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BSPN2017-005378-495 CALLE TAMPICO . LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: STEVE CHANG 40255 HARRIS LANE -#105 PALM DESERT, CA 92211. 4 tP Qulftrcu DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT SPECIAL INSPECTION/ BSPN2017-0053 79800 HIGHWAY 111 STE 106 600010021 CHANG / UTILITY RELEASE CSC I i 2017 CITYOFLAQUINTAJ COMMUNITY DEVELOPMENT DEPARTNIEN7 --� 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 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).: as owner of the property, or my employees with wages as their sole o nsation, 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 e did not build or improve for the purpose of sale.).. • , 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.)'. CA 741 am exempt under Sec. B.&P.C. for this reason 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: 12/11/2017 Owner: SOINELLO COMMERCIAL 68936 ADELINL. ROAD CATHEDRAL CI—Y, CA 92234 Contractor: Llc. No.: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ 1 have and will maintain a certificace 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: Carrier: _ .Policy Number: _ 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 agree t iat, 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: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIM4NAL 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 fie Building Official for a permit. subject to the conditions and restrictions set forth on tFisapplication. 1. Each person upon whose behalf this app@cation 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 cancellatic n. I certify that I have read this application and -tate that the above information is correct. I agree to comply with all city and county ordnances and state laws relating to.building construction, and hereby authorize representatives of this city to enter upon the above- mentioned property for inspection purposes. BnM. l Y � i �igyr re (Applicantor A4_1�� Date:. 12/11/2017 Application Number: BSPN2017-0053 Owner: Property Address: 79800 HIGHWAY 111 STE 106 SOINELLO COMMERCIAL APN: 600010021. 68936 ADELINA ROAD Application Description: CHANG / UTILITY RELEASE CATHEDRAL CITY, CA 92234 Property Zoning- Application Valuation: Applicant: Contractor: STEVE CHANG 40255 HARRIS LANE #105 PALM DESERT, CA 92211 ---=-------------------------------------------------------------------------------•--------- Llc. No.: Detail: SPECIAL NSPECTION TO RELEASE POWER AS IT HAS BEEN OFF FOR OVER 6 MONTHS. It I DESCRIPTION FINANCIAL INFORMATION ACCOUNT QTY AMOUNT SPECIAL J NSPECTI O N 101-0000-42404 0 .$78.02 Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION: $78.02- 78.02DESCRIPTION DESCRIPTION. ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE:. TOTALS: $5.00 It I ^ J PERMIT # PLAN LOCATION: rojectTAddress_: �. C(�(/ 6 1 ' Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN City, St, Zip Garage SF A licant Nam'e� � � y� Patio/Porch Address: 'Je Email: City, ST, Zip: o 1 S i r C /I 2� SF . Telephone: Z 2 Email: Valuation of Project $ Contractor Name: New SFD Construction: Address: Address: Conditioned Space SF City, St, Zip Garage SF Telephone: Patio/Porch SF Email: Fire Sprinklers SF State Lic: City Bus Lic: Arch/Eng Name: Construction Type: Occupancy: Address: Grading: City, St, Zip C a A 2 ($onstruction Type: Occupancy: Telephone: Bedrooms: Stories: # Units: Email: State Lic: City Bus Lic: roperty Owner's Nam e co Of Commercial / Tenant Improvements: iD& Address: I�M36 le, Rd Total Building SF City, ST, Zip C a A 2 ($onstruction Type: Occupancy: Telephone: Email: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 OFFICE USE ONLY - r' ` # Submittal Req'd . •� .Rec'd ,. Plan Sets Structural Calcs r Y C v ` Truss Calcs _ 1' Title 24 Calcs , t Soils Report Grading Plan (PM 10) Landscape Plan Subcontractor List Grant Deed ' HOA Approval ' School Fees • �: Yf 2 Burrtec Debris Plan r Planning approval ; , Public Works approval { 7 1. Fire approval r City Business License r ¢ f.' r .i • �: Yf 2 r