BRES2017-016078-495 CALLE TAMPICO D VOICE (760) 777-7125
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Application Number: BRES2017-0160 Owner:
Property Address: 61210 CACTUS SPRING DR GERALD PETERSON
APN: 764510007 61210 CACTUS SPRING DR
Application Description: PETERSON / FIRE DAMAGE REPAIR AT GARAGE Q +14TA, CA 92253
Property Zoning:
Application Valuation: $20,000.00
Applicant: JUL 1 $ 2017Yo . - c r:
LEY DREW INC L EW INC
981 W ARROW HWY STE 156 981 W ARROW HWY #156
SAN DIMAS, CA 91773 QUINTA
CITY Ur lA CA 91773
DESIGN AND DEVELOPMENT DO (909)538-2938
LIC. No.: 888598
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: Bo, License No.: 88859
Date: / Ir�y 7 ,..Contra or:
OWNER -BUILD DECLARATION
I.hereby affirm under penalty of perjury that 1 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 thel
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 Address:
Date: 7/19/2017
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: EXEMPT 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 spmect to the
workers' compensation provisions of Section 3700 o Labe, I shall forthwith
comply with those provisions.
Die: ��- *Applicant:
WARNING: FAILURE TO SECURE WORKE COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO RIMINAL 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 elating building
construction, and hereby authorize representatives of this ci �o er e
above-mentioned property for inspection purposes.
Matti_ Signature.(Applicant orAgen11 t)
i
Application Number: BRES2017-0160
Property Address:
61210 CACTUS SPRING DR
APN:
764510007
Applicatiod Description:
PETERSON / FIRE DAMAGE REPAIR AT GARAGE
Property Zoning:
Application Valuation:
$2QOOb.00
Owner:
GERALD PETERSON
61210 CACTUS SPRING DR
LA QUINTA, CA 92253 .
Date: 7/19/2017
Applicant: Contractor:
LEY DREW INC LEY - DREW INC
981 W ARROW HWY STE 156 981 W ARROW HWY #1156
SAN DIMAS, CA 91773 SAN DIMAS, CA 91773
(909)538-2938
Llc. No.: 888598
----------------------------- ---------------------------------------------------------------
Detail: FIRE DAMAGE REPAIR AT GARAGE. APPLY TRUSS FIX PER ENGINEERED DESIGN. REMOVE AND REPLACE ALL DRYWALL AT GARAGE, REPLACE SUB -
PANEL AND OTHER MISCELLANEUOS AFFECTED CIRCUIT WIRING. THIS PERMIT DOES)NOT INCLUDE ALTERATIONS TO AREAS OTHER THAN THE GARAGE.
2016 BUILDING CODES.
FINANCIAL
DESCRIPTION, ACCOUNT QTY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SERVICES
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SERVICES PC
101-0000-42600
0
$12.67
Total Paid for ELECTRICAL: $38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$22.80
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0.
$18.24
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 100 SF
101-0000-42400
0
$51.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 500 SF PC
101-0000=42600
0
$141.36
Total Paid for REMODEL: $234.08
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI- RESIDENTIAL
101-0000-20308
0
$2.60
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $2.60
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Bin #
City of Ld Quihta ..
Building &' Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 -•-(760) 777-7012
Building°PermitApplication and Tracking Sheet
Permit #(��
Project Address:D Je, It._ rim" D��
Owner's Name:'
A. P. Number:
Address: j GEc GTC� 1 %tet �l
Legal Description:
City, ST, Zip: -
G�.�a�53
Contractor:])YA66LI 4n
Telephone:
Address: $ % !.f/ r� W �� z
Project Description: / /-•e
City, ST, Zip: 17
P AA -
Telephone: a°13
q 3
State Lic. # :
GityLic. #;
i �Q
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: ><
State Lic. #:
Construction cion TY e: Occupancy:
P c7:
YPe circle one): New Add'n Alter Repair Demo
Name of Contact Person:10 e �, ��h
Sq. Ft:
# Stories,�:
# Units:
Telephone # of Contact Person: (`f - �j _
Estimated Value of Project: V � Q o
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'.d
TRACKING
PERMIT FEES
Plan Sets
Pian 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.
H.O.A.-Approval
Plans resubmitted
Grading
IN HOUSE:-.
'"' 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
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