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BSPN2016-002178-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 �w 44vQ91Arw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT 14 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: .2/23/2016 Application Number: BSPN2016-0021 Owner: Property Address: 54920 AVENIDA JUAREZ MICHAEL TERRY APN: 774266009 Property Zoning: COPY Application Valuation: ISSUED Applicant: FEB- 23 ,2016 Contractor: LACEY KING 72245 EL PASO PALM DESERT, CA 92260 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 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 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 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: 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: 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 IK 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 ' y to enter upon the above -mention d property for inspection purposes. J Da " 'Signature (App' nt FINANCIAL INFORMATION r : CC DESCRIPTION-, =s`T. AOUNT a QTY:,-; `., . =AMOUNT'' . PAID "PAID DATE' SPECIAL INSPECTION 101-0000-42404 •0 $72.52 $0.00 PAID BYE `` `.,y METHOD RECEIPT #., :$` CHECK CLTD,BYt Total Paid for.COMPLIANCE SURVEY/SPECIAL INSPECTION: TOTALS:•• $72.52 $0.00 Description: SPECIAL INSPECTION ELECTRICAL / TERRY Type: SPECIAL INSPECTION Subtype: Status: UNDER REVIEW Applied: 2/23/2016 RSE Approved: Parcel No: 774266009 Site Address: 54920 AVENIDA 1UAREZ LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 276 Lot: 16 Issued: UNIT 25 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 ELECTRICAL RELEASE. THIS PERMIT IS NOT FOR ANY WORK Printed: Tuesday, February 23, 2016 9:41:14 AM 1 of 2 SYSTEMS PARENT PROJECTS Printed: Tuesday, February 23, 2016 9:41:14 AM 2 of 2 CN?WlYsTems Bin # City. of La Quinta Buifding &r Safety Division 78-495 Caffe Tampico La Quinta, CA 92253 - (760) 777-7012 b 2` Building Permit Application and Tracking Sheet Permit #f p 51 N p fib` Project Address:SLf ciao ven cdz Owner's Namd: M 1���� �.LJ7 A. P. Number: Address:— Legal Description: City, ST, Contractor: Telephone: Address:9p3�1,-4 j G C) Project Description: � City, ST, Zip: lel�n c Z T h n e• ele 0 P I ' f State Lie. # : City Lie. #; �(<:fQs Arch., Engr., Designer: Address: City., ST, Zip: e: Telephone: h0 n PancY• Con tru ttn Type: Occupancy: #. Project type (circle one): • New Add'n Alter Repair 'DemoState Lic. 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 Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 21d Review, ready for corrections/issue ' Electrical Subeontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '1! Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, Total Permit Fees LACEY KING property manager 760.851.0516 lacey@sp-re.com CalBRE # 01219074 ' S+P REALTY 72-245 EL PASEO PALM, DESERT, CA 92260 P 760.346.1154 f 760.346.1155 www.sp-re.com