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BSPN2014-000178-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BSPN2014-0001 Property Address: 50654 CEREZA APN: 776340012 Application Description: FINAL HTE#07-3185 Property Zoning: Application Valuation: $25,000.00 Applicant: LANE BUILDING SYSTEMS INC 1732 YERMO PLACE FULLERTON, CA 92833 C& 0 D J*'P 09"o VOICE (760) 777-7125 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT 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. 'l License Class: LICENSE CLASSIFICATION OZ. License No.: 4 (Z J/Date: 7--1 Jq %Contractor: 6—In 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 for the alleg 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 ) 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 Lender's Address: Date: 7/1/2014 Owner: CITRUS EL DORADO LLC 1157 N RED GUM ST ANAHEIM, CA 92806 y ( t Contractor: LANE BUILDING SYSTEMS INC 1732 YERMO PLACE FULLERTON, CA 92833 (714)630-7149 LIC. No.: I OCpalo 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 3100 of the Labor Code, for the performance of the work for which this permit is issued. 1 have and will maintain wo)ers' compensation insurance, as required by Section 3700 of the Labor Code, fora performance of the work for which this permit is issued. My workers' compensatio nsurance carrier and polity num er are: Carrier: _ Policy Number: _ "r*• �(J1�� I certify that in the performance of the workfor hich 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: YApplicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE ISUNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TOTHE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'SFEES. 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 tothe 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. �ate:'7i_lq" Signature (Applicant or Agent)• _ ' FINANCIAL INFORMATION < ~DESCRIPTION ACCOUNT. QTY,i AMOUNT PAID PAID DATE SPECIAL INSPECTION *NONE* 1 $72.50 $72.50 7/1/14 PAID BY =, ' ' 'METHOD ' ` .i RECEIPT # CHECK #, * CLTD BY CITRUS ELDORADO LLC CHECK R235 30792 BHA DESCRIPTION,.- 'ACCOUNT i QTY AMOUNT . `.. ' PAID 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 G Permit Number: BSPN2014-0001 Applied: 6/30/2014 Issued:, Status: ISSUED Parent Permit: Parent Project: Approved: Finaled: Description: FINAL HTE#07-3185 Site Address: 50654 CEREZA City, State Zip Code: LA QUINTA, CA 92253 Applicant: LANE BUILDING SYSTEMS INC Owner: CITRUS EL DORADO LLC Contractor: LANE BUILDING SYSTEMS INC Details: . SPECIAL INSPECTION TO FINAL SFD - LOT 12, PLAN 1AR, 2946 SF. PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2001 CBC, CMC, CPC, 2004 CEC, 2005 ENERGY CODES LIST OF REVIEWS 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 1of1 .Bin# i-.•. COM . MUNITY LJ'—V -- Ctry or ia wutma Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit /application and Tracking Sheet Permit # ProjectAddress:_50 - LQN Cere za fk ejg± Owner's Name: Citrus El Dorado LL(C A. P. Number: Address: 1157N. Red Gum Street Legal Description: City, ST, Zip: Anaheim, CA 92806 Contractor: Lane Building Systems Tele hone: 714 630-7685 p ( ) Address: 1732 Y er m o Place Project Description: Single Fa milt' H o m e City, ST, Zip: Fullerton, C A 92833 Telephone: 4 0-7149 71 63 ( ) 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'Ty e: Residentia lOccu an :Single. Family Project tYPa circle one): GDAdd'n Alter Repair Demo C 15561State Lic. #: ........g...:.....>......'`.......s..........'z.......>..J..V.. Name of Contact Person: Debbie Adams Sq. Ft.: q # Stories: # Units: Telephone # of Contact Person: (714)630-7149 Estimated Value of Project:, APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submittedItem Amount Structural Caics. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"'. Review, ready for correctioslissue 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 corrections/issue Developer Im ee Planning Approval Called Contact PersontV �.. Pub. Wks. Appr Date of permit issue ,mo School Fees 2 M4 COM . MUNITY LJ'—V --