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BRES2016-0075LICENSED 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: B License No.: 820801 Pate: Z / 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, 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 Lender's (760)57&7757 Llc. No.: 320801 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a=ertificate of consent to self -insure for workers' co pensat,on, as provided for by Section 3700 of the Labor Code, for the performance of ork for which this permit is isaued. I have and will maintain _kers' compensation insurance, as required by S ct, n 3700 of the Labor Code, for tF`e performance of the work for which this permit is , ed. My workers' cornpensat,on,,nsurance carrier and policy number are: Carrier: EVEREST NATIONAL INSURANCE COMPANY Policy Number: 7600013192 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 w' h tho a provisions. Date: ( (� Applicait:~' WARNING: FAILURE TO SECURE WORk_ERS' C PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 0100,000). 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 fort.i on this application. 1. Each person upon whose behalf tF•is 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 harm,ess the City of La Quinta, its officers, agents, and employees for any act or omission rela-ed to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of th6 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 tc cancellation. I certify that I have read this applicatior and state that the above information is correct. I agree to comply with all city and courty ordinances and state.laws relating to building construction, and hereby authorize representatives of this city to enter upon the above-merf,one4property for inspection purposes. r l Date: / � / � Signature (Applicant or Agent): 78-495 CALLE TAMPICO """r'� 4 � VOICE (760) 777-7125! FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 DESIGN &DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 1/13/20171 Application Number: BRES2016-0075 Owner: Property Address: 81315 ANDALUSIA ROBERT MCLEAN APN: 764620023 Application Description. MCCLEAN / POOL BATH ADDITION 92253 w m Property Zoning: R Application Valuation: $40,000.00 o Applicant: Contractor: Q ; JORGE GARCIA SANTUCCI BUILDERS INC Q U 45175 PANORAMA DR STE E 72529 BEAVERTAIL STREET PALM DESERT, CA 92260 PALM DESERT, CA 92260 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: B License No.: 820801 Pate: Z / 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, 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 Lender's (760)57&7757 Llc. No.: 320801 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a=ertificate of consent to self -insure for workers' co pensat,on, as provided for by Section 3700 of the Labor Code, for the performance of ork for which this permit is isaued. I have and will maintain _kers' compensation insurance, as required by S ct, n 3700 of the Labor Code, for tF`e performance of the work for which this permit is , ed. My workers' cornpensat,on,,nsurance carrier and policy number are: Carrier: EVEREST NATIONAL INSURANCE COMPANY Policy Number: 7600013192 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 w' h tho a provisions. Date: ( (� Applicait:~' WARNING: FAILURE TO SECURE WORk_ERS' C PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 0100,000). 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 fort.i on this application. 1. Each person upon whose behalf tF•is 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 harm,ess the City of La Quinta, its officers, agents, and employees for any act or omission rela-ed to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of th6 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 tc cancellation. I certify that I have read this applicatior and state that the above information is correct. I agree to comply with all city and courty ordinances and state.laws relating to building construction, and hereby authorize representatives of this city to enter upon the above-merf,one4property for inspection purposes. r l Date: / � / � Signature (Applicant or Agent): �,. Date: 1/13/2017 Application Number. BRES2016-0075 Owner: Property Address: 81315 ANDALUSIA ROBER— MCLEAN APN: 764620023. Application Description: MCCLEAN / POOL BATH ADDITION 92253 Property Zoning: Application Valuation: $40,000.00 Applicant: Contractor:- ontractorsJORGE JORGEGARCIA SANTUCCI BUILDERS INC 45175 PANORAMA DR STE E 72529 BEAVERTAIL STREET PALM DESERT, CA 92260 PALM DESERT; CA 92260 a (760)57x.3-7757. Llc. No.: 820801 • p -------------------------------(------------------ ----------------------------------------- Detail:'UNCONDITIONED POOL BATH ADDITION 56 SQ. FT. WITH OUTDOOR SHOWER: PER 2013 CRC CODES. FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, FIRST 100 SF 101-0000-42400 0 $120.83 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, FIRST 100 SF PC • 101-0000-42600 0 $171.14 Total Paid for ADDITION: $291.97 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY PLAN CHECK - YES 101-0000-42600 1.5 $105.00 Total Paid for BLDG CITY STAFF - PER HOUR: $105.00 DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $2.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $145.03 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $47.86 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $192.89 DESCRIPTION .ACCOUNT QTY AMOUNT VENT FAN 101-0000-42402 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN PC 101-0000-42600 0 $4.83 Total Paid for MECHANICAL: .$16.92 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $36.27 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP PC. 101-0000-42600 .0 $36.27 DESCRIPTION ACCOUNT QTY AMOUNT 'WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.09 . Total Paid for PLUMBING FEES: $96.72 DESCRIPTION ACCOUNTQTY AMOUNT SMI - RESIDENTIAL 101-0000-20308. 0 $5.20 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $5.20 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 Bin # City of La Quinta Building &r Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 C 4 Building Permit Application and Tracking Sheet Project Address: #315 AgDALVIIA DR Owner's Name: F106GIT Rb wN m �" A. P. Number: ^V. (40. . (523 Address: E5(l5 Legal Description: �.i Contractor: xi u I 21601 f1 l CC ��l City, ST, Zip: ZZ53 T Telephone: • , :•: Y Address: J2-5a_MqL:V-Tfq1, ST.Project Description: City, ST, Zip: C. Telephone:C €' i.,•::; <' .................:... State Lie. # Cite Lie. #; Arch., Engr., Desiener: Address: 4,srls DR City, ST, Zip: q224 )0 Telephone: E Construction Type: Occupancy: u State Lie. Project type (circle one): New 6DAltcr Repair Demo Name of Contact Person: C fl. Sq. Ft.: 5 'fp # Stories: # Units: --� Telephone # of Contact Person: Estimated Value of Project: Go 0 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. 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. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''d 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 '�—\-i YOUNG ENGINEERING ". P' CA r 2211 PVa .r r .r =.ail Jnf0@zVa1Uengr'WM web www.valuengr.com Letter of Transmittal To: City of La Quinta Today's Date: 3-31-16 78-495 Calle Tampico City Due Date: 4-1-16 La Quinta, CA 92253 Project Address: 81-315 Andalusia Attn: Ramses Sevilla Plan Check #: BRES2016-0075 Submittal: ® 1st ❑ 4th ❑ 2nd ❑ 5th ❑ 3rd ❑ Other: We are forwarding: ® By Messenger ❑ By Mail (Fed Ex or UPS) ❑ Your Pickup Includes: Descriptions: Includes: # Of Descriptions: Copies: ® 1 Structural Plans ❑ Revised Struct. Plans ® 2 Structural Calculations ❑ Revised Struct. Calcs ❑ Truss Calcs ❑ Revised Truss Calcs ❑ Soils Report Update ❑ Revised Soils Report ❑ Structural P/C Comments ❑ Approved Structural Plans ❑ Redlined Structural Plans ❑ Approved Structural Calcs ❑ Redlined Structural Calcs ❑ Approved Truss Calcs ❑ Redlined Truss Calcs ❑ Approved Soils Report ❑ Redlined Soils Reports ® 1 Other: Plans — Assesors Copy Comments: Structural content is approvable. Structural Plan Review Time = 1.5 HR This Material Sent for: ❑ Your Files ❑ Your Review ❑ Checking Other: ❑ By: John W. Thompson Office: ® (760) 772-5107 Other: ❑ ® Per Your Request ❑ Approval ❑ At the request of: