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BRES2015-019878-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: DONALD FISCHLEIN 79685 BUTTERCUP LN LA QUINTA, CA 92253 BRES2015-0198 79685 BUTTERCUP LN VOICE (760) 777-7125 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/29/2015 Owner: DONALD FISCHLEIN 604081041 LOCKEN / GARAGE REMODEL ADD WALLS $700.00 MAY 2 9 2015 GITy OF U% QUINTA COMMUNITY DE`,IELOP61ENT DEPARTMENT 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.: 795252 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 far 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 wh'o 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 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 79685 BUTTERCUP LN LA QUINTA, CA 92253 Contractor: LOCKEN CONSTRUCTION CO* 78183 CALICO GLEN DRIVE BERMUDA DUNES, CA 92203 (760)534-5303 Llc. No.: 795252 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 ofk for which this permit is issued. 4r3ve 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 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 ofaityto er upon the above•mentioned property for inspection purposes. Date: Signature (Applicant or Agen FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY :AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSAc $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK #' CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 PAID BY. METHOD. RECEIPT # • CHECK # CLTD BY Total Paid for ELECTRICAL: $48.34 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE REMODEL, FIRST 100 SF 101-0000-42400 0 $49.31 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE REMODEL, FIRST 500 SF PC 101-0000-42600 0 $134.88 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forREMODEL: $184.19 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.00 'PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forSTRONG MOTION INSTRUMENTATION SMt $0.50 $0.00 TOTALS:• 00 KiT I La Quinta Prod Page T of 1 s:waiv--tdS 3r�At Workspace Favorites' History J& BURT HANADA Construction is NOT PE on the following Code H New Year's Day Dr. Martin Luther Ki President's Day Memorial Day Independence Day Labor Day Veteran's Day. Thanksgiving Day Christmas Day Gc�(c.5e U ie &.I `'5 1 ort Doo2 a66T' W041 1 ,,J pp Iry b u l✓,r�v W041S�vdS 1b OV 064or PlIV60 IFJT. a 5 0UT( L-rs a 00&0 (Gr - o g • s Fi ee� Sinl� is�cisfi•� /' (o0wt P�(�oSG t S+oc,ia-f 0Q5 �L S1dl e-,/'Uovvl �Jc�cJ 2 .. 1I.i -- rCITYOF1A' 'BUILDINGW SAFE yAP P RO) FOR CONST l DAT4�� . ED T C.C)T octolber est Alt, Fricia37..' p.,n. In Monday - OP*• Saturday' oe SundaY'. None Govern May Code, 1401AkAays' 1st - Septeml)er 30th 7-00 P -m - may 1 FridaY- 6a 0 a,nl- to mondaY - ()o.m. to 5*00 P -m' Saturday: 8 None Sun None G eru* ent Code Holidays 'pN ADEQUATELY Is REQUIRED ON THE JOB SITE T e' PHASES Or CONSTRUCTION AND MUS EMPTIED AS NECESSARY. lllwn 10 Do SG MAI CAUSET"E CITY TO HATE jI.IE CONTAINER UUMPED E UPENSE of T"E "NER/ M V CONTRACTOR. it wl D, QAK AR, T THE F0K-,,A, -SC E E INS E0104' NO EXCEPTIONS!' Qin # Qty Of La QUinto Building & 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: 717619S Owner's Name: A AJT (+ p -J !:e A. P. Number: Address: -7969,<- 796gS . i, 041 erci t? Legal Description: City, ST, Zip: L,- v "& Contractor'. UiJb S�i L( �. Telephone: Address:I co(0 6�-6M V - / Project Description: LJ I" 6 p c '�I✓�( City, ST, Zip: l%(N�t U u GAL lA J corf C.�e O, � ele h ne T o . P ............................ _ 3 �" � � or o State Lic. # : City Lic. Arch., Engr., Designer:i Address: City, ST, Zip: Telephone: ....................:.........................�.> n TY Construction e: occupancy: eY si P � le State Lic. #: roJect hP P(circle one):. Add'n Alter Repair r Dem o Name of Contact Person: &r)L1Q Loor,eAj Sq. Ft.: fT I # Stories: # Units: Telephone. # of Contact Person: S 3L1 Estimated Value of Project: %QQ APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. 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 correct' ns/issue Electrical Subcontactor List Called Contact Person 3 Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue 23q.1 School Fees . Total Permit Fees MAT 16 ZU15 CITY OF LA QUINTA COMMUNITY DEVELOPMENT Description: LOCKEN / GARAGE REMODEL ADD WALLS Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: ISSUED Applied: 5/18/2015 SKH Approved: 5/22/2015110 Parcel No: 604081041 Site Address: 79685 BUTTERCUP LN LA QUINTA,CA 92253 Subdivision: TR*22982 Block: Lot: 78 Issued: 5/29/2015 AZA Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $700.00 Occupancy Type: Construction Type: Expired: 11/25/2015 AZA No. Buildings: 0 No. Stories: 0 No. Unites: 0 5/22/2015 Details: ADD TWO WALLS TO CREATE A STORAGE AREA IN GARAGE, SINK AND LIGHT WERE EXISTING. CODE CASE 7 4 _.__! Applied to Approved Approved to Issued ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES PLANS FOR CODE CASE, ANDY LOCKEN ON 79-685 BUTTERCUP NOTE MOISES RODARTE 5/22/2015 5/22/2015 LANE, WAS APPROVED TODAY. APPLICANT STILL NEEDS TO PULL PERMITS PLAN CHECKSUBMITTAL STEPHANIE KHATAMI 5/18/2015 5/18/2015 RECEIVED TELEPHONE CALL JIM JOHNSON 5/22/2015 5/22/2015 CALLED MR LOCKEN AND INFORMED CODE OFFICER, MOISES THAT THE PERMIT WAS APPROVED. TELEPHONE CALL JIM JOHNSON 5/22/2015 5/22/2015 CALLED MR LOCKEN TO INFORM HIM PLANS HAVE BEEN APPROVED CONDITIONS Printed:. Friday, May 29, 2015 12:36:39 PM 1 of 3 Cri . sysrrnns NAME TYPE NAME ADDRESSI CONTACTS CITY STATE ZIP PHONE FAX EMAIL APPLICANT DONALD FISCHLEIN 79685 BUTTERCUP LN LA QUINTA CA 92253 (760)534-5303 CHECK # METHOD PAID BY CONTRACTOR LOCKEN CONSTRUCTION CO . 78183 CALICO GLEN DRIVE BERMUDA DUNES CA 92203 (760)534-5303 OWNER DONALD FISCHLEIN 79685 BUTTERCUP LN LA QUINTA CA 92253 (760)534-5303 DEBIT LOCKEN Printed: Friday, May 29, 2015.12:36:39 PM 2 of 3 - N?SYSTEAAS FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY . BSAS SB14'73 FEE 101-0000-20306 0 $1.00 $1.00 5/29/15 MR177 DEBIT LOCKEN AZA CONSTRUCTION CO Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: DEVICES, FIRST•20 101-0000-42403 0 $24.17 $24.17 5/29/15 MR177 DEBIT LOCKEN AZA CONSTRUCTION CO DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $24.17 5/29/15 MR177 DEBIT LOCKEN AZA CONSTRUCTION CO Total Paid for ELECTRICAL: $48.34 $48.34 FIRST 100 SF 101-0000-42400 0 $49.31 $49.31 5/29/15 MR177 DEBIT LOCKEREMODEL, AZA CONSTRUCTION CO REMODEL, FIRST 500 SF 101-0000-42600 0 $134.88 $134.88 5/29/15 MR177 DEBIT LOCKEN AZA PC CONSTRUCTION CO Total Paid forREMODEL: $184.19 $184.19 SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.50 5/29/15 MR177 DEBIT LOCKEN AZA CONSTRUCTION CO - Total Paid forSTRONG MOTION INSTRUMENTATION SMI $0.50 $0.50 TOTALS:4• Printed: Friday, May 29, 2015.12:36:39 PM 2 of 3 - N?SYSTEAAS / � ' | DATE | ��T[ � | � | | . . . . . . PARENT PROJECTS BOND INFORMATION ATTACHMENTS Printed: Friday, May 2l2O1512:36:39PN1 3of3