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07-1947 (AR)"r:,T� 1 • P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760).7-77-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 7/23/07 Application Number. 107-00001947 Owner: Property Address: 48410 -VISTA CALICO LAPADO RICHARD L APN: 649-530-029-' - - 3990.LAGUNA AVE Application description: ADDITION - RESIDENTIAL PALO ALTO, CA 94306 Property Zoning: LOW DENSITY RESIDENTIAL _ Application valuation: 3136 D n (� Contractor: (i -►1 u Applicant: Architect or Engineer: RISEN CONSTRUCTION f pp g 82775 CHARLESTOWN AVENUE JUL 3 T• 2007 } INDIO, CA 92201 (760)347-6399 CITY6FLAdd1_NTA Lic. 14o.:-792381 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 Professionals Code, 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 Cla : B -- - -- License No.: 792381 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -- � .issued. - Date: Contractor_: f � _ 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 OWNER -BUILDER 6ECLARATION .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 STATE FUND Policy Number 229-0025305 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 subject 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 become subject to the workers' compensation provisions of Section " License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) -or 37 of the Labor Code, 1 shall fotthw/rth/�c/y�,mply with those provisions. / that he li she o exempt therefrom and the basis for the alleged exemption. Any violation d Section 7031.5 by . it ��_��'_'� �•t// P 9 P any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date: pplicant: 1 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 Coder The WARNING: FAILURE TO'SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State `License 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 ( I I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and -Safety for a. permit subject to the 7044, Business and Piufessiuns Code: The Contractors' State License Law docs not apply to an owner of - conditions and restrictions set.fnrth nn this application. ..property who builds 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 pursuant to the Contractors'. State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, " (_ 1 I am exempt under Sec. , B.&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 180dayswill subject CONSTRUCTION LENDING AGENCY - permit to cancellation. I hereby affirm under penalty of perjury that there is a construction 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 cons , n, and hereby authorize representatives of this co ty t nter upon) the above-mentioned property for tion pur o Lender's Name: - Dat� Signature (Applicant or Agent): . Lender's Address: - - LQPERDIIT Application Number . . . . . 07=00001947 Permit ,. BUILDING PERMIT Additional desc . Permit Fee . . . 63.00. Plan Check Fee.. 40.95 Issue Date Valuation 3136 Expiration -Date 1/19/08 Qty Unit Charge Per Extension BASE FEE '45.00 _ 2.00. 9.0000 THOU BLDG 2,001-25,000 18.001 Permit ELECT - ADD/ALT/REM Additional desc` Permit -Fee . . . 15.02 Plan Check Fee 3.76 Issue Date Valuation 0 Expiration Date 1/19/08 Qty Unit Charge ,Per Extension BASE FEE 15..00 1.00 .0200 ELEC GARAGE OR NON-RESIDENTIAL, 02 Special Notes.and Comments 160 SQ. FT. GARAGE ADDITION. 4 Other Fees ...". . ENERGY REVIEW FEE 4.10 STRONG MOTION.(SMI) - RES .50 Fee ;summary Charged Paid Credited Due 'Permit Fee Total -78.02 .00 00 78.02 Plan Check Total 44.71 .00 .00 44.71 Other Fee Total 4:60 .00 .00 4'.60 Grand Total 127:33 .00 .00 127.33 LQPERMIT . Bin if -- City. of LaQuinta �• . . Building a Safety Division �l P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit /application and Tracking Sheet Permit.# ,{� 7-19'[ Project Address -49-4( 0 V s Owner's Name: r A. P. Number: Address: AE -410 Vj �. v. Legal Description:City, Contractor: rV ST, Zip: 04 I -q- 2 ZS3 Telephone: Address:M --r,u Project Description: City, ST, Zip: a ZZl� Telephone: State Lie. #391 City Lice. #: Arch. Desi er: n- 8r•� gn W C-- . = : 40 117 Address: 7Z-Sb6-FrecA-riof0i. S City, ST, Zip: ,� p �� Telephone: 7(06 346,— 3S- State Lie. #: % 3.3 Name of Contact Person: 3, e Consttuption Type: Occupancy: Project type (circle one): New Add'n' Alter Repair Demo Sq. Ft : #Stories: #Units: Telephone # of Contact Person: , 57 7 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACMG 'PERMIT FEES Plan Sets Plan Check submitted 116 Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calm Called Contact Person Plan Check Balance Energy Calcs: Plans picked up Construction Flood plain plan. Plans resubmitted Mechanical Grading plan 2°" Review, ready for correcti issue Electrica. Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. . H.O.A. Approval Pians resubmitted Grading IN HOUSE: ''" Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. I.Pub. Wks. Appr Date of permit issue oo School Fees Total Permit Fees