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BRES2015-041678-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: WENCESLAO RAZO , 92253 c&tyx 4 4� Qu&rcu COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BRES2015-0416 54414 AVENIDA MARTINEZ 774254007 WINDOW, DOOR, AND STUCCO REPLACEMENT $500.00 OCT 2 9 2015 I CIIYOFLAQUINTA COMMUNITY DEVELOPMENT DEPARTMENT 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.::CONV:140528101254094176 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 $5 0).: /4) 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 rh_e Aor, she did not build or improve for the purpose of sale.). / 'Uj, 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: r 2- caner: 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 Add 11111111111111111111 37 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/29/2015 Owner: WENCESLAO RAZO , 92253 Contractor: WENCESLAO RAZO , 92253 Uc. No.::CONV:140528101254094176 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 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 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: Signature (Applicant or Agent): FINANCIAL ,• 1• DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 10/29/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY WENCESLAO RAZO DEBIT R10375 JFU Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: '$1.00 $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.50 10/29/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY WENCESLAO RAZO DEBIT R10375 JFU Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 $0.50 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE STUCCO APPLICATION, FIRST 500 SF 101-0000-42404 0 $24.66 $24.66 10/29/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY WENCESLAO RAZO DEBIT R10375 JFU DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE STUCCO APPLICATION, FIRST 500 SF PC 101-0000-42600 0 $73.97 $73.97 10/29/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY WENCESLAO RAZO DEBIT R10375 JFU Total Paid for STUCCO APPLICATION: $98.63 $98.63 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DOOR/WINDOW, REPLACE FIRST 7 101-0000-42400 0 $60.91 $60.91 10/29/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY WENCESLAO RAZO DEBIT R10375 JFU DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DOOR/WINDOW, REPLACE, FIRST 7 PC 101-0000-42600 0 $110.22 $110.22 10/29/15 PAID BY METHOD, RECEIPT # CHECK # CLTD BY WENCESLAO RAZO DEBIT R10375 JFU Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $171.13 $171.13 0 F OZ cF'b OF'!N4'��`' Description: WINDOW, DOOR, AND STUCCO REPLACEMENT ADDITIONAL Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: APPROVED Applied: 10/29/2015 JFU Approved: 10/29/2015 JFU Parcel No: 774254007 Site Address: 54414 AVENIDA MARTINEZ LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA AT VALE LA QUINTA Block: 301 Lot: 12 Issued: UNIT 27 NOTES PUBLIC COUNTER VISIT JAKE FUSON Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT FINANCIAL INFORMATION Printed: Thursday, October 29, 2015 3:14:40 PM 1 of 2 RWSYS7EMS ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES PUBLIC COUNTER VISIT JAKE FUSON 10/29/2015 10/29/2015 APPLICANT CAME TO COUNTER TO PULL REMODEL PERMIT FOR THE INSTALLATION OF (1) WINDOW, (1) FRENCH DOOR, AND 35 LF OF STUCCO. CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT WENCESLAO RAZO 92253 CONTRACTOR WENCESLAO RAZO 92253 OWNER WENCESLAO RAZO 92253 FINANCIAL INFORMATION Printed: Thursday, October 29, 2015 3:14:40 PM 1 of 2 RWSYS7EMS Printed: Thursday, October 29, 2015 3:14:40 PM 2 of 2 CI?W SYSTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS 561473 FEE 1 101-0000-20306 0 $1.00 $1.00 10/29/15 R1037S DEBIT WENCESLAO RAZO I JFU Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.50 10/29/15 R10375 DEBIT WENCESLAO RAZO JFU Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 $0.50 STUCCO APPLICATION, 101-0000-42404 0 $24.66 $24.66 10/29/15 R10375 DEBIT WENCESLAO RAZO JFU FIRST 500 SF STUCCO APPLICATION, 101-0000-42600 0 $73.97 $73.97 10/29/15 R10375 DEBIT WENCESLAO RAZO JFU FIRST 500 SF PC Total Paid for STUCCO APPLICATION: $98.63 $98.63 DOOR/WINDOW, 101-0000-42400 0 $60.91 $60.91 • 10/29/15 R10375 DEBIT WENCESLAO RAZO JFU REPLACE FIRST 7 DOOR/WINDOW, 101-0000-42600 0 $110.22 $110.22 10/29/15 R10375 DEBIT WENCESLAO RAZO JFU REPLACE, FIRST 7 PC Total Paid for WINDOW/SLIDING GLASS $171.13 $171.13 DOOR/FENESTRATION: TOTALS: $271.26 $271.26 Printed: Thursday, October 29, 2015 3:14:40 PM 2 of 2 CI?W SYSTEMS Iain # City of La Quinta ' Building tai: Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 0\ �S� Project Address: Aja- � e Z Owrier's Name: W-e—A R Z- U A. P. Number: Address: Sq .4.,t 1 Legal Description: City, ST, Zip: . 2 &,4 92ZS-5 Contract r o. T ele hone: z P SO % 7� c� Address: Project Description: City, ST, Zip: FC171 v Vcs W-dtJ S G G G Telephone: c�1 c L State Lie. # : City Lie. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: n TYPe: Construction State Lie. Project cthP (circlecle one) New Ad d'n Alter Repairair Demo Name of Contact Person:ic � Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 6 0-- 27.E J 7C) 15 1 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE It Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount"' Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subeontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval Plans resubmitted Grading IN ROUSE:- 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 Aiv &*j D4' �� vj ' 4 'nd or Cejfv�IL.�IC�l.11IV A BUiLDI qG & SAFETY DET. V ; FOR CONSTRUCTION pA � Iyq � --BYI � 111 l�pr �{ IdI1►�1 I cu. dove Tv��o PIT --"to I