BRES2017-000850503 Mandarina
BRES2017-0008
7VOICE (760) 777-7125
8-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT FAX (760) 777-7011
, INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 1/23/2017'
Application Number: BRES2017-0008 Owner:
Property Address: 50503 MANDARINA CITRUS COUNTRY CLUB
APN: 776200018 50503 MANDARINA DR
Application Description: CITRUS CLUBHOUSE / FIRE REPAIR TO LOCKER AND STORAGE ROOMS LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $15,000.00
Applicant: ® ® Contractor:
JUAN PEREZ MAC DONALD SERVICE GROUP INC DBA FLOOD R
PO BOX 1868 JAN 2 3 2017 72-104 CORPORATE WAY
LA QUINTA, CA 92247 THOUSAND PALMS, CA 92276
CITY OF LA QUINTA (760)343-3933
DESIGN AND DEVELOPMENT DEPARTMENT Llc. No.: 956037
------------------------ --------------------------------------------------------------------
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: C-9 B License No.: 956037
Date.)d J 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).:
(_) 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.).
( 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 Name:
Lender's Address:
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: GRANITE STATE INSURANCE COMPANY Policy Number: WC065259913
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 shal forthwith
comply with t ose2provisions.
DatO 3 Applicant:
WARNING: FAILUR 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 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 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 city to enter upon the
above-menTZ
'p operty for inspection purposes.
Date1 Signature (Applicant or Agent):
i
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�.
Date: .1/23/2017
Application Number: . BRES2017-0008
Owner:
Property Address: 50503 MANDARINA
CITRUS COUNTRY CLUB
APN: 776200018.
50503 MANDARINA DR
Application Description: CITRUS CLUBHOUSE / FIRE REPAIR TO LOCKER AND STORAGE ROOMS
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $15,000.00
Applicant:
Contractor: .
JUAN PEREZ
MAC DONALD SERVICE GROUP INC DBA FLOOD R
PO BOX 1868
72-104 CORPORATE WAY
LA QUINTA, CA 92247
THOUSAND PALMS, CA 92276
(760)343-3933
Llc. No.: 956037
Detail: FIRE DAMAGE REPAIR TO MENS LOCKER ROOM AND STORAGE AREA. SEE STRUCTURAL REVIEW
LETTER AND EXISTING CONSTRUCTION PLAN (SET
#100611) FOR REPAIRING REQUIREMENT OF EXISTING CONSTRUCTION. THIS PERMIT DOES NOT INCLUDE ADDITIONAL SQUARE FOOTAGE OR REMODELING
TO THE EXISTING FLOOR PLAN. 2016 CALIFORNIA BUILDING CODE.
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FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$25.33
Total Paid for ELECTRICAL: $50.66
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FURNACE
101-0000-42402
0
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FURNACE PC
101-0000-42600
.0
$25.33
Total Paid for MECHANICAL: $63.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$68.40
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$54.72
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 100 SF
101-0000-42400
0
$51.68
DESCRIPTION .
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$141.36
Total Paid for REMODEL: $316.16
DESCRIPTION
ACCOUNT
QTY'
AMOUNT
SMI -COMMERCIAL
101-0000-20308
0
$4.20
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $4.20 '
DESCRIPTION
ACCOUNT
QTY
T AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
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Permit � �.� W
Project Address: `;�50
.. City of La •Quinta
Building 8r Safety Division
- 78-495 Calle Tampico
La Quinta, CA 92253 (760) 777701,2'
Building Permit Application and Tracking Sheet
Owner's Name: .G G
y_
A. P. Number:
Address: 03 /041-I 19.441— %,14X
Legal Description: CCL,, $
City, ST, Zip:
Contractor: o.J
Tele hone:
Address: %a/Qtf-C.02 , OAd-rzr ediU-Y
Project Description: w „�
City- ST, Zip: '7446 ,1a.*p ��=-�-"'7S C!d • �c3i� ��3
�/1LGs C► w .a •�I•sLS
Tele h ne -
P o .
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State Lie. # : qCL
City Lie.
Arch., Engr es finer:
Address:
City, ST, Zip: L4g- r C4-- 'Fa >,+ 7
Telephone: !oO• 7 5a
=`.ti:`..
aneY�
Con tructi n TYP e: Occupancy:
P
State " #
S t Lie.
'Project type circle one): NewAdd'n Alter RepairairDemo.
Name of Contact Person: G
s+'L,TZ
Sq. Ft.:
#Stories`
# Units:
Telephone # of Contact Person: 7(00. (0t t�,
' �a
Estimated Value of Project: (/ °
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionslissue
Electrical
Subcontactor List'
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'rd Review, ready for correctionslissue.
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P._
Pub. Wks. Appr
Date of permit issue '
School Fees,
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Total Permit Fees
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