BOTH2014-001478-495 CALLE TAMPICO '
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
DBCA INC
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
BOTH2O14-0014
81540 BAFFIN AVE
767710036
STEEL TRELLIS 17,000 SQ FT
$14,000.00
D Q 0
LDECI8 1O14
CITY OF LA OUI61TA
COMMUNITY DEVELOPM6DcPARWENT
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.: :LIC -0104804
y pate: D Contractor 7
OWNER -BUILDER DECLARATIO
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 Name:
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/18/2014
Owner:
JAMES LIPPMAN
317 N ROCKINGHAM
LOS ANGELES, CA 0
Contractor:
DBCA INC
000TSIDE CITY LIMITS
LA QUINTA, CA 92253
(760)393-5270
Llc. No.: :LIC -0104804
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/prrovissions.
ba
te: A�11e l Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIONL@VERAGE 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 a above-
mentioned property for inspection purposes.
c
Date: Signature (Applicant or Agen
FINANCIAL INFORMATION
y D6�CRIPTION -a' �' *�» X ': ACCOUNT �jr'.-� �QTY t AMOUNT �' ' PAID • PAIDIDATE
BSAS SB1473 FEE
101-0000-20306 0
$1.00 $0.00
s•:� ,^
PAID BY, '
METHOD "` t RECEIPT;# r '; CHECK # CLTD BY;
Total Paid forBUILDING STANDARDS ADMINISTRATION BSP $1.00 $0.00
DESCRIPTION .a:
_ 'µACCOUNT,- r
QTY
-AMOUNT} -
PAID
PAID, DATE
PATIO COVER, DESIGNED
101-0000-42404
0
$133.43
$0.00
PAID, BY
r ;:METHOD''
RECEIPT#
CHECK #
CLTD,BY..`
s{'-D.ESCRIPTION?, ., ' a ; X
.. r
<,; , :A000UNT R%.,"'
'.QTY
AMOUNT `.',= t
"i PAID' —
PAID DATE
PATIO COVER, DESIGNED PC
101-0000-42600
0
$168.24
$0.00
PAID 'BY ,z,'. y u i,1 p Y
;, �° ` `• METHOD
_-: RECEIPT #
CHECK# ,
CLTD BYt ".
Total Paid forPATIO COVER / COVERED PORCH / LATTICE $301.67 $0.00
1' DESCRIPTION':')
ACCOUNT ' r -
:QTY
AMOUNT"s
, " PAID Y _4
PAID DATE
SMI - RESIDENTIAL
101-0000-20308
0
$1.82
$0.00
;i PAID BY
METHOD
RECEIPT # _
*CHECK # •
CL -TD BY
Total Paid forSTRONG MOTION INSTRUMENTATION SMI $1.82 $0.00
TOTALS:$304.49 00
11
SII
11
Description: STEEL TRELLIS 17,000 SQ FT.
Type: PATIO COVER
Subtype:
Status: APPROVED
Applied: 11/20/2014 PJU
Approved: 12/16/2014 JJO
Parcel No: 767710036 Site Address: 81540 BAFFIN AVE LA QUINTA,CA 92253
Subdivision: PM 36300
Block: Lot: 2
Issued:
Lot Scl Ft: 0
Building Scl Ft: 0
Zoning:
Finaled:
Valuation: $14,000.00
Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0
No. Unites: 0
11/20/2014
Details: 8'X 32' STEEL TRELLIS PER ENGINEERED PLANS. 256 SQ. FT.
TELEPHONE CALL
JIM JOHNSON
12/16/2014
r
CALLED RICK MILLER THAT PLANS ARE READY TO ISSUE
-Process-Summary
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Printed: Thursday, December 18, 2014 4:31:09 PM 1 of 2 An AV
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ADDITIONAL D
CHRONOLOGY
F, CHRONOLOGY TYPE. '`t
w:STAFF,NAME
'" ' ACTIOMDATE
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COMPLETION'DATE
�, —.-NOTES
PLAN CHECK SUBMITTAL
RECEIVED
PHILIP JUAREZ
11/20/2014
11/20/2014
PLAN CHECK RECIEVED JIM SAID DO NOT SEND OUT IN
HOUSE. PUT ON CASE DESK FOR PROCESSING.
TELEPHONE CALL
JIM JOHNSON
12/16/2014
12/16/2014
CALLED RICK MILLER THAT PLANS ARE READY TO ISSUE
CONDITIONS
CONTACTS
a` NAME•TYPE �U
r, t _
77
NAME ADDRESSI -
-
CITY
STATE ,
ZIP ,PHONE , ``-� 'FAX ; EMAIL
APPLICANT
DBCA INC
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
CONTRACTOR
DBCA INC
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
OWNER
JAMES LIPPMAN
317 N ROCKINGHAM
LOS ANGELES
CA
0
Printed: Thursday, December 18, 2014 4:31:09 PM 1 of 2 An AV
CR.
SYSTEMS