BSPN2017-001078-495 CALLE TAMPICO 4 C` 0 D VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN &DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date:. 2/17/2017
Application Number: BSPN2017-0010
Owner:
Property Address: 79305 HIGHWAY 111 STE 2
UGGS7
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APN: 600340004
2205 N POINSETTIA AV
LU
Application Description: FUNTASTIK BALLOONS AND PARTY RENTALS
MANHATTAN BEACH,
2
Property Zoning:
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Application Valuation:
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Applicant:
Contractor:
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LIZETTE VELA
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79305 HIGHWAY 111 STE 2
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LA QUINTA, CA 92253
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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:
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).:
(1 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.).
(_J 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.).
(� l am am exempt under Sec. .'B.&P.C. for this reason
�aL to 11II Owner: /htlilN Vl1
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. Q.
Lender's Name:
Lender's Address:
WORKER'S COMPEN°ATION 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.
I have and will maintain workers compensation insurance, is required by
Section 3700 of the Labor Code, for the perormance 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 :)f the work for which this permit is issued, I
shall not employ any person in any manner ;o as to become subject to the workers'
compensation laws of California, and agree :hat, if I should become subject to the
workers' compensation provisions of Sectiom 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date:
Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIVINAL 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 he Building Official for a permit subject to
the conditions and restrictions set forth on Yiis application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is perfowned 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 tothe work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this appication 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 canc2llation.
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 orc inances and state laws relating to building
construction, and hereby authorize represen-atives of this city toenter upon the
above-mentioned property for inspection pu ,poses. n . , )
Date: 2/17/2017
Application Number: BSPN2017-0010
Owner:
Property Address: 79305 HIGHWAY 111 STE 2
UGGS7
APN: 600340004
2205 N POINSETTIA AVE
Application Description: FUNTASTIK BALLOONS AND PARTY RENTALS
MANHATTAN 3EACH, CA 92253
Property Zoning:
Application Valuation:
Applicant:
Contractor:
LIZETTE VELA
79305 HIGHWAY 111 STE 2
LA QUINTA, CA 92253
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Llc. No.:
Detail: SPECIAL INSPECTION FOR NEW BUSINESS LICENSE.
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT QTY
AMOUNT
SPECIAL INSPECTION
101-0000-42404 0
$76.00
Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION:
$76.00
DESCRIPTION
ACCOUNT QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611 0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
•
$5.00
00
Bin #
Permit #; W�
Project Address 3a S
Qty of U Q yhi to
Buifding u Safety Division
78-495 Calle Tampico
-
La Quinta, CA 92253 - (760) 777-7012
Building Permit_ Application and Tracking S.ieet
, (�� ner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
C�a�letr:
Address: C) S
Project Description:
City, ST, Zip: Ljo�_ UL
L'`"
CA Of �s3
e
TeleP hon . S-
� I
3
State-Lic. # :
City Lic. #:
Arch.,`Engr., Designer:
Address:
City, ST, Zip:
Telephone:
ane
:
Con tructi n Type: O ccuo-
State Lic. #.
'n Atter Repair.ai
'crceone:New r Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
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°d Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.1.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Jrd 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,
1
Total Permit Fees