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VOICE (760) 777-7125
78-495 CALLE TAMPICO
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FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS
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(760) 777-7153
BUILDING PERMIT
ate: 017
Application Number: BSPN2017-0009.
Owner:
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Property Address: 53420 AVENIDA JUAREZ
JACK SCHMITT
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APN: 774071008
53420 AVENIDAJUAREZ
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Application Description: SCHMITT / INSPECTION FOR IID RELEASE
LA QUINTA, CA 92253
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Property Zoning:
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Application Valuation:
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Applicant:
Contractor:
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JACK SCHMITT
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53420 AVENIDA JUAREZ
LA QUINTA, CA 92253
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Llc. No.:
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 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 Name:
Lender's
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one Y 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 insurarre carrier and policy number are:
Carrier: Polity Number:
I certify that in the performance o- the work for which this permit is issued, I
shall not employ any person in any manner sc as to become subject to the workers'
compensation laws of California, and agree tfat, if I should become subject to the
workers' compensation provisions of Section .9700 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 CRIMILIAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,OCO). 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 owne-, 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 laws relating to building
construction, and hereby authorize representatves of this city to enter upon the
above-mentioned property for inspection purpcses.
Dat : U Signature (Applicant or Agen
Date: 2/6/2017
Application Number:
BSPN2017-0009
Owner:
Property Address:
53420 AVENIDA JUAREZ
JACK SCHMITT
APN:
774071008
53420 AVENICA JUAREZ
Application Description:
SCHMITT / INSPECTION FOR IID RELEASE
LA QUINTA, Ci; 92253
Property Zoning:
Application Valuation:
Applicant:
Contractor:
JACK SCHMITT
53420 AVENIDA JUAREZ
LA QUINTA, CA 92253
Llc. No.:
Detail: ELECTRICAL INSPECTION OF MAIN BREAKER CHANGE OUT. 2016 CALIFORNIA BUILDING CODES.
SPECIAL INSPECTION 101-0000-42404 0
$76.00
Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION:
$76.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
.TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
1
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Permit-##
Project Address:-
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Building 8£ Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
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Project Description:
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Arch.,'Engr., Designer:
Address:
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Telephone:
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Contructi n ccir c
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Sto Lic. # •
Project tYPa circle one • New Add'nAlter Repair Demo
Name of Contact Person:
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:Estimated
Value of Project: f
APPLICANT: DO NOT WRITE BELOW THIS LINE
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Submittal
Req'd
Rcc'd
TRACKING
LERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for -corrections
Plan Check Derosit
Truss Calcs.
Called Contact Person
Plan Check Bal ante
Title 24 Calcs.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading "plan
2"" Review, ready for corrections/issue
Electrical .
Subcontacl'or.List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"! Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Ms. Appr
Date of permit issue
School Fees,
Total Permit Fee;