14-0927 (RR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 14-00000927
Property Address: 81790 LA PAZ CT
APN: 764-280-999-96 -300237-
/Application description: REMODEL - RESIDENTIAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 100
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of periury that m licensed and provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busine a Professional Code, and my License is in full force and effect.
License Class: C53 D35 ✓ i ens No.: 728796
. �� .
Date: B, 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 1$5001.:
1 _ 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. It, 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: tf�
LQPERMIT
Owner:
T.D. DESERT DEVELOPMENT
81570 CARBONERAS
LA QUINTA, CA 92253
(760)771-1941
Contractor:
BUBBLE SPRINGS
P.O. BOX 1046
RANCHO MIRAGE, CA 92270
(760)341-2336
Lic. No.: 728796
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153 .
Date: 6/24/14
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
_ 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
sued.
_ 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 EVEREST NATL Policy Number 76001635
_ 1 certify that, in the performance of the work for which his permit is issued, I shall not employ any
person in any manner so a o ecome subject to a wor s' compensation laws of California,
nd agree that, if I sho
Vrre subjectation provisions of Section
700 of the Labor C e,forthwith co p y wi ose provisions.
Date: Applicant:
WARN( G: FAILURE TO SECURE RKERS' 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 statetha
t the abo ormation is co rect. I agree to comply with all
city and county ordinances and state laws relating to buildi con ruction, an ereby authorize representatives
of this coun . to er upon the above-mentioned prope for i ection pu oses.
i
Date: nature (Applicant or Agent):
1P
Application Number 14-00000927
Permit . . . ELECTRICAL 2013
Additional desc .
Permit Fee . . . . 23.83 Plan Check Fee
00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 12/21/14
Qty Unit Charge Per
Extension
1.00 23.8300 LS ELEC DEVICES, FIRST 20
23.83
Permit . . . PLUMBING 2013
Additional desc .
Permit Fee . . . . 11.92 Plan Check Fee,.
. .00
Issue Date . . . . Valuation
0
Expiration Date 12/21/14
Qty Unit Charge Per
Extension
1.00 11.9200 LS PLBG GAS SYS, 1-4 OUTLETS
11.92'
----------------------------------------------------------------------------
Special Notes and Comments
REMODEL - GAS AND ELECTRICAL FOR FUTURE
BBQ AND FIRE POT. [2 INCH GAS PIPING/#8.
-
AWG IN 1 INCH CONDUIT ELECTRICAL] 2013
CALIFORNIA BUILDING CODES..
-----------------_-_----------------
Other Fees . . . . PLAN CHECK, ELECTRICAL
23.83
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, PLUMBING
23.83
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total. 35.75 .00 .00
35.75
Plan Check Total .00 .00 .00
.00
Other Fee Total 138.23 .00 .00
138.23
Grand Total 173.98 .00 .00
173.98
LQPERMIT
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C!, Q utnta
ty.
Building a Safety I)Wbn
P.O. Box 1504,"78-495 Calle Tampico
LR Quinta, CA 92253 -(760) 777-7012
Building Permit Application" and Tracking Sheet
Pe it # ^
Project Address
T
owce, Name: T. De e t'•1— �e_v fA &IM
A. P. Number.
Address:
Legal Description:
Ci'y'ST. Zip:
Contractor:
f Vitie"
M
Telepho EN sxr :5
Address:
rMje14 Description:
City, ST, Zip- un-Ck0KM'Q(,,
CoL g277D
'fug A -c)
Telephone:, b. q
City Li'
P6�
State Lic. # LIS -7 (P
Arch., Engr., Designer
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project Vjpc (circle one): (14-) Add'n. Alter Repair Demo.
Name of Contact Person: I
Sq. . FL:
9 Stories:units.
Telephone 4 of C . ontact Person: h
Estimated Value of Proj
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Rcqld
'Rcc1d
TRACMNG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structur�d Calls .
Reviewed, ready for corrections
Plan Check Deposit.
Truss Cates.—
Called Contact Person
Plan Check Balance
Tide 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted.'.
Mechanical . . .
Grading plan
2`! Review, ready for correctionsrLcsue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE-
k4 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