BRES 2016-025578175 Masters Cir
BRES2016-0255
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
BRES2016-0255
Property Address:
78175 MASTERS CIR
APN:
770350009
Application Description:
GLENN RESIDENCE / GAS &
Property Zoning:
Application Valuation:
$1,500.00
Applicant:
SUN VISTA DEVELOPMENT CORPORATION
PO BOX 1144
i.n, ill IINTA, CA 92247
D i VOICE (760) 777-7125
FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT=
Date: 9/8/2016
o n Owner:
d MICHAEL GLENN
7420 BISCAYNE WAY SE
LECTRICAC (L P ( 2016 GRAND RAPIDS, MI 92253
COMP U 7 p OFU 061N U
f OP ENTD, FP=RTng fNT Contractor:
SUN VISTA DEVELOPMENT CORPORATION
P 0 BOX 1144
LA QUINTA, CA 92247
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.: 744091
Date: L/I - Y— / ( — 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.).
L -i 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 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:
(760)771-4722'
Uc. No.: 744091
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: STATE COMPENSATION INSURANCE FUND Policy Number: 9037385
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 Secti 00 of the Labor Code, I shall forthwith
comply wv^it►h those provisions.
Date: L V 1 Applica t:
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 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 o is city to enter " pon the
above-mentioned property for inspection purpose,, .
Date: signature (ApplicantAgent.
Application Number: BRES2016-0255
Property Address: 78175 MASTERS CIR
APN: 770350009
Application Description: GLENN RESIDENCE / GAS & ELECTRICAL
Property Zoning:
Application Valuation: $1,500.60
Owner:
MICHAEL GLENN
7420 BISCAYNE WAY SE
GRAND RAPIDS, MI 92253
Date: 9/8/2016
Applicant: Contractor:
SUN VISTA DEVELOPMENT CORPORATION SUN VISTA DEVELOPMENT CORPORATION
PO BOX 1144 PO BOX 1144
LA QUINTA, CA 92247 LA QUINTA, CA 92247
(760)771-4722
LIc. No.: 744091
. ---------------------------------------------------------------------------------------------
Detall: GAS LINE TO FIRE PIT AND BBQ. (5) ELECTRICAL OUTLETS FOR TV AND BBQ. PER 201�'C�
I
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
Credit Card. Fee
101-0000-43505
0
$3.92 .
Total Paid for Credit Card Fee: $3.92
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$24.17
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
'Total Paid for ELECTRICAL: $48.34
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$91.85
Total Paid for PERMIT ISSUANCE: $91.85
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.09
DESCRIPTION _
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$24.17
Total Paid for PLUMBING FEES: $36.26
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50
Bin #
Permit #{
Project Address: — •l
City of La Quinta
Buifding SF Safety Division
. 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name: /V),
,
A. P. Number:
1VGL2J
Address:'
Legal Description:
City, ST, Zip i
Contractor:
ele hon e.
TP
.................
Address:
A/1/
Project Description:
City- ST, Zip:`J/ "—)-N 4A
1
6S
Telephone:
State Lic..# :
City Lie. #;
GCvQC / l.•1. /J/
Arch.,:Engr., Designer:
Address:
City, ST, Zip-
Tele h ne:
Construction n TYPe• an cY•
Occupancy:
State ,.
Lie-#.
. Project type (circle one):• NewAdd'n Alter Repair Demo
Name of Contact Person:
r} 2......
Sq. Ft.:
# Spies:
#Units: .
Telephone # of Contact Person:
^ 2
O
Estimated Value of Projec
# Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact person
Plan Clieck Balance.
Title 24 Cates.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontacl'or List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
1I.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'"! Review, ready for corrcctions/issuc
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks- Appr
Date of permit issue
School Fees,
Total Permit Fees
0-1
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