BRES2017-0062r,
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
DEBRA O'DELL HECKERT
850 MAT+IENS RD
LAKE PORT, CA 95453
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BUILDING RESIDENTIAL/REMODEL
BRES2017-0062
50825 CALLE GUAYMAS
770102006
O'DELL / CHANGE OUT (13) DOORS AND WINDOWS
$30,000.00
FEB 1.2 2018
CITY OF LAQUIKT- A`J
COMMUNITYDEVELOPMENTDEPARThIENT
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:
Contractor:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/12/2018
Owner:
DEBRA O'DELLHECKERT
850 MATHENS RD
LAKE PORT, CA 95453
Contractor:
OWNER BUILDER
Llc. No.:
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:
OWNER -BUILDER DECLARATION .
Carrier:_ Policy Number: _
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
-I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair any
compensation laws of California, and agree that, if I should become subject to the
structure, prior to its issuance, also requires the applicant for the permit to file a signed
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
statement that he or she is licensed pursuant to the provisions of the Contractor's State
comply with those provisions.
License Law (Chapter 9'(commencing with Section 7000) of Division 3 of the Business
and frofessions Code) or that he or she is exempt therefrom and the basis for the
Date: Applicant:
xemption. Any violation of Section 7031.5 by any applicant for a permit
s the applicant to a civil penalty of not more than five hundred dollars ($500).:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
I, as owner of the property, or my employees with wages as their sole
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ompensation, will do the work, and the structure is not intended or offered for sale.
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF ,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,.
apply to an owner of property who builds or improves thereon, and who does the work
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
it one year of completion, the owner -builder will have the burden of proving that he
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
did not build or improve for the purpose of sale.).
the conditions and restrictions set forth on this application.
I, as owner of the property, am exclusively contracting with licensed contractors to
1. Each person upon whose behalf this application is made, each person at whose
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State
request and for whose benefit work is performed under or pursuant to any permit issued
Licen a La does not apply to an owner of property who builds o� improves thereon,
as a result of this application , the owner, and the applicant, each agrees to, and shall
and o contracts for the projects with a contractor(s) licensed pursuant to the
defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
ors' State License Law.).
employees for any act or omission related to the work being performed under or
I am exempt under Sec. B.&P.C. for this reason
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
Date: Ti Own
for 180 days will subject permit to cancellation.
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 Na
Lender's Address:
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 the above-
mentioned p operty for inspection purposes.
Date: 45ignattire (Applicant or Agent
1
Date: 2/12/2018
Application Number:
BRES2017-0062
Owner:
Property Address: ' °"`30825
CALLE GUAYMAS
DEBRA O'DELL HECKERT
APN:
770102006
850 MATHENS RD
Application Description:
O'DELL / CHANGE OUT (13) DOORS AND WINDOWS
LAKE PORT, CA 95453
Property Zoning:
Application Valuation:
$30,000.00
Applicant:
Contractor:
DEBRA O'DELL HECKERT
OWNER BUILDER
850 MATHENS RD
LAKE PORT, CA 95453
_
Llc. No.:
Detail: CODE COMPLIANCE CASE. Meredith.
v
0
DESCRIPTION
ACCOUNT QTY AMOUNT
HOURLY CHARGE - CITY BUILDING STAFF
101-0000-42600 O.S $78.00
Total Paid for BLDG CITY STAFF - PER HOUR: $78.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$2.00'
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PARTITION
101-0000-42400
0
$76.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PARTITION PC
101-0000-42600
0
$139.84
Total Paid for PARTITION: $215.84
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$3.90
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $3.90
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DOOR/WINDOW,-RETRO/REPAIR, EA ADDITION S
101-0000-42400
0
$21.84
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7
101-0000-42400
0
$65.54
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7 PC
101-0000-42600
0
$63.98
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $151.36