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BRES2014-1029LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of hapter 9 (commencing with Sect' n 7000) of Division 3 of the Business and Profess' ns Code, and my Licen is in full orce and effect. License CIas Bicen No.: 728102 Date: Contractor: ' OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's tate License Law for the following reason (Sec. 7031.5, Business an rofessions Co : Any city or county that requires a permit to construct, alter, improve, molish, o epair 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 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 Na Lender's Address: 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' esmpensation, as provided for by Section 3700 of the Labor Code, for the performance of t1i; �efor which this permit is issued. (�� 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 orkers' compensation laws of California, and agree that, if I should become subje to the workers' com ensatio provisions of Section 3700 of the Lab de, I all forthwith comply with ose r visions 1 Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C ERAGE IS UNAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ND CIVIL FINESPTO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDIT N TO THE COST F COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIO'3706 OF THE LA R 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 tolouildio construction, and her by authorize representatives of this city enter up e a ve• mentioned ropertori pection purposes. 1 - Date:' � Signature (Applicant or Agent)-tLf J C` 4 � "1^""`^Ct/ VOICE (760) 777-7125 78-495 CALLE TAMPICO p D FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 7/24/2014 Application Number: BRES2014-1029 Owner: Property Address: 54010 CANANERO CIR IOTA GRIFFIN APN: 767780066 4675 MACARTHUR CT NO 155 t� !—�J Application Description: GRIFFIN RANCH TM 32879 PH 2 BELMONT (SERIES 1) NEWPORT BEACH, CA 0 Property Zoning: -Id- Application Valuation: $227,420.10 N o Q C,UJ 14d`1 2 CLg Applicant: Contractor: ULRICH SAUERBREY LENNAR HOMES OF CALIFORN A O USIandLink 25 ENTERPRISE d 74948 LIVE OAK STREET ALISO VIEJO, CA 92656 INDIAN WELLS, CA 92210 (949)349-8000 Llc. No.: 728102 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of hapter 9 (commencing with Sect' n 7000) of Division 3 of the Business and Profess' ns Code, and my Licen is in full orce and effect. License CIas Bicen No.: 728102 Date: Contractor: ' OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's tate License Law for the following reason (Sec. 7031.5, Business an rofessions Co : Any city or county that requires a permit to construct, alter, improve, molish, o epair 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 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 Na Lender's Address: 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' esmpensation, as provided for by Section 3700 of the Labor Code, for the performance of t1i; �efor which this permit is issued. (�� 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 orkers' compensation laws of California, and agree that, if I should become subje to the workers' com ensatio provisions of Section 3700 of the Lab de, I all forthwith comply with ose r visions 1 Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C ERAGE IS UNAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ND CIVIL FINESPTO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDIT N TO THE COST F COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIO'3706 OF THE LA R 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 tolouildio construction, and her by authorize representatives of this city enter up e a ve• mentioned ropertori pection purposes. 1 - Date:' � Signature (Applicant or Agent)-tLf FINANCIAL • 1 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE ART IN PUBLIC PLACES - RESIDENTIAL 270-0000-43201 0 $68.55 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forART IN PUBLIC PLACES - AIPP: $68.55 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $10.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $10.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - LIBRARIES 253-0000-43200 0 $344.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - PARKS/REC 251-0000-43200 0 $2,048.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 $0.00 PAID -BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forDIF - SINGLE FAMILY DWELLING: $6,894.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $48.64 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY• AMOUNT PAID PAID DATE RESIDENTIAL, EA ADDITION 1,000SF, PC 101-0000-42600 0 $20.04 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $143.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $47.19 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL - NEW CONSTRUCTION: $258.87 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL FINISH GRADING PC 101-0000-42600 0 $143.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forGRADING: $143.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE CONDENSER/COMPRESSOR 101-0000-42402 0 $107.25 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE CONDENSER/COMPRESSOR PC 101-0000-42600 0 $71.49 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE EXHAUST HOOD 101-0000-42402 0 $11.92 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE EXHAUST HOOD PC 101-0000-42600 0 $4.77 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE ' FURNACE 101-0000-42402 0 $107.25 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FURNACE PC 101-0000-42600 0 $71.49 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE VENT FAN 101-0000-42402 0 $95.36 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE VENT FAN PC 101-0000-42600 0 $38.16 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forMECHANICAL: $507.69 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE MULTI -SPECIES RESIDENTIAL 0-8 UNITS 101-0000-20310 0 $1,292.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for MULTI -SPECIES RESIDENTIAL- $1,292.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PERMIT 101-0000-42400 0 $589.11 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forNEW CONSTRUCTION PERMIT: $589.11 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $1,251.06 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forNEW CONSTRUCTION PLAN CHECK: $1,251.06 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BACKFLOW DEVICE 101-0000-42401 0 $11.92 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT • QTY AMOUNT PAID PAID DATE BACKFLOW DEVICE PC 101-0000-42600 0 $4.77 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BUILDING SEWER 101-0000-42401 0 $11.92 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BUILDING SEWER PC 101-0000-42600 0 $11.92 $0.00 PAID BY METHOD RECEIPT # . CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP 101-0000-42401 0 $274.16 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP PC 101-0000-42600 0 $274.16 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $35.75 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 5+ OUTLETS PC 101-0000-42600 0 $23.83 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER HEATER/VENT 101-0000-42401 0 $23.84 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER HEATER/VENT PC 101-0000-42600 0 $14.30 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $11.92 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $11.92 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $710.41 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $29.56 $0.00 PAID BY METHOD . RECEIPT # CHECK # CLTD BY Total Paid forSTRONG MOTION INSTRUMENTATION SMt $29.56 $0.00 DESCRIPTION . '. ". ACCOUNT, -CITY 'AMOUNT .; PAID PAID DATE SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 $0.00 PAID BY " METHOD„ ;; ` . RECEIPT# CHECK # ,' CLTD BY. Total Paid forTUMF - RESIDENTIAL: $1,837.44 $0.00 TOTALS:0•