The URL can be used to link to this page

09-1313 (RER)'P.O. BOX 1504 VOICE (760) 777-7012 F 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 ' BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 C. BUILDING PERMIT -- Date: 12/29/09 Application Number: 9==:�-0, 00-0.0-13-13 -:1 A c Owner: Property Address: 50112 AVENIDA VISTA BONITA:' LYON LORNA ANN APN: 658-260-048- - 14 MANOR ROAD Application description: REMODEL - RESIDENTIAL GREENBRAE, CA 94904 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 10000 PFINARCE Contractor:�yApplicant: Architect gr Engineer: OLGEPi CONOTRUCTION, ' LT 9 1009 P.O. BOX 202 PENNGROVE, CA.94951AQUINTA / (41.5)987:3561 DEPT.. Ilk ^ Lic. No.: 501009 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION .l hereby affirm under penalty of perjury that I am licensed under provisions of Chapter (conynencing 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'a -full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided Lice a Class: B License I 50 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is A issued. • Date:/ .. O ontractor:Yf - • _ 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 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 EXEMPT Policy Number EXEMPT 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 emp oy 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 alifornia. 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 becom subject to the workers' compensation provi ' sof Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Lab r , I shall orthwith comply with those provisions that he or she is exempt therefrom and the basis for the alleged exemption. A`ny violation of Section 7031.5 by0.9 .any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars IS5001.: - ate: ✓J plicant: 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 - 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 , ' (_) 1, 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 Professions Code: The Contractors' State License Law does not apply to.an owner of conditions and restrictions set forth on 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, (_ I 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 resulrof 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. - 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 tate laws relating to building construction, and hereby authorize representatives /ofathicountytoterupoa above-mentioned property for ins action purposeLender's Name: 'e: V ignature (Applicant or Agent): Lender's Address: LQPERMIT Application Number 09-00001313. Permit . . . BUILDING PERMIT •, Additional desc . - Permit Fee 117.00 Plan Check Fee 76.05 Issue -Date Valuation 10000 Expiration Date'. 6/27/10: Qty Unit Charge Per Extension BASE FEE 45.00 8.00 9.0000 THOU BLDG 2,001-25,000 ---------------------------------------------------------------------------- 72.00 '- Permit . . . PLUMBING Additional desc . Permit Fee 18.00 Plan Check Fee ,. 4.50 Issue Date . . . . Valuation 0 Expiration Date 6/27/10 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 REMOVE EXISTING TUB AND INSTALL WALK IN SHOWER STALL, NEW SHOWER VALVE, SINKS, FAUCETS AND COUNTER TOP. INCLUDES - INCIDENTAL DRYWALL. 2007 CODES. ------------------------------------------------ Other Fees . . . . : . BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 7.61 Fee summary Charged Paid Credited ---------- Due ----------------- Permit Fee Total 135.00 .00 .00 135.00 Plan Check Total 80-55 .00 .00 80.-5 e Other Fee Total 8.61 .00 .00 8:61 Grand Total 224.16 .00 .00 224.16 LQPERAIIT Bin # City Of La Quinta Building a Safety Divislon Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #P.O. Project Address:5 o (a, Owner's Name: L p ria : L ;D LYU �� ca Address: I C/ Legal Description: (ty, ST, Zip: l> re- jT,,e l q Q`i Contractor• I —� L I f"Z(—"hone- —_ t3 hone:Address:5(0 „ av:; .•->.:+ K� { Address. 5 (0C) Project Description: City, ST, Zip: / �� I� G✓Y�Ot/� ��jC�� Telephone: State Lie. # : `Jo ( OD City Lie. Arch., Engr.; Designer. Address: Cu Jl �P City, ST, Zip:, i Telephone: State Lie. #::.,;;fw. a.. :`�,..� :.., y,e;:... , �� ..+ ~'�� ¢�� y ?.'y 4. Construction Type: Occupancy: Proj� type (circle one): New Add.'n 'Alte Repair Demo Sq. Ft : #Stories: #Units: r Name of Contact Person.. �� V l� Telephone # of Contact Person: y1 98 3 (Z16 9 1 Estimated Value of Projec 000 APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Recd TRACKING PERMIT FEES Pian Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cala. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2i. Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed. Plans picked up S.M.I. H.O.A. Approval Pians resubmitted Grading IN HOUSE:- 3'4 Review, ready for correctionsliissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue . School Fees Total Permit Fees