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05-4030 (SOTB)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T-v4t 4 4 Q" Application Number: 05-00004030 Property Address: 80956 VIA PUERTA AZUL APN: 762-240-003-3 -300961- Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: MEDIUM DENSITY RES Application valuation: 300 Applicant: Architect or Engineer: 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 Business and Professionals Code, and my License is in full force and effect. License Class: License No.: , c Date: _?_Z::5 Contracto . ,"1/ 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).: (_ I 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.). (_ I 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 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: 9/15/05 Owner: WILLIAMS MARY 80-956 VIA PUERTA AZUL LA QUINTA, CA 92253 Contractor: ARTISTIC LANDSCAPE INC. WCC: ZENITH INS WC: Z047911804 01/14/06 CSLB: 379421 08/31/07 ----------------------------------------------- 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 C27 HIC 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 to the workers' compensation provisions of Section /3700 of the Labor Co, I shall f@ hwitp comply ' h those provisions. Dat 7 SApplicant, 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 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 Quints, 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 ofthis county to enter upon the above-mentioned prope/ for inspe ;i p oses. D t3 e: 9 /x !C Signature (Applicant or Agent): -C Application Number . . . . . 05-00004030 Permit BUILDING PERMIT Additional desc . Permit Fee . . . . 15.00 Plan Check Fee 9.75 Issue Date Valuation . . . . 256 Expiration Date 3/14/06 Qty Unit Charge Per Extension ---------------------------------------------------------------------------- BASE FEE 15.00 Permit PLUMBING Additional desc . Permit Fee . . . 18.00 Plan Check Fee 4.50 Issue Date . . . . Valuation 0 Expiration Date 3/14/06 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 16 L.F. 4' EQUIPMENT BLOCK WALL, CITY STANDARD. FIREPIT. ---------------------------------------------------------------------------- Other Fees . . . . . . • . . ENERGY REVIEW FEE .98 Fee summary Charged Paid -------------------------------------- Credited ---------- Due Perm it Fee Total 33.00 ----------- .00 .00 33.00 Plan Check Total 14.25 .00 .00 14.25 Other Fee Total .98 .00 .00 .98 Grand Total 48.23 .00 .00 48.23 LQPERMIT Bin # — "Permit # - --- --- D5' ­' `1636 Project Address: 1 A. P. Number: Legal Description: Contractor: X < < Address: City. ST, Zip: Y_ Telephone: X . State Lic. # : X, 3 42 Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Telephone # of Contact Person: # Submittal Plan Sets Structural Calcs. Truss Calcs. Title 24 Calcs. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees 2S4 Llq 'd I City of La Quinta - Building & Safety Division --p;O.-Box-1504; -78-495-Calle Tampico-- — - La Quinta, G4 92253 - (760) 777-7012 Building Permit APPlication and Tracking Sheet d 4 . .zul Owner's Name: X Address: X �-� „ rt A f Lic. #: . 43—!0`730 APPLICANT: DO Recd Plan Check sub Reviewed, read Called Contact Plans picked up Plans resubmitt 2" Review, read Calle d Contact I Plans picked up Plans resubmitti Review, reads Called Contact 1 Date.of permit ii City. sr, zip:2253 Telephone: Project Description: K W. fin do) Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo `o Sq. Ft.: # Stories: # Units: Estimated Value of Project: X##300 . NOT WRITE BELOW THIS LINE TRACKING PE91111T FEES nitted 6 Item Amount for corrections Plan Check Deposit 'erson Plan Check Balance Construction ASM µ t'H OTf/ d Mechanical y for corrections/issue Electrical 'erson Plumbing O trrd8•'T S.M.I. d ------------ Grading for corrections/issue Developer Impact Fee erson A.-I.P.P. sue ' Total Permit Fees �o oo© 6+utier 2� H Gas:L;,�t? . �y T cool �u; lie `"�� �=;� F �,`- t t �:�! -� Q �.;�{y ��'.A �1a.11 ..;f-tAe,1t ic) lvl jc.b. .. L 4 j s :( �{ �, i ! ., s.. .. �,.�. t r„.. � ;.Ar.►*`.i,,.,, ... :: __..__s......----r._-... --....s-.w.-,e.•n,.. Y J i -If � t55KA P' .•_ - i6 4& V 1 S i, L t fit 5_9,0 '�•'. ..,.�'"�. .'..j.� / t ; .;"-i. �, ,,,:k }” C'rr'tj'ri j.�! . h{�i� f'#:r i �.'i'/r.�i �A,` �� ''t � !S • (.r t }'�(L(�i' �1��P y �"t � �Y 2 crGtS (,�n�� 1-T c Ly 1. 1 ;vY-ai �J� 1 C'r' we ::'+ { ,I j � I Q1. �13.t/I{Qll6. �U✓�� 1 �';e► f i � f �r� J �1 I e N —S, S KWi° k. g,7�� 5 utcc P0, e hcws� CITY OF LA QUINTA r Z 5g! • fN I s- BUILDING & SAFETY DEPT. I ! 4 APPROVED jri �• 1, Cf FOR CONSTRUCTION t oar 9-/y 3 sY _par Foo ►.►gh J, x r ( tt ii { j J /� J!'��41 � �. 4^�1•.Y+�� f SEi Q�iVll. 7?t: �'i�t' l�i/ wtiY; h0'J1[:Pl }.!Yt� �! �rikP', 1"r1c iJ2�%^✓ ter 1' w:.� �. , , � ❑ Gas � �«�,� �I —7 ?c,�;} � r�t*� �,�:�, t �-� L4 STOCiG GQTI��-tjVej, e 4A a4v, SV eoil fP r" t t SCALEt _ r. APPROVED By DRAWN BY S. A �;h(r Irtr+ar , �.1 ,,�gi r. .� /g 1 a ' f t ;1 --- --- " DATE REViSEO:57 DRAW?NG NUMBER r-LA