BSPN2015-0035Iri
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
. `&ti�t.4 44"&
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BSPN2015-0035
Property Address: -
7837.0 HIGHWAY 111 145
APN:
604050068
Application Description:
WRIGHTTODD SPECIAL INSP,ECTIOI
Property Zoning:
workers' compensation provisions of Section 3700 of abo ode, I shall forthwith
Application Valuation:
comply with those provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3
(+
de: - 7�
Applicant:
d Applicant:
TODD WRIGHT
78370 HIGHWAY 1.11 #145 WNTA
MENT
LA QUINTA, CA 92253MEM_
1
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: License No.:
Date:
Contractor:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/12/2015
Owner:
,POINT HAPPY REALTY
8665 WILSHIRE BLV STE 410
BEVERLY HILLS, CA 92253
Contractor: -�
Lic. No.:
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:
OWNER -BUILDER DECLARATION
Carrier:- Policy Number: _
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
Compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of abo ode, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with those provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3
(+
de: - 7�
of the Business and Professions Code) or that he or she is exempt therefrom and the
d Applicant:
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for
permit subjects the applicant to a civil penalty of not more than five hundred dollars
KERS' COMPENSATION COVERAGE IS UNLAWFUL,
WARNING: FAILURE TO SZDOLLARS
($500).:
AND SHALL SUBJECT AN TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(� I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSA ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold,
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this application is made, each person at whose
(� I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(_) I am exempt under Sec. • B.&P.C. for this reason
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
L
work for 180 days will subject permit to cancellation.
Date: Owner:
I certify that I have read this application and state that the above information is correct.
CO ION LENDING AGENCY
I agree to comply with all city and county ordinances and state laws relating to building
I hereby affirm under pe of perjury that there is a construction lending agency for
construction, and hereby authorize representatives of this city to enter upon hove
the performance.of the work for which this permit is issued (Sec. 3097, Civ. C.).
mentioned property for inspection purposes.
Lender's Na
Lender's Address:
r
J-42 Signature (Applicant or Agent)::
Description: WRIGHT TODD SPECIAL INSPECTION
Type: SPECIAL INSPECTION
Subtype: Status: UNDER REVIEW
Applied: 8/12/2015 PJU
Approved:
Parcel No: 604050068 Site Address: 78370 HIGHWAY 111 145 LA QUINTA,CA 92253
Subdivision: PM 29736
Block: Lot: 11
Issued:
Lot Scl Ft: 0
Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $0.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: SPECIAL INSPECTION NEW TENANT TODD WRIGHT NO CHANGES APPROVED SK.
ADDITIONAL SITES I u,
CONDITIONS
Printed: Wednesday, August 12, 2015 10:34:19 AM 1 of 2
wSYSTEtitS
PARENT PROJECTS
ATTACHMENTS
Printed:, Wednesday, August 12, 2015 10:34:19 AM 2 of 2 r
SYS7f•MS
Bin #
City of La Quinta
Building 8z Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building, Permit Application and Tracking Sheet
Permit #
Project Address: 3 �� l �c�r
Owner's Name: R/,Vj— _ L/
A. P. Number: Q 6 nQ
Address: OP -6 ( g� 4--11
Legal. Description:
City,ST, Zi
Contractor:
Telephone:
Address:
Project Description:
City, ST, Zip:
Telephone: ,
State Lic. # :
City Lic.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: one:
.
Construction s on TY e• O ecu ane Y:
P P
State to Lic. #
Pr Je ct hPa (circle ne • New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
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:-
7rd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Schddl Fees
+
Total Permit Fees