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BRES2017-0301LICENSED 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 orce and effect. License Class: icense No.: 762987 Date: I Contract 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).: ( 11, 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.). U 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.�&F fpr t reason Date: 't / / -f // /CLwner: 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 Nan Lender's Add 4 (760)777-1001 Llc. No.: 762987 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certifica-e of consent to self -insure for workers' compensation, as provided for by Section 37CO 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 perfo mance of the work for which this permit is issued. My workers' compensation insuran:e carrier and policy number are: Carrier: REPUBLIC UNDERWRITERS INSURANCE COMPANY Policy Number: I certify that in the performance oll the work for which this permit is issued, I shall not employ any person in any manner sc as to become subject to the workers' compensation laws of California, and agree ti -at, if I should become subject to the workers' compensation provisions of Section .5700 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 CRIMI JAL 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 th s application. 1: Each person upon whose behalf this appl -cation is made, each person at whose request and for whose benefit work is perforned 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 fie work being performed under or following issuance of this permit. 2. Any permit issued as a result of this appli.:ation 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 cancelation. I certify that I have read this application and s -.ate that the above informat' correct. I agree to comply with all city and county ord-jand laws r ting t uildingconstruction, and hereby authorize represent:o er upo heabove-mention prop y for inspection purDate: ,.'nature(Applica 4 � XPa � VOICE (760) 777-7125 78-495 CALLE TAMPICO D FAX (760) 777-7011DESIGN LA QUINTA, CALIFORNIA 92253 & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153. BUILDING PERMIT Date: 11/14/2017 Permit Type/Subtype: BUILDING RESIDENTIAL/DWELLING - SINGLE FAMILY DETACHED Owner: Application Number: BRES2017-0301 T D DESERT DEV Property Address: 81746 ANDALUSIA w` 81570 CARBONERAS ,= APN: 764670004 LA QUINTA, CA C Application Description: ANDALUSIA/ NEW SFD /PLAN 23 CS cu Property Zoning: cp C Application Valuation: $326,905.50 Applicant: J Contractor: / U T D DESERT DEVELOPMENT LIMITED PARTNERSH T D DESERT DEV1LOP-MFNT L -IMI ED PARfTNERSH 81570 CARBONERAS 81570 CARBONEft9AVS�o j LA QUINTA, CA 92253 LA QUINTA, CA 5.2253 Q. 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 orce and effect. License Class: icense No.: 762987 Date: I Contract 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).: ( 11, 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.). U 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.�&F fpr t reason Date: 't / / -f // /CLwner: 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 Nan Lender's Add 4 (760)777-1001 Llc. No.: 762987 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certifica-e of consent to self -insure for workers' compensation, as provided for by Section 37CO 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 perfo mance of the work for which this permit is issued. My workers' compensation insuran:e carrier and policy number are: Carrier: REPUBLIC UNDERWRITERS INSURANCE COMPANY Policy Number: I certify that in the performance oll the work for which this permit is issued, I shall not employ any person in any manner sc as to become subject to the workers' compensation laws of California, and agree ti -at, if I should become subject to the workers' compensation provisions of Section .5700 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 CRIMI JAL 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 th s application. 1: Each person upon whose behalf this appl -cation is made, each person at whose request and for whose benefit work is perforned 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 fie work being performed under or following issuance of this permit. 2. Any permit issued as a result of this appli.:ation 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 cancelation. I certify that I have read this application and s -.ate that the above informat' correct. I agree to comply with all city and county ord-jand laws r ting t uildingconstruction, and hereby authorize represent:o er upo heabove-mention prop y for inspection purDate: ,.'nature(Applica •0 Application Number: BRES2017-0301 Property Address: 81746 ANDALUSIA APN: 764670004 Application Description: ANDALUSIA / NEW SFD / PLAN 23 Property Zoning: Application Valuation: $326,905.50 Applicant: T D DESERT DEVELOPMENT LIMITED PARTNERSH 81570 CARBON ERAS LA QUINTA, CA 92253 Date: 11/14/2017 Owner: T D DESERT DEV 81570 CARBONEFAS LA QU I NTA, CA 0 Contractor: T D DESERT DEVE-OPMENT LIMITED PARTNERSH 81570 CARBONEFAS LA QUINTA, CA 92253 (760)777-1001 LIC. No.: 762987 ------------------------------------------------------'-------------------------------=------- Detail: 3,612 SF DWELLING - PLAN 23 LOT 32 [VB/RES-3/CLASS-A/13D] THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS, BBQ OR WATER FEATURE. PER 2016 CALIFORNIA BUILDING CODES &I. FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $14.00 Total Paid for BUILDING STANDARDS ADMINISTRATIOM BSA: $14.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - CIVIC CENTER 252-0000-43200 0 $942.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF.- COMMUNITY CENTERS 254-0000-43200 0 $129.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - LIBRARIES 253-0000-43200 0 $344.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - PARKS/REC 251-0000-43200 0 $2,048.00 DESCRIPTION ACCOUNT -QTY AMOUNT DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 DESCRIPTION ACCOUNT QTY AMOUNT DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 DESCRIPTION ACCOUNT QTY AMOUNT .RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $53.04 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF, PC 101-0000-42600 0 $21.84 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $156.04 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $51.49 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $282.41 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL PRECISE GRADING -TRACT HOME 101-0000-42408 0 $143.56 Total Paid for GRADING: $143.56 DESCRIPTION ACCOUNT CTY AMOUNT CONDENSER/COMPRESSOR 101-0000-42402 D $195.05 DESCRIPTION ACCOUNT CTY AMOUNT CONDENSER/COMPRESSOR PC 101-0000-42600 $130.05 DESCRIPTION ACCOUNT CITY AMOUNT EXHAUST HOOD 101-0000-42402 ) $13.00 DESCRIPTION ACCOUNT QTY. AMOUNT EXHAUST HOOD PC 101-0000-42600 $5.20 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE 101-0000-42402 0 $195.05 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE PC 101-0000-42600 0 $130.05 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN 101-0000-42402 0 $91.00 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN PC 101-0000-42600 0 $36.40 Total Paid for MECHANICAL: $795.80 DESCRIPTION ACCOUNT QTY AMOUNT MULTI SPECIES RESIDENTIAL 0-8 UNITS - 2017 UPDATE 101-0000-20310 0 $1,245.00 Total Paid for MULTI-SPECIES RESIDENTIAL: $1,245.00 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PERMIT 101-0000-42400 0 $684.45 Total Paid for NEW CONSTRUCTION PERMIT: $684.45 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $1,463.45 Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,463.45 DESCRIPTION ACCOUNT QTY_ AMOUNT BACKFLOW DEVICE 101-0000-42401 0 $13.00 DESCRIPTION ACCOUNT QTY AMOUNT BACKFLOW DEVICE PC 101-0000-42600 0 $5.20 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER 101-0000-42401 0 $26.01 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER PC 101-0000-42600 0 $18.20 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $273.00 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP PC 101-0000-42600 .0 $273.00 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $39.01 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 5+ OUTLETS PC 101-0000-42600 0 $26.01 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $26.00 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 • $15.60 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $13.00 DESCRIPTION ACCOUNT QTY AMOUNT V WATER'SYShM INST/ALT/REP PC 101-0000-42600 0 $13.00 ' Total Paid for PLUMBING FEES: $741.03 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $42.50 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $42.50 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 DESCRIPTION ACCOUNT QTY AMOUNT SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 Total Paid for TUMF - RESIDENTIAL: $1,837.44 TOTALS: $14,148.64 l