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13-1061 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00001061 Property Address: 45245 SEELEY DR UNIT 17 A APN: 604-040-999-2 -31116 - Application description:' REMODEL - RESIDENTIAL Property Zoning: TOURIST COMMERCIAL Application valuation: 2000 Applicant: Architect or Engineer: r / w M M. LICENSED CONTRACTOR'S DECLARATION 4VOICE (760) 777-7012 FAX (760),777-7011 BUILDING & SAFETY DEPARTMENT _ �/ INSPECTIONS (760) 777-7153 BUILDING PERMIT \v/ Date: 8/26/13 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 C ass: Bt / License No.: 9�7�5�4,/4,3 ,� � �% � _Pate':, 15 Contractor: �h� UL)� �CJLt� C;L t 'w` �Ci 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).: (_) 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 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.). 1 _ 1 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.). Lender's Name: _ Lender's Address: LQPERMIT Owner: DOLPHIN LA QUINTA 18818 TELLER AVE #200 C/O DOLPHIN PARTNERS INC IRVINE,.CA 92612 Contractor: FRONTIER WEST BUILDERS INC 139 BELLINI WAY PALM DESERT, CA -92211 (760)702-1098 Lic. No.: 975443 p u � � b202013 CITY OF to QUINTA FINANCE DEPT. ------------------ 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 EXEM Policy Number EXEMPT certify that, in the performs a of the work for which this.permit is issued, I shall not employ any person in any manner so o become subject to the workers' compensation laws of California, and agree that, if I shouL e subject to the workers' compensation provisions of Section Q� 37700 of the Labor Codort with comply w'th those provisions. Date: D �✓ Applicant: WARNING: FAILURE TO SECURE ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES 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 a information is correct. I agree to comply with all city and county ordinances and state laws relating to buildi construction, and hereby authorize representatives of this r[cc(o�nty to enter upon the above-mentioned property or inspection purposes. Date: O ol(J✓Signature (Applicant or Agent): Application Number . . . . . . 13-00001061 Structure Information OPTION 1 - LAUNDRY HOOKUPS AT TOILET RM ----- Other struct info . .'. . . CODE EDITION ------------------------------------------------------------ 2010 --------------- Permit REMODEL 2013 Additional desc Permit Fee 48.62 Plan Check Fee .00 Issue Date . . . . valuation . . . . 0 Expiration Date 2/22/14 Qty Unit Charge Per Extension 1.00 48.6200 LS MISC REMODEL, 1ST 100 SF 48.62 ------------ ------------------------------------------------------- Special Notes and Comments WASHER/DRYER,HOOKUPS - OPTION ONE (TOILET ROOM) AS APPROVED IN MASTER PLAN SET DATED JULY 2013. 2010 CALIFORNIA BUILDING CODES. August 22, 2013 8:42:03 AM AORTEGA ------------ ---------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PLAN CHECK, REMODEL 132.99 STRONG MOTION (SMI) RES .50 Fee summary Charged Paid Credited ---------- ---------- ---------- Due ----------------- ---------- .-Permit Fee Total 48.62 .00 .00 48.62 Plan Check Total .00 .00 .00 .00 Other Fee Total 134.49 .00 .00 134.49 Grand Total 183.11 .60 .00 183.11 LQPERMIT F At- C1ty Of Qutntd Tjy Bat[ding asafety Division -LA Qu. P.O Box 1504,•78.495 Calle T'amplcfl a 4.Qtdnta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet, 13 T A Permit # t3=�obt' Pmject Addtess:�24J $.+.a, a. 1-1 A. Ownet's Name:. A. P. Number. Legal Deuription. Address: CiRY, ST, Zip:CA Contractor. I Wor 8t%iL0 Telephone: 2.- Address 3 • ELLIN1 WA Project Description: © 10 city, 4T, zip: ?ALM VVES Telephone O -04% A ca 9 221 l • w O QST " BATM State Lia #: 15 #43 Atch., EW, Designs G c cy Lir_#, 0 06 EN Address: City, ST. Zip: ' Tele hon "02 P p : '90 Stat Lia #: Name of Cotlsat Person: A-� L. T ConstructionType:. Ocwgancy: - • Project type (circle one): New Add'n ter Repair Deno Sq. Ft: ` . # Stories: # Uniq Telephone # of Contact Poison 130matod Value of Projecx 2-,000- QQOAPPLICANT: APPLICANT:DO NOT WRITE BELOW THIS UNE # 3abmittdl ReVd 'Rec'd TRACMG PERMTFEES- Plan Set, Pian Cheek submitted Itea Amount Structural Coles. Reviewed, ready for corrections Pian Cbm* Deposit. . Tian Calm called Contact Person Pisa Cheek Balance. Title 24 Calls. Plans picked up Construction Flood plain plan Pkms resubmitted. • . Mechatikal G:mdtng plan 2" Review, ready for oorcections/fsatte Electrical Subeoatactor List Called ContaetPerson Phtntbkug ' Grant Deal Pians picked up S.bu H.O.A. Approval Plans tesabmttkd Grading IN HOUSE:- 3r' ReAm, ready for torrectloudissae Developer Impact Fee Planning Approval • called contact Person A.LP.P. Pub. Wks. Appr Date of peewit issue &had Fees Total Peralt Fees