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