BSOL2015-005778-495 CALLE TAMPICO D `�� VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
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.: 896912
Date: —90 —IT— 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).: .
(1 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.).
(_) 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 Address:
• 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.
1EP—L 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: 5^ 20^f _CApplicant:
Applicant: q,, el-/
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-
mentioned property for inspection purposes.
Date: JSignature (Applicant or Agent
Date: 5/20
Application Number:
BSOL2015-0057
Owner: I.�
Property Address:
51150 AVENIDA CARRANZA
MARCELINO FAUSTO
V
L&
APN:
773061007
51150-AVENIDA CARRANZA
Application Description:
FAUSTO RESIDENCE
LA QUINTA, CA 92253
Lc">
Q i
Property Zoning:
p 0
i
Application Valuation:
$15,000.00
" N
o
g
Applicant:
Contractor:
UNITED FIELD REMODELING INC DB
UNITED FIELD REMODELING I
V
17855 VANOWEN STREET
17855 VANOWEN STREET
RESEDA, CA 91335
RESEDA, CA 91335
(818)402-5656
l —_
Llc. No.: 896912
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.: 896912
Date: —90 —IT— 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).: .
(1 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.).
(_) 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 Address:
• 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.
1EP—L 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: 5^ 20^f _CApplicant:
Applicant: q,, el-/
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-
mentioned property for inspection purposes.
Date: JSignature (Applicant or Agent
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT QTY AMOUNT'
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306 0
$1.00
$1.00
5/20/15
PAID BY
METHOD. RECEIPT #
CHECK #
CLTD BY
LIBERTY FINANCIAL GROUP
CHECK R6301
1909
SKH
Total Paid for -BUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PV SYSTEM - ARRAY, FIRST 20
101-0000-42403
0
$24.17
$24.17
5/20/15
PAID BY
METHOD
4RECEIPT # '
CHECK V
CLTD BY
LIBERTY FINANCIAL GROUP
CHECK
R6301
1909
SKH
DESCRIPTION
ACCOUNT.
QTY
AMOUNT+
PAID
PAID DATE
PV SYSTEM - ARRAY, FIRST 20 PC
101-0000-42600
0
$24.17
$24.17
5/20/15
PAID BY
METHOD
RECEIPT # -
CHECK #
CLTD BY
LIBERTY FINANCIAL GROUP
CHECK
R6301
1909
SKH
Total Paid for ELECTRICAL: $48.34 $48.34
DESCRIPTION
- ACCOUNT` "
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE .
101-0000-42404
0
$91.85
$91.85
5/20/15
PAID BY
METHOD
:RECEIPT #
CHECK #
CLTD BY
LIBERTY FINANCIAL GROUP
CHECK
R6301
1909
SKH
Total Paid forPERM1T ISSUANCE: $91.85 $91:85
TOTALS:
Description: FAUSTO RESIDENCE
ADDITIONAL
CHRONOLOGY
Type: SOLAR Subtype:
Status: APPROVED
Applied: 5/11/2015 KHE
Approved: 5/14/2015 JFU
Parcel No: 773061007 Site Address: 51150 AVENIDA CARRANZA LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 73
Lot: 16
Issued:
UNIT 9
PLAN CHECK SUBMITTAL
RECEIVED
KAY HENSEL
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $15,000.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
5/14/2015
Details: 2.24 kW SOLAR ARRAY - (8) 280W SOLARWORLD SW280 PANELS W/ (1) SMA-2500HF-US-30-240V INVERTER [128SF] 2013
CALIFORNIA ELECTRICAL CODE.
5/14/2015
Printed: Wednesday, May 20, 2015 1:13:53 PM 1 of 3 0?SYSTEMS
ADDITIONAL
CHRONOLOGY
CHRONOLOGY TYPE
STAFF NAME
ACTION DATE —
'COMPLETION DATE..
NOTES
PLAN CHECK SUBMITTAL
RECEIVED
KAY HENSEL
5/8/2015
5/11/2015
APPLICATION RECEIVED BY FEDEX. PICKED UP FROM PHILIP'S
DESK AND PROCESSED ON 5/11/2015.
TELEPHONE CALL
JAKE FUSON
5/14/2015
5/14/2015
NOTIFIED ENVER WITH UNITED FIELD REMODELING (562 -396 -
1728) THAT PLANS WERE APPROVED AND PERMIT WAS
READY TO ISSUE.
CONDITIONS
EMAILAPPLICANT
NAME TYPE
NAME ADDRESSI
7RES
STATE
ZIP
PHONE
FAX
UNITED FIELD REMODELING INC DB
17855 VANOWEN
STREET .
CA
91335
CONTRACTOR
UNITED FIELD REMODELING INC DB
17855 VANOWEN
STREET
RESEDA
CA
91335
Printed: Wednesday, May 20, 2015 1:13:53 PM 1 of 3 0?SYSTEMS
CONTACTS
NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE: FAX EMAIL
OWNER MARC ELINO FAUSTO 51150 AVENIDA LA QUINTA CA 92253
CARRANZA
INSPECTIONSTOTALS:
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
SOLAR FINAL" BLD
FINANCIAL
INFORMATION
CLTD
DESCRIPTION
ACCOUNT QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS S81473 FEE
101-0000-20306 0
$1.00
$1.00
5/20/15
R6301
1909
CHECK
LIBERTY FINANCIAL
SKH
GROUP
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00
$1.00
BSA:
PV SYSTEM - ARRAY,
101-0000-42403
0
$24.17
$24.17
5/20/15
R6301
1909
CHECK
LIBERTY FINANCIAL
SKH
FIRST 20
GROUP
PV SYSTEM - ARRAY,
101-0000-42600
0
$24.17
$24.17
5/20/15
R6301
1909
CHECK
LIBERTY FINANCIAL
SKH
FIRST 20 PC
GROUP-
Total Paid forELECTRICAL:
$48.34
$48.34
PERMIT ISSUANCE
101-0000-42404
FO
$91.85
$91.85
S/20/15
R6301-
1909
CHECK
LIBERTY FINANCIAL
SKH
GROUP
Total Paid for PERMIT ISSUANCE:
$91.85
$91.85
$141.19
$141.19
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
SOLAR FINAL" BLD
Printed: Wednesday, May 20, 2015 1:13:53 PM 2 of cRull
3
SYSTEMS
NON-STRUCTURAL I JAKE FUSON I 5/8/2015 I 5/15/2015 I 5/14/2015 I APPROVED I
Printed: Wednesday, May 20, 2015 1:13:53 PM 3 of 3 1
IWEIF SYSTrMS
Qin #
51
City. of La Quinta
Buifding U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
,1q
Permit # -;ID '
Project Address: f J ,9VC'nl r'
C 112
Owner's Name: M K C e.) ! O V S O
A. P. Number: 7-� 3 2 p `�
Address: S I I SO A v eN I I)A CP R9,4
IV —0 P
Legal Description:
City, ST, Zip: -�A Q U+ cj' -
S-3
Contract r:
o U � • 2
o DI i
Tel e hone:
Address: A W S fi
Project Description:
City, ST, Zip: ReSp C
I
2 R 9 doF C)U
S S q.
Telephone:
State Lic. #
Arch., Engr.; Designer:
Address:
City, ST, Zip:
Telephone:
aneY
n T Pe: Occupancy:
Construction ti •
Lic #:
roJ'ne : New Add'n Alter Repair DemooStato
PectnP �circle o
Name of Contact Person: g n/V eQ
vi) l iq S i C
Sq. Ft.:
# Stories: #Units:
Telepp�h��oneyy# of Contact Person: S6 2 ^
3 9 1; — 112 e
Estimated Value of Project: IS 013lz
C1 cZ3.i6����ha�•e •Cc>r,
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
�f
Item
Amount
Structural Calcs.
Reviewed, ready for etftollp" 155b5;
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
21' 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:-
'"' 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