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BRES2017-025078-495 CALLE TAMPICO LA QUINTA,_CALIFORNIA 92253 Titvx .4 e(P QuIR& DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRES2017-0250 Property Address: 45010 DESERT HILLS CT CT APN: 604280008 Application Description: JIMINEZ/KITCHEN REMODEL Property Zoning: Application Valuation: $10,000.00 Applicant: ORDINC 82950 WILLIAM WAY THERMAL, CA 92274 SEP 15 2017 L CITY OF LA QUINTA COMMUNITY DEVELOPMENT DEPARTMENT 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: L_ Ijcense No.: 893549 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-buildeir.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 Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/15/2017 Owner: JUAN JIMENEZ ' 45010 DESER— HILLS LA QUINTA, C4 92253 Contractor: 0RDINC 82950 WILLIAAA WAY THERMAL, CA 92274 (760)578-099'D Llc. No.: 893549 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 3 700 of the Labor Code, for the performance of the work for.which this permit is issued. _ave and will maintain workers compensation insurance, as required by S ctioT n 3700 of the Labor Code, for the per ormance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: STATE COMPENSATION INSURANCC FUND Policy Number: 9157504 �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 agreethat, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Cod forthwith comply with th a provi 'ons. Date: Appli�cantt, WARNING: FAILURE TO SECURE WORKERS' :OMPENSATION 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 IOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made tc the Building Official for a permit subject to the conditions and restrictions set forth on -his 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, ar,.d the applicant, each agrees to, and shall defend, indemnify and hold harmless th'e City of La Quinta, its officers, agents, and employees for any actor 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 cancellat=on. ' I certify that 1 have read this application anc state that the above information is correct. I agree to comply with all city and county or-Jinances and state laws relating to building construction and her authorize representatives of t ' to enter upo ove- mentioned ropert -for inspection purpose!. �Daate:' 7 / Signature (Applicant or Agen : ' Date: 9/15/2017 Application Number: BRES2017-0250 Owner: Property Address: 45010 DESERT HILLS CT CT JUAN JIMENEZ APN: 604280008 45010 DESERT HILLS Application Description: JIMINEZ / KITCHEN REMODEL LA. QUINTA, CA 92253 Property Zoning: Application Valuation: $10,000.00 Applicant: Contractor: ORDINC 0RDINC 82950 WILLIAM WAY 82950 WILLIAM WAY THERMAL, CA 92274 THERMAL, CA 92274 ' . (760)578-0992 ------------------------------ ------------------------------ Ll c. • N o.: 893549 ------------------- Detail: .------------- I FINANCIAL DESCRIPTION INFORMATION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 • 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRA—ION.BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PERMIT .101-0000-42400 0 $326.80 Total Paid for NEW CONSTRUCTION' PERMIT:. $326.80 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $532.00 Total Paid for NEW CONSTRUCTION PLAY CHECK: $532.00 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $1.30 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $1.30 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 Bin# City of La Quinta Building & Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 SO Building Permit Application and Tracking Sheet Permit# SPE-S)ZI -7109 Project Address: SD lo _ f a- �/K/T- Owner's Name: A.P: Number Address: 56 rC-) Legal Description: City, ST, Zip: Contractor: Ui C ^ Telephone: Address:/ (/•/ LLQ Project Description' e City, ST, Zip: elt" �� ( ,Qi✓�'Q Gi/r_ Telephone: 5 D 6 7 V �V State Lic. #: � City Lic #:co-j r,—C ! k P Arch, Engr., Designer: /� G 0l_/'Z Ct)9 IS S V g-. t + mss- Address: City, ST, Zip: Telephone: State Lic. #: a*-SqFt: Construction Type: Proj. Type New Add'n Occupar_cy: Alter Repair Demo Name of Contact:. irl ? /'� �C ' pVI / 'CJ7 #Stories # Units: Telephone of Contact: Q _ O C1 Estimated Value of Project: Cyt D� O V APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check Submitted Item Amount Structural Cales 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 Mechancal: Grading Plan 2nd Rev, Ready for corrections / Electrical: Subcontractor List Called Contact Person Plumbing: Grant Deed Plans Picked Up S.M.I. HOA Approval Plans Resubmitted Grading IN-HOUSE 3rd Rev, Ready for corrections / Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Apps Date of permit issue School Fees Total Permit Fees C, la � pve �W SBS(, AD 0 I 011 4e bil Cl OF LA Cil INTA BURDING & SAFETY DEPT. kIPPROVED F JIB CONSTRUCTION