BRES2016-0181Applicant:
JOE VENUTTI
P.O. BOX 5098
LA QUINTA, CA 92253
D -A-. 0 -
A.0-
AUG 1 1 2016
CITY OF U; QUINTA
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 7000) 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
4(SF4,
owner of the property, or my employees with wages as their sole
tion, will do the work, and the structure is not intended or offered for sale.
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
wi hin one year of completion, the owner -builder will have the burden of proving that
or a did not build or improve for the purpose of sale.).
as owner of the property, am exclusively contracting with licensed contractors
to c truct 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
t C tractors' State License Law.).
exempt under Sec. r this reason
Date- !/— Own(,. . r
CONSTRUCTION LENDING AGENC
I hereby affirm under penalty of perjury that there is a constr coon lending agen
the performance of the work for -which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/11/2016
Owner:
HELMA C BLOOMBERG
80424 PEBBLE BEACH
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
80424 PEBBLE BEACH
- ..,'LA QUINTA, CA 92253•.:•.
(310)858-1559
Llc. 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: _ 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 15 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 kertify that I have read this application and state that the above information istorrect.
a ree to comply with all city and county ordina sand state laws relating to building
Zco
struction, and hereby authorize rel to s of this city to ente Pon the
ove-mentioned property for inspe ion pu ses.
Date: �� Signature ( Ij
i
aIw
78-495 CALLE TAMPICO
LA QUI NTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BRES2016-0181
Property Address:
80424 PEBBLE BEACH
APN:
775131058
Application Description:
HELMA C BLOOMBERG / REMODEL
Property Zoning:
Application Valuation:
$4,800.00
Applicant:
JOE VENUTTI
P.O. BOX 5098
LA QUINTA, CA 92253
D -A-. 0 -
A.0-
AUG 1 1 2016
CITY OF U; QUINTA
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 7000) 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
4(SF4,
owner of the property, or my employees with wages as their sole
tion, will do the work, and the structure is not intended or offered for sale.
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
wi hin one year of completion, the owner -builder will have the burden of proving that
or a did not build or improve for the purpose of sale.).
as owner of the property, am exclusively contracting with licensed contractors
to c truct 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
t C tractors' State License Law.).
exempt under Sec. r this reason
Date- !/— Own(,. . r
CONSTRUCTION LENDING AGENC
I hereby affirm under penalty of perjury that there is a constr coon lending agen
the performance of the work for -which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/11/2016
Owner:
HELMA C BLOOMBERG
80424 PEBBLE BEACH
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
80424 PEBBLE BEACH
- ..,'LA QUINTA, CA 92253•.:•.
(310)858-1559
Llc. 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: _ 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 15 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 kertify that I have read this application and state that the above information istorrect.
a ree to comply with all city and county ordina sand state laws relating to building
Zco
struction, and hereby authorize rel to s of this city to ente Pon the
ove-mentioned property for inspe ion pu ses.
Date: �� Signature ( Ij
i
Date: 8/11/2016 .
Application Number:
BRES2016-0181
Owner:.
Property Address:
80424 PEBBLE BEACH
HELMA"C BLOOMBERG
APN:
775131058
80424 PEBBLE BEACH
Application Description:
HELMA C BLOOMBERG / REMODEL
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:" '
$4,800.00
Applicant:
Contractor:
JOE VENUTTI
OWNER BUILDER
P.O. BOX 5098
80424'PEBBLE BEACH
LA QUINTA, CA 92253
LA QUINTA, CA 92253
(310)858-1559 `
-----------------------------------------------=---------------------------------------------
LIC. No.:
". Detail: I*NTERIOR REMODEL
TO EXISTING 2,825 -SF DWELLING. NEW DOOR
OPENINGS AT MASTER BEDROOM & BEDROOM #2. NEW OPENING BETWEEN'
KITCHEN LIVING ROOM. REMODEL ARCHWAY AT LIVING & DINING AREA.
ELECTRICAL, MECHANICAL AND PLUMBING WORK NOT A PART OF THIS PERMIT.
2013 CODES •
c
.0
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: . $171.13
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT . CITY AMOUNT
HOURLY CHARGE - CITY BUILDING STAFF 101-0000-42600 1 $145.00
DESCRIPTION ACCOUNT CITY AMOUNT
HOURLY CHARGE - ESGIL PLANS EXAMINER 101-0000-42600 2 $180.00 '
Total Paid for BLDG CITY STAFF - PER HOUR: $325:00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:. $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
Credit Card Fee
101-0000-43505
0
$10.95
Total Paid for Credit Card Feer `' $10.95 '
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.62
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.62
DESCRIPTION
ACCOUNT
CITY
AMOUNT .
DOOR/WINDOW, REPLACE FIRST 7
101-0000-42400
0
$60.91
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DOOR/WINDOW,.REPLACE, FIRST PC
101-0000-42600.
0
$110.22'
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: . $171.13