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BRES2015-0205i r Applicant: JORGE GARCIA 45175 PANORAMA DR E PALM DESERT, 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 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: B License No.: 8220801 mat: 6/0/45— Contractor. � �u i OWNER -BUILDER ECLARATION 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, 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 Contractor: SANTUCCI BUILDERS INC 72529 BEAVERTAIL STREET PALM DESERT, CA 92260 (760)578-7757 Llc. No.: 820801 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 ork for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Sec J3700 of the Labor Code, for the performance of the work for which this permit is issu d. 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 wit hose provisions. ``/ Date V Applicant: i 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 of this city to enter upon the above- mentio/n�ed roperty for inspection purposes. Date:>F �� / Signature(Applicant orAgent): lJ VOICE (760) 777-7125 7,8-495 CALLE T,AMPICO D LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 6/12/2015 Application Number: BRES2015-0205 Owner: Property Address: 79346 W MISSION DR DALLAS OTTER APN: 602250013 79346 MISSION DR W Application Description: OTTER/INTERIOR REMODEL DEMO WALL FOR PASS THROUGH LA QUINTA, CA 92253 Property Zoning: Application Valuation: $10,000.00 Applicant: JORGE GARCIA 45175 PANORAMA DR E PALM DESERT, 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 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: B License No.: 8220801 mat: 6/0/45— Contractor. � �u i OWNER -BUILDER ECLARATION 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, 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 Contractor: SANTUCCI BUILDERS INC 72529 BEAVERTAIL STREET PALM DESERT, CA 92260 (760)578-7757 Llc. No.: 820801 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 ork for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Sec J3700 of the Labor Code, for the performance of the work for which this permit is issu d. 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 wit hose provisions. ``/ Date V Applicant: i 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 of this city to enter upon the above- mentio/n�ed roperty for inspection purposes. Date:>F �� / Signature(Applicant orAgent): lJ FINANCIAL , • DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE HOURLY PLAN CHECK - YES 101-0000-42600 0.75 $52.50 $52.50 6/12/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY SANTUCCI BUILDERS INC CHECK R7006 7229 AZA Total Paid for BLDG CITY STAFF - PER HOUR: $52.50 $52.50 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 6/12/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY SANTUCCI BUILDERS INC CHECK R7006 7229 AZA Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 101-0000-42403 0 $24.17 $24.17 6/12/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY SANTUCCI BUILDERS INC CHECK R7006 7229 AZA DESCRIPTION .ACCOUNT QTY ` AMOUNT PAID : PAID DATE DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $24.17 6/12/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY SANTUCCI BUILDERS INC CHECK R7006 7229 AZA' Total Paid for ELECTRICAL: $48.34 $48.34 1 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.09 $12.09 6/12/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY SANTUCCI BUILDERS INC CHECK R7006 7229 AZA DESCRIPTION ACCOUNT QTY - AMOUNT PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $24.17 $24.17 6/12/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY SANTUCCI BUILDERS INC CHECK R7006 7229 AZA Total Paid forPLUMBING FEES: $36.26 $36.26 DESCRIPTION .,ACCOUNT QTY AMOUNT PAID PAID DATE REMODEL, FIRST 100 SF 101-0000-42400 0 $49.31 $49.31. 6/12/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY SANTUCCI BUILDERS INC CHECK R7006 7229 AZA DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE REMODEL, FIRST 500 SF PC 101-0000-42600 0 $134.88 $134.88 6/12/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY SANTUCCI BUILDERS INC CHECK R7006 7229 AZA Total Paid forREMODEL: $184.19 $184.19 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 '$1.30 $1.30 6/12/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY SANTUCCI BUILDERS INC CHECK Total Paid forSTRONG MOTION INSTRUMENTATION SMt R7006 $1.30 7229 1 AZA $1.30 Description: OTTER/INTERIOR REMODEL DEMO WALL FOR PASS THROUGH Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: ISSUED Applied: 5/26/2015 SKH Approved: 6/9/2015 JJO Parcel No: 602250013 Site Address: 79346 W MISSION DR LA QUINTA,CA 92253 Subdivision: Block: Lot: 50 Issued: 6/12/2015 AZA Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $10,000.00 Occupancy Type: Construction Type: Expired: 12/9/2015 AZA No. Buildings: 0 No. Stories: 0 - No. Unites: 0 JIM JOHNSON Details: INT REMODEL CREATE A PASS THRU. PER 2013 CRC CODES 14 3 __j Applied to Approved N Approved to Issued . Printed: Friday, June 12, 2015 12:39:05 PM 1 of 3 „ J SYS7fti1S ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME' ACTION.DATE COMPLETION DATE NOTES. NOTE JIM JOHNSON 6/4/2015 6/9/2015 PENDING STRUC APPROVAL PLAN CHECK COMMENTS FROM CONSULTANT_ MARY FASANO 6/8/2015 6/8/2015 APPROVED BY YOUNG RECEIVED TELEPHONE CALL JIM JOHNSON 6/9/2015 6/9/2015 CALLED JORGE GARCIA TO INFORM HIM PLANS ARE READY TO ISSUE. CONDITIONS CO NTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT JORGE GARCIA 45175 PANORAMA DR PALM DESERT CA 92253 E Printed: Friday, June 12, 2015 12:39:05 PM 1 of 3 „ J SYS7fti1S FINANCIAL INFORMATION DESCRIPTION ACCOUNT. QTY AMOUNT : PAID PAID DATE RECEIPT # CHECK # METHOD.:. PAID BY CLTD BY HOURLY PLAN CHECK - 101-0000-42600 0.75 $52.50 $52.50 SANTUCCI BUILDERS 6/12/15 R7006 7229 CHECK AZA YES INC Total Paid forBLDG CITY STAFF - PER HOUR: $52.50 $52.50 BSAS SB1473 FEE 101-0000-203060 $1.00 $1.00 6/12/15 R7006 7229 CHECK SANTUCCIBUILDERS AZA Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: DEVICES, FIRST -20 101-0000-42403 0 $24.17 $24.17 6/12/15 R7006 7229 CHECK SANTUCiNCUILDERS AZA DEVICES, FIRST 20.PC 101-0000-42600 0 $24.17 $24.17 6/12/15 R7006 7229 CHECK SANTUCiNCUILDERS AZA Total Paid for ELECTRICAL: $48.34 $48.34 GAS SYSTEM, 1-4 101-0000-42401 0 $12.09 $12.09 6/12/15 R7006 7229 CHECK SANTUCCI BUILDERS AZA OUTLETS INC GAS SYSTEM, 1-4 101-0000-42600 0 $24.17 $24.17 6/12/15 R7006 7229 CHECK SANTUCCI BUILDERS AZA OUTLETS PC INC Total Paid for PLUMBING FEES: $36.26 $36.26 REMODEL, FIRST 100 SF 101-0000-42400 0 $49.31 $49.31 6/12/15 R7006 7229 CHECK SANTUCiNCUILDERS AZA REMODEL, FIRST 500 SF 101-0000-42600 0 $134.88 $134.88 6/12/15 R7006 7229 CHECK SANTUCCI BUILDERS AZA PC INC Total Paid for REMODEL: $184.19 $184.19 Printed: Friday, June 12, 2015 12:39:05 PM 2 of 3 CRIAI srsrrMs DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY SMI - RESIDENTIAL 101-0000-20308 0 $1.30 $1.30 6/12/15 R7006 7229 CHECK SANTUCCI BUILDERS INC AZA Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $1.30 $1.30 BOND INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES FINAL" BLD REMARKS BOND RETURNED STATUS - REMARKS REVIEW TYPE REVIEWER SENT DATE DUE DATE NOTES DATE NON-STRUCTURAL - NON STRUC APPROVABLE PENDING STRUC JIM JOHNSON 5/26/2015 6/9/2015 6/4/2015 APPROVED 2 WK APPROVAL 5/26/2015 6/9/2015 6/8/2015 READY FOR APPROVAL STRUCTURAL - 2 WKYOUNG ENGINEERING BOND INFORMATION ATTACH M E NTS Printed: Friday, June 12, 2015 12:39:05 PM 3 of 3. . 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