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06-2398 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 06-00002398 Property Address: 47585 VIA MONTESSA APN: 643-120-061-240 -26152 - Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4700 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: License No.: Date: 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 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 contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. , B.&P.C. for this reason Date: �Q •' �1 Q (p 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 Owner: GILHOUSEN BRENT J 1 PEAKMONT LN CLARKSON VALLEY, MO 63005 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/19/06 FJUNContractor:cOwner 1 91006 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 ' Policy Number 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 should become subject "he workers' compensation provisions of Section 3700 of the Labor C �, shall forthwith omply w' h those provisions. Date: (. •19't) Applicant: 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 c rrect. I agree to comply with all city and county ordinances and state laws relating to building construction, and ereby ahorize representatives of this county to enter upon the above-mentioned pro a pection purpo s. •�*Date: A gnature (Applicant or Agent): - Application Number . . . . . 06-00002398 Permit . . . BUILDING PERMIT ' Additional desc . . Permit Fee . . . . 72.00 Plan Check Fee 46.80 Issue Date . . . . Valuation . . . . 4700 Expiration Date 12/16/06 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 9.0000 THOU BLDG 2,001-25,000 27.00 ---------------------------------------------------------------------------- `� Special Notes and Comments BOAT DOCK, 30 L.F. 5' WALL, 43 L.F. 4' BLOCK WALL ---------------------------------------------------------------------------- t Other Fees . . . . . . . . . ENERGY REVIEW FEE 4.68 } Fee summary Charged Paid Credited Due ----------------------------------------------- ---------- Permit Fee Total 72.00 .00 .00 72.00 Plan Check Total 46.80 .00 .00 46.80 Other Fee Total 4.68 .00 .00 4.68 Grand Total 123.48 .00 .00 123.48 LQPERMIT Bin # ' 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 # A/�I�0 O Project Address:' Owner's Name: A. P. Number: 6 3 I a 0 — / Address: Legal Description: City, ST, Zip: Contractor: e Address: Telephon : Project Description: City, ST, Zip: Telephon : 'f%6� ��cS•� O9 �O e if State Lie. # City Lie. Arch., Engr., Designer: Address: ? r� L City, ST, 'p: Telepho e: O./ CN - ffiSlO _ . Construction Type: Occupancy: State Lie. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: renv Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING. PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading. plan' 2°" Review, ready for corrections/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:- 7nd Review, ready for correctionslissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Tdf 414 a" P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT (760) 777-7012 FAX (760) 777-7011 Finance Department, Please Collect The Following Fees For The Services Rendered HTE APPLICATION No._04-_6438 PROJECT: SFD rue Code ADDRESS: 47-585 Via Montessa CUSTOMER: Dan Dryden SERVICES RENDERED: TRUSS MANUFACTURER REVISION TO ISSUED PERMIT # 04-6438 Fees: PlanReview: .......................................:.................................... $ 35.00 TOTAL FEES NOW DUE: ................................. $ 35.00 Date: _August 15, 005 Initials:7w