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14-0820 (DSF)P.O. BOX 1504 78-495 CALLE TAMPICO a, LA QUINTA, CALIFORNIA 92253 0 T4'yl 4 4 Q" act }" Application Number: 14-00000820 Property Address: 47965 VIA NICE APN:" 643-130-023-23 -26152 - Application description: DEMO - COMML/OTHER Property Zoning: LOW DENSITY RESIDENTIAL ZI Application valuation: 2500 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: BALLARDO RESIDENCE 47965 VIA NICE LA QUINTA, CA 92253 Contractor: BERA WEST P.O. BOX 2487 PALM SPRINGS, CA 92263 r. (760)323-5497 Lic. No.:: 414614 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 16/11/14 D Cf^% tai !A QUkN IM - LICENSED CONTRACTOR'S DECLARATION 1 - - WORKER'S COMPENSATION DECLARATION . I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with - ., I hereby affirm under penalty of perjury one of the following declarations: - - - Section 7000) of Division 3 o the Business and Professionals Code, and my License is in full force and effect. I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: B C54 - Lic No.: 414614 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -issued. — Contractor: _ Ihave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor )(Date: Code, for the performance of the work for which this permit is issued. My workers' compensation .. OWNER -BUILDER DECLARATION insurance carrier and policy number are: - hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the - Carrier EXEMPT Policy Number EXEMPT - following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to - _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any '- construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State - - and agree that, if I should become subject to the workers' compensationprovisions of Section - - -- License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or - 3700 of the labor Code, I sh I forthwith ply with those provisions. 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)•: ate: �� Applicant: l //� (_ 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 - WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, - SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND _ and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN - improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - - 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.). APPLICANT ACKNOWLEDGEMENT ' (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety fora permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). - whose benefit work is performed under or pursuant to any permit issued as a result of this application,. (_ 1 I am exempt under Sec. ,.B.&P.C. for this reason - the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City 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: LQPERMIT 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 relating to building constru ion, and her a thor' -a re sentatives of this county to enter upon the above-mentioned property for ' p ion purpos Date- aignature (Applicant or Agent): Application Number . . . . 14-00000820 Permit . . . DEMO PERMIT Additional desc . YF Permit Fee . . . . 24.31 Plan Check Fee .00 r Issue Date Valuation 2500 Expiration Date 12/08/14 Qty Unit Charge Per Extension 1.00 24.3100 LS MISC DEMOLITION,'FULL 24.31 ------------------------------------------------------- Special Notes and Comments DEMO POOL AND SPA PER APPROVED PLANS & AJ.HOLES TO BE DRILLED IN BOTTOM OF POOL AND JACUZZI NO BUILDING ON TOP OF POOL. ------------------------ 7 ---------------------- 7 ------------------ Other Fees . . . . . . . PLAN CHECK, DEMOLITION --------- 85.80 Fee summary,, Charged Paid Credited Due - ---------- ---------- ---------- Permit Fee Total 24.31 .00 ---------- .00 24.31 Plan Check Total -- .00 .00 .00 , .00 Other Fee Total, -85.80 .00 00 85.80 Grand. Total 1110.11. 00 .00 110.11 LQPERMIT .1" A. P. Number: Address: Legal Description: City, ST, Zip: 1. ► �.. - Iain # City .of La Quinta -Building 8s• Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico. / r► v La Quinta, CA 92253 - (760) 777-7012` Building Permit Application and Tracking Sheet Project Address: ` 7 ,� 7� V llq Al/C° t! • Owner's Name: /q Z, L {i}- x go A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: Telephone: Address: R Q - 0 Project Description: , City, ST, Zip: �� v! d VC l iL S �/� O 6 �. O (� C� ea z Zi Telephone: p I-CityLic.m... State Lic. # : / (y Arch., Engr., Designer: Address: City., ST, Zip: Telephone: < %i% :y.c%::'%>y :<;`c;>:f::;:::% <: <::.:.::...: ::.::«:.....;.... Construction Type: Occupancy: to S to Lic. #: , Project type (circle one): New Add n Alter Repair .Demo Name of Contact Person: Sq. Ft.: #Stories: #Units: Telephone #,of Contact Person: Estimated Value of Projcc 2 (i 0 © --v 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 Cala. Called Contact Person 1 Plan'Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrcctions/issue Electrical Subcontactor List Called Contact Person Plumbing . Grant Decd Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN IiOUSE:- '•' Rcyiew, 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 ti .