BRES2015-015778-495 CALLE TAMPICO w 0 D Qum&
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BRES2015-0157
Property Address: 51184 AVENIDA HERRERA
APN: 773064010 '
Application Description: LUXE VACATION HOMES ROOM ADDITION
Property Zoning:
Application Valuation: . $31,473.60
Applicant:
STEUBS, JUSTIN M
51184 AVENIDA HERRERA
LA QUINTA, CA 92253
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 Professions Code,
and my License is in full force and effect:
License Class: B License No.: 1010918
l
Date:' ContrartQ
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 pursuant to
the Contractors' State License Law.).
I 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
VOICE (760) 777-7125
.FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
STEUBS, JUSTIN M
51184 AVENIDA HERRERA
LA QUINTA CA 92253
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WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one ofrthe following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700rof the Labor Code, for the performance
of the work for which this permit is issued.
ave -and will maintain workers' compensation insurance, as required by
Section i700 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: STATE COMPENSATION INSURANCE FU.AD Polity Number: 9153234
I certify that in the performance of tie 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
comply with those provisions.
Date: Z-ty-t?-- 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 -N SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOVIiEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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 C'ty 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 applicafoon becomes null and void if work is
not commenced within 180 days from date of is::uance of such permit, or cessation of
work for 180 days will subject permit to cancellaxion.
I certify that I have read this application and stat? 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 representati-es of this city to enter upon the
above-mentioned property for inspection purpo:es.
Date: :2 -) "/ 11signature (Applicant or Agent)
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Contractor:
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M J'S FAMILY COMSTRUCTION INC
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31265 RESERVE DRIVE SU
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THOUSAND PALMS, CA 9 2
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(760)343-2000
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LIC. No.: 1010918
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one ofrthe following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700rof the Labor Code, for the performance
of the work for which this permit is issued.
ave -and will maintain workers' compensation insurance, as required by
Section i700 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: STATE COMPENSATION INSURANCE FU.AD Polity Number: 9153234
I certify that in the performance of tie 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
comply with those provisions.
Date: Z-ty-t?-- 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 -N SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOVIiEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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 C'ty 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 applicafoon becomes null and void if work is
not commenced within 180 days from date of is::uance of such permit, or cessation of
work for 180 days will subject permit to cancellaxion.
I certify that I have read this application and stat? 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 representati-es of this city to enter upon the
above-mentioned property for inspection purpo:es.
Date: :2 -) "/ 11signature (Applicant or Agent)
E
Date: 2/14/2011
Application Number:
BRES2015-0157
Owner:
Property Address:
51184 AVENIDA HERRERA
STEUBS, JUSTIN IM
APN:
773064010
51184 AVENIDA.HERRERA
Application Description:
LUXE VACATION HOMES ROOM ADDITION
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$31,473.60'
Applicant:
Contractor:
STEUBS, JUSTIN M
M J'S FAMILY CCNSTRUCTION INC
51184 AVENIDA HERRERA
31265 RESERVE DRIVE SUITE B
LA QUINTA, CA 92253
THOUSAND PALLAS, CA 92276
(760)343-2000
------------------------------------------------------------------------•---------------------
LIc. No.: 1010913
Detail: MSF ADDITION +
132SF REMODEL. CONVERT ONE -CAR GARAGE TO BATHROOM. ADD/REPLACE WINDOWS, PLUMBING FIXTURES, AND ELECTRICAL
FIXTURES. 2013 CALIFORNIA
BUILDING CODES.
DESCRIPTION
ADDITION, EA ADDITIONAL 500 SF
DESCRIPTION
ADDITION, EA ADDITIONAL 500 SF PC
DESCRIPTION
ADDITION, FIRST 100 SF
DESCRIPTION
ADDITION, FIRST 100 SF PC
DESCRIPTION
CHANGE OF CONTR/ARCH/OWNER PROCESSING
DESCRIPTION
CHANGE OF CONTR/ARCH/OWNER PROCESSING
DESCRIPTION
HOURLY CHARGE - CITY BUILDING STAFF
DESCRIPTION
HOURLY CHARGE - CITY BUILDING STAFF
DESCRIPTION
HOURLY CHARGE - CITY BUILDING STAFF
DESCRIPTION
HOURLY PLAN CHECK - YES
DESCRIPTION
HOURLY PLAN CHECK - YES
DESCRIPTION
DEVICES, ADDITIONAL
DESCRIPTION
DEVICES, ADDITIONAL PC
DESCRIPTION
DEVICES, FIRST 20
DESCRIPTION
DEVICES, FIRST 20 PC
DESCRIPTION
RESIDENTIAL, FIRST 1,000SF
DESCRIPTION
RESIDENTIAL, FIRST 1,000SF, PC
DESCRIPTION
AMOUNT
$62.36
AMOUNT
$17.40
AMOUNT
$120.83
AMOUNT
$171.14
$371.73
AMOUNT
$97.17
AMOUNT
$101.84
$199.01
AMOUNT
$152.00
AMOUNT
$228.00
AMOUNT
$152.00
AMOUNT
$105.00
AMOUNT
$52.50
$689.50
AMOUNT
$24.20
AMOUNT
$6.00
AMOUNT
$24.17
AMOUNT
$24.17
$78.54
AMOUNT
$145.03
AMOUNT
$47.86
$192.89
AMOUNT
ACCOUNT
QTY
101-0000-42400
0
ACCOUNT
QTY
101-0000-42600
0
ACCOUNT
QTY
101-0000-42400
0
ACCOUNT
QTY
101-0000-42600
0
Total Paid for ADDITION:
ACCOUNT
QTY
101-0000-42600
1
ACCOUNT
QTY
101-0000-42600
1
Total Paid for ADMINISTFATIVE:
ACCOUNT
QTY
101-0000-42600
1
ACCOUNT
QTY
101-0000-42600
1.5
ACCOUNT
QTY
101-0000-42600
1
ACCOUNT
QTY
101-0000-42600
1.5
ACCOUNT
QTY
101-0000-42600
0.75
Total Paid for BLDG CITY STAFF - PER HOUR:
ACCOUNT
QTY
101-0000-42403
0
ACCOUNT,
QTY
101-0000-42600
0
ACCOUNT
QTY
101-0000-42403
0
ACCOUNT
QTY
101-0000-42600
0
Total Paid for ELECTRICAL:
ACCOUNT
QTY
101-0000-42403
0
ACCOUNT
QTY
101-0000-42600
0
Total Paid for ELECTRICAL - NEW CONSTRUCTION:
ACCOUNT I
aTY
AMOUNT
$62.36
AMOUNT
$17.40
AMOUNT
$120.83
AMOUNT
$171.14
$371.73
AMOUNT
$97.17
AMOUNT
$101.84
$199.01
AMOUNT
$152.00
AMOUNT
$228.00
AMOUNT
$152.00
AMOUNT
$105.00
AMOUNT
$52.50
$689.50
AMOUNT
$24.20
AMOUNT
$6.00
AMOUNT
$24.17
AMOUNT
$24.17
$78.54
AMOUNT
$145.03
AMOUNT
$47.86
$192.89
AMOUNT