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13-0320 (RER)P.O.'BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00000320 Property Address: 45245 SEELEY DR UNIT 17 D APN: 604-040-999-2 -31116 - Application description: REMODEL - RESIDENTIAL Property Zoning: TOURIST COMMERCIAL Application valuation: 2000 T -VY 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or Engineer: ------------------ 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 License No.: 901161 Dater I Contractor:7_ft;,__— �.! 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 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 puisuant to the Contractors' State License Law.). ( ) I am exempt under Sec. , B.&P.C. for this reason Owner: V 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: LQPERD1IT Owner: DOLPHIN LA QUINTA 18818 TELLER AVE #200 C/O DOLPHIN PARTNERS INC IRVINE, CA 92612 Contractor: SCHLICHT CONSTRUCTION ' 45155 DESERT VIEW COURT LA QUINTA, CA 92253 (760)702-1048 Lic. No.: 901161 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/19/13 P Q I . 0 MAR ;22 2013 CITY OF LA QUINTA FINANCE DEPT. -----------------------------------------------7 WORKER'S COMPENSATION DECLARATION 1 herebyaffirmunder 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 iEXEMPT Policy Number EXEMPT 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 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith with those provisions. Datet� —� Applicant: 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 ($100,000). 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 construction, and hereby authorize representatives of this county to enter upon the above-mentioned prop rl= spection purpo/ses Datei Signature (Applicant or Agent): i Application Number . . . . . 13-00000320 ------ 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 9/15/13 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 9/15/13 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 9/15/13 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 9/15/13 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 13-00000320 ---------- Special Notes and Comments WASHER/DRYER HOOKUPS - OPTION ONE (TOILET ROOM) AS APPROVED IN MASTER PLAN SET DATED NOVEMBER 8, 2011. 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 - Bln. City ofLa Quinta BulkUng a Safety Division P.O. Box 1504, *78-495 Calle Tampico La .Quinta, CA 92253 - (760) 777V012 Building Permit Application and Tracking Sheet Permit �l/Jv I Project Address L��S Ct �y o I % D ' Owner's Name:. A. P. Number. Address: 1851 gx<i Legal Description: City, ST, Zap: 12- Contractor.,HC 1t CQN(Sj cW Telephone: 949- 2$3 — 3-7-7 Address: 4SISS V1 ezj Project Description: CptQ 10` l City, ST, Tap: LA 001AIM (24 9EZ53 Telephone:%(o -) p2-1 c* S ; 7r--- • J State Lir. #: 9nro �o City Lic. t _I01 101 Arch., EW., Designer 1 / Address: City,ST. Zip. Telephone: Construction Type:. Occupancy: ecu Proc J type (irele one): New Add'n Repair Sq. Ft.: # Stories: #Unity Demo gp State Lia #: Name of Contact Person: i G14 I— Telephone # of Contact Person: Estimated Value of Project :Z,00 0 APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal B.eq'd Recd TSACMG PERA3[i FEES Plan Sets Pian Check submitted. it. Amount S"ctural Cales. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Caped Contact Person Plan Cheek Balance Title 24 Cates. Plans pickedup Construction Flood pilin plan Plans resubmittM.. Mechatiltal Grading plaa 2' Review, ready for correctionsfcssta Electrical Subcoetactor Ust Called Contact Person Plumbing Groot Deed Pians pldmd up s1u H.O.A. Approval Plans resabmiiled Grading IN HOUSE:- '`" Review; ready for eorreetionsfissae Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees