06-3785 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 4�06=00003785'�� Owner:
Property Address: ` 48270`VISTA ::CALICO SORENSEN GARY L
APN: a 5064 FRANKLIN DR
Application description: REMODEL - RESIDENTIAL PLEASANTON, CA 94588
Property, Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 80000
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 of the Busines an Profes 'o b Code, and my License is in full force and effect.
License Class B icense No.: 793303
Date: r Contractor:
` OWNER R DECLARATION
I hereby affirm under penalty of erjury that 1 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.).
I I I, aS 9 .. ner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions lCbde: I me "ntrautUis' .hate LILel— Lucv Juga +.at apply to on Qviner 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. , 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.). '
Lender's Name: -
Lender's Address:
LQPERD4IT
Contractor:
PRECISION BLDG & RESTR
10722 ARROW ROUTE, #41
RANCHO CUCAMONGA, CA 9
(909) 980-1701
Lic. No.: 793303
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/02/06
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 STATE. FUND Policy Number 0600433
_ 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 be ome sublec to �%�'�'orkers' compensation provisions of Section
3700 of the Labor Code, ha rthw' c pfy with those provisions.
ti
Date: cant:
WAR G: FAILURE TO SEC WORKERS' COMPENSA ON COVERAGE IS UNLAWFUL, AND SHALL-
SUBJECT
HALL-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
rnnrlitinn5 and restrigtign; ;et forth on this appPlication.
1. Each person upon whose behalf tftis applic6t16h is rf=e, U8Uirpeisun at VVlluae � qyu ,L u J NW
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 c ns ction eby authorize representatives
of this count o enter upon the above-mentioned property f i ectio s.
(Date: Sig nature'IApplicant orAgentl:--
'Application Number .. . . . 06=00003785
Permit BUILDING PERMIT,
Additionaldesc .
Permit Fee 549.5.0 Plan Check Fee 357.18
Issue Date . . Valuation . . 80000
Expiration Date 5/01/07 ,
Qty Unit Charge Per -Extension .
BASE FEE 414.50
30.00 4.5000 THOU BLDG 50,001-100,000 135.00
Permit ELECT - ADD/ALT/REM
Additional desc
Permit Fee 20.25 Plan Check Fee 5.06�
Issue Date . . Valuation . . . . D 0L -v IJ
Expiration Date 5/01/07
Qty Unit Charge Per Ex:tensio OV 0 8 2006
BASE. FEE 115.00
7.00 7500 PER ELEC DEVICE/FIXTURE 1ST 20- --------- LS -7-2-5 lf
--------------------
--------------------------------------- FINANCE DEPT.
Permit . . MECHANICAL
Additional desc .
Permit Fee 19..50 Plan Check Fee 4.88
Issue Date . . . . Valuation- 0
Expiration Date 5/01/07
Qty Unit Charge Per Extension
BASE FEE 15:00
1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50
---
Special Notes and Comment's
FIRE DAMAGE REPAIR ENTRY TOWER.October
31, 2006 4:36:17 PM JJohnson
----------------------------------------------------------------------------
Other Fees. . . . . . ENERGY REVIEW FEE 35.72 `
STRONG MOTION (SMI) - RES 8.00
Fee summary Charged Paid Credited Due
Permit Fee Total •589.25 .00 .00 589.25
Plan Check Total 367.12. .00 00 367 12
Other Fee Total 43.72 .00 .00 43.72
Grand Total'. 1000.09 .00 .00 1000.09
LQPERMIT
Bin #
City of La Quinta '
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760)177-7012
Building Permit Application and Tracking Sheet
Permit tf
Project Address: ' , g 2,7C> , r cxC �+j
Owner's Name: p
A. P. Number:
Address:4 S Z -76' 3- C
Legal Description:
Contractor: 1 `C�, 'L t�5
City, ST, Zip: Qu -
Telephone: q gd IZO .`
Address:�,
Z Z p CO ��
Project Description: �-- ,� e R- e
City, ST, Zip: Cko CC -CZ 6u V -2 0c, C l 73 o
Fn/ 1 cL
Telephone: Z 90/76
State Lic. # : D 3 City Lic. #:
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: O K
Construction Type: Occupancy:
Project type (circle one): New Adc'n Alter Repair Demo
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person: `�6 Q
Estimated Value of Project: p a
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd.
Recd
TRACKING.
PERMIT FEES
Z
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Cheek Balance
Energy .Calcs.
Plans picked up
Construc:ion
Flood plain plan
Plans resubmitted
Mechanical
Grading, plan
2" Review, ready for correctistissu
�� a
Electrica'.
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
$.M.I.
H.O.A. Approval
Plans resubmitted .
Grading
IN HOUSE:
''"Review, ready for correctionstiissue
Developer Impact Fee..: .
Planning Approval
Called Contact PersonA.I.P.P.
Pub. Wks. Appr
Date or permit issue
(1
School Fees
Total Permit Fees . -.