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13-1464 (RER)P.O. BOX 1504 Tit�t 4,4'Q" r,.�o 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING &SAFETY DEPARTMENT Application Number: 13-00001464 Property Address: 81373 JACARANDA CT APN: 764-280-999-154 -300236- Application description: REMODEL - RESIDENTIAL Property Zoning: MEDIUM HIGH DENSITY RES Application valuation: 6500 Applicant: Architect or Engineer: 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 Professional de, and my License is in full force and effect. License Clas B -C9 -C15 -C ceNo.: 581149 i Date: '` 1ntractor: 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 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.). (_ 1 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.). 1 _) 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 Name: _ Lender's Address: LQPERMIT Owner: CHRISTINE CASTLE 81373 JACARANDA LA QUINTA, CA 92253 ( Contractor: D DANIEL'S D K I 73950 DINAH SHORE DRIVE # PALM DESERT, CA 92211 , (760)320-2128 1 Lic. No.: 581149 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/19/13 EOV 191013 CITY OF LA Q CIAJA a— UINrA 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 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 BENCHMARK INS Policy Number CST5003957 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 workers' compensation laws of California, and agree that, if I s uld become subject t the workers' compensation provisions of Section 3700 of the Labor e, I sh I forthwith pl with those provisions. rI 1, f� I A plicanCs- WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 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 informatio 's correct. I agree to comply with all city and county ordinances and state lawsrelating to b ding constructio a hereby authorize representatives of this county t enter upon the above-mentioned prop y for i pectin oses. _ f f r r - Date' ' Signature (Applicant or Agent):_ - - — - - Application Number . . . . . 13-00001464 Permit MECHANICAL 2013 Additional desc . Permit Fee . . . . 83.42 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/18/14 Qty Unit Charge Per Extension 2.00 35.7500 EA MECH FURNACE 71.50 1.00 11.9200 ---------------------------------------------------------------------------- EA MECH APPL REP/ALT 11.92 Permit REMODEL 2013 Additional desc . . Permit Fee . . . . 112.97 Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date 5/18/14 Qty Unit Charge Per Extension 1.00 48.6200 LS MISC REMODEL, 1ST 100 SF 48.62 3.00 21.4500 EA MISC REMODEL, ADDL 500 SF 64.35 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PLAN CHECK, REMODEL 184.47 PLAN CHECK, MECHANICAL 52.43 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 196.39 .00 .00 196.39 Plan Check Total _00 .00 .00 .00 Other Fee Total 237.90 .00 .00 237.90 Grand Total 434.29 .00 .00 434.29 l LQPERMIT ' Din # City La Q of Uin to " I Building w Safety'Division Permit #P.O. Box 1504, 78-495 Calle Tampico NOV 18 2013 "La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracki bP LA QUANTA rojectAddress: 0 I ��q�� C-�— wner'sName: \ -I' T A. P. Number: ddress: !J13-7 Legal Description: ity, ST, Zip: LA Contractor: Dahl L' S D YC. I elephone: Address: D Z roject Description: A C City, ST, Zip:I Lfwi I :�' 1 ` , A\ w. e, e,r'r CA l v � � wC� ila a� � 4 Tele s `,-:' PX. hone �O d D- f State Lic. # : g City Lic. M. Arch., Engr., Designer, e�aU�iAh L K to Address: 2�i 1p 1�� Q M O� Q%J City., ST, Zip:ol 8 Telephone:;<€f ;>s;<.•>i;>;.:i:. ;:.:.;;:.;:.::;.:::::::.::s; Construction Type: Occupancy: y P rQ, Ill(< P y �::�:v;:2,v,'.:}•f:;i A.;: r.. n: iiiii } :bili•. (�J State Lic. #.Urm '"'b•:'t<?n>z:` i`' :'.;>.< >s;.`:;> •::<;<!<:::::;; ^::. t>.:< Project type (circle one): New Add, n Alter epau Demo . I 1 -Name of Contact Person: Sq. Ft : 5 O #Stories: #Units: —Telephone #,of Contact Person:p Estimated Value of Projec� 6_0D 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 Pians resubmitted Grading IN HOUSE:- '"' 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 A I1 CITY- OF LA QUINTA4 SUB -CONTRACTOR LIST JOB ADDRESS 1313 !�S-46acayl4 PERMIT NUMBER OWNER . C�f'6'5�" BUILDER. This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to tris list must be approved by. the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. de Classification Tra / C . Contractor .. :.:.:...::.....:: :.::.:..:. •:: tracto s .. r .License ... ......:.:::>:. :::� ... -' -.:=: : --•. Workers• Com ensation:�risurance':��::�-:`..:`-: `•::::<`:::. -Cit . Busnegs LiCense>>..�.. Company Name Classification (e.g. A. B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C-12) • ; CONCRETE (Q - FRAMING STRUCT. `STEEL• (C-51) - 'MASONRY (C-29) PLUMBING (C-36) "TN; PLASTER (07:35) DRYWALL (C-9) ..>..: VAC..(C-20):.:.:: `.::: �� i--eK1� c C $� S1 3 oS 3, I �JMbvI �. ;� �,�. �v� Z�,.} E� ID 7, os Z., I I.ELECTRICAL. (C=10)':, OOFING'.IC.=39)::--:';`:;:;':.. ' •SHEET -METAL (C-43) FLO04RING (0;.:151=. GLAZING (C-17)':.. SULATION (C-2).' v\SJ`�ko or � gB S o iz 31 1 ��/r1 c.� . ��i4..� u5. Vi C1\ Sz-�o % NQS 1011H 332D 3/ / SEWAGE DISP (G-42) PAINTING (C-33) CERAMIC TILE (C-54) CABINETS IC -6) FENCING (C-13) LANDSCAPING (C=27) .: `