BSPN2014-002944150 Mariposa Ct
BSPN2014-0029
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BSPN2014-0029
44150 MARIPOSA CT CT
604091003
SPECIAL INSPECTION FOR ELECTRICAL
Applicant:
FREEDOM VENTURES / ZACH ESSIG
37766 LOWESWATER ST
INDIO, CA 92201
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: License No.:
Date:
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 .
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/3/2014
Owner:
FREEDOM VENTURES/ ZACH ESSIG
37766 LOWESWATER ST
INDIO, CA 92201
Contractor:
OWNER BUILDER
Llc. No.:
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 3700 of the Labor Code, I shall forthwith
comply with those provisions.
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
Date: Applicant:
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the
plic t to a civil penalty of not more than five hundred dollars ($500).:
as
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
/a
owner of the property, or my employees with wages as their sole
A14D SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
compensation, will do the work, and the structure is not intended or offered for sale.
HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
apply to an owner of property who builds or improves thereon, and who does the work
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that he
IMPORTANT: Application is hereby made to the Building Official fora permit subject to
not build or improve for the purpose of sale.).
Vas
the conditions and restrictions set forth on this application.
O id
owner of the property, am exclusively contracting with licensed contractors to
1. Each person upon whose behalf this application is made, each person at whose
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State
request and for whose benefit work is performed under or pursuant to any permit issued
License Law does not apply to an owner of property who builds or improves thereon, and
as a result of this application , the owner, and the applicant, each agrees to, and shall
tacts forthe projects with a contractor(s) licensed pursuant to the Contractors'
defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
ense Law.).
WlLamr
employees for any act or omission related to the work being performed under or
exempt under Sec. , B.&P.C. for this reason
following issuance. of this permit.
2 A d 1 f h; 1' b
Date:,, d Owner:
CONSTRUCTIONgreg
CY
I hereby affirm under penalty of perjury thatruction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Add
. ny permit issue as a resu t o tis app kation ecomes 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-
mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
FINANCIAL INFORM TIO
a DESCRIPTION '• ° `
R ACCOUNT
QTY ;
AMOUNT -
PAID,
PAID DATE.
SPECIAL INSPECTION
101-0000-42404
1
$72.52
$0.00
t< PAID` 6Y ' ''
= =METHOD_ f
# RECEIPT#a,,sX
CHECK #..',;,
CLTDBY
Total Paid forCOMPLIANCE SURVEY/SPECIAL INSPECTION:
$72.52
$0.00
•
00
Permit Number: BSPN2014-0029 Description: SPECIAL INSPECTION FOR ELECTRICAL
Applied: 10/3/2014 Approved: Site Address: 44150 MARIPOSA CT CT
Issued: Finaled: City, State Zip Code: LA QUINTA, CA 92253
Status: SUBMITTED Applicant: FREEDOM VENTURES / ZACH ESSIG
Parent Permit: Owner: FREEDOM VENTURES / ZACH ESSIG
Parent Project: Contractor: OWNER BUILDER
Details:
SPECIAL INSPECTION FOR ELECTRICAL. 2013 CALIFORNIA BUILDING CODES.
LIST OF
vl—
RETU]R
IT-DATE;r -#DUE DATE ', _ '"TYPE:s '' CONTACT 'STATUS„„€ 'REMARK
..C ;r... ,cis #a+ aDATE "y , •;yyt ,, : ; :{[x ' } ' 4 _ ' ” ” v- ' `t', 8+. ° . f 3 " F,r #. r a
Printed: Friday, 03 October, 2014 1 of 1 "4s
1
'Bin #
Permit #
ProjecrAddress:
Qty of La Quinta
Building Sz Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
/ .A Owner's Name:
A. P. Number:
.
Address:`
Legal Description:
City, ST, Zip- 9
Contractor:
Telephone: (00 -- ( %'" t'f/J
Address:
Amount
Project.Description:
City, ST, Zip:
S
Telephone:
Plan Check Deposit
State Lic. # :
Truss Cala.
City Lie. #;
Arch., Engr., Designer:
Plan Check Balance.
Address:
Title 24 Cala.
City, ST, Zip:
Plans picked up
Telephone:
Construction
z<<.,»k
: :.::;::;.;
:...:........ .......
Construction Type: Occupancy:
State Lic. #::»;.v.......:;::;::;::;;;;;:
.Project type (circle one): New Add'n Alter Repair Demo
-Name of Contact Person: L
S
S9 Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
0 —
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 Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Revicw; ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person /
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN IIOUSE:-
'`° Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees