BRES2018-0075LICENSED 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.:
Date:y Contr�actgy :
OWNER -BUILDER XLRATION
1 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).:
(_J 1, 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. BAP.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
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' ompensation 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 ofrthe 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 tLat, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: Appli ac nt:
WARNING: FAILURE TO SECURE WORKERS' CO PENSATION COVERAGE 15 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 FCR IN SECTION 3706.OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to t, -ie 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, andthe 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 Cie 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 cancellation.
I certify that I have read this application and s•:ate 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 the above-
mentioned roperty for inspection purposes.
D- a't� 2"� . f5igna��L�ce,(Applicant or Agent
G,
Ud
VOICE (760) 777-7125
78
FAX (76 0) 777-7011 .
LA QUINTA, CALIFORNIA
92253 DESIGN & DEVELOPMENT DEPARTMENT
.
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/23/2018
Permit Type/Subtype:
BUILDING RESIDENTIAL/REMODEL
Owner:
Application Number:
BRES2018-0075
ALEX TORRES
Property Address:
52475 AVENIDA CARRANZA
Application Description:
TORRES/127SF RESIDENTIAL REMODEL/VB/RES-3/
Property Zoning:
Application Valuation:
$30,000.00
Applicant:
D LrZ1 a
Contractor:
ALEX TORRES
OWNER BUILDER
42669 LA DANZA CT
MAR 2 3 208
INDIO; CA 92203
CITY OFLA QUINTA
COMMUNITYOEVELOPMENTOEPARTMEOT
LIc. No.:
J
------------------------------------------------------------------------------------'---------
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.:
Date:y Contr�actgy :
OWNER -BUILDER XLRATION
1 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).:
(_J 1, 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. BAP.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
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' ompensation 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 ofrthe 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 tLat, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: Appli ac nt:
WARNING: FAILURE TO SECURE WORKERS' CO PENSATION COVERAGE 15 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 FCR IN SECTION 3706.OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to t, -ie 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, andthe 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 Cie 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 cancellation.
I certify that I have read this application and s•:ate 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 the above-
mentioned roperty for inspection purposes.
D- a't� 2"� . f5igna��L�ce,(Applicant or Agent
G,
'
Date: 3/23/2018
Application Number:
BRES2018-0075
Owner:
Property Address:
52475 AVENIDA CARRANZA
ALEX TORRES
APN:
773285013
Property Zoning:
Application Valuation: '
$30,000.00 .
Applicant:
Contractor:
ALEX TORRES
OWNER BUILDER
42669 LA DANZA CT
INDIO, CA 92203
Llc. No.:
--------------------------------------------------------------------------------------------
Detail: 1.271 SF. FIRE REMODEL FOR AN EXISTING DWEILLING. THIS PERMIT DOES NOT
INCLUDE ANY MODIFICATIOM ALTERATIONS TO EXISTING
. GARAGE,INTERIOR WALLS OR EXTERIOR WALLS. [CONVENTIONAL] 2016 CALIFORNIA
BUILDING CODES.
DESCRIPTION
ACCOUNT QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
$2.00
0
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$2.00
DESCRIPTION
QTY
ACCOUNT
QTY
AMOUNT
TEMP POWER SERVICE
$5.46
101-0000-42403
0
$26.01
DESCRIPTION
RESIDENTIAL, FIRST 1,000SF
ACCOUNT
QTY
AMOUNT
TEMP POWER SERVICE PC
ACCOUNT .
101-0000-42600.
0
$18.20
101-0000-42600
Total Paid for ELECTRICAL:
$44.21
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, EA ADDITION 1,000SF
101-0000-42403
0
$13.26
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, EA ADDITION 1,000SF, PC
101-0000-42600
0
$5.46
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: $226.25
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402
0
$39.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$26.01
DESCRIPTION
ACCOUNT I
QTY
AMOUNT
EXHAUST HOOD
101-0000-42402
0
$13.00
DESCRIPTION
ACCOUNT 1 QTY
AMOUNT
EXHAUST HOOD PC
101-0000-42600 0
$5.20
DESCRIPTION
ACCOUNT QTY
AMOUNT
FURNACE
101-0000-42402 0
$39.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FURNACE PC
101-0000-42600
0
$26.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN
101-0000-42402
0
$26.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN PC
101-0000-42600
0
$10.40
Total Paid for MECHANICAL: $184.64
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PLAN CHECK DEPOSIT - ADDITION/REMODEL
101-0000-42600
1
$125.00
Total Paid for PLAN CHECK DEPOSIT-ADDITION/REMODEL: $125.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$91.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT