BRES2014-1188S
784195 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&tr44Q9,1xrw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BRES2014-1188
Property Address:
50685 BREVA
APN:
776330006
Application Description:
BBQ- GAS LINE W/ ELECTRICAL
Property Zoning:
Application Valuation:
$5,000.00
Applicant:
MARK A TEMPLE CONSTRUCTION INC
699 INDIAN TRAIL
PALM SPRINGS, CA 92264
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.: 430358
Date:/( Contractor:
O R -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.):
( ) 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:
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 Name:
Lender's Addre:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/14/2014
Owner:
29TH STREET CITRUS PROJECT
1010 ANDREAS PALMS
PALM SPRINGS, CA 0
Contractor:
MARK A TEMPLE CONSTRUCTION INC
699 INDIAN TRAIL
PALM SPRINGS, CA 92264
(760)323-5310
Llc. No.: 430358
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: /` Applican :
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 city to enter upon the above-
mentioned property for inspection purposes.
Date: Signature (Ap
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT QTY AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0 $1.00
$1.00
11/14/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
MARK A TEMPLE CONSTRUCTION INC
CHECK
R2880
3567
AZA
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$24.17
11/14/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
MARK A TEMPLE CONSTRUCTION INC
CHECK
R2880
3567
AZA
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$24.17•
11/14/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
MARK A TEMPLE CONSTRUCTION INC
CHECK
R2880
3567
AZA
Total Paid for ELECTRICAL: $48.34 $48.34
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
11/14/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
MARK A TEMPLE CONSTRUCTION INC
CHECK
R2880
3567
AZA
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.09
$12.09
11/14/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
MARK A TEMPLE CONSTRUCTION INC
CHECK
R2880
3567
AZA
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$24.17
$24.17
11/14/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
MARK A TEMPLE CONSTRUCTION INC
CHECK'
R2880
3567.
AZA
Total Paid forPLUMBING FEES: $36.26 $36.26
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SMI - RESIDENTIAL
101-0000-20308
0
$0.65
$0.65
11/14/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
MARK A TEMPLE CONSTRUCTION INC
CHECK
R2880
3567
AZA
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.65 $0.65
TOTALS: $178.10 $178.10
Description: BBQ- GAS LINE W/ ELECTRICAL
CONDITIONS
Type: BUILDING, RESIDENTIAL
Subtype: REMODEL Status: SUBMITTED
Applied: 11/14/2014 AZA
Approved:
Parcel No: 776330006 Site Address: 50685 BREVA LA QUINTA,CA 92253
Subdivision: TR 32068
Block: Lot: 6
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $5,000.00
Occupancy Type: - Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: BBQ WITH ELECTRICAL & 20 FT. OF 1/2 INCH GAS LINE. 2013 CALIFORNIA BUILDING CODES.
CHRONOLOGY
CONDITIONS
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
MARK A TEMPLE CONSTRUCTION
INC
699 INDIAN TRAIL
PALM SPRINGS
CA
92264
CONTRACTOR
MARK A TEMPLE CONSTRUCTION
INC
699 INDIAN TRAIL
PALM SPRINGS
CA
92264
OWNER
29TH STREET CITRUS PROJECT
1010 ANDREAS PALMS
PALM SPRINGS
I CA
0
Printed: Friday, November 14, 2014 2:38:31 PM 1 of 3 1 9"Rrmw-
IPARENT PROJECTS
- - --------- -
Printed: Friday, November 14, 2014 2:38:31 PIA 2 of 3
--- ----
CLT6
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20106
0
$1.00
$1.00
11/14/14
R2880
3567
CHECK
MARK A TEMPLE
AZA
CONSTRUCTION INC
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $1.00
BSA:
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$24.17
11/14/14
R2880
3567
CHECK
MARK A TEMPLE
AZA
CONSTRUCTION INC
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$24.17
11/14/14
R2880
3567
CHECK
MARK A TEMPLE
AZA
CONSTRUCTION INC
Total Paid for ELECTRICAL: $48.34 $48.34
PERMIT ISSUANCE
101-0000-42 404
0
$91.85
$91.8s
11/14/14
R2880
3567
CHECK
MARK A TEMPLE
AZA
CONSTRUCTION IN C
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
GAS SYSTEM, 1-4
101-0000-42401
0
$12.09
$12.09
11/14/14
R2880
3567
CHECK
MARK A TEMPLE
AZA
OUTLETS
CONSTRUCTION INC
GAS SYSTEM, 1-4
101-0000-42600
0
$24.17
$24.17
11/14/14
R2880
3567
CHECK
MARK A TEMPLE
AZA
OUTLETS PC
CONSTRUCTION INC
Total Paid for PLUMBING FEES: $36.26 $36.26
SMI - RESIDENTIAL
101-0000-209080
$0.65
$0.65
11/14/14
R2880
3567
CHECK
MARK A TEMPLE
AZA
CONSTRUCTION INC
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.65 $0.65
TOTALS: $178.10 $178.10
IPARENT PROJECTS
- - --------- -
Printed: Friday, November 14, 2014 2:38:31 PIA 2 of 3
#
Qty of La Quints
Building 8[ 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: X07 /d S l -e v a /
A P. Number. % / Cj — 33 D - O6 (�
Owner's Name:
G
Address: %l Z� ,
/`2
Legal Description: C, Q6 8 v
Contractor. /',(2^ %PIt.( e. CtM 7,w
City, ST, Zip: Z ✓ r`'r.t
- ephone7061
Project Description:
Address: jj < `j / 2-t % l'Z .
City, ST, Zip
Telephone: 264) — 3a. 3 J5 wo '"' '
L e%�
State Lic. #: �,3(� 3 50 City ic.
Arcfi., Engr., Designer. kle 7 e,11'
W 2 5
Address: U U IC M igo
City, ST, Zip: 64L !'� s 9o2a26
Telephone7& S-3L��SS U
Y, �� �:-
. , �-
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Derno
�- ra
State Lic. #: C Sp2 GJ� ' . ,rV
t^
Name of Contact Person: 2 %mak Q
,/
Sq. Ft.: 1
.
# Stories: # Units:
e�
Telephone # of Contact Person: ?�� - %% z/
t- ` Y
Estimated Value of Project: SOV U
APPLICANT: DO NOT WRITE BELOW THIS UNE
p
Submittal
Req'd
Reed
TRACMG
PERMIT FEES -
Plan Sets
Plan Cheek submitted
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
- Called Contact Person
Plan Check Balance.
Title 24 Cales.
Plans picked up'
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
tad Review, ready for corrections/issue
Electrical
Subeontattor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE-.-
Review, ready for torrections/issue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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