06-1595 (CCOM)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00001595
Property Address:
47875 CALEO BAY
APN:
643-200-001-3 -31248 -
Application description:
CARPORT - COMMERCIAL
Property Zoning:
COMMUNITY COMMERCIAL
Application valuation:
63680
Tiht °F 4Qu«rw
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
!J ` -
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:}��B(( p Licen : 186863
/Date*1g, 'Al �r Contractor:
11 EBUI ER DION
I hereby affirm under penalty of perjury that I a emp _ 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).:
(_ 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
( I I am exempt under Sec. , B.&P.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.).
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/16/06
Owner:
PHAN STEVE
44139 MONTEREY AVE STE B
PALM DESERT, CA 92260 FF1NANriE=
( AUG
C
Contractor: 17 2006
AFFILIATED CONSTRUCTION FLAQUINTA
77900 AVE OF THE STATES DEPT.
PALM DESERT, CA 92211
(760)345-2626
Lic. No.: 186863
------------------
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.
LC 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 0015385-2006
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 sh 1(1`I. ome subject to the workers' compensation provisions of Section
3700 of he LaAWORKE
forthwity with those provisions.
Date: Applicant,
WARNING: FAILURE TO SECUM ENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CT S 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 o su lion, and he by authorize representatives
of t is my t er upon the above-mentioned property f r in id purpos
ate:�nature (Applicant or Agent):
Application Number . . . . . 06-00001595
Permit . . . . .
CARPORT/GARAGE
Additional desc . .
Permit Fee . . . .
477.50 Plan Check
Fee
310.38
Issue Date . . . .
Valuation
. . . .
63680
Expiration Date . .
2/12/07
Qty Unit Charge
Per
Extension
BASE FEE
414.50
14.00 4.5000
----------------------------------------------------------------------------
THOU BLDG 50,001-100,000
63.00
Permit . . .
ELECTRICAL-CARPORT/GARAGE
Additional desc . .
Permit Fee . . . .
15.75 Plan Check
Fee
3.94
Issue Date
Valuation
. . .
. 0
Expiration Date
2/12/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 .7500
PER ELEC DEVICE/FIXTURE 1ST 20
.75
----------------------------------------------------------------------------
Special Notes and Comments
two , 14 stall metal
carports.August
16, 2006 10:09:33 AM
jjohnson
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . STRONG MOTION (SMI)
- COM
13.37
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
Permit Fee Total
493.25 .00
.00
493.25
Plan Check Total
314.32 .00
.00
314.32
Other Fee Total
13.37 .00
.00
13.37
Grand Total
820.94 .00
.00
820.94
LQPERMIT
S 1-0-4 U 'n [ko - , //. - ,
40,1 n
City -of La Quinta
Building &'Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 7
Y-7 5 CA7,5a
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor:
Address: q0D
City, ST, Zip:
Co�,F,37_4&1�e �he ephone:
�Proiect Description:
City, ST, Zip: J0,044 -P
Telephone:
State Lic. # 9(0
Arch., Engr., Designer:
City LiQ. #:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
bixi"9L
Construction Type: Occupancy:
Project type (circle.one): New Add'n Alter Repair Demo
Aomc—z-. -Sq. Ft.: # Stories: _T# Units:
Telepho ne # of Contact Person:
q�9_ Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec.'d
TRACKING
PERMIT FEES
;_>
57,re
P an Sets
Plan Chc c
Item
Amount
7
, cl-
Ktructural CaIcs.
Reviewed, ready (or corrections
Plan Check Deposit
2-
q7?—� -1�>
,s C.IC4
ru. CS.
Called Contact Pe\rWQ
Plan Check Balance
Energy Cales.
Plans bicked up
Construction
Flood plain plan
Plans resubmitted 4�1 L g;/06
Mechanical
Grading.plan
2,d Review, ready for corrections/issue
Electrical
Subcontactor. List
Called Contact Person
Plumbing
Grant Dee d
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted 7/& 6
Grading
IN HOUSE:-
3,d RiVi issue
rectio�ri
eveloper Impact Fee
Planning Approval
Called Contac 0
,Pub. W ks Appr
School Fees
>
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