BRES2015-044678-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&�t 4 e(P 0":
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BRES2015-0446
Property Address:
44825 FRONTERRA DR
APN:
604271019
Application Description:
DOSS/ REAR YARD ADD (3) FANS, CONNECT WATER, GAS, SEWER
Property Zoning:
44825 FRONTERRA DR
Application Valuation:
$500.00
Applicant:
rn D
CASTLE ROCK BUILDERS INC
P 0 BOX 5756
LrI
LA QUINTA, CA 92248
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: B License No.: 917273
Date: 2 /( �7 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 ) 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' Stafe License Law.).
I I 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:
I Illlll VIII I'll llll
10
VOICE (760) 777-7125
FAX (760) 777-7011
Contractor:
CASTLE ROCK BUILDERS INC
P 0 BOX 5756
LA QUINTA, CA 92248
(760)272-7878
Llc. No.: 917273
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 wo 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 Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 2 �� /S Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPEN TION COVE AGE 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: ? f I f , Signature (Applicant or Agent):
aj�
V
n
dtm 11
Owner:
m p
C"_ D
DAVID DOSS
44825 FRONTERRA DR
m 0
LA QUINTA, CA 922531.
rn D
C�
LrI
Contractor:
CASTLE ROCK BUILDERS INC
P 0 BOX 5756
LA QUINTA, CA 92248
(760)272-7878
Llc. No.: 917273
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 wo 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 Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 2 �� /S Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPEN TION COVE AGE 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: ? f I f , Signature (Applicant or Agent):
aj�
V
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WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.09 $0.00
PAID BY. METHOD _ ` RECEIPT # CHECK # ;, ` _
CLTD BY
Total Paid for PLUMBING FEES: $84.62 $0.00
DESCRIPTION`.. ACCOUNT QTY AMOUNT f?AID , PAID DATE.,
SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.00
PAID BY `, METHOD .. -RECEIPT # CHECK 'CLTD BY -
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 • $0.00
Description: DOSS / REAR YARD ADD (3) FANS, CONNECT WATER, GAS, SEWER
Type: BUILDING, RESIDENTIAL
Subtype: REMODEL Status: UNDER REVIEW
Applied: 12/11/2015 SKH
Approved:
Parcel No: 604271019 Site Address: 44825 FRONTERRA DR LA QUINTA,CA 92253
Subdivision: TR 23913
Block: Lot: 82
Issued:
Lot Scl Ft: 0
Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $500.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
LA QUINTA
Details: REAR. YARD AT PATIO -ADD (3) FANS, CONNECT TO EXISITNG SEWER, GAS, AND WATER PER APPROVED PLAN. 2013 CALIFORNIA
BUILDING CODES.
CONTRACTOR
Printed: Friday, December 11, 2015 9:10:21 AM 1 of 3 C
SYS TERAS
CONDITIONS
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
STATE
ZIP.- PHONE; FAX ..
EMAIL
APPLICANT
CASTLE ROCK BUILDERS INC
P 0 BOX 5756
LA QUINTA
CA
92248
CONTRACTOR
CASTLE ROCK BUILDERS INC
P 0 BOX 5756
LA QUINTA
CA
92248
OWNER
DAVID DOSS
44825 FRONTERRA DR
LA QUINTA
CA
92253
Printed: Friday, December 11, 2015 9:10:21 AM 1 of 3 C
SYS TERAS
DESCRIPTION
ACCOUNT
QTY
AMOUNT.
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
DEVICES, FIRST 20
.101-0000-42403
0
$24.17
$0.00
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$0.00
Total Paid for ELECTRICAL: $48.34 $0.00
PERMIT ISSUANCE
101-0000-42404
.0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
FIXTURE/TRAP
101-0000-42401
0
$12.09
$0.00
FIXTURE/TRAP PC
101-0000-42600
0
$12.09.
$0.00
GAS SYSTEM, 1-4
101-0000-42401
0
$12.09
$0.00
OUTLETS
GAS SYSTEM, 1=4
101-0000-42600
0
$24.17
$0.00
OUTLETS PC
WATER SYSTEM
101-0000-42401
0
$12.09
$0.00
INST/ALT/REP
WATER SYSTEM
101-0000-42600
0
$12.09
$0.00
INST/ALT/REP PC
Total Paid for PLUMBING FEES: $84.62 $0.00
SMI - RESIDENTIAL
101-0000-20308
0
$O.SO
$0.00
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 $0.00
$0.00
INSPECTIONS
PARENT PROJECTS
Printed: Friday, December 11, 2015 9:10:21 AM 2 of 3 c
SYSTEMS
ATTACHMENTS
Printed: Friday, December 11, 2015 9:10:21 AM 3 of 3
SYS TEti1S
Bin
city of La Quinta
Building u Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit if
U,vs
Project Address:
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: act r
. C��/iG
l
Telephone:
.•..
Address: 7��Sd
Project Description: 7/d'�lj...•. rjt/
City, ST, Zip: ��' v( (A—
�Gj �404t P Me
Telephone:
Z �
7
O 0 � N
State Lic. # :
City Lic. #...
Arch., Engr., Designer:
�(� �4j
Address:
City, ST, Zip:
Telephone:
nTY O ecu Pan cY •
Construction Type-.
State Ltc.
Project t hPec�(circle one): New Add'n Alter Repair Demo
Name of Contact Person:
�
Sq. Ft_:
# Stories: —Ft,
Units:
Telephone # of Contact Person:
Estimated Value of Project: Vo
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue.
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval'
Plans resubmitted
Grading
IN HOUSE:-
Reyiew, 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
TIS to
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