Mirage (Plans 1-3)1 -qts ���
Azo
6
W.
j5 —7_ erqs to P.O. BOX 1504 APPLICATION ONLY
Building78-495 CALLE TAMPICO
Address ✓�' 1- g �6 "r LA QUINTA, CALIFORNIA 92253
J.11- Owner L 0 D_ A 1 I0 -- i
` Address j ��l Z 1 4J
City _ Zip Tel.
Z lute Zoo! $ (14q) I$ -I
cont
� t4
& Classif. F, 60"[ f l G� ILic. #
.o /n
Designer "RMA*L
Address r� Tel.
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Sei
7000) of Division 3 of the Business and Professions Code, and my license is in full force
effect.
OWNER -BUILDER DE/nh
RATION
I hereby affirm that I am exempt from the Coctor's License Law for th ollowing
r son: (Sec. 7031.5, Business and Professions C: Any city or county whic requires a
p it to construct, alter, improve, demolish, or repany structure, prior to its . suance also
req 'res the applicant for such permit to file a signedtement that he is licen d pursuant to
the visions of the Contractor's License Law, Chap9 (commencing with action 7000) of
Divisi 3 of the Business and Professions Code, or he is exempt there m, and the basis
for the leged exemption. Any violation of Section 705 by any applicant / r a permit subjects
the app ant to a civil penalty of not more than five hdred dollars ($50
❑ I, as o er of the property, or my employees with es as their sol compensation, will do
the work, a d the structure isnot intended or offered sale. (Sec. 7 4, Business and Profensions Code: he Contractor's License Law does not ly to an ow r of property who builds
or improves t reon and who does such work himselthrough h' own employees, provided
that such impvemensarenotintended or offeredr sale. If, owever, the building or im-
provement is s within one year of completion, towner- ilder will have the burdenofproving thathe notbuildor improve for the purpof sa❑I,asowneroth roperty, am exclusively contracwit icensed contractors to construct
the project. (Sec. 74Business and Professions Ce: a Contractor's License Law does
not apply to an owne f property who builds or imprhereon, and who contracts for such
projects with a contra r(s) licensed pursuant to thentractor's License Law)❑Iamexemptunder S B.&P.C.fois reason
Date
WORK 'S COMP SATION DECLARATION
I hereby affirm that I have _%._
f consent to self -insure, or a certificate of Worker's
CompensatioAE
ce, or a c iried py thereof. (Sec. 3800, Labor Code.)
Policy No.Co
O Copy ith the city. Certified copy is hereby furnished.
CE IFIC TE OF EXEMPTION FROM
WO RS' C MPENSATION INSURANCE
(This section t be mpleted if a permit is for one hundred dollars ($100) valuation
or less).
I certify te erformance of t work for which this permit is issued, I shall not
employ any py manner so as to come subject to Workers' Compensation Laws of
California.Date nerNOTICE TO ANT.• If, after making thi Certificate of Exemption you should become
subject to thrs' Compensation provi 'ons of the Labor Code, you must forthwith
comply with sisions or this permit shal a deemed revoked.
CONSTRUCTION LE ING AGENCY
/Leer's
by affirm that there is a construction lendi agency for the performance of the work
this permit is issued. (Sec. 3097, Civil Co )
Name
Address
is a building permit when properly filled out, si ned and validated, and is subject to
n if work thereunder is suspended for 180 days.
ify that I have read this application and state th the above information is correct.
to comply with all city and county ordinances a state laws relating to building
tion, and hereby authorize representatives of this to enter the above-mentioned
for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
WHITE = BUILDING
BUILDING: TYPE CONST._ OCC. GRP.
A.P. Number -I VZ two — 01'Z_
Legal Description Ste' Project
�"► "- �� 'e
Project Description
Sq. Ft.
Size
New E-
t��; of
No. No. Dw.
Stories Units
Add ❑ Alter ❑
Ckh
Repair ❑ Demolition ❑
S
�ie
b
Estimated Valuation
PERMIT
AMOUNTOB
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
--A
�7
�—
1I I IU-
IP
��II!
III mf 17 2M 1
TOTAL
F I1
REMARKS
I CITY OFLAQUINA
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
YELLOW = APPLICANT PINK = FINANCE
P.O. BOX 1504 BUILDING & SAFETY DEPARTMENT
78-495 CALLE TAMPICO ' (760) 777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
a
To: Greg Butler, Building & Safety Manager To CDD: May 17, 2006
- From: Doug Evans, Director -CDD Due Date: May 31, 2006
Status: 1 st Review
Building Plans Approval
(This is an approval to issue a Building Permit)
The, Community Development Department has reviewed the Building Plans for
the following project: °
Description:. Mirage (SFDx3)
Address or General Location: 57-925/895/865 Rosewood Court
Applicant Contact: Rosie Lara (760)218-8258
The Community Development Department finds that:
❑ ...these Building Plans do not require Community Development
Department approval.
...these Building Plans are approved by the Community Development
Department.
❑ ...these 'Building Plans require corrections. Please forward a copy of the
attached corrections to the applicant. When the corrections are made
please return them to the Community Development Department for
review.
S}25
Doug Evans, Director -CDD
a
Date
0
4