BPAT2015-002578-495 CALLE TAMPICO
T,iti�p 4 4 Qubtrw
LA QUINTA, CALIFORNIA 92253 , COMMUNITY DEVELOPM
BUILDING P
Application Number:
B AT2015-0025
Property Address:
79315 DESERT STREAM DR
APN:
604323006
Application Description:
GILLETT/282 SQUARE FOOT PATIO COVER AT BACKYARD
Property Zoning:
Application Valuation:
$3,000.00
Applicant:
ANILOM INC DBA GOLD STAR'CUSTO
42-335 WASHINGTON STREET
SUITE F363
PALM DESERT, CA 92211
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C33. C51 License No.: 855623 /
Date: 7. 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 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:
ENT DEPARTMENT
PE
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
EUGENE GILLETT
79315 DESERT STREAM
LA QUINTA, CA 92253
Contractor:
ANILOM INC DBA GOLD STAR
42-335 WASHINGTON STREET
SUITE F363
PALM DESERT, CA 92211
(760)641-7544
Llc. No.: 855623
Date: 4/15/2015
n I>
O COD
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!or which this permit is issued.
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 La de, I shall forthwith
comply with those. provisions.
Date: Z 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 informatio ,s correct.
I agree to comply with all city and county ordinances and state laws rela ' to building
construction, and,hereby authorize representatives of this city to a to upon the ve•
mentioned pr perty for inspection purposes.
Dater Z Signature (Applicant or Agent):
i
t
FINANCIAL INFORMATION
DESCRIPTION
ACCOUNT
QTY
AMOUNT PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00 $0.00
PAID BY
METHOD
RECEIPT # CHECK #
CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT .
PAID
PAID DATE
PATIO COVER, STD, OPEN
101-0000-42404
0
$97.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PATIO COVER, STD, OPEN PC
101-0000-42600
0
$95.72
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PATIO COVER / COVERED PORCH / LATTICE $192.89 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00
TOTALS:•0
Description: GILLETT/282 SQUARE FOOT PATIO COVER AT BACKYARD
Type: PATIO COVER Subtype: Status: APPROVED
Applied: 4/15/2015 SKH
Approved: 4/15/2015 LUR
Parcel No: 604323006 Site Address: 79315 DESERT STREAM DR LA QUINTA,CA 92253
Subdivision: TR 23935-5 Block: Lot: 25
Issued:
Lot Scl Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $3,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
ADDRESSI
Details: 280SF SOLID PATIO COVER AT REAR YARD [DURALUM ] THIS PERMIT DOES NOT INCLUDE ELECTRICAL INSTALLATIONS. 2013
CALIFORNIA BUILDING CODES.
CHRONOLOGY
r
Printed: Wednesday, April 15, 2015 4:38:19 PM 1 of 2
ww SYSTEMS
CONTACTS
NAMETYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
ANILOM INC DBA GOLD STAR CUSTO
42-335 WASHINGTON
STREET
PALM DESERT
CA
92211
-
CONTRACTOR
ANILOM INC DBA GOLD STAR CUSTO
42-335 WASHINGTON
STREET
PALM DESERT
CA
92211
OWNER
EUGENE GILLETT
79315 DESERT STREAM
LA QUINTA
CA
92253
r
Printed: Wednesday, April 15, 2015 4:38:19 PM 1 of 2
ww SYSTEMS
PARENT PROJECTS
Printed: Wednesday, April 15, 2015 4:38:19 PM 2 of 2
CRWY57fM5
lCITY
CLT
DESCRIPTION
ACCOUNT
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
PATIO COVER, STD,
101-0000-42404
0
$97.17
$0.00
OPEN
PATIO COVER, STD,
101-0000-42600
0
$95.72
$0.00
OPEN PC
Total Paid for PATIO COVER / COVERED PORCH / LATTICE $192.89 $0.00
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
$0.00
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00
TOTALS:••
PARENT PROJECTS
Printed: Wednesday, April 15, 2015 4:38:19 PM 2 of 2
CRWY57fM5
Bin #
Qty of ra QCuhta
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 #
4 ort
Project Address: M.�
Owner's Name: G m-,ee W ew
A. P. Number.
Address:
Legal Description:
City, ST, Zip:
Contractor: `
Te phone:. ,
Address: ;fit. F
Project Description
City, ST, Zip: Gin f'�
tili�Zi F��✓
Telephone: 40 tF7 (OU �j � ` �
State Lia # : Sr�% a City Lie. #;
Arch., Engr., Designer
Address:
City, ST, Zip:
Telephone: L
State Lie. #: „}
Name of Contact Person:
ConstructionType: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft: #Stories: # Units:
Telephone #,of Contact Person:
Estimated Value of Project: '36Wa'
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACIMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance.
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2' Review, ready for correctionsrissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for correctionsfrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
17
Total Permit Fees
i
-7avjs--0aaS7
EUGENE GILLET�
79315 DESERT
STREAM
LA Q U I N TA, CA
12'
10-0z"
9' T-91"
21'
16'-62"
CITY OF LA QUIETY P TA
BU1LDiNGR��V
FOR CONSTRUCTION
DATE l l � �-