BSPN2015-002578-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BSPN2015-0025
Property Address: 51360 EISENHOWER DR
APN: 773092002
Application Description: SPECIAL INSPECTION
Property Zoning:
Application Valuation:
Applicant:
JULIE KIRK
51360 EISENHOWER DR
LA QUINTA, CA 92253
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COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
D Q D
JUL 20 2015
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DE
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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/20/2015
RE KIRK
yy++ 60 EISENHOWER DR
LA UINTA, CA 92253
Llc. No.:
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 polity 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.
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
Date: Applicant:
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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
I ) I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this application is made, each person at whose
(� I, as•owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
( ) I am exempt under Sec. . B.&P.C. or this rea on
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.
VV
I certify that I have read this application and state that the above information is correct.
CONSTRUCTIOfENING GENCY
I e to comply with all city and county ordinances and state laws relating to building
I hereby affirm under penalty of perjury construction lending agency for
constru ion, and hereby authorize representatives of this city to enter upon the above•
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
mentione roperty for inspection purposes.
Lender's Name: Vie: I r/`l `-Signature (Applicant or Agent):
Lender's Address:
Description: SPECIAL INSPECTION
CONDITIONS -
••
Type: SPECIAL INSPECTION
Subtype:
Status: ISSUED
Applied: 7/20/2015 MFA
Approved: 7/20/2015 MFA
Parcel No: 773092002 Site Address: 51360 EISENHOWER DR LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA AT VALE LA QUINTA Block: 138
Lot: 12
Issued: 7/20/2015 MFA
NO 14
Lot Sq Ft: 0
Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $0.00
Occupancy Type:
Construction Type:
Expired: 1/16/2016 MFA
No. Buildings: 0
No. Stories: 0
No. Unites: 0
Details: SPECIAL INSPECTION FOR ELECTRIC RELEASE DUE TO FIRE DAMAGE
•• • •
CONDITIONS -
••
,
CONTACTS
NAME TYPE NAME ADDRESSi CITY
STATE ZIP PHONE FAX EMAIL
APPLICANT JULIE KIRK 51360 EISENHOWER DR LA QUINTA
CA 92253 (
Printed: Monday, July 20, 2015 9:12:37 AM 1 of 2
��SYSTEMS
Printed: Monday, July 20, 2015 9:12:37 AM 2 of 2 c9?
SYSTEti1S
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE, DATE
RESULT REMARKS NOTES
FINAL" BLD
Printed: Monday, July 20, 2015 9:12:37 AM 2 of 2 c9?
SYSTEti1S
B1" #
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
Building Permit. Application and Tracking Sheet
Permit #
Project Address:�
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Owner's.Name: e
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Legal Description:
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Telephone:
Address:
Project Description: I q .e
City, ST, Zip:
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Telephone:
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State Lic. # :
City Lic. #.:
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Arch., Engr., Designer:
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Address:
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City, ST, Zip:.
Telephone:Construction
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TYP e: Occupancy:
State Lic. #
Project type (circle one)N w• Add'n Alter Repair it Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
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Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical "
Grading plan
2ad 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 HOUSE:
'"' 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