BSPN2015-004478-495 cALLE TAMPICO
D
VOICE (760) 777-7125
LA QUINA, CALIFORNIA 92253
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/3/2015
Application Number:
BSPN2015-0044
Owner:
Property Addres�:
78080 AVENIDA LA FONDA
BARRY PARKINS
APN: 1
770121005
Property Zoning:
Application Valuation:
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w
Applicant:
Contractor:
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JENNIFER HEARNE
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it
LIJ
No.:
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.:
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 Na
Lender's Address:
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: _ 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:
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 informatipn is correct.
I agree to comply with all city and county ordinances and st a laws relating to building
construction, and hereby authorize representatives of t&,tyenter u do the above -
men •oned property for inspection purposes.
a e: Signature (Applicant or Agent
1
� Permit Details PERMIT NUMBER
City of La Quints BSPN201�5=00/4
Description: PARKINS / SPEICAL INSPECTION TO OCCUPY
CHRONOLOGY
CONDITIONS
Type: SPECIAL INSPECTION Subtype:
Status: UNDER REVIEW
Applied: 9/3/2015 SKH
Approved:
Parcel No: 770121005 Site Address: 78080 AVENIDA LA FONDA LA QUINTA,CA 92253
Subdivision: DESERT CLUB TR UNIT 4 Block:
Lot: 43
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 TO OCCPY. THIS PERMIT IS NOT FOR WORK. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL
APPLICANT JENNIFER HEARNE
OWNER BARRY PARKINS 50940 MANGO LA QUINTA CA 92253
Printed: Thursday, September 03, 2015 5:27:43 PM 1 of 2 CRWYSTEMs
PARENT PROJECTS
Printed: Thursday, September 03, 2015 5:27:43 PM 2 of 2 CB?
SYSTEM S
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
RESULT REMARKS NOTES_,
DATE DATE
FINAL"* BLD
PARENT PROJECTS
Printed: Thursday, September 03, 2015 5:27:43 PM 2 of 2 CB?
SYSTEM S
Qin #
.0ty of La Quin to
Building 8F Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Abject Address:Z $� _7d,
Owners Name: _ 6
A. P. Number:
Address:7R)O �
Legal Description: G4. � Ge__
City, ST, Zip:
Contractor:
ele hone:
TP
Address: •
Project Description:
City, ST, Zip:—
TeleP ho n •
e.
State Lic. # :
City Lie.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
le one:
P
Can tr ucti n TY Pe:Occupancy:
Lie.#
d'nStato
Project hPa circle ne • New AdAlter Repair Demo
ot Person:
tel,p'h�o'f.e#of
Sq. Ft.: CW- C
# Stories:
# Units:
21
Contact Person: j
Estimated Value of Project:
;�FO, /a 57_-2%9APPLICANT: DO NOT WRITE BELOW THIS LINE
9
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
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.
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"! Review, ready for corrcctionsrssue
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.S.A.P.
PUMP/NG
Lic #C42 855 851
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FAX 760 328-6607
P.O. Box 2318 - Cathedral City, CA 92235
CUSTOMER'S ORDER NO.
DATE ORDERED
ORDER TAKEN BY
DATE PROMISED ❑ A.M.
❑ P.M.
BILL TO
jC
PHONE
ADDRESS
Pumping Fee per 1000 gal. itil
SGHANIC
CITY _
HELPER
JOBINAMEAND LOCATION
❑ DAY WORK
DESCRIPTION OF WORK
❑ CONTRACT
❑ EXTRA
Out of Area Fee
QUANT
DESCRIPTION OF MATERIAL USED
PRICE
AMOUNT
Gallons
Pumping Fee per 1000 gal. itil
e
Dumping Fee per 1000 gal.
Out of Area Fee
Locating / Opening Fee (per hour)
I
Size System:
A SERVICE CHARGE OF $20 WILL BE DUE ON ALL RETURNED CHECKS.
18% PER YEAR WILL BE CHARGED ON PAST DUE
ACCOUNTS OVER 30 DAYS.
TOTAL
MATERIALS
TOTAL
LABOR
WAIVER: Not responsible for secondary damage such as water
damage, chipped concrete, =on s2 eet.or driveways or trees.
SIGNATURE DATE COMPLETED
TAX
TOTAL,