BELC2016-0065Applicant:
DISCOVERY BUILDERS CALIFORNIA INC DBA DB D
14605 N 73RD STREET
SCOTTSDALE, AZ 8526076�
t
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: B License No.: 915336 / C— /.,
Dater 7"� �-C C
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).:
(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. 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 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/28/2016
Owner:
EAST OF MADISON
P 0 BOX 1482
LA QUINTA, CA 0
Contractor:
DISCOVERY BUILDERS CALIFORNIA INC DBA DB .
14605 N 73RD STREET
SCOTTSDALE, AZ 85260
(480)624-5200
Llc. No.: 915336
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.
X101 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: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA Polity
Number: YJUB282D7797
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 370 a abor Code, I shall forthwith
comply with those provisions. c
Applicant. l
WARNING: FAILURE TO SECURE WOR ERS' 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 laws ing to building
construction, and hereby authorize representatives of this city t nter u n the
above-mentioned property for inspection purposes.
Da„ te: f_ �ZS l(J Signature_(Applicant o� Ag/e
_ V
78-495 CALLE TAMPICO
4
LA QUINTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BELC2016-0065
Property Address:
52505 MERIWETHER WY
APN:
767690025
Application Description:
ALAN SMOISDKY/TEMP POWER POOL
Property Zoning:
Application Valuation:
$400.00
Applicant:
DISCOVERY BUILDERS CALIFORNIA INC DBA DB D
14605 N 73RD STREET
SCOTTSDALE, AZ 8526076�
t
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: B License No.: 915336 / C— /.,
Dater 7"� �-C C
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).:
(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. 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 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/28/2016
Owner:
EAST OF MADISON
P 0 BOX 1482
LA QUINTA, CA 0
Contractor:
DISCOVERY BUILDERS CALIFORNIA INC DBA DB .
14605 N 73RD STREET
SCOTTSDALE, AZ 85260
(480)624-5200
Llc. No.: 915336
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.
X101 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: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA Polity
Number: YJUB282D7797
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 370 a abor Code, I shall forthwith
comply with those provisions. c
Applicant. l
WARNING: FAILURE TO SECURE WOR ERS' 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 laws ing to building
construction, and hereby authorize representatives of this city t nter u n the
above-mentioned property for inspection purposes.
Da„ te: f_ �ZS l(J Signature_(Applicant o� Ag/e
_ V
Date: 7/28/2016
Application Number:
BELC2016-0065
Owner:
Property Address:
52505 MERIWETHER WY
EAST OF MADISON
APN:
767690025
P 0 BOX 1482
,Application Description:
ALAN SMOISDKY / TEMP POWER POOL
LA QUINTA, CA 0
Property Zoning:
Application Valuation:
$400.00
Applicant:
Contractor:
DISCOVERY BUILDERS CALIFORNIA
INC DBA DB
DISCOVERY BUILDERS CALIFORNIA INC DBA DB
14605 N 73RD STREET
14605 N 73RD STREET
SCOTTSDALE, AZ 85260
SCOTTSDALE, AZ 85260
(480)624-5200
Llc. No.: 915336
Detail: "TEMP POWER PEDESTAL ONLY. 2013 CALIFORNIA ENERGY CODE.
FINANCIAL •R •
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TEMP POWER SERVICE
101-0000-42403
0
$24.17
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TEMP POWER SERVICE PC
101-0000-42600
0
$16.92
Total Paid for ELECTRICAL: $41.09
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE'
101-0000-42404
0
$91.85
r
Total Paid for PERMIT ISSUANCE: $91.85
r
Description: ALAN SMOISDKY / TEMP POWER POOL
NAME TYPE
Type: ELECTRICAL
Subtype:
Status: UNDER REVIEW
Applied: 7/28/2016 RSE
Approved:
Parcel No: 767690025 Site Address: 52505 MERIWETHER WY LA QUINTA,CA 92253
Subdivision: TR 33076-2
Block:
Lot: 33
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $400.00.
Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0
No. Unites: 0
OWNER
Details: TEMP POWER PEDESTAL ONLY. 2013 CALIFORNIA ENERGY CODE.
P O BOX 1482 LA QUINTA
ADDITIONAL SITES
CHRONOLOGY
NAME TYPE
NAME """ """'° """"'
CONTACTS
.. "ADDRE551 CITY
STATE
ZIP PHONE
FAX
EMAIL
APPLICANT
DISCOVERY BUILDERS CALIFORNIA
INC DBA DB
14605 N 73RD STREET SCOTTSDALE
AZ
85260
SBIRDWELL@DISCOVE
RYLANDCO.COM
CONTRACTOR
-DISCOVERY BUILDERS CALIFORNIA
INC DBA DB
14605 N 73RD STREET SCOTTSDALE
AZ
85260
SBIRDWELL@DISCOVE
RYLANDCO.COM
OWNER
EAST OF MADISON
P O BOX 1482 LA QUINTA
CA
0
FINANCIAL INFORMATION
Printed: Thursday, July 28, 2016 9:09:06 AM 1 of 2 ,,
sysrf•Ms
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
' RECEIPT#
CHECK # .
METHOD
PAID BY
CLTD
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
7/28/16
R17450
CASH
DISCOVERY BUILDERS
RSE .
CALIFORNIA
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:
TEMP POWER SERVICE
101-0000-42403
0
$24.17
$24.17
7/28/16
R17450
CASH
DISCOVERY BUILDERS
RSE
CALIFORNIA
TEMP POWER SERVICE
101-0000-42600
0
$16.92
$16.92
7/28/16
R17450
CASH
DISCOVERY BUILDERS
RSE
PC
CALIFORNIA
Total Paid for ELECTRICAL: $41.09 $41.09
PERMIT ISSUANCE
101-0000-42404
0
$91.85.
$91.85
7/28/16
R17450
CASH
DISCOVERY BUILDERS
RSE
CALIFORNIA
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
•, $133.94
INSPECTIONS
BOND INFORMATION
Printed: Thursday, July 28, 2016 9:09:06 AM 2 of 2
SYSTEnOS
Bih #
City of La Quinta
Building U Safety Division
`',78 495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
ebb Building Permit Application and Tracking Sheet
Permit #=.'."
201b
Project Address: — t
ner's Name: 5/77C5 o�
A. P. Number:
Address: Z SOS
Legal Description:
City, ST, Zip: 7—f4 !47 -2 -S -
Contractor:
L
T •
ele h ne
P o .
Address:
.............
Project Description:
City, ST,Zip:LA—
Telephone: 6 6 - 3
X.0
State Lie. # :
City Lie. #.:
61A� l
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
Con truct
s 1 onType: Occupancy:
Y P
State a Lie. ic. #
Add'nProject type (circle one)
Alter r Repair Demo
Name of Contact Person: I cj�G 1 L cewz
Sq. Ft.: # Stories:
# Units:
Telephone # of Contact Person: O Z 2 —
Estimated Value of Project: 401z>
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 Cates.
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.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
7rd. 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
N i
OOR PLAN
PRELIMINARY FL
r