/20/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
180.00 0350. ELEC NEW RES - 1 OR 2 FAMILY
6.30
Permit . . MECHANICAL
Additional desc .
Permit Fee 33.00 Plan Check Fee
8'.25
Issue Date Valuation
0
Expiration Date 3/20/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 - 9.0000 EA MECH FURNACE <=100K
9.00
1.00 9.0000 EA MECH B/C <=3HP/100K BTU
9.00
Notes and Comments
_Special
Convert garage to office (180 s.f.).
Investigation fee added for work
performed prior to issuance of building.
permit per 2001 CBC Section 107.5.
September 20, 2005 4:21:35 PM gbutler
------------------------ -------------------------------------
Other Fees . . . . . ENERGY REVIEW FEE
11.70
STRONG MOTION (SMI) - RES
.67
Fee summary Charged Paid. Credited
Due
Permit Fee Total .234.30 .00 .00
234.30
Plan Check Total 72•.08 00 .00
.72.08
'PREMRED 10/24/05, 11:21:16
'PROGRAM
INSPECTION HISTORY REPORT
PAGE 1
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CITY OF ,LA QUINTA •
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APPLICATION PROPERTY ADDRESS
----------------------------------`--------
APN'*
Alternate ID
---._STRUCTR PERMIT -
INSPECTION "
---------------------------------------------------------
RESULT-DATE/STATUS
S
INSPECTOR------------------------------------------------------------------------
00002839 44470 VIA CORONADO
604-211-040-47- -23971 -
" 000 000 BI01 00 BUILDING PERMIT INV FEE
199 0001 FINAL
10/10 /05 APPROVED
TM
" '000 000`.'E02 00ELECT',-ADD/ALT/REMODEL-"
3990001'ELECTRICAL FINAL
10/10/05 APPROVED,
''.TM - -
•000 000 M01 00 MECHANICAL -'
499 0001 MECHANICAL FINAL
10/10/0.5 APPROVED.
TM - -
t BUILDING & SAFETY DEPARTMENT
. .e THERESE VELLA-FINORIO
SENIOR SECRETARY
P.O. BOX 1504
OFFICE (760) 777-7074
78-495 CALLE TAMPICO
FAX
LA QUINTA, CA 92247-1504 (760) 777-7011
EMAIL: tfinorio@la-quinta.org