BPAT2017-0028.b`+ tP .N
78-495 CALLE TAMPICO D 0"Kro
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/24/2017
Application Number: BPAT2017-0028 Owner:
Property Address: 51425 MADISON ST PAUL TOLLETT
APN: 777030004 51425 MADISON ST
Application Description: TOLLETT RESIDENCE / PATIO COVER LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $25,000.00
Applicant:Contractor:
BRADSHAW CONSTRUCTION INC D BRADSHAW CONSTRUCTION INC
46-248 ROUDEL LANE 46-248.ROUDEL LANE
LA QUINTA, CA 92253 APR 2 4 2011 LA QUINTA, CA 92253
CITY OF LA QUINTA (760)347-4246
DESIGN AND DEVELOPMENT DEPARTMENT Llc. No.: 848057
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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: BPJ License No.: 848057
%Date: ZT /7,Conte d it
OWNER -BUILDER DECLARATION
1 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 Na
Lender's Address:
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
oft or which this permit is issued.
t T -have and will maintain workers' compensation insurance, as required by
Se 700 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: STATE COMPENSATION INSURANCE FUND Policy Number: 9043902
_ 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.
i /
Date:,4 Applicant: _A0
WARNING:
r
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 t e above-
mentioned property for inspection purposes.
Date: 4W" Signature (Applicant or Agent).
Date: 4/24/2017
Application Number: BPAT2017-0028
Owner:
Property Address: 51425 MADISON ST
PAUL TOLLETT
APN: 777030004
51425 MADISON ST
Application Description: TOLLETT RESIDENCE / PATIO COVER
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $25,000.00
Applicant:
Contractor:
BRADSHAW CONSTRUCTION INC
BRADSHAW CONSTRUCTION INC
46-248 ROUDEL LANE
46-248 ROUDEL LANE
LA QUINTA, CA 92253
LA QUINTA, CA 92253
(760)347-4246
Llc. No.: 848057
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Detail:'544 SF FREE STANDING OPEN LATTICE PATIO COVER AT FRONT YARD [SPECIAL ENGINEERING] THIS PERMIT DOES NOT INCLUDE ELECTRICAL
INSTALLATIONS. 2016 CALIFORNIA BUILDING CODES.
el
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 • $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
Credit Card Fee
101-0000-43505
0
$5.86
Total Paid for Credit Card Fee: $5.86
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PATIO COVER, DESIGNED
101-0000-42404
0
$139.84
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PATIO COVER, DESIGNED PC
101-0000-42600
0
$176.32
Total Paid for PATIO COVER / COVERED PORCH / LATTICE: $316.16
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$3.25
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $3.25
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Bin #
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Project Address: 51L
City of D Q'UhAa
Building 8£ Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701.2
Building Permit Application and Tracking Sheet
Owner's Name: &1A, T
so
A. P. Number:
Address: '
Legal Description: O
City, ST, Zip:
Te ]eP hoot: minim
r
Contact r•
o .
a
Address: 714
`
Project Description:7 lye
City, ST,Zip:
Telephone:
3 2
State Lic. # : L{ 90-6 7
City Lic.
Arch., Engr., Designer: I A. '
Address:
City, ST, Zip: r- 4
Telephone: ne:
Z I l
Constructiontraction Type: n ecu an cY:
D rO
a ,.
t �c. # _
State L
r Demo
Project type circle one),, New Add'n Alter Repair.ai o
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
q p �� CD�yI
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
tl Submittal Req'd Rcc'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Clicck Deposit
Truss Calcs.
Called Contact Person
Plan Check Bala ice.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" Revicw, 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:-
'"' Revicw, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
I'ub. Wks. Appr
Date of permit issue
School Fees,
Total Permit Fars
10
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' Letter 'of Transmittal,
' To City of La Quintal ,' Today's Date 4-18716
78-495 Calle Tampico _ City'Due Date: 4-18;16
La Quinta, CA 92253
t= .::Project Address:
y Attn:'Plan Check #:•,; BPAT-2017-0028'
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'Submittal: ®, 1st - ❑° 4!h r -
k ; ❑'. 2nd ,.❑ 5th zi _
3rd ❑ Other:
We are forwarding: ®� . By Messenger ❑ By Mail (Fed Ex or UPS) ❑ " Your Pickup '
•
Includes: Descriptions:'- - �'` i `'Includes. # Of Descriptions: '
Copies:
1 `` *;'Structural Plans " ❑ . rr Revised Struct.'Plans
® ,• 1 Structural Calculations - ❑ - Revised Struct. Calcs
77 Y- -
❑ Truss Calcs- , ❑ .� . Revised Truss Calcs
❑ , Soils Report = Update .. , ❑F - - Revised Soils Report
❑ '.. " Structural P/C Responses '' ❑`., Approved Structural Plans
•
/Comments :, s �,: �• `.' ..
El Structural Plans El.�, Approved Structural Calcs
. ❑ Redlined Structural Calcs-El , Approved Truss Calcs
❑ Redlined Truss Calcs-. -❑ Approved Soils Report
- - ❑ Redlined Soils Reports;' ❑ �' , Other:
Comments: STRUCTURAL APPROVABLE CONDITIONALLY- WITH: ,1. UPDATED CALCS-2 SIGNED PLANS &
CALCS-COLLATED PLANS BY ENGINEER OF RECORD
Transit Per' Diem= v. `
Admin Time '- .25 HR
A•
Structu"raI Engineer/Principal Review Time = 1 HR.
* ' Plan?Review Engineer Time - HR
•This Material ,Sent • for.
❑ . Your Files®«!'Per Your Request
EJYour Review ' r ❑ 'Approval • ! '
❑ Checking.. Y, A aYjEl At the reAa t `
Other: ❑ , . { F s ,; 1
r �•:J ` �.
By: Bronz Young A_.. OR 9 2
+ �. X► r Office : ® (760) 772-5107. ciry p
Other : ® LQPC@a VALUENGR_COM =, MM(/njI r 4 QUI
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