13-1459 (SPIN)s
-i
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
13-00001459
50865 CALLE QUITO.
770-103-009-57 -000000-
SPECIAL INSPECTION
LOW DENSITY RESIDENTIAL
100
Tiht 4 4 "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect
1 or Engineer:
\ p
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of pethat I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Di ision 3 of the lfsiness and Professionals Code, and my License is in full force and effect.
,.License. Class:. License No.:
Date: - ntractpr:
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 permitto
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).:
Gi9,f� 1 1, 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.).
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
A�l pursuant to the Contractors' State License Law.).
exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
\` e61uSTRUCTION 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 Address:
LQPERMIT
VOICE (760) 777-7012
% FAX (760) 777-7011
INSPECTIONS (760) 777-7153.
Owner:
NICK AND LINDA.ZUCCARO
50865 CALLE QUITO
LA QUINTA, CA 92253
(760)289-7000
Contractor:
Owner
Date: 11/18/13
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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
rtify 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
��,[��377%00 of the Labor Code, I sl 11 c r ith those provisions.
-.Pate:
����'Applicant:
WARNING:
�
WARNING: FAILURE TO SECURE WORK E MPENSATION*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 Director of Building and Safety 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 personat 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 co s tion, and hereby authorize representatives
,of this county o en r upon the above-mentioned property i p tion ses. "
Date: ignature (Applicant or Agent •
J
Application Number 13' -00001459 -
Permit . . SPECIAL INSPECTION
Additional desc
Permit Fee- . . . .71.50 Plan Check Fee 00
Issue Date . . . . Valuation 100
Expiration Date 5/17/14 p
Qty Unit Charge Per Extension ,
1.00 71.5000 EA MISC SPECIAL INSPECTION 71.50 f
- - - - - - - - - - - - - ------------------------------------------------
Special
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Special Notes and Comments
SPECIAL INSPECTION FOR GAS RELEASE. 2010
CALIFORNIA BUILDING CODE.
Fee summary Charged Paid Credited Due
--------------------------------------------------------
Permit Fee Total 71.50 .00 .00 71.50
Plan Check Total .00 .00 .00 .00
Grand Total 71.50 .00 .00 71.50
APPLICANT`110 Nr1T WRITE RFI nW T441C 1 INF i
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Submittal
pity of La Quinta
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Street
Permit #
Project Address:
PZRMIT FEES
Owner's Name:
A. P. Number:
Address:,Ij 9'4!;' Cf
Legal Description:
City, ST, Zip: ,¢ `
Contractors
Telephone: 7�Q� — �o O F!is:A«>::><:s'>s>>.•r<;F.>:<#::
Address:
Project Description:
City, ST, Zip:
Plan Check Deposit
Telephone,
Truss Caics.
State Lic. # :
City Lic. #•:
Arch., Engr., Designer
Title 24 Caics.
Address:
Plans picked up
City., ST, Zip: .
Telephone:
Construction Type: Occupancy:
-
Project type (circle on ew Add'n _Iter Repair Demo
State Lic. #.
Mechanical
:,:<r;:<;�:<�<:�,>r.;;�>:::>.<>.::>::::,<:;.;:;:::>.>.>-�
%:<;! <>z:<<,;r:<.:s;>t'vsz
Name of Contact Person: �(f �� Zu
Sq. Ft.: 2,Zo.� # Stories:
Units: /
Telephone *,of Contact Person:
d Oiq 0
-� p�#
Estimated Value of Project: b��iLCG(�ylf
APPLICANT`110 Nr1T WRITE RFI nW T441C 1 INF i
#
Submittal
Rcq'd
Rcc'd
TRACMG
PZRMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Caics.
Reviewed, ready for corrections
Plan Check Deposit
Truss Caics.
Called Contact Person
Plan Check Balznce
Title 24 Caics.
Plans picked up
Construction
Floodplain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionsfissue
Developer Impa•-.t Fee
Planning Approval
Called Contact Person •
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
X
J •
A.
1
•