BRES2014-113678-495 CALLE TAMPICO C` 0 D�IIICl/
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BRES2014-1136 Owner:
Property Address:
53025 AVENIDA VALLEJO PINSCORP INC.
APN:
774052025 P.O. BOX 18524
Application.Description:
GAS LINE, LIGHTING, KITCHEN/BATHROOM GFI CHANGE OUT IRVINE, CA 92623
Property Zoning:
Application Valuation:
$557.00
Applicant:
PINSON CONSTRUCTION & DESIGN
69-202 DORAL WAY
CATHEDRAL CITY, CA 92234
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: License No.: 995012
Dat It � d (K Contractoe,�y
V
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.).
(� 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:
f 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
PINSON CONSTRUCTION & DE
69-202 DORAL WAY
CATHEDRAL CITY, CA 92234
(760)578-1790
Llc. No.: 995012
Date: 10/10/2014
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
o
rk for which this permit is issued.
V?l 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 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: 10 V k�=
Applicant:'—
WARNING:
pplicant:`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 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 om ssion 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 to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property f r inspection purposes.
o ��.
Date' (� I Signature (Applicant or Ageht):'
FINANCIAL '
:w DESCRIPTION y ACCOUNTfQTY
a R
1•
AMOUNT', PAID ,- PAID DATE
BSAS SB1473 FEE 101-0000-20306
0
$1.00 $0.00
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PAIBY
`�D = :. r . n..:yMETHOD��yx�RECEIPT#
�•,... , - .--• ._t. -
. CHECK CLTD BY
' �
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION `:; s".
•- ;,ACCOUNT, ;' �'
QTY.,
"' F, AMOUNT E,
PAID a"
PAID DATE
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$0.00
PAID BY `� .
;METHOD
4 �RECEIPT # t' .:
CHECK # . ` ::i
CLTD BY_
DESCRIPTION:` ' , * .
,C ACCOUNT ' *
;'QTY
;,AMOUNT
,� - PAID
PAID DATE
DEVICES, FIRST 20 PC
'101-0000-42600
0
$24.17
$0.00
_.PAID BY ''•.a
h y
F`" METHOD'.'
u
�w •- 'RECEIPT # „ f,
o , 'CHECK #
CLTD BY t
Total Paid for ELECTRICAL: $48.34 $0.00
DESCRIPTION"' s
ACCOUNT -
�
QTY,'
^ AMOUNT ..
, PAID ` .
PAID DATE
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.09
$0.00
- 4 PAID BY- = k _
* ' "'METHOD _*
r ` �RECEIPT #CHECK
# �
-.,CLTD BY "
'DESCRIPTION
ACCOUN
QTY
`.„ +AMOUNT
:, PAID .s `
,:PAID DATE
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$24.17
$0.00
PAID BY a
fWETHOD ' F '
"r RECEIPT #
CHECK #:
CLTD BY
,
Total Paid for PLUMBING FEES: $36.26 $0.00
`* DESCRIPTION . ;
' " ;ACCOUNT : " ^ '
'QTY,
•'AMOUNT ` `
�. 'PAID `` •+
PAID DATE
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
$0.00
wPAID BY,, , '' ' ' {%
"_ METHOD '
+ ` '� RECEIPT # e
" .CHECK # f
CLTD BY
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00
TOTALS:• $0.00
A
t
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^
Description: GAS LINE, LIGHTING, KITCHEN/BATHROOM GFI CHANGE OUT
Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: APPROVED
Applied: 10/10/2014 SKH
Approved: 10/10/2014 JJO
Parcel No: 774052025 Site Address: 53025 AVENIDA VALLEJO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 219 Lot: 2
Issued:
UNIT 21
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $557.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0 '-
STATE t
Details: ADDITION OF 2 GAS LINES, AND REPLACE GFI IN BATHROOM AND TRACK LIGHTING IN DINNING ROOM AND LIVING ROOM AREA.
" 2013 CALIFORNIA BUILDING CODE.
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
CONTACTS
?NAMETYPE
? i NAME41'= .. , "ADDRESSI' z
. fit,CITY"'
STATE t
'' ZIP` ,
$ PHONE.
FAX`;
"• EMAIIs `= '
APPLICANT
PINSON CONSTRUCTION & DESIGN 69-202 DORAL WAY
-
CATHEDRAL,
.CITY
CA
• 92234-
CONTRACTOR
PINSON CONSTRUCTION & DESIGN 69-202 DORAL WAY
r
CATHEDRAL'
CITY
CA
92234
OWNERS
PINSCORP INC. P.O. BOX 18524
IRVINE
CA
92623
FINANCIAL INFORMATION
I a
Printed: Friday,'October 10, 2014 3:25:34 PM 1 of 3
• - CWYS iEMS
46
i DESCRIPTION
.,�; ACCOUNT
QTY
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AMOUNTPAID
AM
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Yrs--�+.�-�+..
..., Y
PAID DATE
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,
RETURNED
DATE,
REVIEWS
STATUS
�
REMARKS r
�.
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'.,NOTES'
z
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
10/10/2014
10/10/2014
APPROVED
APPROVED
REPLACE TRACK LIGHTING IN DINNING ROOM
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$0.00
DEVICES, FIRST 20 PC
101-0000-42600 '
0
$24.17
$0.00
Total Paid for ELECTRICAL: $48.34 $0.00
GAS SYSTEM, 1-4
101-0000-42401
0
$12.09
$0.00
OUTLETS
GAS SYSTEM, 1-4
'
101-0000-42600
0
$24.17
$0.00
'
OUTLETS PC
Total Paid for PLUMBING FEES: $36.26 $0.00
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
$0.00
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.501 $0.00
TOTALS:00
INSPECTIONS
yEQID, f INSPECTION TYPE � r INSPECTOR SCHEDULED COMPLETED
RESULT . REMARKS r` > `'" NOTES
DATE- 'DATE
FINAL** -
-
PARENT.O
'REVIEWTYPE,
REVIEWER
T
SENT DATE
DUE DATE
RETURNED
DATE,
REVIEWS
STATUS
�
REMARKS r
�.
J <
'.,NOTES'
APPROVED ADDITION OF 2 GAS LINES AND
NON-STRUCTURAL
JIM JOHNSON
10/10/2014
10/10/2014
10/10/2014
APPROVED
APPROVED
REPLACE TRACK LIGHTING IN DINNING ROOM
AND LIVING ROOM AREA
BOND INFORMATION
Printed: Friday, October 10, 2014 3:25:34 PM 2 of 3
- CRSYS 7EM5
Bin #
City O -f La Qui
Rcq'd
Rcc'd
Building & Safety Division
PERMIT FEES.
Permit #
P.O. Box 1504, 78-495 Calle Tampico .
3 his �1�,1136
La Quinta, CA 92253 - (760) 777-7012.
Item
Building Permit Application and Tracking
Wet
Project Address: S _ 0 2S d Owncr's Name: V177
1 n$ �• S
A. P. Number:
Reviewed, ready for corrections
Address: S3 -- Q 'Z S l.- V,4
Legal Description:
City, ST, Zip: Ui_ ovIq
Truss Calcs.
Contractor: I h
Telephone:
Plan Check balance. -
alance.Title
Address:.- 6 l -'Zd 2
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Project Description:
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City, ST, Zip: Cefl,�,�Q
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Telephone.%`9d CZ
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Statc Lic. # :
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City Lic. #:
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Grading plan
Arch., Engr., Designer.
Electrical
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Address:
Subcontactor List
s AAACG—' 1L5(4r_aQ
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ancY•
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Project type (circle one): New Add'n
Alter e a Demo
,lame of Contact Person:
Grading
Sq. Ft.: S
#' Stories:
IN HOUSE:-
# Units:
[ elcphone #,of Contact Person:(Oct r g', U
Estimated Value of Proj S
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Rcq'd
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TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Cal cs.
Reviewed, ready for corrections
Plan Chcek Deposit
Truss Calcs.
Called Contact Person
Plan Check balance. -
alance.Title
11 (1 c24 Cala.
'-
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for corrcctionsCssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'`' Reyiew, ready for correctionslissuc
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue.
School Fees
Total Permit Fccs
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