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13-0135 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: X1-3-=000.00.138 Property Address: 45245 SEELEY DR UNIT 17 F APN: 604-040-999-2, -31116 - Application description: REMODEL - RESIDENTIAL. Property Zoning: TOURIST COMMERCIAL Application valuation: 2000 Applicant: T4!t 4 f�'itiGv BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION /t///,H- 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 Cl a s: 1 License No: 901161 �Date� ✓ �Conytractor: `"C.--�-- i.•~� 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 _ 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. , 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: 2/08/13 Contractor: SCHLICHT CONSTRUCTION A FnD 80207 MARAMAR DRIVE BERMUDA DUNES, CA 92203 n g (760)702-104.8 'F� t� �U1J Lic. No.: 901161 DEQ ----------------------------------------------- WORKER'S COMPENSATION DECLARATION 1 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 t insurance carrier and policy number are: Carrier Policy Number EXEMPT jonff'y 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, {1,'] and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code hwith comply with thou rovisions. Dat e• • V -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 pection purpose Date` :Signature-(Applicany6r Agent . / LQPERMIT Application Number . . . . . 13-00000135 Structure Information LAUNDRY HOOKUP ADDITION AT MASTER BATH ------- Other struct info . . ------------------ --------------------------------------------------------- . . . CODE EDITION 2010 PermitBUILDING *desc ' PERMIT Additional Permit Fee . . . . 45.00 Plan Check Fee 29.25 Issue Date . . . . Valuation 2000, Expiration Date 8/07/13 Qty Unit Charge Per- Extension BASE FEE 15.00 15-00 2.0000 - -------------------------------------------------- HND BLDG 501-2,000 7---.-- -------------------- 30.00 - - Permit . . . . ELECT - ADD/ALT/REM Additional desc Permit Fee' 16.50 Plan Check Fee 4.13 Issue Date Valuation . . . . 0 Expiration Date 8/01[13, Qty Unit Charge Per Extension BASE FEE 15.00 2.00 .7500 ----------- ------------ PER tLEC DEVICE/FIXTURE 1ST 20 ---------------------------------- --------------- 1.50 Permit . . . . . . MECHANICAL, I Additional desc Permit Fee 21.50 Plan Check Fee 5.38 Issue Date . . . . Valuation 0 Expiration Date.. 8/07/13 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 8/07/13 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 Application Number ' ' ' ' ' 13-00000135 _----__--_----_---____--__---__--_--___-____---_---__ ial motea and Comments � WASHER/DRYER`----_-- ----_- ONE (TOILET ROOM) AS aeeso`nso IN xmAoTsa PLAN' ` oor oazoo NOVEMBER 2012' 2010 CALIFORNIA � aozLozmo CODES. � ----------_----------------------------------------------------------------- Otbez Fees ' ' ' I ' ' ' ' ' ' oLoo GToG aoMzm (oa1473)' z'ou Exmsagr REvzow noo z'os � STRONG MoTzom (SMI) - Roo 'sO � nee summary Charged Paid Credited ---------- ---------- ---------- Due ----------------- Permit Fee Total ---------- 107'00 'VV ,OO 107'00 Plan Check Total 44'76 'OO 'oo 44'76 Other nee Total 4'43 '00 'uo 4'43 ' Grand Total 156'19 -OO '00 ` 156.'19 � LQPERMIT �'. City of La Quinta Bitfitiiag ar Safety r)ti+hion P.O Box x504,-78 49S Comte Tampico La QttiM4 CA 92253 -{760) 777,7012 Btn7dmg Permit AppGcatzar-and Traddng Sheet ?„ ;L7 ve. owna'SNa=`D0I In- A P Number. Addmmr B e,542 aoo aa, sT, zip:T-fV - 1 Cont 2dor Ib ri Tnle "(—Z'tiJ car, sr, zi= © , T@epho�-7�DO-IOZ-IO c5ty Lic M 0 10 Arch, &wDwizuw. Address: Ci z ST. zip- Telephone Statm Um #!: Coe>strutiioaTypc Oca - PMjeatAx (cWc =k New Add'n Demo - Name of Coataet Pason: Sq. Ft : d Staaiem d Uttit Teiephone P of Caftd Petwn-- ` - - FAamatod vahte of Pmjcct OOO. DO APPUCAW IM NOT WINE WWW TM UNE p ?bbnakpd gegd PIMKMTM. Phn3eb Plan (�eel;iahmiaed I ier� Amami, Baia[ Gia. &Ms%raft Ler wnuff ac Pia Cheek Deposit. 'hats Gkc l�tied Gnbtet Pam Pian CU& salaam Tm u Gks. ft" oft pin Pians piked ap Phos resahmktN • . Gatti nctFou Mechtikd Raiew, ready tor oareetionrfesae ffiearieai Sabeoatador Iat canm CnatadPason "Mkbft" Grant Deed Pius *W up S.MJ. W.A. Appewal Ptaas resa6eitlyd � IiV HOISE:- '"' IIe sere: reaft ter ewr Developer Impact Fee = SAPP 1 CaliedCoYCeetPasaa A".P " P.6. WkL AWr Date atpermittttae sdad Fees . - lblal Perdu Fat