13-0112 (RER)Z
1q
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000112
Property Address:
45245 SEELEY DR UNIT 18
APN:
604-040-999-2 -31116
Application description:
REMODEL - RESIDENTIAL
Property Zoning:
TOURIST COMMERCIAL
Application valuation:
2000
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
/�-- - ::7 VOICE (760) 777-7012
FAX (760) 777-7011
�r..� INSPECTIONS (760) 777-7153
Date: 2/05/13
Owner:
D DOLPHIN LA QUINTA
18818 TELLER AVE #200
C/O DOLPHIN PARTNERS INC
IRVINE, CA 92612
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
i< Date:- —ISJ� Contractor:
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 Y
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 0500).: .n
(_) 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.).
( 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
Contractor:
SCHLICHT CONSTRUCTIO Fi�o
80207 MARAMAR DRIVEBERMUDA DUNES, CA 92
OF
Lic. No.: 901161 q(760)702-1048 (� 201
IGI�DEPTTA
WORKER'S COMPENSATION DECLARATION _
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 E) MPT Policy Number EXEMPT
I 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 forth w comply with those provisions-
Date:Q?1('/3 Applicant:& &
1
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 pro e y for,inspection pu oses.
Date.02"&43 Signature (Applicant or Agent):
Application Number . . . 13-00000112
------ 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
8/04/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00
15.00 2.0000
------------------------------------------------------7---------------------
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
8/04/13
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
8/04/13
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
Issue Date . . . .
Expiration Date . . 8/04/13
Plan Check Fee .
Valuation . . .
Qty Unit Charge Per
BASE FEE
1.00 6.0000 EA PLB FIXTURE
1.00 3.0000 EA PLB WATER INST/ALT/REP
LQPERMIT
6.00.
0
Extension
15.00
6.00
3.00
1
cam.
Application Number . . . . .
13-00000112
------------------------------------------------------------------------.----
Special Notes and Comments
WASHER/DRYER HOOKUPS - OPTION
ONE
(TOILET ROOM) AS APPROVED IN MASTER PLAN
SET DATED NOVEMBER 2012. 2010
CALIFORNIA
BUILDING CODES. •
i
-----------------_-------------------------------------
Other Fees . . . . . . .
---------------------
BLDG STDS.ADMIN (SB1473)
1.00
ENERGY REVIEW
FEE
2.93
STRONG MOTION
(SMI) - RES.
.50
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 4.43
.00_
.00
4.43
Grand Total. 156.19
.00
.00
156.19
LQPERMIT
Bin.
City of La Quanta
Bonding BE Safety Division
Penn[ #
P.O. Box 1504,78-495 Cagle Tampico
I
La.Qufita, CA 92233 -:(760) 777-7012
Building Permit' Applicatton'and Tracking Sheet
Project. `
`aD Owner's Name:.
L
A. P. Number. .
Address: ( 7Gt� f�»p
Legal Description:
City. ST, Zip:
Contractor. /- f Li C -1 4r CSN
ST Je7Joi✓
Telephone: -gS2 - ?.�3C7
Address: — 2
Project Description:
city. ST, Zip: L 0 vi ti�
CA 92
_
Telephone: 76D - %O 2 -104 $
f`�T 0? 9S 7"O/ t—gr %�eoeav
State Lia B : .� (o (
City Lic. 4;
p�O
Arrck.. Eagr, Designer: C,
IN •• 'A-
Address: -
Add WI.City,
City, ST. Zip:
Telephone:
Construction Type:. Occupancy:
State Lic. t3:
Project type (circle one): New Add'n Alt Repair Demo
Name of Contact Person: ��
S HL f.C- l •
Sq. Ft.:
9 Stories.
a Univ:
Telephone Y of Contact Person: _
Estimatbd Value of Project: 2 t
APPLICANT: DO NOT WRITE BELOW THIS UNE
N Sabmlttal Req'd Recd TRACMG PERMIT FEES
Plan Sear
Pi- Check submitted iwL Item Amount
Structural Cala
Reviewed, ready for corrections
Plan Check Deposit.
Truss Cala.
Called Contact Person
Plan Cheek Ralanee_
We ZI Cala-
Plans picked up
Construction
Flood plain plan
Plans rembmltted '
Maharilcal
Grading plan
Y! Review, ready for eorrectimWiissue
Electrical
Subeontaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SM.L
HOA Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Review; ready for cormcdonvIssue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees