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07-1001 (RER)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO ' - t FAX (760),777-701 1. , LA QUINTA,. CALIFORNIA 92253 • BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777=7153 • ' BUILDING PERMIT Date: 4/11/07 Application Numbe7-00001001 Owner: Number: CO Property Address: 79"605 -VIA :SIN CUIDADO - LORENZO LOMBARDELLI - APN: 772-370-024- - - 79605 VIA SIN CUIDADO Application description: REMODEL - RESIDENTIAL PHOENIX, AZ 85034 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: :6800' 0 Contractor: 7 Applicant: Architect or Engineer: PELLETIER & LEATHEAD GEN R APR 1 1 2007 41-589 ALLIGATOR -POND RO BERMUDA DUNES, CA 92203 ' I (760)200-9211 CITY OF LAWINTA . �l I Lic. No. 851948 • FINANCE DEPT. -----------------_--------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION - - I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter -9 (commencing with. - , - I hereby -'affirm under penalty of perjury one of the following declarations: - Section 7000) of Division 3 of the Business and Pr and my License is.in full force and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided • License Class: B 48 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is - �/ r1 / - issued. te: " l: I I-0 / tractor. O< I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor y Code, for the performanceofthe work for which this permit is issued. My. workerscompensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the.Contractor's State License Law for the Carrier GRANITE STATE Policy Number 1969937 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that, requires a permit to . _ I certify that' in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the - person in any manner so as to become to the workers' compensation laws of California, permit to file a signed statement'that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should beco ubj.5 to the rl mpensation provisions of Section License Law. (Chapter 9 (commencing with Section,7000) of Division 3 of the. Business and Professions Code) or 3700 of the Labor Code mp a ovisions. 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).: te: rl- ��V / A cant: I, as owner of the property; or my employees with wages as their sole compensation, will do the work, andthe structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' StateLicense Law does not apply to,an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). APPLICANT ACKNOWLEDGEMENT (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec. IMPORTANT'. Application is hereby made to the Director of Building acid Safety, for permit subject to the 044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. 1 prop ' s or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each,person at whose request and for pur to the Cntrac o icense Lawa. - whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_) I am exempt -under S P.C. for this reason ' 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. • Date: Owner: - 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 " CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is aconstruction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C:). city and county ordinances and state laws relating to building consyt;v+ on, and here uthorize representatives •of this county to enter upon the above-mentioned property for i spectioa.oucpece Lender`s Name: _ _ Da —1) o ignature (Applicant or Agen � _ - . ~ Lender's Address: - LQPER.N11T , • . Application Number, 07-00001001 Permit . . BUILDING PERMIT Additional desc .'. Permit Fee . . . 90'.00 Plan Check Fee 58.50 Issue Date Valuation . . . . 6800 Expiration Date 10/08/07 Qty Unit Charge Per Extension BASE FEE 45.00 • 5.00 9.0000 THOU BLDG 2,001-25,000 45.00 Permit ELECT - ADD/ALT/REM Additional desc.. Permit Fee 18.00 Plan Check Fee 4.50 Issue Date . . . . Valuation 0 Expiration Date 10/08/07, Qty Unit Charge Per Extension . BASE FEE 15.00 4.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 3.00 Permit . . MECHANICAL Additional desc . Permit Fee 24.00 Plan Check Fee 6.. 00 Issue Date Valuation 0 -Expiration Date.. 10/08/07 Qty Unit Charge Per Extension BASE FEE 15.00` 1.00 9.0000 .EA MECH APPL REP/ALT/ADD 9.00 - --------------------------------------------------------------------- Special Specal Notes and Comments - REMOVE EXISTING WALL AND FIREPLACE AND. REPLACE WITH GLASS WALL.April-11, 20.07 9:29:'26 AM JJOHNSON Other Fees ENERGY REVIEW FEE 5;85 STRONG MOTION (SMI) - RES .68 . Fee summary Charged Paid ,' Credited Due - Permit Fee Total 132.00 .00 .00 132.00 Plan Check Total 619.00 .00. .00 69.00 Other Fee Total 6.53 _ .00 .00 6.53 Grand Total- 207.53 .00 .00 207.53 LQPERAIIT V Bin # � Permit # tool Project Address:' A. P. Number: Contractor: Address: City, ST, Zip: Telephone: (� L State Lic. # Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Telephone # of Contact Person: # I Submittal I Plan Sets Structural Cales. Truss Caics. Energy Cala. Flood plain plan Grading, plan Subcontactor List . Grant Deed H.O.A. Approval IN HOUSE: 0. Planning Approval Pub. Wks. Appr School Fees City of La Quints Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 ,Building Permit Application and Trackin Sheet g 1 l wl -Dp Owner's Name: U fiv z 2 f Address: O, t m: 5-,,v Cal .Der'W i -Re. -_ I City Lic. #: WE City, ST, Zip: /_ ./-}'` Tvl ht '7Y�1- �1at •-�j Description: Construction Type: Occupancy_ Project hype (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: #Units: Estimated value of projec APPLICANT: DO NOT WRITE BELOW THIS LINE Recd TRACIQNG Plan Check submitted oc Reviewed, reeady for corrects Caped Contact Pe on Plans ticked ap'� l f lQ Plans resubmitted 2" Review, ready for corrects ssue Called Contact Person Plans picked up Plans resubmitted Review, ready for.correctlowissue Called Contact Person Date of permit issue • y�Uo7 4/6/0 ern. APVRou,qBc.E- z PERMIT FEES Plan Check Deposit Plan Cheek Balance Construction Mechanical Electrical Plumbing S.M.L Grading Developer Impact Fee A.I.P.P. Total Permit Fees Amount .