06-2059 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Applicant:
Tu�144Q"
BUILDING &SAFETY DEPARTMENT
BUILDING PERMIT
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 Business and Professionals Code, and my License is in full force and effect.
License Class: CC3366 cense No.: 828264
,_Date:*&k Contractor}
WR -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
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 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.).
(_ 1 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , B.&P.C. for this reason
fate:
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
i' FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/17/06
Owner:
FRANK PERSICHETTI
Application Number
06-00002059_________—.____
Property Address:
80393_. -PEBBLE BEACH
APN:
775-131-034- - -
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
500
Applicant:
Tu�144Q"
BUILDING &SAFETY DEPARTMENT
BUILDING PERMIT
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 Business and Professionals Code, and my License is in full force and effect.
License Class: CC3366 cense No.: 828264
,_Date:*&k Contractor}
WR -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
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 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.).
(_ 1 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , B.&P.C. for this reason
fate:
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
i' FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/17/06
Owner:
FRANK PERSICHETTI
80393 PEBBLE -BEACH
4 •,
LA QUINTA, CA 92253
C
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!a
rd
Contractor:
-
Q
C)
FOY, SCOTT A.
43579 MAIN STREET
ty
INDIO, CA 92201
(760)775-9405
Lic. No.: 828264
------------------
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.
1 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 FLTND Policy Number 1576840
_ 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 Code, I shall fort wi#1 tt ly with those provisions.
-Date !j Applicant:
7V -
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 ($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 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 construction, and hereby authorize representatives
--of this county to enter upon the above-mentioned property for inspection purposes.
_.Date. ignature (Applicant or Agent): '
LQPERMIT
Application Number
. . . . . `06-00002059
Permit
PLUMBING
Additional desc .
' Permit Fee . . .
22.50
Plan Check
Fee
5.63
Issue Date
Valuation
0
Expiration Date
11/13/06
Qty. Unit Charge Pet
Extension
BASE FEE
15.00
1.00 7.5000
EA PLB WATER
HEATER/VENT
7.50
----------------------------------------------------------------------------
Special Notes and
Comments
REPLACE 40 GAL GAS
HOT WATER HEATER.58
EF
Fee summary.
-----------------
Charged Paid
----------
Credited
Due
Permit Fee Total
----------
22.50
----------
.00
----------
00
22.50
Plan Check Total
5.63
.00
.00
5.63
Grand Total
28.13
.00
.00
28.13
A. P. Nwnbcr.
Arch., Engr.. Designer:
Address:
City; ST, Zip:
Telephone.
State Lir
Name of Contact Person:
Tcephonc # of COMM Person:
•—� til.t i y lel Lad %4UU I E4d
BL&ft at Safety DkWon HtA
P.O Box 1504, 78-495 Calle Tarrlpko
U QWM, CA 92253 - (760) 7777012
Building Permit jWflcadon and Tracking Sheet
APPLlCMT.
DO NUT WRITE BELOW THIS LAE
i2ed
TRACMG
PER63IT PEES
Plan Cheek submitted
Irem
Amounk
Ret tires. ready foreeneetions
Plan Check Depmit
Called CoutaerPerson
Plan Check Balance
Plans picked up
Cousnvetion
Plans resubmitted J
llfechaniu. l
""° Review, ready for eorreetiouvisme
Electrical
Called Coatact Person
Plumbing
Plans picked up
5 M.1.
Plans remb®itted
Grading
4"` Review, ready for correcdous<issae
Developer Impact Fee
Called Contac! Person
A.U.P.
Date of permit issue
Total Permit Pew
4