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BP 12-0151P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000151 Property Address: 56705 VILLAGE DR APN: 764-050-020- - - Application description: ADDITION - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 12000 rM mt, in WIM Applicant: ) Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Busin ss and Professionals Code, and my License is in full force and effect. License Class B License No.: 788530 d ntractor._ ` t NER-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 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 1, 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 contractor(s) licensed pursuant to the Contractors' State License Law.). '.. I—) 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.I. Lender's Name: Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/30/12 Owner: BRUCE VOGEL 56705 VILLAGE DRIVE LA QUINTA, CA 92253 k% n I— irrf Contractor: $ APR 0 , I U� SUNTERRA BUILDERS 0 i_..� P.O. BOX 5217 LA QUINTA, CA 92248 )TY OF tAQ t (760) 902-0428 4,&E0 Lic. No.: 788530 ----------------------------------------------- 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 9005774-12 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 IMIshal Miomply workers' compensation provisions of Section 700 of the Labor with those provisions. jate: ( go rL-"' scant: WARM G: FAILU ECURE WORKERS' PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES 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 tha I have read this application and state that above mf mation is rrect. I agree to comply with all city and c my rdinances and state laws relating to build, con u tion, ereby authorize representatives of this co ty t enter upon the above-mentioned property in ec on r es. ta: �i ture (Applicant or Agent): Application Number . . . . . 12-00000151 ------ Structure Information 104SF PATIO ENCLOSURE/VB/RES-3/CL A -FR ----- Other struct info . . . . . CODE EDITION 2010 FLOOD ZONE NO 1ST FLOOR SQUARE FOOTAGE 104.00 ---------------------------------------------------------------------------- Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 135.00 Plan Check Fee 87.75 Issue Date . . . . Valuation . . . . 12000 Expiration Date . . 10/27/12 Qty Unit Charge Per Extension BASE FEE 45.00 10.00 9.0000 THOU BLDG 2,001-25,000 90.00 ---------------------------------------------------------------------------- Permit . . . ELECT - ADD/ALT/REM Additional desc . . Permit Fee . . . . 18.64 Plan Check Fee 4.66 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/27/12 Qty Unit Charge Per Extension BASE FEE 15.00 104.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 3.64 ---------------------------------------------------------------------------- Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 19.50 Plan Check Fee 4.88 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/27/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 EA MECH VENT INST/ DUCT ALT 4.50 ---------------------------------------------------------------------------- Special Notes and Comments 104SF PATIO ENCLOSURE/VB/RES-3/CLASS A -FR [CONVENTIONAL] THIS PERMIT DOES NOT INCLUDE ALTERATION TO EXISTING FRAMING OR PLUMBING INSTALLATIONS. 2010 CALIFORNIA BUILDING CODES. April 16, 2012 8:33:30 AM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 LQPERMIT Application Number . . . . . 12-00000151 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENERGY REVIEW FEE 8.78 STRONG MOTION (SMI) - RES 1.20 Fee summary Charged Permit Fee Total 173.14 Plan Check Total 97.29 Other Fee Total 10.98 Grand Total 281.41 LQPERMIT Paid Credited Due .00 .00 173.14 .00 .00 97.29 .00 .00 10.98 .00 .00 281.41