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BRES2015-018378-495 CALLE TAMPICO T4hY "( 4Qw"fw LA QUINTA, CALIFORNIA 92253 COMMUNITY Bi Application Number: BRES2015-0183 Property Address: 43485 CROISETTE CT l APN: 609052002 Application Description: DARBY ESTATES TM31087 PH 3 LOT 13 Property Zoning: Application Valuation: $172,362.80 Applicant: GHA ENTERPRISE, INC. 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 ENT DEPARTMENT I MAY 0 8 2015 L CITYOFLq WNTti—, 172ENT DEW, 7ME v — 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.. LIC -0104516 Dat 15 S contractor, i/ 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: 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: VOICE.(760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/7/2015 ADOM VENTURES 77-682 COUNTRY CLUB DR. STE A3 PALM DESERT, CA 92211 Contractor: GHA ENTERPRISE, INC. 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 (760)969-1400 Llc. No.: :LIC -0104516 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 CodeJor 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 Labo- 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 p ovisions. Date: 5� O ' Applic t: WARNING: FAILURE TO SECURE WORKERS'COMPENSATIQCOVER"AGE 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 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 information is correct. I agree to comply with all city and county ordinances and sta la s relati e-bu�ding construction, and hereby authorize representativesX y to en r upon the ab ve mentioned p oop rty for inspection purposes. Date: O I� Signature (Applicant or A aina DESCRIPTION FINANCIAL • /• ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $7.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $7.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - LIBRARIES 253-0000-43200 0 $344.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY -AMOUNT PAID PAID DATE DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - PARKS/REC 251-0000-43200 0 $2,048.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE TEMP POWER SERVICE 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE TEMP POWER SERVICE PC 101-0000-42403 0 $16.92 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL: $41.09 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $36.99 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL, EA ADDITION 1,000SF, PC 101-0000-42600 0 $15.24 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL, FIRST 1,000SF 101-0000-42403. 0 $145.03 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $47.86 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL - NEW CONSTRUCTION: $245.12 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL PRECISE GRADING - TRACT HOME 101-0000-42408 0 $133.43 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forGRADING: $133.43 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE CONDENSER/COMPRESSOR 101-0000-42402 0 $72.52 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE CONDENSER/COMPRESSOR PC 101-0000-42600 0 $48.34 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE EXHAUST HOOD 101-0000-42402 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE EXHAUST HOOD PC 101-0000-42600 0 $4.83 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FURNACE 101-0000-42402 0 $72.52 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY. DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FURNACE PC 101-0000-42600 0 $48.34 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE VENT FAN • 101-0000-42402 0 $60.45 $0.00 PAID BY 'METHOD RECEIPT # CHECK # .. CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE VENT FAN PC 101-0000-42600 0 $24.15 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forMECHANICAL: $343.24 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE MULTI -SPECIES RESIDENTIAL 0-8 UNITS 101-0000-20310 0 $1,292.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forMULTI-SPECIES RESIDENTIAL $1,292.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PERMIT 101-0000-42400 0 $559.35 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forNEW CONSTRUCTION PERMIT: $559.35 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $1,159.53 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forNEW CONSTRUCTION PLAN CHECK: $1,159.53 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BUILDING SEWER 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BUILDING SEWER PC 101-0000-42600 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP 101-0000-42401 0 $217.62 $0.001. PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP PC 101-0000-42600 0 $217.62 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $36.26 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 5+ OUTLETS PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER HEATER/VENT PC 101-0000-42600 0 $7.25 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $563.37 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $22.41 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forSTRONG MOTION INSTRUMENTATION SMt $22.41 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 $0.00 Description: DARBY ESTATES TM31087 PH 3 LOT 13 Type: BUILDING, RESIDENTIAL Subtype: DWELLING - SINGLE Status: APPROVED Applied: 5/6/2015 MFA FAMILY DETACHED Approved: 5/7/2015 MFA Parcel No: 609052002 Site Address: 43485 CROISETTE CT LA QUINTA,CA 92253 Subdivision: Block: Lot: 13 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $172,362.80 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 0 OUTSIDE CITY LIMITS Details: 2,698 SF DWELLING PLAN TYPE 1XBR, LOT 13[VB/RES-3/CLASS A-FR/13D] THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2013 CALIFORNIA BUILDING CODES. Applied to Approved CHRONOLOGY CONDITIONS NAME TYPE NAME ADDRESS1 CONTACTS CITY STATE ZIP PHONE FAX EMAIL APPLICANT GHA ENTERPRISE, INC. 0 OUTSIDE CITY LIMITS LA QUINTA CA 92253 (760)200-5989 CONTRACTOR GHA ENTERPRISE, INC. 0 OUTSIDE CITY LIMITS LA QUINTA CA 92253 (760)200-5989 OWNER ADOM VENTURES 77-682 COUNTRY CLUB DR. STE A3 PALM DESERT CA 92211 (760)200-5989 Printed: Thursday, May 07, 2015 8:22:29 AM 1 of 5 SYSTEMS Printed: Thursday, May 07, 2015 8:22:29 AM 2 of 5 SY57: M S CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT# CHECK METHOD PAID BY BY DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $0.00 DIF - COMMUNITY 254-0000-43200 0 $129.00 CENTERS DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 $0.00 DIF - LIBRARIES 253-0000-43200 0 $344.00 $0.00 DIF - PARK 256-0000-43200 0 $40.00 $0.00 MAINTENANCE DIF - PARKS/REC 251-0000-43200 0 $2,048.00 $0.00 DIF - STREET 255-0000-43200 0 $116.00 $0.00 MAINTENANCE DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 $0.00 Total Paid forDIF - SINGLE FAMILY DWELLING: $6,894.00 $0.00 TEMP POWER SERVICE 101-0000-42403 0 $24.17 $0.00 TEMP POWER SERVICE 101-0000-42403 0 $16.92 $0.00 PC Total Paid for ELECTRICAL: $41.09 $0.00 RESIDENTIAL, EA 101-0000=42403 0 $36.99 $0.00 ADDITION 1,000SF RESIDENTIAL, EA 101-0000-42600 0 $15.24 $0.00 ADDITION 1,000SF, PC RESIDENTIAL, FIRST 101-0000-42403 0 $145.03 $0.00 1,000SF RESIDENTIAL, FIRST 101-0000-42600 0 $47.86 $0.00 1,000SF, PC Total Paid for ELECTRICAL - NEW CONSTRUCTION: $245.12 $0.00 Printed: Thursday, May 07, 2015 8:22:29 AM 2 of 5 SY57: M S Printed: Thursday, May 07, 2015 8:22:29 AM 3 of 5 C SYSTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY RESIDENTIAL PRECISE GRADING - TRACT 101-0000-42408 0 $133.43 $0.00 HOME Total Paid forGRADING: $133.43 $0.00 CONDENSER/COMPRES 101-0000-42402 0 $72.52• $0.00 SOR CONDENSER/COMPRES 101-0000-42600 0 $48.34 $0.00 SOR PC EXHAUST HOOD 101-0000-42402 0 $12.09 $0.00 EXHAUST HOOD PC 101-0000-42600 0 $4.83 $0.00 FURNACE 101-0000-42402 0 $72.52 $0.00 FURNACE PC 101-0000-42600 0 $48.34 $0.00 VENT FAN 101-0000-42402 0 $60.45 $0.00 VENT FAN PC 101-0000-42600 0 $24.15 $0.00 Total Paid for MECHANICAL: $343.24 $0.00 MULTI -SPECIES 101-0000-20310 0 $1,292.00 $0.00 RESIDENTIAL 0-8 UNITS Total Paid forMULTI-SPECIES RESIDENTIAL $1,292.00 $0.00 NEW CONSTRUCTION 101-0000-424000 $559.35 $0.00 PERMIT Total Paid forNEW CONSTRUCTION PERMIT: $559.35 $0.00 NEW CONSTRUCTION 101-0000-42600 0 $1,159.53 $0.00 PLAN CHECK Total Paid forNEW CONSTRUCTION PLAN CHECK: $1,159.53 $0.00 BUILDING SEWER 101-0000-42401 0 $12.09 $0.00 BUILDING SEWER PC 101-0000-42600 0 $12.09 $0.00 Printed: Thursday, May 07, 2015 8:22:29 AM 3 of 5 C SYSTEMS INSPECTIONS .SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES FINAL•" BLD CLTD~ DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT# CHECK# METHOD PAID BY BY FIXTURE/TRAP 101-0000-42401 0 $217.62 $0.00 FIXTURE/TRAP PC 101-0000-42600 0 $217.62 $0.00 GAS SYSTEM, 5+ 101-0000-42401 0 $36.26 $0.00 OUTLETS GAS SYSTEM, 5+ 101-0000-42600 0 $24.17 $0.00 OUTLETS PC WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 WATER HEATER/VENT 101-0000-42600 0 $7.25 $0.00 PC WATER SYSTEM 101-0000-42401 0 $12.09 $0.00 INST/ALT/REP , WATER SYSTEM 101-0000-42600 0 $12.09 $0.00 INST/ALT/REP PC Total Paid for PLUMBING FEES: $563.37 $0.00 SMI - RESIDENTIAL 101-0000-20308 1 0 $22.41 $0.00 Total Paid forSTRONG MOTION INSTRUMENTATION SMI $22.41 $0.00 SINGLE FAMILY 224-0000-203200 $1,837.44 $0.00 DETACHED Total Paid forTUMF - RESIDENTIAL: $1,837.44 $0.00 TOTALS:0• 00 INSPECTIONS .SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES FINAL•" BLD PARENT PROJECTS Printed: Thursday, May 07, 2015 8:22:29 AM 4 of 5 CR , SYSTEMS REVIEW TYPE REVIEWER SENT DATE DUE DATE DATE STATUS REMARKS NOTES 1ST PW GREEN AMY YU 5/6/2015 5/6/2015 5/6/2015 READY FOR APPROVAL SHEET BOND INFORMATION ATTACHMENTS Printed: Thursday, May 07, 2015 8:22:29 AM 5 of 5 SY57: M 5