Loading...
BSPN2015-005878-495 CALLE TAMPICC' LA QUINTA, CALIFORNIA 92253 4 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BSPN2015 0058 Property Address: 78120 CALLE ESTADO STE 207 APN: 770151005 Application Description: OLD TOWN / FARMERS INSURANCE Property Zoning: Application Valuation: Applicant: CHRISTINA GUTIERREZ 78120 CALLE ESTADO #207 LA QUINTA, CA 92253 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/2/2015 __....-73 __. Owner: WELLS MARVIN� �I air © a C c �c Contractor: C UC�g u 0 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: 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 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).: (_)1, 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.). (_J 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: Uc. 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 policy number are: Carrier: Polity 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. Date: 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 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 the above-mentioned property for inspection purposes. Date�alo2 �� Signature (Applicant orAgen) y FINANCIAL INFORMATION DESCRIPTION ACCOUNT p. :QTY AMOUNT •` PAID PAID DATE, - �1SPEC1At4N5PEC CON 101-0000-42404 0 $72.52 $0.00 PAID BY METHOD < RECEIPT # '' CHECK # CLTD BY Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION: TOTALS: $72.52 $72.52 $0.00 00 Description: OLD TOWN / FARMERS INSURANCE DESCRIPTION ACCOUNT QTY AMOUNT Type: SPECIAL INSPECTION Subtype: Status: UNDER REVIEW Applied: 12/2/2015 SKH Approved: Parcel No: 770151005 Site Address: 78120 CALLE ESTADO STE 207 LA QUINTA,CA 92253 Subdivision: DESERT CLUB.TR UNIT 1 Block: 10 Lot: 12 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $0.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: SPECIAL INSPECTION TENANT IN NEW SPACE. THIS PERMIT IS NOT FOR WORK. 2013 CALIFORNIA BUILDING CODES. FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID.BY CL BY SPECIAL INSPECTION 101-0000-42404 0 $72.52 $0.00 Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION: $72.52 $0.00 TOTALS:0i Printed: Wednesday, December 02,'2015 1:58:23 PM 1 of 2 Jrjww_ BOND INFORMATION Printed: Wednesday, December 02, 2015 1:58:23 PM 2 of 2 Bin # .' t Pty of La Quinta Building 8i Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: Co ntract 0 r T h ele one: P Address: Project Description: . City, ST, Zip: 9a�J n e: Telephone: �02X. d State Lie. # : City Lie. #; Arch., Engr., Designer: Address: City, ST, Zip: - Telephone: Construction T e• Y P an cY• Occupancy: tate ic. S L type (circle one): New Alter Repair DemoProject Add'n Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"d Review, ready for corrections/issue Electrical Subconlacl'or List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. 14.0•A. Approval Plans resubmitted Grading IN 14OUSE:- 'rd 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