BRES2017-036278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation!
Applicant:
NANCY COOGAN
53225 AVENIDA HERRERA
LA QUINTA, CA 92253
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DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BUILDING RESIDENTIAL/REMODEL
BRES2017-0362
53225 AVENIDA HERRERA
774053023
COOGAN / [1] NEW WINDOW
$400.00
D p
[.DEI% -22Z117
CITY OF LA QUINTA
COI,1E"UNiTY DEVELOPn1ENT OEPARTt,IENT
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 Professions Code, and
my License is in full force and effect.
License Class: License No.::CONV:140528101254126172
Date:Le Contractor:
OWNER -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, as owner of the property, or my employees with wages as their sole
comp nsation, 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, as owner of the property, am exclusively contracting with licensed contractors to
on ruct 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 contractor(s) licensed pursuant to the
Contractors' State License Law.).'
I am exempt under Sec. B.&P.C. for this reason
Date: J --Owner:
CONSTRUCTION LENDIN 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
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/22/2017
Owner:
NANCY COOGAN
53225 AVENIDA HERRERA
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
Llc. No.::CONV:140528101254126172'
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 =.700 of the Labor Code, for the performance
of the work for which this permit is issued.'
_ I have and will maintain worker:' compensation insurance, as required by
Section 3700 of the Labor Code, for the pe-formance of the work for which this permit is
issued. My workers' compensation insurance carrier and policy number are:
Cartier: Policy Number:
certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manne - 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 Secti in 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date:2— ,Applicant:
WARNING: FAILURE TO SECUREWORKERSCOMPENSAT N COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CR MINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($10),000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDEDFOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACCNOWLEDGEMENT '
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth or this application.-
1.
pplication:1. Each person upon whose behalf this a 3plication 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 :o 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 ssuance of.such permit, or cessation of work
for 180 days will subject permit to cancellation.
I certify that I have read this application ar cl state tfiat 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 city to enter upon the above-
mentioned property for' spection purposes.
Date: Z 2 ianv (ApplicantorAgent): r
Date: 12/22/2017
Application Number: BRES2017-0362
Owner:
Property Address: 53225 AVENIDA HERRERA
NANCY COOGAN
APN: 774053023
53225 AVtWDA HERRERA
Application Description: COOGAN / [1] NEW WINDOW
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $400.00
Applicant:
Contractor:
NANCY COOGAN
OWNER BUILDER
53225 AVENIDA HERRERA
LA QUINTA, CA 92253
------------------------------------------------------------
Llc. No.::COMV:140528101254126172
--------------------------------
Detail: REPLACE [1] WINDOW IN FRONT OF HOME. REPLACE 48"X72" WITH A 54"X72" LOWER SILL 6". HEADER AF9D SIDE FRAMING WILL REMAIN. PER
2016 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43.611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR; FIRST
101-0000-42400•
0
$65.54
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST PC
101-0000.;42600
0
$63.98
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $129.52