BELC2017-006678-495 CALLE TAMPICO Cv"tv, D
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BELC2017-0066
Property Address: 81830 SEABISCUIT WY
APN: 767740029
Application Description: RANCHO SANTANA / TEMPORARY POWER 100A 5 SUB -POLES
Property Zoning:
Application Valuation: $915.00
Applicant:
DESERT ESTATES DEVELOPMENT INC
78401 HWY 111 STE X JUL 18 2017
LA QUINTA, CA 92253 F 0
CITY OF LA QUINTA '
DESIGN AND DEVELOPMENT 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.: 1019375
Qaf 1-7/7-7 'Contractor:
OWNER -BUILDER ECLARATION
I hereby affirm under penalty of perjury that I 'm 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
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).:
(1 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/18/2017
Owner:
RANCHO SANTANA HOLDINGS LP
78401 HIGHWAY 111 STE X
LA QUINTA, CA 92253
Contractor:
DESERT ESTATES DEVELOPMENT INC
78401 HWY 111 STE X
LA QUINTA, CA 92253
(760)777-9920
Llc. No.: 1019375
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
of the work for which this permit is issued.
_ I have and will maintain workers' compensation insurance, as required by
lion3700 of the Labor Code, for the performance of the work for which this permit is
is d. My workers" compensation insurance carrier and policy number are:
Ca r. EXEMPT Polity Number: _
I certify that in the performance of the work for which this permit is issued, I
shall of employ any person in any manner so as to become subject to the workers'
comp nsation laws of California, and agre t t, if I should become subject to the
worke s' compensation provisions of Secti 700 of the labor Code, I shall forthwith
comply with those provisions.
Date: l / Applic
WARNING: FAILURE TO SECURE WORKERS' C MPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL 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 t e above information is correct.
I agree to comply with all city and county ordinances an tate laws relating to building
construction, and hereby authorize representatives of thi ity to enter upon the above-
mentioned p�inspedion purposes.
D� 1Y % Signature (Applicant-or'Agent)
Date: 7/18/2017
Owner:
RANCHO SANTANA HOLDINGS LP
78401 HIGHWAY 111 STE X
LA QUINTA, CA 92253
Applicant: Contractor:
DESERT ESTATES DEVELOPMENT INC DESERT ESTATES DEVELOPMENT INC
78401 HWY 111 STE X 78401 HWY 111 STE X
LA QUINTA, CA 92253 LA QUINTA, CA 92253
(760)777-9920
Llc. No.: 1019375
Detail: (1) 100AMP METER POLE [LOT 29] (5)SUB POLES [LOTS 30, 31, 42, 43t 44] PER 2016 CALIFONRIA BUILDING CODES ,
Application Number:
BELC2017-0066
Property Address:
81830 SEABISCUIT WY
APN:
767740029
Application Description:
RANCHO SANTANA / TEMPORARY POWER 100A 5 SUB -POLES
Property Zoning:
Application Valuation:
$915.00
Date: 7/18/2017
Owner:
RANCHO SANTANA HOLDINGS LP
78401 HIGHWAY 111 STE X
LA QUINTA, CA 92253
Applicant: Contractor:
DESERT ESTATES DEVELOPMENT INC DESERT ESTATES DEVELOPMENT INC
78401 HWY 111 STE X 78401 HWY 111 STE X
LA QUINTA, CA 92253 LA QUINTA, CA 92253
(760)777-9920
Llc. No.: 1019375
Detail: (1) 100AMP METER POLE [LOT 29] (5)SUB POLES [LOTS 30, 31, 42, 43t 44] PER 2016 CALIFONRIA BUILDING CODES ,
I
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TEMP POWER SERVICE
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TEMP POWER SERVICE PC
101-0000-42600
0
$17.73
Total Paid for ELECTRICAL: $43.06
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
I
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Bin #
City of La Quinta
Building Br 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: �% ? J C/1/Ti/ / u� > ��
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip: vll,,,F� /,�V
Contractor: ,,�/�1 /`-/l : �I i�iar;� /,1/ v _`� 6 oi✓_ f �
Telephone: % 0 % 7 7 d
.. .. ..::........:.:.:::...
Address: i fo i A- c Y /ii
Project Description:
City, ST, Zip:
Telephone: 76a 777- 9%.) J
^ ' f «:: ':'<:<#:';:» :::?:<:;<: s<'.• ': '::>::;: >s
State Lic. # : / 6 / 9 7 /
City Lic. #•:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: ..«...."..:^..:.;':>....:::
....�:.,;:
:2t':"
State Lic.:.,•,4«::.... >:>
Name of Contact Person: cr 14;1j-///� 4 /V U
Construction Type: Occupancy:
project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: #Units:
Telephone # of Contact Person:
Estimated Value of Project:
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 Calcs.
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 corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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IN THE CITY OF LA OUINTA, STATE OF CALIFORNIA
RANCHO SANTANA 11� _ - " smi-z
DESERT ELITE INC f1tw4: TAg3�wa-
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