Loading...
BRES2017-0118LICENSED 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: LJtense No.: 820801 Date: • �6 / Contractor! OWNER-BUILDE C�T, 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 i 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 ) 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.). 1 (_) 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 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 Df w for which this permit is issued. I have and will maintain workers' compensation insurance, as required by S1 i 3700 of the Labor Code, for the performance of the work for which this permit ,S iss My workers' compensation insurance carrier and policy number are: Carrier: BENCHMARK INSURANCE COMPANY Policy Number: CST5010232 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 3 0 of the Labor C shall forthwith comply with t ose pr visions. Dat Da • l� Applicant: WARNING: FAILURE TO SECURE WORKERS' C PENSATI. 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 relating to building construction, and hereby authorize representatives of this city to enter upon e above -menti ed Voperty for inspection purposes. • Date /6 /� Signature (Applicant or Agent): 1r. VOICE (760) 777-7125 78-495 CALLE TAMPICO. U . FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 7/10/2017 1 Application Number: BRES2017-0118 Owner: Property Address: 48545 VISTA CALICO PELLOW APN: 602190016 48545 VISTA CALICO Application Description: PELLOW / INTERIOR REMODEL+CASITA ENTRY ADDITION z LA QUINTA, CA 92252C. Property Zoning: Application Valuation: $45,000.00 cz:� o Q a Applicant: Contractor:�� SANTUCCI BUILDERS INC SANTUCCI BUILDERS INC 72529 BEAVERTAIL STREET 72529 BEAVERTAIL STREET a PALM DESERT, CA 92260 PALM DESERT, CA 92260 (760)578-7757 G Llc. No.: 820801 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: LJtense No.: 820801 Date: • �6 / Contractor! OWNER-BUILDE C�T, 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 i 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 ) 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.). 1 (_) 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 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 Df w for which this permit is issued. I have and will maintain workers' compensation insurance, as required by S1 i 3700 of the Labor Code, for the performance of the work for which this permit ,S iss My workers' compensation insurance carrier and policy number are: Carrier: BENCHMARK INSURANCE COMPANY Policy Number: CST5010232 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 3 0 of the Labor C shall forthwith comply with t ose pr visions. Dat Da • l� Applicant: WARNING: FAILURE TO SECURE WORKERS' C PENSATI. 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 relating to building construction, and hereby authorize representatives of this city to enter upon e above -menti ed Voperty for inspection purposes. • Date /6 /� Signature (Applicant or Agent): 1r. a Date: 7/10/2017 Application Number: BRES2617-0118 Owner: Property Address: 48545 VISTA CALICO PELLOW APN: 602190016 48545 VISTA CALICO Application Description: FELLOW/ INTERIOR REMODEL+CASITA ENTRY ADDITION LA QUINTA, CA 92252 Property Zoning: . Application Valuation: $45,000.00 Applicant: Contractor: SANTUCCI BUILDERS INC SANTUCCI BUILDERS INC 72529 BEAVERTAIL STREET 72529 BEAVERTAIL STREET PALM DESERT, CA 92260 PALM DESERT, CA 92260 (760)578-7757' - ---------------------- ---`---- ---- --- Llc. No.: 820801 ------------------------------------- -------------- -------'Detail: 'Detail: ADDITION AT CASITA + MAIN HOUSE INTERIOR REMODEL. RELOCATE FIREPLACE AND INSTALL NEW SLIDING DOOR AT MAIN HOUSE GREAT ROOM. REPLACE APPLIANCES AND COUNTERTOP AT KITCHEN. ADD 7.9 S.F. AT CASITA ENTRY AND INSTALL NEW FRENCH DOOR ENTRY DOORS. THIS PERMIT DOES NOT INCLUDE ALTERATIONS AT KITCHEN; OTHER THAN AS INDICATED ON PLANS. 2016 CALIFORNIA BUILDING CODES. F DESCRIPTION ACCOUNT CITY AMOUNT ADDITION, FIRST 100 SF 101-0000-42400 0 $127.68 DESCRIPTION ACCOUNT CITY AMOUNT ADDITION, FIRST 100 SF PC 101-0000-42600 0 $179.36 Total Paid for ADDITION: $307.04 DESCRIPTION ACCOUNT QTY AMOUNT INVESTIGATION FEE 101-0000-42400 1 $250.29 Total Paid for ADMINISTRATIVE: $250.29 DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $2.00 Total Piid for BUILDING STANDARDS AWINISTRATION BSA: $2.00 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $25.33 Total•Paid for ELECTRICAL: $50.66 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, EA ADDITIONAL 500. SF 101-0000-42400 0 $45.60 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $36.48 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, FIRST 100 SF 101-0000-42400 0 $51.68 DESCRIPTION ACCOUNT CITY -AMOUNT REMODEL, FIRST 500 SF PC 101-0000-42600 0 $141.36 Total Paid for REMODEL: $275.12 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $5.85 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $5.85 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 I