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BRES2017-01043t-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRES2017-0104 Property Address: 55837 CONGRESSIONAL APN: 775241050 Application Description: RADLOFF RESIDENCE / INTERIOR REMODEL Property Zoning: Application Valuation: $5,000.00 Applicant: SOUTHWEST CONCEPTS 78115 CALLE ESTADO STE 105 LA QUINTA, CA 92253 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 icense No.: 1001901 Dat" e� � O� � 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).: J_) 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 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: RADLOFF 55837 CONGRESSIONAL LA QUNTA, CA 92253 Contractor: DONLEY VAN MALSEN 49578 AVILA DR LA QUINTA, CA 92253 (760)578-3889 Llc. No.: 1001901 Dater 6/19/2017 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1 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 ofk for which this permit is issued. ' W1 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 polity number are: Carrier: VEMPT Policy Number: _ �f0certify 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, ')shoId becomesubject to the workers' compensation provisions c Section 3 Labor Code, I shall forthwit comply with those provisions. 9 Dates e4Z�6 f Applican" L - VIZ," 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 la elating to building construction, and hereby authorize representatives of this city t ent u th above-mentioned property for inspection purposes. Dat�_ Signature (Applicant or Agenf)_ Date: 6/19/2017 `.i C'/ Application Number: BRES2017-0104 Owner: Property Address: 55837 CONGRESSIONAL RADLOFF ' F} ESPN: 775241050 ( 55837 CONGRESSIONAL ii�plication Description: RADLOFF RESIDENCE / INTERIOR REMODEL LA QUNTA, CA 92253 Property Zoning: Application Valuation: $5,000.00 Applicant: Contractor: . SOUTHWEST CONCEPTS DONLEY VAN MALSEN 78115 CALLE ESTADO STE 105 49578 AVILA DR LA QUINTA, CA 92253 LA QUINTA, CA 92253 (760)578-3889 ---------------------------------------------------------------------------------------------- Llc. No.: 1001901 Detail: INTERIOR KITCHEN AND LIVING ROOM FRAMING ALTERATIONS, WITH NEW REFRIGERATOR LOCATION. THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2016 CALIFORNIA BUILDING CODES. i FIrIAIACIAL DESCRIPTION IrIFORcTIAT101`1 ACCOUNT QTY AMOUNT y HOURLY CHARGE - ESGIL CIVIL ENGINEER 101-0000-42600 1.5 $157.50 Total Paid for BLDG CITY STAFF - PER HOUR: $157.50 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 . PARTITION 101-0000-42400 0 $76.00 DESCRIPTION ACCOUNT QTY AMOUNT PARTITION PC 101-0000-42600 0 $139.84 Total Paid for PARTITION:' $215.84 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $0.65 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.65 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 . Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 CITY OF LA QUINTA SUB-CONTRACTOR LIST JAR ADDRESS 558��_C1�` __ PERMIT NUMBER 3r2ot��lo4- OWNER-� _ -BUILDER This form shall be�OSted. UTl the 1C)f) Wlih the Building. Inspection Card. at all times in a conSDicuoels dace. Only persons appearing on this list or their emplo s are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant.. "On File" is not an.acce.ptable response. n5 �ccT_.atiort I�isiararicc : Crty tau Tridc Y: Cla�s,f,cat,on :.. Co,ttractor Statc,Contractor s, L,cet�sp Workers Go . l stress License Company Name Classification License Number Exp. Date Carrier Name Policy Number Exp. Date License Number Exp. Date (e.g. A, B, C-8) (xxxxxx) (xx/xx/xx) (e.g. State Fund, CalComp) (Format Varies) (xxlxxlxx) (xxxx) (xxlxxlxx) CONCRETE iC;a1 I l .FRAMING, (C-5) _ MASONRY (C-29) 'PLUMBING (C-36)•. DRYWALL (C=9) HVAC:(C;201> : ELECTRICAL (C-10) RQQfI►VG {C=3) Sk(EET:META( (C 43) FLOORING' (C-15} `GLAZING (C- ;1N.SULA7IOfV'{C,2) SEWAG.1i, DISP_ (C-42) _ PAINTING (C-33):..*.;— -CERAMICTILE (C; 54) CABINETS (C-G).r.. -- FENCING (C-13) LANDSCA{'ING.(C-27).. '.,. — POOL (C-53) B'°#40City of La Quinta Building a Safety Division r i P.O. Box I504,�79-495 Calle Tampico La.Quinta, CA 92253 - (760) 777-7012 Building Permit .APPlication and Tracking Sheet Permit # Project Address: Owner's Name: v A. P. N.umber. °15 — ZA I M5 Address: ��$7J'� eon �� ❑ Legal Descriptive: ( OT - Contractor: City, ST, Zip: A t... . Te!ephonc: Address: Project Description: City, ST, Zip: Telephone: , State Lie. # : City Lie. #: . Arch., Bngr., Designer. Low (Po Address: — 1 C C City., ST. Zip: Telephoae:1(00 State Lie. #: Construction Type: V Occupancy: Project type (circle one): New Add'n A3ter Repair Demo Name of Contact Person: i Sq. Ft.: Stories: # Units: Telephone # of Contact Person: 1. O Estimated Value of Project: 15, dry APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Reed TRACKING PERMITFEES Z Plan Sets Plan Check submitted item Amount 2 Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Cales• Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan rl Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.MX H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 34 Review, ready for correctlonsAssue Developer Impact Fee Planning Approval Called Contact Person AXP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees st Orr 0 pt.�►.Y RR++tA�.c�' t u EsGil Corporation In Partnership with Government for Building Safety DATE: 5/25/2017 ❑ APPLICANT e-- J RIS. JURISDICTION: LA QUINTA ❑ PLAN REVIEWER ❑ FILE PLAN CHECK NO.: BRES2017-0104 SET: I PROJECT ADDRESS: 55 837 CONGRESSIONAL PROJECT NAME: SFD INTERIOR ALTERATIONS - STRUCTURAL ONLY ® The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's codes. ❑ The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. ❑ The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. ❑ The check list transmitted herewith is for your information. The plans are being held at EsGil Corporation until corrected plans are submitted for recheck. ❑ The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. The applicant's copy of the check list has been sent to: ® EsGil Corporation staff did not advise the applicant that the plan check has been completed. ❑ EsGil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: .r-- Telephone #: Date contacted: (�) Email: Mail Telephone Fax In Person ❑ REMARKS: By: Bert Domingo Enclosures: EsGil Corporation ❑ GA ❑ EJ ❑ MB ❑ PC 5/17/2017 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576