BSPN2014-002178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN: '
Application Description:
Property Zoning:
Application Valuation:
Tit(t 4 4 Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BSPN2014-0021
51300 CALLE HUENEME
770164005
SPECIAL INSPECTION FOR IID RELEASE
Applicant:
MARTINEZ ELECTRIC
31040 AVENIDA LA GAVIOTA
CATHEDRAL CITY, CA 92234
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/15/2014
\ Owner:
PHIL GERTSMAN
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: C10 License No.: 866958
//
Date: Contractor:
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
Contractor:
MARTINEZ ELECTRIC
31040 AVE NIDA LA GAVIOTA
CATHEDRAL CITY, CA 92234
(760)880-1960
Llc. No.: 866958
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 th qr which this permit is issued.
ave 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.
r;
Date: / Applicant
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 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 state la s relating to building
construction, and hereby authorize representatives of thrcio en r upon a above-
mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
f a° Permit Detail5 PERMIT NUMBER
City OfNa Quinta BSPN20141002.1
Description: SPECIAL INSPECTION FOR IID RELEASE
Type: SPECIAL INSPECTION Subtype:
Status: SUBMITTED
Applied: 8/15/2014 SKH
Approved:
Parcel No: 770164005 Site Address: 51300 CALLE HUENEME LA QUINTA,CA 92253
Subdivision: DESERT CLUB TR UNIT 2 Block: 4
Lot: 20
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0
Zoning:
Finaled:
Valuation: $0.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: SPECIAL INSPECTION FOR IID RELEASE. THIS PERMIT IS NOT FOR WORK. 2013 CALIFORNIA BUILDING CODES.
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APPLICANT
MARTINEZ ELECTRIC
•• AVENIDA LA
CATHEDRAL
�®
GAVIOTA
CITY
• •MARTINEZ
ELECTRIC
31040 AVENIDA LA
CATHEDRAL
�®
GAVIOTA
481 W 23RD AVE
FINANCIAL
INFORMATION
�T Permit Det0aiI PERMIT NUMBER
City, of La Quinta BSPN201'4-002.1
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1
SEQID
INSPECTION TYPE
INSPECTOR
SCHEDULED
COMPLETED
RESULT
REMARKS
NOTES
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FINAL"
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
SPECIAL INSPECTION
1
101-0000-42404
1
$71.50
$71.50
8/15/14
R711
CASH
MARTINEZ ELECTRIC
SKH
Total Paid forCOMPLIANCE SURVEY/SPECIAL INSPECTION:
$71.50
$71.50
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1
SEQID
INSPECTION TYPE
INSPECTOR
SCHEDULED
COMPLETED
RESULT
REMARKS
NOTES
DATE
DATE
FINAL"
W
Printed: Friday, August 15, 2014 2:38:58 PM 2 of 2
t7LJ U LJ V SYSTEMS
Description: SPECIAL INSPECTION FOR IID RELEASE
CONDITIONS
Type: SPECIAL INSPECTION Subtype:
Status: SUBMITTED
Applied: 8/15/2014 SKH
Approved:
Parcel No: 770164005 Site Address: 51300 CALLE HUENEME LA QUINTA,CA 92253
Subdivision: DESERT CLUB TR UNIT 2 Block: 4
Lot: 20
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $0.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
NAME
Details: SPECIAL INSPECTION FOR IID RELEASE. THIS PERMIT IS NOT FOR WORK. 2013 CALIFORNIA BUILDING CODES.
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
MARTINEZ ELECTRIC
31040 AVENIDA LA
GAVIOTA
CATHEDRAL
CITY
CA
92234
CONTRACTOR
MARTINEZ ELECTRIC
31040 AVENIDA LA
GAVIOTA
CATHEDRAL
CITY
CA
92234
OWNER
PHIL GERTSMAN
481 W 23RD AVE
VANCOUVER BC
CANADA VST
HS
92253
Printed: Friday, August 15, 2014 2:38:58 PM 1 of 2 NAAF
SYSTEMS
C
Bin #
Qty of La Quinto
Building 8t: 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: / —
Ga
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Owtier's Name: e17
A. P. Number:
Address:
Legal Description:
City, ST, Zip: -(
'Contract or:
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Tele hone: �
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9b Vold6412zProject
Description:
City, ST, Zip:JJ LrYQ
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Telephone-0_
State Lic. # : • !
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City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
a Li
c. State L c. #:
ProJ'e t �Pe (circle le ne : New Add'n Alter Repairair Demo
0
Name of Contact Person:
Sq. Ft.:#Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
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 correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Description: SPECIAL INSPECTION FOR IID RELEASE
Type: SPECIAL INSPECTION Subtype:
Status: SUBMITTED
Applied: 8/15/2014 SKH
Approved:
Parcel No: 770164005 Site Address: 51300 CALLE HUENEME LA QUINTA,CA 92253
Subdivision: DESERT CLUB TR UNIT 2 Block: 4
Lot: 20
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $0.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: SPECIAL INSPECTION FOR IID RELEASE. THIS PERMIT IS NOT FOR WORK. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
CONDITIONS.
Printed: Friday, August 15, 2014 2:38:58 PM 1 of 2
SYSTEMS
..