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BRES2015-0378lir 78-495 CALLE TAMPICO f LA QUINTA, CALIFORNIA 92253 COMMUNITY E BU Application Number:- BRES2015-0378 Property Address: 43575 CROISETTE CT APN: 609052002 Application Description: DARBY ESTATES TM31087 PH 7 PLAN 1M Property Zoning: Application Valuation: $155,694.10 Applicant: G H A ENTERPRISES INC 30-875 DATE PALM DRIVE STE C CATHEDRAL CITY, CA 92234-3747 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.: 75095 Date: /i/ / 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 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: OCT 0 " 1S c `oF44 23 VOICE (760) 777-7125 FAX (760) 777-7011 NTS INSPECTIONS (760) 777-7153 Date: 10/7/2015 A-B61Vf ENTURES 77-681 COUNTRY CLUB DR. STE A3 PALN4 DESERT, CA 92211 Contractor: G H A ENTERPRISES INC 30-875 DATE PALM DRIVE STE C CATHEDRAL CITY, CA 92234-3747 (760)969-1400 Llc. No.: 750957 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 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 X of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant - .WARNING: FAILURE TO SECURE WORNSATION 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 is city o enter upon e above-mentioned property for inspection purposes. Date: to l I'S_ Signature (Applicant or Agen . DESCRIPTION FINANCIAL .• ACCOUNT 1. QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $7.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $7.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - LIBRARIES 253-0000-43200 - 0 $344.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID . PAID DATE DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 $0.00_ PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION = ACCOUNT QTY AMOUNT PAID PAID DATE DIF, PARKS/REC 251-0000-43200 0 $2,048.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE TEMP POWER SERVICE 101-0000-42403 0 $24.17 $0.00 ,P, AID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL: $24.17 $0.00 DESCRIPTION ACCOUNT QTY. AMOUNT PAID PAID DATE RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $36.99 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $145.03 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL - NEW CONSTRUCTION: $182.02 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL PRECISE GRADING - TRACT HOME 101-0000-42408 0 $133.43 $0.00 PAID BY METHOD RECEIPT # CHECK # . CLTD BY Total Paid for GRADING: $133.43 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE CONDENSER/COMPRESSOR 101-0000-42402 0 $72.52 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY- AMOUNT PAID PAID DATE EXHAUST HOOD 101-0000-42402 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FURNACE 101-0000-42402 0 $72.52 $0.00 PAID BY .. METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE VENT FAN 101-0000-42402 0 $48.36 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD. BY Total Paid for MECHANICAL: $205.49 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE MULTI STRUCTURE PLAN CHECK - EACH 101-0000-42600 0 $48.34 $0.00 PAID BY METHOD RECEIPT #. CHECK # CLTD BY Total Paid for MULTI STRUCTURE PLAN CHECK - EACH: $48.34 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE MULTI -SPECIES RESIDENTIAL 0-8 UNITS - 2015 UPDATE 101-0000-20310 0 $1,301.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for MULTI -SPECIES RESIDENTIAL: $001.00 $0.00 DESCRIPTION ACCOUNT ` QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PERMIT 101-0000-42400 0 $545.41 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for NEW CONSTRUCTION PERMIT: $545.41 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BUILDING SEWER 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT' QTY AMOUNT PAID PAID DATE FIXTURE/TRAP 101-0000-42401 0 $181.35 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $36.26 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD' . RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $253.88 $0.00 DESCRIPTION - ACCOUNT CITY. " AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308. 0 $20.24. $0.00 PAID BY. METHOD RECEIPT # CHECK # CLTD BY Total Paid for STRONG MOTION INSTRUMENTATION SMI: $20.24 $0.00 DESCRIPTION = ACCOUNT QTY AMOUNT PAID PAID DATE SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for TUMF - RESIDENTIAL: $1,837.44 $0.00 TOTALS:0• Description: DARBY ESTATES TM31087 PH 7 PLAN 1M Type: BUILDING, RESIDENTIAL Subtype: DWELLING - SINGLE Status: APPROVED Applied: 9/22/2015 MFA FAMILY DETACHED Approved: 10/7/2015 MFA Parcel No: 609052002 Site Address: 43575 CROISETTE CT LA QUINTA,CA 92253 Subdivision: Block: lot: 30 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $155,694.10 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 ZIP Details: 2,415 SF DWELLING PLAN TYPE 1M, LOT 10 [VB/RES-3/CLASS A-FR/13D] THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2013 CALIFORNIA BUILDING CODES ADDITIONAL SITES __j Applied to Approved CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE 'FAX EMAIL APPLICANT G H A ENTERPRISES INC 30-875 DATE PALM CATHEDRAL CA 92234- (760)200-5989 MARIOGONZALEZ@GH DRIVE STE C CITY 3747 ACOMPANIES.COM CONTRACTOR G H A ENTERPRISES INC 30-875 DATE PALM CATHEDRAL CA '92234- (760)200-5989 MARIOGONZALEZ@GH DRIVE STE C CITY 3747 ACOMPANIES.COM OWNER ADOM VENTURES 77-682 COUNTRY CLUB PALM DESERT CA 92211 (760)200-5989 DR. STE A3 FINANCIAL INFORMATION Printed: Wednesday, October 07, 2015 10:55:01 AM 1 of 4 C SYSTEMS Printed: Wednesday, October 07, 2015 10:55:01 AM 2 of 4 SYSTEMS 'CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $7.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $7.00 $0.00 BSA: DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $0.00 DIF - COMMUNITY 254-0000-43200 0 $129.00 $0.00 CENTERS DIF - FIRE PROTECTION 257-0000-43200 0 _$433.00 $0.00 DIF - LIBRARIES 253-0000-43200 0 $344.00 $0.00 DIF - PARK 256-0000-43200 0 $40.00 $0.00 MAINTENANCE DIF - PARKS/REC 251-0000-43200 0 $2,048.00 $0.00 DIF - STREET 255-0000-43200 0 $116.00 $0.00 MAINTENANCE DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 $0.00 Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 $0.00 TEMP POWER SERVICE 101-0000-42403 F 0 $24.17 $0.00 Total Paid for ELECTRICAL: $24.17 $0.00 RESIDENTIAL, EA 101-0000-42403 0 $36.99 $0.00 ADDITION I,000SF RESIDENTIAL, FIRST 101-0000-42403 0 $145.03 $0.00 1,000SF Total Paid for ELECTRICAL - NEW CONSTRUCTION: $182.02 $0.00 RESIDENTIAL PRECISE GRADING - TRACT 101-0000-42408 0 $133.43 $0.00 HOME Total Paid for GRADING: $133.43 $0.00 Printed: Wednesday, October 07, 2015 10:55:01 AM 2 of 4 SYSTEMS _ ' CLTD DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY CONDENSE R/COMPRES 101-0000-42402 0 $72.52 $0.00 50 R EXHAUST HOOD 101-0000-42402 0 $12.09 $0.00 FURNACE 101-0000-42402 0 $72.52 $0.00 VENT FAN 101-0000-42402 0 $48.36 $0.00 Total Paid for MECHANICAL: $205.49 $0.00 MULTI STRUCTURE 101-0000-42600 0 $48.34 $0.00 PLAN CHECK - EACH Total Paid for MULTI STRUCTURE PLAN CHECK - EACH: $48.34 $0.00 MULTI -SPECIES RESIDENTIAL 0-8 UNITS 101-0000-20310 0 $1,301.00 $0.00 - 2015 UPDATE Total Paid for MULTI -SPECIES RESIDENTIAL: $1,301.00 $0.00 NEW CONSTRUCTION 101-0000-424000 $545.41 $0.00 PERMIT Total Paid for NEW CONSTRUCTION PERMIT: $545.41 $0.00 BUILDING SEWER 101-0000-42401 0 $12.09 $0.00 FIXTURE/TRAP 101-0000-42401 0. $181.35 $0.00 GAS SYSTEM, 5+ 101-0000-42401 0 $36.26 $0.00 OUTLETS WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 WATER SYSTEM 101-0000-42401 0 $12.09 $0.00 INST/ALT/REP Total Paid for PLUMBING FEES: $253.88 $0.00 SMI - RESIDENTIAL 101-0000-20308 0 $20.24 $0.00 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $20.24 $0.00 Printed: Wednesday, October 07, 2015 10:55:01 AM 3 of 4 CmMYSTEMs DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY SINGLE FAMILY 224-0000-20320 0 $1,837.44 $0.00 DETACHED Total Paid for TUMF - RESIDENTIAL: $1,837.44 $0.00 Printed: Wednesday, October 07, 2015 10:55:01 AM 4 of 4 rpW SYSTEMS