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BDEM2015-000577490 Loma Vista BDEM2015-0005 Property Address:. 77490 LOMA VISTA APN: 658220013. Application Description: O CONNOR RESIDENCE / DEMO Property Zoning: Application Valuation: $25,000.00 Applicant: STARK CONSTRUCTION COMPANY INC 39-725 GARAND SUITE E PALM DESERT, CA 92211 LICENSED CONTRACTOR'S DECLARATION 1 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 Cl as : B `License No.: 577776 Date: Gam' 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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ( 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, 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 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 Na Lender's Add VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/12/2015 Owner: DAN O'CONNOR 77490 LOMA VISTA LA QUINTA, CA 92253 Contractor: 'STARK CONSTRUCTION COMPANY INC' 39-725 GARAND SUITE E PALM DESERT, CA 92211 (760)345=9711 Llc. No.: 577776 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 insurance carrier and policy number are: Carrier: _ Policy Number: 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 37000 the Labor Code, I shall forthwith complywith-those sions. Date: Applicant:CS i WARNING: FAILURE TO SECURE WORKERS' COMP TION 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 Building Official for a permit subject to the conditions and restiictions 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 Quinti, 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 city to enter upon the above mentioneii rop yfor inspection purposes. /r Date: Signature (Applicant or Agent) s FINANCIAL INFORMATION n- z Spy M `R DESCRIPTION x °rj y ACCOUNT =" AMOUNT PAID PAID DATE , L2DEMOLITION, ,MO INTERIOR 101-0000-42404 $36.26 $36.26 8/12/15 PAIDrBY x«°X§METHOD ;`jRECEIP.T# %CHECk#-,',; f STARK CONSTRUCTION COMPANY INC CHECK R8424 762 MFA `;DESCRIPTIONS `} ACCOUNT N w ' QTY g4,' AMOUNT PAID ; PAID DATE: r, fit'. DEMOLITION, INTERIOR PC 101-0000-42600 0 $97.17 $97.17 8/12/15 ,. f 4'PAID BY ON- ~ METHODS , ". kp" " RECEIPT # s p CHECK # '" BY . ri 4' s ,;w , 7 n,f ,.'.. kK* ,4e xP. vk.. + .. +i .+Y'''a.1s.ri$-d:u., yCLTD STARK CONSTRUCTION COMPANY INC CHECK R8424 762 MFA ! Total Paid for DEMOLITION: $133.43 $133.43 TOTALS: Description: 0 CONNOR RESIDENCE / DEMO Type: DEMOLITION Subtype: SINGLE FAMILY Status: ISSUED Applied: 8/12/2015 MFA Approved: 8/12/2015 MFA Parcel No: 658220013 Site Address: 77490 LOMA VISTA LA QUINTA,CA 92253 Subdivision: TR 25237 Block: Lot: 41' Issued: 8/12/2015 EVA Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $25,000.00 Occupancy Type: Construction Type: Expired: 2/8/2016 EVA No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: TEARING OUT DRYWALL, CABINETS, STUCCO AND CONCRETE. NO STRUCTURAL TO BE REMOVED. Printed: Wednesday, August 12, 2015 2:29:45 PM 1 of 2 SYSTEMS SEQID: INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED , RESULT REMARKS NOTES DATE ° DATE PRE -SITE BLD FINAL" I BLD PARENT PROJECTS REVIEWS RETURNED STATUS REMARKS REVIEW TYPE REVIEWER SENT DATE DUE DATE DATE NOTES. Printed: Wednesday, August 12, 2015 2:29:45 PM 2 of 2 srsTrMs y "PAID CLTD ' DESCRIPTION :.. ACCOUNT QTY AMOUNT PAID PAID DATE ,'RECEIPT # CHECK # METHOD BY BY STARK DEMOLITION, INTERIOR 101-0000-42404 0 $36.26 $36.26 8/12/15 R8424 762 CHECK CONSTRUCTION MFA COMPANY INC STARK DEMOLITION, INTERIOR 101-0000-42600 0 $97.17 $97.17. 8/12/15 R8424 762 CHECK CONSTRUCTION MFA PC COMPANY INC Total Paid for DEMOLITION: $133.43 $133.43 TOTALS: $1j3.43 $131.43 SEQID: INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED , RESULT REMARKS NOTES DATE ° DATE PRE -SITE BLD FINAL" I BLD PARENT PROJECTS REVIEWS RETURNED STATUS REMARKS REVIEW TYPE REVIEWER SENT DATE DUE DATE DATE NOTES. Printed: Wednesday, August 12, 2015 2:29:45 PM 2 of 2 srsTrMs B;" # Qity of La Quinta Building &' Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 0005 Building Permit Application and Tracking Sheet Permit # pt 2Q l . .41 O Project Address:'77 Owner's Name: Ce7l..iyCJ A. P. Number: -? f 3j Address:`1 "q 2 D, -A of Legal Description: City, ST, Zip: L(,) Contractor: c or. _ / cY 1T D ne• c4T q le h 0 Address:39'7 Z- Pi[ ProjectDescription: D r1 City, ST, Zip PAI -Al 0011S_eA1;1' c4N, 95 2_1 j Telephone: ele h Po . J Gtr d State Lic. # : J % -7 City Lic. #; Arch., Engr., Designer: Address: G SS' L —4_et tr% City, ST, Zip: Pq✓ Telephone: U c' %h 1 u Con truct s ton T e• O Y• YP 41 U 4✓— Occupancy: P State to Lic. #• Project tYPa (circle one): New Add'n Alter r Re air De m Name of Contact Person: &41101Y s — %p Q,4A Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: i Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes.. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance Title 24 Cafes. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees