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BRES2016-025178-495 CALLE TAMPICO Twit 4al a" LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRES2016-0251 Owner: Property Address: 53767 ROSS AVEJAMES RANDALL APN: 767680043 D— Property Zoning: 7 2016 Application Valuation: $860,343.70 'DEC1, / u VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Applicant: CITY OF LA QUINTA Contractor: PREST VUKSIC ARCHITECTS INC. DESIGN AND DEVELOPMENT DEPARTMENTRJC BUILDERS INC 44530 SAN PABLO STE 200 3509 W 6TH STREET PALM DESERT, CA 92260 LOS ANGELES, CA 90020 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.: 740011 // Date: l? — 7 —i6 OWContractor. J L b", I4 e 2,i (213)388-9327 Llc. No.: 740011 Date: 12/7/2016 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: STATE COMPENSATION INSURANCE FUND Policy Number: 9120786 1 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 I certify that in the performance of the work for which this permit is issued, I city or county that requires a permit to construct, alter, improve, demolish, or repair shall not employ any person in any -manner so as to become subject to the workers' any structure, prior to its issuance, also requires the applicant for the permit to file a compensation laws of California, and agree that, if I should become subject to the signed statement that he or she is licensed pursuant to the provisions of the workers' compensation provisions of Section 3706 of the Labor Code, I shall forthwith Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division comply with those provisions. 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 � / L —7 —��i A c nt: n&z�/(z permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, (_) I, as owner of the property, or my employees with wages as their sole AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO compensation, will do the work, and the structure is not intended or offered for sale. ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, apply to an owner of property who builds or improves thereon, and who does the work INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT within one year of completion, the owner -builder will have the burden of proving that IMPORTANT: Application is hereby made to the Building Official for a permit subject to he or she did not build or improve for the purpose of sale.). the conditions and restrictions set forth on this application. (1 I, as owner of the property, am exclusively contracting with licensed contractors 1. Each person upon whose behalf this application is made, each person at whose to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' request and for whose benefit work is performed under or pursuant to any permit State License Law does not apply to an owner of property who builds or improves issued as a result of this application , the owner, and the applicant, each agrees to, and thereon, and who contracts for the projects with a contractor(s) licensed pursuant to shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and the Contractors' State License Law.). employees for any act or omission related to the work being performed under or (� I am exempt under Sec. . B.&P.C. for this reason 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 Date: Owner: work for 180 days will subject permit to cancellation. 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 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. r DaatTll2Signature (ApplPcant or Ag t): Date: 12/7/2016 Application Number: BRES2016-0251 Owner: Property Address: 53767 ROSS AVE JAMES RANDALL APN: 767680043 Property Zoning: Application Valuation: $860,343.70 Applicant: Contractor: PREST VUKSIC ARCHITECTS INC. RJC BUILDERS INC 44530 SAN PABLO STE 200 3509 W 6TH STREET PALM DESERT, CA 92260 LOS ANGELES, CA 90020 (213)388-9327 ---------------------------.---------------------------------------=-------------------------- Llc. No.: 740011 Detail: NEW 9200 S.Q. FT. SFDWITH 1082 SQ. FT. GARAGE THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS, DRIVEWAY APPROACH, FIRE PIT BBQ, OR WATER FEATURE. HOME IS FIRE SPRINKLED PER 2013 CRC CODES. FINANCIAL ' r DESCRIPTION ACCOUNT QTY AMOUNT ART IN PUBLIC PLACES - RESIDENTIAL 270-0000-43201 0 $1,650.86 Total Paid for ART IN PUBLIC PLACES - AIPP: $1,650.86 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - CITY BUILDING STAFF 101-0000-42600 1 $145.00 Total Paid for BLDG CITY STAFF - PER HOUR: $145.00 DESCRIPTION ACCOUNTQTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $35.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $35.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - CIVIC CENTER 252-0000-43200 0 $942.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - LIBRARIES 253-0000-43200 0 $344.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - PARKS/REC 251-0000-43200 0 $2,048.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF -TRANSPORTATION 250-0000-43200 0 $2,842.00 Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 DESCRIPTION ACCOUNT QTY AMOUNT POWER APPARATUS 101-0000-42403 0 $48.34 DESCRIPTION ACCOUNT QTY AMOUNT POWER APPARATUS PC 101-0000-42600 0 $48.34 DESCRIPTION ACCOUNT QTY AMOUNT TEMP POWER SERVICE 101-0000-42403 0 $24.17 DESCRIPTION ACCOUNT QTY AMOUNT TEMP POWER SERVICE PC 101-0000-42600 0 $16.92 Total Paid for ELECTRICAL: $137.77 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $123.30 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF, PC 101-0000-42600 0 $50.80 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $145.03 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, FIRST 1,OOOSF, PC 101-0000-42600 0 $47.86 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $366.99 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT >7KSF 101-0000-42408 0 $36.26 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT>7KSF PC 101-0000-42600 0 $181.29 Total Paid for GRADING: $217.55 DESCRIPTION ACCOUNT CITY AMOUNT CONDENSER/COMPRESSOR 101-0000-42402 0 $435.12 DESCRIPTION ACCOUNT CITY AMOUNT CONDENSER/COMPRESSOR PC 101-0000-42600 0 $290.04 DESCRIPTION ACCOUNT CITY AMOUNT EXHAUST HOOD 101-0000-42402 0 $24.18 DESCRIPTION ACCOUNT CITY AMOUNT EXHAUST HOOD PC 101-0000-42600 0 $9.66 DESCRIPTION ACCOUNT CITY AMOUNT FURNACE •101-0000-42402 0 $435.12 DESCRIPTION ACCOUNT CITY AMOUNT FURNACE PC 101-0000-42600 0 $290.04 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN 101-0000-42402 0 $181.35 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN PC • 101-0000-42600 0 $72.45 DESCRIPTION ACCOUNT QTY AMOUNT WALL HEATER 101-0000-42402 0 $24.71 DESCRIPTION ACCOUNT QTY AMOUNT WALL HEATER PC 101-0000-42600 0 $12.09 Total Paid for MECHANICAL: $1,774.76 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PERMIT 101-0000-42400 0 $999.51 Total Paid for NEW CONSTRUCTION PERMIT: $999.51 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $1,200.00 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $984.35 Total Paid for NEW CONSTRUCTION PLAN CHECK: $2,184.35 DESCRIPTION ACCOUNT QTY AMOUNT BACKFLOW DEVICE 101-0000-42401 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT BACKFLOW DEVICE PC 101-0000-42600 0 $4.83 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER 101-0000-42401 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER'PC 101-0000-42600 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT FIXTUREITRAP' 101-0000-42401 0 $531.96 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $531.96 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM,,5+ OUTLETS 101-0000-42401 0 $36.26 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 5+ OUTLETS PC 101-0000-42600 0 $24.17 DESCRIPTION ACCOUNT QTY AMOUNT ROOF DRAIN 101-0000-42401 0 $302.25 DESCRIPTION ACCOUNT QTY AMOUNT ROOF DRAIN PC 101-0000-42600 0 $302.25 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 $7.25 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.09 Total Paid for PLUMBING FEES: $1,813.47 DESCRIPTION ACCOUNT QTY AMOUNT' SMI - RESIDENTIAL 101-0000-20308 0 $111.84 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $111.84 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 DESCRIPTION ACCOUNT QTY AMOUNT SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 Total Paid for TUMF.- RESIDENTIAL: $1,837.44