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BSPN2016-001378-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BSPN2016-0013 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Property Address: 54140AVENIDA CORTEZ APN: 774192007 Application Description: BANK OF AMERICA/ SPECIAL INSPECTION FOR IID RELEASE Property Zoning: Application Valuation: Applicant: ACKERSON PROEPRTY SERVICES, CHAD OUTSIDE CITY LIMITS 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.: 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, as owner of the property, or my employees with wages as their sole compehsation, 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.). (__j I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: TheContractors' 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: 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: 06 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Llc. 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: 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 tothe workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: 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 citvto enter upon the above-mentioned for inspection purposes. Dat Signature (Applicant or AgenZ-L I A Date: 2/8/2016 Owner: BANK OF AMERICA �—=J PO BOX 742226 DALLAS, TX 75324 c 2 = oCi C v � dp Contractor: �o� o D rn Llc. 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: 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 tothe workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: 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 citvto enter upon the above-mentioned for inspection purposes. Dat Signature (Applicant or AgenZ-L I A DESCRIPTION FINANCIAL INFORMATION ACCOUNT` :', "QTY, >.`AMOUNT NPAID6 PAID DATE SPECIAL INSPECTION 101-0000-42404 0 $72.52 $0.00 PAID BY.{ METHOD % ° ° .>. { . :RECEIPT F CHECK # . _ CLTD BY . Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION: $72.52 $0.00 TOTALS:• 00 a z 3 ff'M OF 7'NF'v Description: BANK OF AMERICA / SPECIAL INSPECTION FOR IID RELEASE Type: SPECIAL INSPECTION Subtype: Status: UNDER REVIEW Applied: 2/8/2016 SKH Approved: Parcel No: 774192007 Site Address: 54140 AVENIDA CORTEZ LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 258 Lot: 18 Issued: UNIT 24 (972)590-2738 ackreo@gmail.com Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $0.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: SPECIAL INSPECTION FOR IID RELEASE. THIS PERMIT IS NOT FOR WORK. 2013 CALIFORNIA BUILDING CODES. Printed: Monday, February 08, 2016 2:21:57 PM 1 of 2 C SYSTEh1S CONTACTSCONDITIONS NAME TYPE- NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT ACKERSON PROEPRTY SERVICES, OUTSIDE CITY LIMITS CHAD (972)590-2738 ackreo@gmail.com OWNER BANK OF AMERICA PO BOX 742226 DALLAS TX 75324 (972)590-2738 Printed: Monday, February 08, 2016 2:21:57 PM 1 of 2 C SYSTEh1S INSPECTIONS Printed: Monday, February 08, 2016 2:21:57 PM 2 of 2 0? • SYSTEMS gin # City of La Quinta )� Building &r Safety Division Permit #{ 78-495 Calle Tampico 6xkM..qx,La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: &LIN O 4W -,41U 1Aq 6M 1 Z Owner's Name: 61\ PtA'' CSP-. " A. P. Number: e Address: P _ O Legal Description: City, ST, Zip: O , 1 \G x x S 3? Contractor: l� Telephone': � a e. S Address: �3 O S �,nq G S Project Description:. �,cc�nC�,, _l ✓�S. city, ST, zip: e�eJ - �t ( firms �e-AJ'e; Telephone:-? dK. ele h o � - �0 Si P State Lic. #: City Lic. #; Arch., Engr., Designer: A Lo c v- bcx \ ..S ?2 ?-yti Address: N 0 0 CAAC4-`760 - S6q- City, ST, Zip: Telephone: ...............:...................................... Co tructi n Type: Occupancy:cu an cY v► g State Lic. Project type le one • New Add'n Alter Repair Demo Nanid,of Contact Person: R C��/�� Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: '� p - &fl� ^ �3 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 Cafes. 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.T. H.O.A. Approval Plans resubmitted Grading IN I{OUSE:- 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 Bank of America'''* Safeguard Properties 7887 Safeguard Circle Valley View, OH 44125 Tax ID # 90-0881590 February 5, 2016 Authorized Agents: y� CHAD ACKERSON c- Christine McElhone Rich Stifel Rosemarie Magro Tam! (Tucholski) Eck To Whom It May Concern: Safeguard Properties has our authority to enter the referenced property 54140 AVENIDA CORTEZ LA QUINTA CA and activate/manage all utility services. The billing should be set up: Bank of America c/o SPI/Ecova PO Box 742226 Dallas, TX 75374 972-590-2738 Should you require any additional information or documentation„in order to allow Safeguard Properties to represent us as our Agents on the referenced property, please feel free to contact me. Thank you in advance for your cooperation. ;. Sincerely, Christine M. McElhone Supervisor, REO Operations 216-739-2900 ext. 1781