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13-0404 (RER)r: � P.O. BOX 1504 Tit! h a VOICE (760) 777-7012 78-495 CALLE TAMPICO`-�—, FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT V INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 4/04/13. Application Number: 13-00000404 Owner: Property Address: 45245 SEELEY DR UNIT 16 F DOLPHIN LA QUINTA , APN: 604-040-999-2 -31116 - 18818 TELLER AVE #200 Application description: REMODEL - RESIDENTIAL C/O DOLPHIN PARTNERS INC Property Zoning: TOURIST COMMERCIAL D p IRVINE, CA 92612 Application valuation: 2000 APR 0 4 2013 Contractor: Applicant: Architect or Engin r. SCHLICHT CONSTRUCTION CITY OF LA QUINTA 80207 MARAMAR DRIVE FINANCE DEPT. BERMUDA DUNES, CA 92203, (760)702-1048 Lic. No.: 901161 ------------------ 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 a" Licen.sLe. No.: 901161 �D/'atf—t'�I' 13 Conkor: W1 Vr,Y I Ili` 1 e 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).: (_ 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.). l _ ) 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: LQPEPMIT WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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 rr�issued. 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 EXEMPT Policy Number EXEMPT _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any Lperson in any manner so as to become subject to the workers' compensation laws of California, tr and agree that, if I should become subject to the workers' compensation provisions of Section �l 3700 of the Labor Code, I shall forth th comply with those provisions. Date: 1 t3 Applicant: ��A�� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL "SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001. 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 construction, and hereby authorize representatives of this county to enter upon the above-mentioned prope y for inspection purp Dater _I *1j 3 Signature (Applicant or Agent):fii tr el Application Number . . . 13-00000404 Structure Information LAUNDRY HOOKUP ADDITION AT MASTER BATH Other struct info . . . . . CODE EDITION 2010 Permit . . . BUILDING PERMIT Additional desc . ` Permit Fee . . . . 45.00 Plan Check Fee 29.25 Issue Date . . . . Valuation . . . . 2000 Expiration Date 10/01/13 Qty Unit Charge Per Extension BASE FEE 15.00 15.00 2.0000 HND BLDG 501-2,000 30.00 Permit . . ELECT - ADD/ALT/REM Additional desc.. Permit Fee . . 16.50 •Plan Check Fee 4.13 Issue Date Valuation . . 0 Expiration -Date 10/01/13 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 1.50 Permit . . . . MECHANICAL Additional desc . Permit Fee . . . . 21.50 Plan Check Fee 5.38 Issue Date . . . . Valuation . . . 0. Expiration Date 10/01/13 Qty Unit Charge Per Extension BASE FEE 15.00 .1.00 6.5000 ----------------------------------------------.------------------------------ EA MECH VENT FAN 6.50 Permit . . . PLUMBING Additional desc . Permit Fee . . . . 24.00 Plan Check Fee 6.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/01/13 Qty Unit Charge Per Extension • BASE FEE 15.00 1.00 6.0000 EA PLB FIXTURE 6.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 LQPERMIT LQPERMIT - Application Number . . . 13-00000404 Special Notes and Comments WASHER/DRYER HOOKUPS - OPTION ONE (TOILET ROOM) AS APPROVED IN MASTER.PLAN SET DATED NOVEMBER 2012. 2010 CALIFORNIA BUILDING CODES. ---------------------------------- Other Fees. --------------- BLDG STDS ADMIN ------------ (SB1473) 1.00 ENERGY REVIEW FEE 2.93 Fee summary Charged Paid Credited, Due Permit Fee Total 107.00 .00 .00 107.00 Plan Check Total 44.76 00 •.00, 44.76 Other Fee Total 3.93 .00 .00 3.93 Grand -Total 155.69 .00" .00 155.69 LQPERMIT Bin. # CII}/ Of Q uin to Building 8t Safety Division P.O. Box 1504,78-495 Calle Tamplco la.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # _ 710 [J % Project Address: 24 ,� *616 F. Owner's Name:. A. P. Number. Address: (8 tGAVE, sup 7-c=, c>' Legal Description: City, ST, Zip: Contractor. LIGHT t N Je oiv Telephone: — g» U0 H Address: '� T 1 . Project Description: O 1W City, ST, Zip: L Telephone:�� 02 -1 d4 ME z' City Lic. #; .47-A�$'J 1 L State Lie. #: 9 01 io 6 t Arch, Engr., Designer C N� N Address: N City., ST. Zip: 4 s, ;, Gg 9226 d Telephone: State Lie. #: Name of Contact Person: FA)r Construction Type:. Occupancy: - <C Project type (circle one): New Add'n Alter Repair Sq. Ft : # Stories: # Units: Demo Telephone # of Contact Person:% Estimated Value of Project: 2 Ont APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACKING PERhIIT FEES Plan Sets Plan Cheek submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Balance Tide 24 Calci. Pians picked up Construction Flood plain plan Pians resubmitted.. Mechanical Giading plan 2'! Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S3LL H.O.A. Approval Plans resubmitted Grading IN ROUSE:- ' d Revlew', ready for corrections/issue Developer Impact Fee Planning Approval "led Contact Person -r Ad.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees