BRES2015-025878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
BRES2015-0258
51780 AVENIDA NAVARRO
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
773184002
PEREZ RESIDENCE WINDOW REPLA(
$200.00
Applicant:
JUAN G PEREZ
51780 AVENIDA NAVARRO
LA QUINTA, 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 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect. `
License Class: License No.::CONV:140528101254106854 _
Date: Cont
OWNER -BUILDER DECLARATION/
I hereby affirm under penalty of perjury that I am exempt,ffom 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).:
(
11, 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 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.).
(_J 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
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/7/2015
Owner:
JUAN G PEREZ
51780 AVENIDA NAVARRO
LA QUINTA, CA 92253
Contractor:
JUAN G PEREZ
51780 AVENIDA NAVARRO
LA QUINTA, CA 92253
(760)679-8752
Llc. No.::CONV:140528101254106854
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.
Date: �7 7- f 5— Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION,eOVERAGE 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-
mentioned property for inspection purposes.
s
Date: i Signature (Applicant or Agent):
FINANCIAL INFORMATION
s
DESCRIPTION ' `ACCOUNT s� .Y FQTY e'AMOUNi1- ' PAID �-"°-PAID'DATE'
Y .._ ,
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
METHOD, .g „;`RECEIPT #*, '' CHECK #€_ CLTD BYY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
2 'DESCRIP.TION �`
I4. �R = ACCOUNTS "
QTY
AMOUNT ;.;.'.
PAID
PAID DATE
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
$0.00
PAID BY
METHOD 4
"" i ;RECEIPT # � ;
' `, CHECK #
CLTD BY,
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00
DESCRIPTION k'� > `x , y
? K ACCOUNT' '.
QTY.
€..x AMOUNTS
PAIDPAID:DATE
t.
DOOR/WINDOW, NEW, FIRST 1
101-0000-42400
0
$60.91
$0.00
N
r PAID BYq "',
METHOD '+ z
1 `;RECEIPT # .�
g -CHECK # t
`TCLTD BY
P . DESCRIPTIONA000UNT
.°
;.QTY °
" s AMOUNTJA
P PAID
`PAID DATE'
DOOR/WINDOW, NEW, FIRST 1 PC
101-0000-42600
0
$59.46
$0.00
_ , •
,r. PAID BY
.. ... .s. ... _
,rtf
k._ Y as - _ f"�#. "E. —x
METHOD 'RECEIPT
„ aY # r
CHECK # , ,
-
CLTD BY
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $120.37 $0.00
TOTALS:••
s
-
Description: PEREZ RESIDENCE WINDOW REPLACEMENT
CONDITIONS,
Type: BUILDING, RESIDENTIAL Subtype: REMODEL
Status: UNDER REVIEW
Applied: 7/7/2015 EVA
Approved:
Parcel No: 773184002 Site Address: 51780 AVENIDA NAVARROLA QUINTA,CA 92253
Subdivision: SANTA CARMELITA AT VALE LA QUINTA Block: 121
Lot: 23
Issued:
NO 12
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $200.00 Occupancy Type:
Construction Type:
,
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: REPLACE (1) BATHROOM WINDOW, FROM 4'2" TO 4'6",
USING TEMPERRED GLASS..
Printed: Tuesday, July 07, 2015 1:46:36 PM 1 of 2
SYSTBndS
CONDITIONS,
,.. :.
r _
_
CONTACTS
Printed: Tuesday, July 07, 2015 1:46:36 PM 1 of 2
SYSTBndS
PARENT PROJECTS
Printed: Tuesday, July 07, 2015 1:46:36 PM 2 of 2 Or
sysrr•Ms
-----
.._._ __ _----------
--
LTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
: RECEIPT. #
CHECK # .
METHOD
PAID BY
BY-
BSAS SB1473 FEE
1 101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
$0.00
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00
DOOR/WINDOW, NEW,
101-0000-42400
0
$60.91
$0.00
FIRST 1
DOOR/WINDOW, NEW,
101-0000-42600
0
$59.46
$0.00
FIRST 1 PC
Total Paid for WINDOW/SLIDING GLASS
$120.37 $0.00
DOOR/FENESTRATION:
TOTALS:• ••
PARENT PROJECTS
Printed: Tuesday, July 07, 2015 1:46:36 PM 2 of 2 Or
sysrr•Ms
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
v25 8 Building Permit Application and Tracking Sheet
Permit #
32E S Z O 1 G
Project -7250 ZZ77, 1M
;�%
Owner's Name:
A. P. Number: '77 . 1 f3.q
Address: 7/' % �+��.�✓tom
Legal Description: S/-4 4--7Ci
Contractor.
tY,ST,Zi P
telephone: hone: v• � 7 a
Address:
Project Description:,y p�� I g� ,, �f yf.,l DOi✓
City, ST, Zip:
Telephone: ele h
o .
P ,
.State Lic. # :
City Lie. #.
Arch., Eng ., Designer:
Address:,
a - SVlTs C r+,! t3 15-1
City., ST, Zip: '7,,t r) r p CAI ��pl
Telephone: one: •
�%b 0�
6
Construction n TY e: Occupancy:
P :
State Lic.
S #.
Project type (circle one • New Add'n Alter Repair Demo
Name of Contact Person: 1-L'44-14t�, . t—.Irt•07Z.,o
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person: 7&c,- tI0 / q - p7 S
Estimated Value of Project: o0
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 Calcs.
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 corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
W,