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. .
SYSTEMS