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BSPN2014-000578-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BSPN2014-0005 Property Address: 50597 CEREZA APN: 776340016 Application Description: FINAL HTE #07-3189 Property Zoning: (� O the work for which this permit is/woers'compensation7s.—rancl, Application Valuation: $25,000.00 Applicant: Section 3700 of the Labor Code, ormance of the work for which this permit is LANE BUILDING SYSTEMS INC 1732 YERMO PLACE OWNER -BUILDER DECLARATION FULLERTON, CA 92833 I hereby affirm under penalty of perjury that I am exempt from the Contractor's State C 0 D VOICE (760) 777-7125 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 7/1/2014 Owner: CITRUS EL DORADO 1157 N RED GUM ST ANAHEIM, CA 92806 l� Contractor: LANE BUILDING SYSTEMS INC 1732 YERMO PLACE FULLERTON, CA 92833 (714)630-7149 Llc. No.: 924123 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 1 hereby affirm under penalty of perjury one of the following declarations: (commencing with Section 7000) of Division 3 of the Business and Professions Code, and _ I have and will maintain a certificate of consent to self -insure for workers' my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance of License Class: LICENSE CLASSIFICATION WcenseNb92412 (� O the work for which this permit is/woers'compensation7s.—rancl, I have and will maintaas required by 7^�^ Date: ontractor Section 3700 of the Labor Code, ormance of the work for which this permit is issued. My workers' compensatice carrier and policy number are: OWNER -BUILDER DECLARATION Carrier: Policy Number: -rm IASL, zZwe i=� I hereby affirm under penalty of perjury that I am exempt from the Contractor's State _ I certify that in the performance of the work for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair any compensation laws of California, and agree that, if 1 should become subject to the structure, prior to its issuance, also requires the applicant for the permit to file a signed workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith statement that he or she is licensed pursuant to the provisions of the Contractor's State comply with those provisions. 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 allegeV Date: "r! Applicant – 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).: WARNING: FAILURE TOSECURE WORKERS' C ENSATION COVERAGE ISUNLAWFUL, (_) I, as owner of the property, or my employees with wages as their sole AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE compensation, will do the work, and the structure is not intended or offered for sale. HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TOTHE COST OF (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, apply to an owner of property who builds or improves thereon, and who does the work INTEREST, AND ATTORNEY'SFEES. 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 APPLICANT ACKNOWLEDGEMENT within one year of completion, the owner -builder will have the burden of proving that he IMPORTANT: Application is hereby made to the Building Official for a permit subject to or she did not build or improve for the purpose of sale.). the conditions and restrictions set forth on this application. (_J I, as owner of the property, am exclusively contracting with licensed contractors to 1. Each person upon whose behalf this application is made, each person at whose construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State request and for whose benefit work is performed under or pursuant to any permit issued License Law does not apply to an owner of property who builds or improves thereon, and as a result of this application , the owner, and the applicant, each agrees to, and shall who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and State License Law.). employees for any act or omission related to the work being performed under or (_ _) I am exempt under Sec. B.&P.C. for this reason 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 Date: Owner: for 180 days will subject permit to cancellation. 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 Address: 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: —ignature (Applicant or Ag t): ice` FINANCIAL ,•• DESCRIPTION ACCOUNT`". QT AMOUNT PAID PAID DATE SPECIAL INSPECTION *NONE* 1 $72.50 $72.50 7/1/14 PAID BY METHOD RECEIPT.# CHECK # CLTD BY j CITRUS ELDORADO LLC CHECK R235 30792 BHA DESCRIPTION ACCOUNT QTY AMOUNT PAID 7 PAID DATE SPECIAL INSPECTION PC *NONE* 1 $178.75 $178.75 7/1/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY .� CITRUS ELDORADO LLC CHECK R235 30792 BHA Total Paid forCOMPLIANCE SURVEY/SPECIAL INSPECTION! $251.25 $251.25 Permit Number: OSPN2014-0005 Applied: 6/30/2D14 Issued: 7/1/2014 Status: ISSUED Parent Permit: Parent Project: Approved: 6/30/2014 Finaled: Description: FINAL HTE #07-3189 Site Address: 50597 CEREZA City, State Zip Code: LA QUINTA, CA 92253 Applicant: LANE BUILDING SYSTEMS INC Owner: CITRUS EL DORADO Contractor: LANE BUILDING SYSTEMS INC Details: SPECIAL INSPECTION TO FINAL SFD - LOT 16, PLAN 3BXR, 4195 SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2001 CBC, CMC, CPC, 2004 CEC, 2005 ENERGY CODES. REFER TO HTE #07-3189 FOR INSPECTIONS. RETURNED SENT DATE DUE DATE TYPE CONTACT STATUS REMARKS DATE Review Group: AUTO 6/30/2014 6/30/2014 7/5/2014 NON-STRUCTURAL BURT HANADA APPROVED Notes: Printed: Tuesday, 01 July, 2014 1 of 1 r7wS SYS i£MS Bin # Qty Of La Quintd Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 6600' Building Permit Application and Tracking Sheet Pennit # ?751p N Project Address: - Owner's Name: Citrus El Dorado LL(C A. P. Number: '3 1 Address: 1157N. Red Gum Street Legal Description: Of r ' 3L Contractor:Lane Building Systems City, ST, Zip: Anaheim, CA 92806 Tele hone:(714 )630-7685 Address: 1732 Y er m o Place Project Description: Single Fa mily H o m e City, ST, Zip: Fullerton, C A 92833 © © _ 3 fFj Telephone: (714) 630-7149 State Lic. # : 924123 City Lic. #.. Arch., Engr., Designer: Kevin L. Crook Architect,Inc. Address: 1360 Reynolds Ave. City, ST, Zip: Irvine, C A 92614 Tele hone:(949) 660 1587 'Construction Type. Resident 1Occu an oy.Single. Fa mily C 1 State Lic. #: 1556 Project type (circle one): ew Add'n Alter Repair Demo Name of Contact Person: Debbie Adams Sq. Ft.: 4, # Stories: # Units: Telephone # of Contact Person: (714)630-7149 Estimated Value of Project: . 00 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted (P Item Amount Structural Cults. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"a Review, ready for correctionslissue'% Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'N Review, ready for correctionsli sue Developer Impact Fee Planning Approval Called Con ct so A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees 6 2014 Lr-%r-\Ipl n CrTY MEN11 Total Permit Fees 2 l