BELC2017-0048.,,
78-495 CALLE TAMPICO 4
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BELC2017-0048
Property Address:
81771 BAFFIN AVE
APN:
767700042
Application Description:
DOAN / TEMPORARY POWER LOT 119
Property Zoning:
Application Valuation:
$800.00
Applicant:
RICHARD DOAN CONSTRUCTION
PO BOX 8011,
RANCHO SANTA FE, CA 92067
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.: 374118
Date: C .tor: ` v- •
10 r
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.).
( 11, 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 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 Addre!
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/17/2017
Owner:
RICHARD DOAN '
POBOX 8011
RANCHO SANTA FE, CA 92067
Contractor:
RICHARD DOAN CONSTRUCTION
P0BOX 8011
RANCHGSANTA FE, CA 92067
(858)756-4930
Llc. No.: 374118
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
Monrk for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
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: 1908709
_ 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.
ze�(�
Da .cant:
r 1
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 bove---,,.
mentioned rop ty for inspection purposes.
Signature (Applicant or Agent):
Date: 5/17/2017
Application Number: BELC2017-0048
Owner:
Property Address: 81771 BAFFIN AVE
RICHARD DOAN
APN: 767700042
POBOX 8011
Application Description: DOAN /TEMPORARY POWER LOT 119
RANCHO SANTA FE, CA 92067
Property Zoning:
Application Valuation: $800.00
Applicant:
Contractor:
RICHARD DOAN CONSTRUCTION
RICHARD DOAN CONSTRUCTION
P0BOX 8011
PO, BOX 8011
RANCHO SANTA FE, CA 92067
RANCHO SANTA FE; CA 92067
(858)756-4930
---------------------------------------------7----------------------------------------------
LIc. No.: 374118
Detail: TEMPORARY SERVICE FOR LOT 119. NO TEMPORARY TRAILERS ALLOWED WITHOUT PROPER APPROVAL. PER 2016 CALIFONRIA ELECTRICAL CODE
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
CITY
1
AMOUNT
Credit Card Fee
101-0000-43505
0
$2.62
-Total Paid for Credit Card Fee: $2.62
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TEMP POWER SERVICE
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TEMP POWER SERVICE PC
101-0000-42600
0
$17.73
Total Paid for ELECTRICAL: $43.06
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
U I ALJ: j141.95
Bin /! ..
City of La Quinta
Building 8t Safety Division
Permit„
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
—ProAddress:! 7 ?
Name:
�Ow cr's
A. P. Number:
/Address: Q
Legal Desp '
City, ST, Zip:
Contractor.
_ �.
ele Phon'
c.
Aress:
P ject Description: .
City; ST, Zip:Ld
T r
ele h 0
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State Ltc. # :
City Lie.;Lf�
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Arch., Cngr., Designer:
Address:
City, ST, Zip: .
Tele hon e:
Con tructt n Type: Occupancy:
an cY
State te Lic.
Project type (circle one): New Add'n Alter Repair De m 0
i ��
l Name of Contact Person:
Sq. Ft.:
# Ybries:
# Units:
Telephone # of Contact Person:
f
' Dst mated Value of Proje 0
APPLICANT: DO NOT WRITE BELOW THIS LIN
N
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction '
Flood plain plan'
Plans resubmitted
Mechanical
Grading plan
2"" Review, 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:-
Review, ready for corrections/issue
Developer Impact Pee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. \Vks. APPr
Date of permit issue
School Fees,
1
Total Permit Fees
r-
81-771 SAF -FI PJAV E
1