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13-1062 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA. 92253 Application Number: 13-00001062 Property Address: 45245 SEELEY DR UNIT 17 B APN: 604-040-999-2 -31116 - Application description: REMODEL - RESIDENTIAL Property Zoning: TOURIST COMMERCIAL Application valuation: 2000 Titit 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or En ineer: ------------------ 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 !' 1 �Liicense No.: 1J97754433 -DLa O Bio ContrLV actor:l'd'4JiLl K',t' LTfUXS \CJS tC/ 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 anyapplicant for a permit subjects the applicant to a. civil penalty of not more than five hundred dollars ($500).: (_ 1 1, 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.). (_ I 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 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 Owner: DOLPHIN LA QUINTA 18818 TELLER AVE #200 C/O DOLPHIN PARTNERS INC IRVINE, CA 92612 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/26/13 Contractor: FRONTIER WEST BUILDERS 139 BELLINI WAY An2' PALM DESERT, CA.92211 . (760)702-1098 Lic. No.: 975443 CITY OF LA 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 y insurance carrier and policy number are: _ Carrier EXE Policy Number EXEMPT eL,.Ircertify 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 sho 1 become subject to the workers' compensation provisions of Section J�p�� j37700 of the Labor C I shall fo hwith comp) with those provisions. /Date: _�+--�� Applicant - WARNING: FAILURE TO SECUREORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 personupon 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 pbpve information is correct. I agree to comply with all city and county ordinances and state laws relating to buildin.1 construction, and hereby authorize representatives of this co my to enter upon the above-mentioned propert r inspection purposes. Date ✓ Signature (Applicant or Agent): `s Application Number . . . . . 13-00001062 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 8:43:13 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 .00 .00 183.11 LQPEFNI [T Bin. # : City Of. U Qur`nta Building 8c Safely DhMoti �0 Cj . 13. - P.O Box 1504,"78.495 Calle Tampico MMU �A PINTA ta.Qtiirlta, CA 92253 -x(760) 777-7012 NIS' DFS Building Permit Applicadon and Tracking Sheet Perink # :1to1e�- Project Addt � S .tom '� ovn ccs Naraw. . IDO.LpMM; A- P. Address: City. ST. Zip= = V I N c C A 9 Z!o 12 Legal Description: Contractor. # wasr 60#06 i Telephone: Z- 2..30 3 0tt LI I WA PmjectDescrtption: © p City, PT, zip: ?ALM DES£ C✓' A 92-2.11t . V F Tdephone:� o - - ASST r Stele Lia #: 3 City Lic, #: O O G Arrh., EW, Designer-. .N y Address. City, ST, Zip. Telephone: � �: ' 'p . on Type: . occupancy"• State Lia #: Name of Cotltact Person: Ax I -r- Project type (circle one): New Add'a Repair Demo Sq. FL:' # Stories: # Unitx Telephone # of contact Peisou E ti nWzd Vahw of Project QOO APPLICANT: DO NOT WINE BELOW THIS UNE tR Submittal RWd Reed TRA4 G PERMIT FM - Plea Sete Pico Cheek enbmitted new Amount Stractaral Calea. Reviewed, ready for terradons Plan Check Deposit.-. Titers Cats. Ca11ed Contact Person Pian check Balance. •Title Z4 Usice. Plans picked cep Conetrattioa Flood plain plan Plans resubmltied.' . Mechanical Grading plan 2. Review, ready for correctionsiassu.e Fdecit teal Snbeoataetor list Caged CoubdPerson Plumbing r Grant Deed Plans picked op S.M.I. H.O.A. Approval Plans reohni ted - Grating of HOUSB:- ''' Review, ready for tormcdonslissae Devdoper Impact Fee - Plaodug Approval Called Contact Person A.LP.P. Pub, WE& Appr - Date of permit issue School Fees ' ' Tocol Permit Fees .