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BRES2016-0219I. 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description: Property Zoning: ` Application Valuation: Applicant: F & F CONSTRUCTION INC 78870 WAKEFIELD CR LA QUINTA, CA 92253 Tiat 4 4 Qum& DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT BRES2016-0219 - 77921 GREY WOLF TR 623510016 WARFIELD / WINDOW CHANGE W/STRUCTURAL $10,000.00 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: RICHARD WARFIELD 77921 GREY WOLF TR LA QUINTA, CA 92253 Contractor: F & F CONSTRUCTION INC 78870 WAKEFIELD CR LQ QUINTA, CA 92253 (760)275-5789 Llc. No.: 802281 Date: 8/30/2016 ----------------------=--=------------------------------------------------------------------- L 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.: 802281 Date 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 ) 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 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: 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 ofth work for which this permit is issued. 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: 1542839 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 or Code, I shall forthwith comply with those provisions. �Date: 7C7_(1(1_ Applica 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 Quints, 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. CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct. I hereby affirm under penalty of perjury that there is a construction lending agency for I agree•to comply with all city and county ordinances and st a laws relating to building the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this c y to er u the above-mentioned property for inspection purposes. Lender's Name: C]_.& Date , Signature (Applicant or A t): Lender's Address: l I Date: 8/30/2016 Application Number: BRES2016-0219 Owner: Property Address: 77921 GREY WOLF TR RICHARD WARFIELD APN: 623510016 77921 GREY WOLF TR Application Description: WARFIELD / WINDOW CHANGE W/STRUCTURAL ' LA QUINTA, CA 92253 Property Zoning: Application Valuation: $10,000.00 Applicant: Contractor: F & F CONSTRUCTION INC F & F CONSTRUCTION INC 78870 WAKEFIELD CR 78870 WAKEFIELD CR LA QUINTA, CA 92253 LA QUINTA, CA 92253 (760)275-5789 LIC. No.: 802281 , --------------------------------------------------- ' :Detail: REMOVED 3 DAMAGED WINDOWS AND REPLACE WITH ONE 23 X10 WINDOW PER 2013 CRC CODES. l FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - YES ADMINISTRATIVE STAFF 101-0000-42600 0.25 $10.00 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE -YES STRUCTURAL PLAN REVIEW ENGINEER 101-0000-42600 1 $95.00 Total Paid for BLDG CITY STAFF - PER HOUR:. $105.00 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 $6.13 -Total Paid for Credit Card'Fee: $6.13 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $1.30 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $1.30 DESCRIPTION ACCOUNT QTY AMOUNT DOOR/WINDOW, REPLACE FIRST 7 101-0000-42400 0 $60.91 DESCRIPTION ACCOUNT QTY AMOUNT DOOR/WINDOW, REPLACE, FIRST 7 PC 101-0000-42600 0. $110.22 Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $171.13 1 Rin # ` v Ctoty of La Quin to Building u Safety Division . . 78-495 Calle 'Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit '# S Project Address: 7! k --y wVL-P 2L , Owner'sName: A. P. Number: Address: Legal Description: City, ST, Zip: n Contractor:bAr 5'1 1 4CTelephone: ele hon e. .................:.........:.:::::::::::::::: Address: e�t�-7� �r'�{(Cq-L� �kSrlFi Project Description: e-tlov 6+ 1 (0 IVY City, ST, Zip: p/it-_�4 P-c3�i�ttr� �►-� dW . Telephone: ..........................................::. t r - 1 Z_ o 6JL9�1 1 i 1 � W State Lic. City Lie. is ..- — -- '"_} .— __ _. ► ___._. --- DI , ,. Con structi n P^e• Occupancy: cu TYancY• Arch., eesigner: i�. /tie. S -I( -T Gl0't-&:f1e Address: ��'J 4�2rTA1 � c -D �SIE City., ST, Zip: $ ft-'llri eg's . C,4, Z 2 (I Telephone: C d V 'a State Lic. lP 7 Project type(circleone : New Add'nAlter Repair aiDemo Name of Contact Person: A- (1 MPO L4` Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: y Estimated Value of Project: 5Mt!tiZl/LLF APPLICANT: DO NOT WRITE BELOW THIS LINE // Submittal Req'd Rcc'd 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 plad,\,: 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. II.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