BRES2017-0302� aw
78-49 s CALLE TAMPICO O�i U
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
ALBERTO DAZA
P.O. BOX 5083
LA QUINTA, CA 92247
BUILDING RESIDENTIAL/ADDITION
BRES2017-0302
81800 LA PAZ CT CT
764550042
ALMQUIST/ 328SF CASITA ADDITI
$55,000.00'
FYARD
C 0 8 1011
C0wuh,!r1y y0F(�QUIflITA —J
----, E(OPM�.,eEPARTNjENT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
REBECCA ALMQU:ST
, 92253
Contractor:
DAZ
P 0 BOX 5083
LA QUINTA, CA 92253
(760)285-3793
Llc. No.: 944325
Date: 12/8/2017
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSAT®N DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I I hereby affirm under penalty of perjury one of the following declarations:
9 {commencing with Section 7000) of Division.3 o d Professions Code,
I have and will maintain a certificate of consent to self -insure for workers',
and my License is in full force and effect.
compensation, as provided for by Section 3700of the Labor Code, for the performance
License Class: B Liorse No.: 944325
of the work for which this permit is issued. '
I have and will maintain workers' co npensation insurance, as required by
Date:, Contrl
aco,
Section 3700 of the Labor Code, for the perfornoance of the work for which this permit
- �
is issued. My workers' compensation insurance carrier and policy number are:
OWNER -BUILDER DECLARATION
Carrier: STATE COMPENSATION INSURANCE FU -4D Policy Number: 9168769
I hereby affirm nder 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
I certify that in the performance of t: -ie work for which this permit is issued, I
city or county that requires'a permit to construct, alter, Improve, demolish, or repair
shall not employ any person In any manner so a to become subject to the workers'
any structure, prior to its issuance, also requires the applicant for the permit to file a
compensation laws of California, and agree that, if I should bet ubject to the
signed statement that he or she is licensed pursuant to the provisions of the
workers' compensation provisions of Section 300 o e lobo ode, I all forthwith
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
ose rovislons.
comply withW�illillarip-)
3 of the Business and Professions Code) or that he or she is exempt therefrom and the
1MXbasis
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
Date ='Aplicantw
permit subjects 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 CRIMIN^L PENALTIES AND CIVIL FINES UP TO
compensation, will do the work, and the structure is not Intended or offered for sale.
ONE HUNDRED THOUSAND DOLLARS ($300,00(.x. IN ADDITION TO THE COST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
COMPENSATION, DAMAGES AS PROVIDED FOR N 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
within one year of completion, the owner-bullder will have the burden of proving that
IMPORTANT: Application Is hereby made to the Building Official for a permit subject to
he or she 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
1. Each person upon whose behalf this applic:,tion is made, each person at whose
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
request and for whose benefit work is performed under or pursuant to any per
State License Law does not apply to an owner -of property who builds or improves
issued as a result of this application , the owner' and the applicant, each agrees to, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
shall defend, Indemnify and hold harmless the City of La Quinta, its officers, agents, and
the Contractors' 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
Date: Owner:
work for 180 days will subject permit to cancell.tion.
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:
--
I certify that I have read this application and sta-e that the ove'information is correct.
I agree to comply with all city and county ordin: nces an sta laws relating to building.
construction, and hereby authorize representat s of is ci nter upon the
above mentis d pr perty for Inspection purpcN
Date:} " Stgnature-(Applicant & Agent):
J
Date: 12/8/2017
Application Number:
BRES2017-0302
Owner:
Property, Address:
81800 LA PAZ CT CT
REBECCA ALMQUIST
APN:
764550042
Application Description:
ALMQUIST / 328SF CASITA ADDITION AT FRONT YARD
92253
Property Zoning:
Application Valuation:
$55,000.00
Applicant:
Contractor:
ALBERTO DAZA
DAZ
P.O. BOX 5083
P 0 BOX S083'"
LA QUINTA,. CA 92247
LA QUINTA, CA 92253
(760)285-3793
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
LIc. No.: 944325
-
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -.- - - - - -I
Detail: 328SF CASITA ADDITION WITH 31SF COVERED ENTRY AT FRONT YARD (CONVENTIONAL] THIS PERMIT DOES NOT INCLUDE BLOCKWALLS OR
ALTERATION TO THE EXISTING DWELLING. 2016 CALIFORNIA BUILDING CODE.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
QTY
AMOUNT
ADDITION, EA ADDITIONAL 500 SF
101-0000-42400
0
$67.10
DESCRIPTION
ACCOUNT
QTY
AMOUNT
ADDITION, EA ADDITIONAL 500 SF PC
101-0000-42600
0
.$18.72
DESCRIPTION
ACCOUNT
QTY
AMOUNT
ADDITION, FIRST 100 SF
101-0000-42400
0
$131.07
DESCRIPTION
ACCOUNT
QTY
AMOUNT
ADDITION, FIRST 100 SF PC
101-0000-42600
0
$184.13
Total Paid for ADDITION: $401.02
DESCRIPTION
ACCOUNTQTY
AMOUNT
HOURLY CHARGE - CITY BUILDING STAFF
101-0000-42600
1.5
$234.00
Total Paid for BLDG CITY STAFF - PER HOUR: $234.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT,
BSAS S61473 FEE
101-0000-20306
0
$3.00
Total Paid for BUILDING STANDARDS ADMINISTRATION 3SA: .$3.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, FIRST 1,000SF
101-0000-42403
0
$156.04
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, FIRST 1,000SF, PC
101-0000-42600
0
$51.49
Total Paid for ELECTRICAL - NEW CONSTRUCT ON: $207.53 .
DESCRIPTION
ACCOUNT
QTY
AMOUNT
AIR HANDLER
101-0000-42402
0
$39.01
DESCRIPTION
ACCOUNT
CITY
AMOUNT
AIR HANDLER PC
101-0000=42600
$13.00
DESCRIPTION
ACCOUNT
CTY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402
$39.01
DESCRIPTION
ACCOUNT
CITY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
)
$26.01
DESCRIPTION
ACCOUNT
CITY
AMOUNT
VENT FAN
101-0000-42402
)
$13.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN PC
101-0000-42600
.0
$5.20
Total Paid for MECHANICAL: $135.23
DESCRIPTION
ACCOUNT
QIY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$52.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$52.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
$13.00
DESCRIPTION
ACCOUNT
Q—Y
AMOUNT