08-0721 (SOTB). -t�"O. BOX 1504..
"78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
•r
BUILDING PERMIT
Application Number: . 08-00000721
Property Address: 53635 VIA MALLORCA
APN: 772-420-999-52 -298943-
Application description: STRUCTURES OTHER THAN BUILDINGS
.Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2000
Applicant: Architect or Engineer:'
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 o the Business and Professionals Code, and my License is infull force and effect.
License Class:' B ILicenseNo.: 683969
Dater �`' Contractor:
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 ($500).:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
thestfucture 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 _ 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.).
(—),,I am exempt under Sec. ., BAP.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.1. -
Lender's Name:
Lender's Address:
Owner:
WHITE DAVE & LIELA
53-635 VIA MALLORC.
LA .QUINTA, CA 922
(805)340-3993
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
�. Dater 4/30/08
Contractor: O20
CAL -TECH DEVELOPMENT CORRQ0V' G �o®"
78150 CALLE TAMPICO STE 2
LA QUINTA, CA -92253
(760)771-3738 -
Lic. No.: 683969
--- - - - - -- -----'---------------------------------
WORKER'S COMPENSATION DECLARATION -
I hereby affirm under penalty of perjury one of the following declarations:
_. I have and will maintain a certificate of consentto 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 workerscompensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1768839
1 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 should become subject to the workers' compensation provisions of Section
Dater�wf37r00,of_the'Labor Cod I shalLforthwith comply wi a pcov'�s,on,,
^' _02pplicant:__� •W/,/1�-��'
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 1$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 permitsubject 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 buil 'n onstruction d hereby authorize representatives
- of this c unty to emer upon the above-mentioned proper r i ection oses.
1 � -
Date: 0-0 Signature (Applicant or Agent):
LQPERN11T
• f
`Application Number 08-00000721
:'!Permit . BUILDING PERMIT
Additional desc .
Permit Fee ^. 45.00. Plan Check Fee
29.25
Issue.Date Valuation
2000
Expiration Date 10/27/08.
Qty Unit Charge Per
Extension
BASE FEE
15.00 :.
15.-00 2.0000 HND -BLDG 501-2,000
30.00 LL
F Permit •. yELEC-MISCELLANEOUS
Additional desc-.
Permit Fee 18.00 Plan Check Fee
4.50
Issue Date .". . Valuation
0-
_
Expiration Date 10/27/08
Qty Unit Charge Per -
Extension
BASE FEE
15.00 .
4.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
3.00 ;
Permit .- PLUMBING
Additional desc .
Permit Fee 18.•00 Pian Check Fee ...
4.50 "
Issue Date Valuation
0
•Expiration Date .. 10/27/08 -
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
r
BBQ ETL# 3061910 METAL STUD CONSTRUCTION
WITH VENEER PER APPROCED PLANS. JJ
--------------------------------------r- - -
Other Fees . . . . ..... . . ENERGY REVIEW FEE
- - -- - - - ---
2:93
Fee summary Charged Paid Credited
Due "
------------------- •--------------------
Permit -Fee Total 81.00 .00 - .00
81.00
Plan Check Total 38.25 .00 *.00
38.25
Other Fee Total 2.93 :00• .00
2..93'
_ Grand -Total 122.18 00 00
122.18
Bing-,.
City of La Quinta r, .
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 -,(760) 777-70.12
Building Permit 'Application and Tracking She
`Permit #
r -L1
Project Address:'/�" 3 • �O3 �. A6
Owner's Name: 'Z f 4C 4 4ELq
A. P. Number
Address:
Legal Description: S, Ali6E rlta 1Q
Contractor: c..�FL _ G�
City, ST, Zip:
Telephone:
Address: -1� COI A ?,qwt Pico STE. O t'.4
Project Description::PAtt64,dr F001 tl O14u
City, ST, Zip: iA/T;tCA7 Z Z
p. �c
Telephone: 7( D. . 7,7 7.341
OA v 2 i L e 1 e AI cc Z
tf4 r L 6 (p L
State Lic. # : 6g City Lic. #:.
Arch., Engr., D.esiper: (� EI
Address: , Q . z �'
�dNS
City, ST, Zip: 5,4od er,4 BAR er4 `13/ 20
E✓ N `e�/�ll — . , ,, ,
Telephone: RC 5— ?42 5.2
State Lib. #:
Construction Type: Occu as
P cY:
Project type (circle one): New . Add'n 'Alter Repair Demo
Name of Contact Person: 'N&a
Ft.: .
S9, #Stories: #Units:
Value.of Proj. 4ye, 01 tj , t •e
Telephone # of Contact -Person: '76.0 _Estimated
ij APPI IRANT. nA aiAT VUn TV'no —u• 4r..... .
#
Submittal Req'd Ree -'d TRACING'.
PERMIT FEES
Plan Sets Plan Check submitted.
Item
Amount
Structural Cales. Reviewed; ready for corrections
Plan Check Deposit
1'uis SCS. Called Contact Person
Plan Check Balance
Energy Cates. Plans picked up
Construction '
Floodplain Plan, Plans resubmitted
Mechanical
Grading. plea 2" Review, ready for corrections/Issue
Electrical
Subcontactor. List Called 'Contact Pers6n
Plumbing
qS uJG'
Grant'Deed Plao§.picked up
S.M.I.
H.O.A. Approval Plans resubmitted
Grading
IN HOUSE:- ' ''' Review, ready for correctionslissue
Developer Impact Fee
Planning Approval Called Contact Person
Pub. Wks. Appr Date of permit issue
School Fees
Total Permit Fees