BRES2016-013978-495 CALLE TAMPICO D
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BRES2016=0139
Property Address: 51715 AVENIDA:OBREGON
APN: 773123028
Application Description:. RANCK / DEMO WALL IN LIVING ROOM
Property Zoning:
Application Valuation: $15,000.00
Applicant:
MARK RANCK
51715 AVENIDA OBREGON
LA QUINTA, CA 92253.
Owner:
MARK RANCK
51715 AVENID
LA QUINTA, CA
(760) 7774125
(Z60) 777-7011
7, 0) 777-7153 .
Contractor:
THE HUMBLE HANDYMAN
44310 WILLOW, CIRCLE
LA QUINTA, CA 92253
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 ofproving 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 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 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:
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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 city to en u n the
above-mentioned property for inspection purposes.
now
Date: Signatdre Applicant or Agent):
(760)578-1908
Llc. No.' 972874 .
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION.DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
I hereby affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: B License No.: 972874
of the work for which this permit is issued.
/ _ /
D te: ' V Con_tu c�
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:
OWNER -BUILDER DECLARATION :
Carrier: _ "Policy Number:.
I hereby affirm under penalty.of perjury that I am exempt.from the Contractor's State
I certify that -in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5; Business and Professions Code: Any
shall not'. employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to:construct; alter, improve; demolish; or repair
compensation laws of California; and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a.
workers' compensation. provisions of Section 3700 of the'Labor Code, I sh ith
signed statement that he or she is licensed pursuant to the provisions of the
comply with those. provisions.
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 theDaet
Applicant:
"basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora
permit subjects the applicant to a civil penalty of not more than five. hundred dollars
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES -AND CIVIL FINES UP TO
(� I, as owner of the property, or my employees with wages as their.sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION; DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions C6de:.The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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 ofproving 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 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 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:
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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 city to en u n the
above-mentioned property for inspection purposes.
now
Date: Signatdre Applicant or Agent):
DESCRIPTIONACCOUNT
FINANCIAL
QTY AMOUNT PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306 0 $1.00 $1.00
5/18/16
PAID BY
:METHOD ` ` RECEIPT #,' ,CHECK #
MARK RANCK
DEBIT R15593
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00
DESCRIPTION,
ACCOUNT A'
QTY,'
AMOUNT
PAID '
PAID DATE
FIXTURES, FIRST 20
101-0000-42403
1
$24.17
$24.17
5/18/16
PAID BY €
METHOD:
IRECEIPT #, '�
CHECK #
CLTD.:BY
MARK RANCK
DEBIT
R15593
RSE
DESCRIPTIONACCOUNT
.
QTYAMOUNT
PAID
PAIDDATE,
FIXTURES, FIRST 20 PC
101-0000-42600
1
$24.17
$24.17
5/18/16
PAID BY
METHOD
RECEIPT # .•
CHECK #
`CLTD BY
MARK RANCK
DEBIT
R15593
RSE
Total Paid for ELECTRICAL: $48.34 $48.34
Y `DESCRIPTION '..
ACCOUNTQTY
AMOUNT
PAID
PAID DATE
APPLIANCE REPAIR/ALTERATION
101-0000-42402
0
$12.09
$12.09
S/18/16
PAID BY
WETHOD ."s
RECEIPT ;#
CHECK # _
CLTD BY.;
MARK RANCK
DEBIT
R15593
RSE
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID .
PAID DATE'
APPLIANCE REPAIR/ALTERATION PC
101-0000-42600
0
$4.83
$4.83
5/18/16
PAID BY ' :
METHOD
RECEIPT #
CHECK #
CL BY .,
MARK RANCK
DEBIT
R15593
RSE
Total Paid for MECHANICAL: $16.92 $16.92
DESCRIPTION
'_ ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$21.75
$21.75
5/18/16
PAID BY
METHOD :
RECEIPT .`
CHECK #
CLTD BY .
MARK RANCK
DEBIT
R15593
RSE
DESCRIPTION:'..
ACCOUNTQTY'
AMOUNT
PAID
,PAID DATE
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$17.40
$17.40
S/18/16
PAID BY
METHOD,
RECEIPT #
CHECK #
CLTD BY
MARK RANCK
DEBIT
R15593
RSE
DESCRIPTIONACCOUNT..:`
QTY
AMOUNT.-
PAID
PAID DATE
REMODEL, FIRST 100 SF
101-0000-42400
0
$49.31
$49.31
5/18/16
PAID BY
'METHOD
RECEIPT 4.
CHECK # .
CLTD BY .
MARK RANCK
DEBIT
R15593
RSE
DESCRIPTION : P
ACCOUNT
QTY°,
, AMOUNT
PAID,.
PAID DATE.,
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$134.88
$134.88
5/18/16
,PAID BY
METHOD .
RECEIPT #
CHECK # ,
CLTD BY ~
MARK RANCK
DEBIT
R15593
RSE
Total Paid for REMODEL: $223.34 $223.34
J
Description: RANCK / DEMO WALL IN LIVING ROOM
Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: ISSUED
Applied: 5/17/2016 SKH
Approved: 5/18/2016 JJO
Parcel No: 773123028 Site Address: 51715 AVENIDA OBREGON LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: Lot: 8
Issued: 5/18/2016 MFA
UNIT 2
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $15,000.00 Occupancy Type: Construction Type:
Expired: 11/14/2016 MFA
No. Buildings: 0No. Stories: 0 No: Unites: 0
Details: REMOVE INT NON BEARING WALLS AND T.V. CABLE, ELEC. OUTLET. PER 2013 CRC CODES
€ 0
__j Applied to, Approved
Approved to Issued
CONDITIONS
FINANCIAL INFORMATION
Printed: Wednesday, May 18, 2016 4:33:42 PM 1 of 3RAJF CRWW
sysrews
INSPECTIONS
Printed: Wednesday, May 18, 2016 4:33:42 PM 2 of 3
ww SYSTFMS
-AMOUNT
"'PAID,.'
DATE'
E PT#
CEI
tl-1
DESCRIPTION
-QTY
PAID
t.BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
5/18/16
R15593
DEBIT
MARK RANCK
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION $*1.00 $1.00:
BSA:
FIXTURES, FIRST 20
101-0000-42403
1
$24.17
$24.17
5/1%8/16
R15593
DEBIT
MARK RANCK
RSE
FIXTURES,FIRST 20 PC
101-0000-42600,
1
$24.17
$24.17
5/18/16
R15593
DEBIT
MARK RANCK
RSE
Total Paid for ELECTRICAL: $48.34 $48.34
APPLIANCE
101-0000-42402
0
$12.09
$12.09
5/18/16
R15593
DEBIT
MARK RANCK
RSE
REPAIR/ALTERATION
APPLIANCE
101-0000-42600
0
$4.83
$4.83
5/18/16
k15593
DEBIT
MARK RANCK
RSE
REPAIR/ALTERATION PC
Total Paid for MECHANICAL: $16.92 $16.92
REMODEL, EA
101-0000-42400
0
$21.75
$21.75
5/18/16
R15593
DEBIT
MARK RANCK
RSE
ADDITIONAL 500 SF
REMODEL, EA
101-0000 . -42600
a
$17.40
$17.40
5/18/16
R15593
DEBIT
MARK. RANCK
RSE
ADDITIONAL SOO SF PC
REMODEL, FIRST 100 SF
101-0000-42400
0.
$49.31
$49.31
5/18/16
R15593
DEBIT
MARK RANCK
RSE
REMODEL, FIRST 500 SF
101-0000-42600
0
$134.88
$134.88
5/18/16
R15593
DEBIT
MARK RANCK
RSE
PC
Total. Paid for REMODEL: $223.34 $223.34
SMI - RESIDENTIAL
101-0000-20308
0
$1.95
$1.95
5/18/16
R15593-
DEBIT
MARK RANCK
RSE
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $1.95 $1.95
TOTALS: $291.55 $291.55
INSPECTIONS
Printed: Wednesday, May 18, 2016 4:33:42 PM 2 of 3
ww SYSTFMS
=REVIEW-T,,YPE7 �--i-7,REVIEWER—,I'SENT[YATE'17DUE"DFAT
E7
BOND
STATUS
s 77,77
-":7REMARKS
, -777NOTE.
. .... . ......... .
T
1777
1ST BLDG NS (1 WK)
JIM JOHNSON
I S/17/2016 I
S/24/2016
I.S/18/2016 I
APPROVED
I
Printed: Wednesday, May 18, 2016 4:33:42 PM 3 of 3 CRw-lYSTEMS
BOND
INFORMATION
. .... . ......... .
........ . .. ATTACHMENTS
Printed: Wednesday, May 18, 2016 4:33:42 PM 3 of 3 CRw-lYSTEMS
k'
4
e
L
L
C
c
Bin #
Qty of L. Quintd
Building &r Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777 -7012
-Building Permit- Application and Tracking Sheet .
Permit #
FProjec teAddress: .Pwnerts-Name:
A. P .
P. Number: f7A es S1 . 15 �.� N (I� REC�6
--_
Legal Description: ;C�ty, ST, Zip: v �y
=Contra ct r.
0 P �j
Tele hone:
� 3ttq
ter.
=dress:9 l C� �.—Project-Description: _
ST, Zi
y, P ;�ti. d 3. l O D.E l:b ATeF
�Te
. le
C.
P ho ne•
U 1.1
»;CityLic..#•.<:::;:::>::: VC A lr
SfateLi: �j
c.#v �O0 Wo f \�
Arch., Engr., Designer:.
Address:.
City., ST, Zip:
Telephone:Occupancy:e
Con tructi n .T y P
Demo Lac.#• .
... PcoJect tYPa (circle one):: New Add n Alter Repair
Name of Contact Person: l l 3.. Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: `J7 imated-Value of Project:
APPLICANT" DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets '
Plan Check.submitted
Item
Amount
Structural Cales.
Reviewed, readyfor corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
-Plans picked up' ,
Construction
Flood plain plan
Plans resubmitted
J '
Mechanical
Grading.plan
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact.Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted ..
Grading
IN HOUSE:-
'"! Reyiew,,ready. for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I:P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
Total Permit'Fees
4
I
ME
mECEIVED
v
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT
N
L
o Do
cy
�:uj
vC3„L�
cr-._
4-
4
��®Z
0
9
u- co 0- 0
0 z
e
cc
<0
LLI
z
4
I
ME
mECEIVED
MAY 17'2016
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT
N
L
4
I
ME
I
eJ
A
t
0
N