BRES2017-02184 VOICE (760) 777-7125
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/11/2017
Permit Type/Subtype:
BUILDING RESIDENTIAL/REMODEL
Owner:
Application Number:
BRES2017-0218
SUSAN GODDARD
Property Address:
APN:
78230 LAGO DR
646200013u r
78230 LAGO DR G7 z
LA QUINTA, CA 92253 LU
Application Description:
GODDARD RESIDENCOk,REMODEL
r,-7 5
Property Zoning:
=� ca ` w i
Application Valuation:
$200,000.00 `�
•�
;.
Applicant:
Contractor:
MDL UNIVERSAL CONTRACTING
MDL UNIVERSAL CONTRACTING C
401 RADIO ROAD #B 32
401 RADIO ROAD #B 32
PALM SPRINGS, CA 92262
PALM SPRINGS, CA 92262�Q-J
hY
(760)219-8488
Llc. No.: 915618
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: B License No.: 915618 -
Dat � / �/ contractor': MAL. dlUi✓1!Oir'S� (.(�AAty
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).:
(_) 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 u er penalty of perjury one of the following declarations:
_ I h nd will maintain a certificate of consent to self -insure for workers'
compe t' , as provided for by Section 37 00 of the Labor Code, for the performance
of th for which this permit is issued.
have and will maintain workers' compensation insurance, as required by
Sectio 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: STATE COMPENSATION INSURANCE FUND Policy Number: 9091728
_ 1 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 wor s'
compensation laws of California, and agree that, if I should become subj he
workers' compensation provisions of Section 3700 f the Labor Cod I forthwith
comply with thos provisions.
cif
Date: � / Applicant. -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL 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 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 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 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 bui g
construction, and hereby authorize representatives of this city to r upon t 4ve-
men�tionned property for inspection purposes.
Date l 6 f Signature (Applicant or Agent)
Date: 10/11/2017
Applicant: Contractor:
MDL UNIVERSAL CONTRACTING MDL UNIVERSAL CONTRACTING
401 RADIO ROAD #B 32 401 RADIO ROAD #B 32
PALM SPRINGS, CA 92262 PALM SPRINGS, CA 92262
(760)219-8488
Llc. No.: 915618
Detail: RECONSTRUCTION OF HOME CAUSED BY FALLING TREE. ROOF AND WALL AREAS
Application Number:
BRES2017-0218
Owner:
Property' Address:
78230 LAGO DR
SUSAN GODDARD
APN:
646200013
78230 LAGO DR
Application Description:
GODDARD RESIDENCE / REMODEL
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$200,000.00
Date: 10/11/2017
Applicant: Contractor:
MDL UNIVERSAL CONTRACTING MDL UNIVERSAL CONTRACTING
401 RADIO ROAD #B 32 401 RADIO ROAD #B 32
PALM SPRINGS, CA 92262 PALM SPRINGS, CA 92262
(760)219-8488
Llc. No.: 915618
Detail: RECONSTRUCTION OF HOME CAUSED BY FALLING TREE. ROOF AND WALL AREAS
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
PLAN CHECK/PERMIT EXTENSION PROCESSING
101-0000-42600 1 $101.84
Total Paid for ADMINISTRATIVE: $101.84
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HOURLY CHARGE - ESGIL STRUCTURAL ENGINEER
101-0000-42600
1
$120.00
Total Paid for BLDG CITY STAFF - PER HOUR: $120.00
-DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$8.00 .
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $8.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, EA ADDITION 1,000SF
101-0000-42403
0
$26.52
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, EA ADDITION 1,000SF, PC
101-0000-42600
0
$10.92
DESCRIPTION
ACCOUNT
QTY
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 CONSTRUCTION: $244.97
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$50.66
DESCRIPTION
ACCOUNT
QTY
AMOUNT
' FURNACE
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FURNACE PC
101-0000-42600
0
$50.66
Total Paid for MECHANICAL: $253.32
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$88.69
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$88.69
Total Paid for PLUMBING FEES: $177.38 .
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$140.46
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$112.32
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 100 SF
101-0000-42400
0
$53.05
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 500 SF. PC
101-0000-42600
0
$145.12
' Total Paid for REMODEL: $450.95
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$26.00
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $26.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS
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City of La Quinta
Building & Safety Division
l 78-495 Calle Tampico `
- 01x La Quinta, CA 92253 - (760) 777-7012
Building Perm it Application and Tracking Sheet
Permit#
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Project Address: �823Q
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Owner's Name: ZA)U j6D e�
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,A.P. Number /� 2 O6 ` i3
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Address: t7-6 2 � (3 &A ^0V02� U E
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Legal Description:
City, ST, Zip:
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L'nnfraeYar: f� U�] E}1 r e [ 1 VL
Telephone: n6 _
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Proj" Descrriiption:
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City, ST, Zip:
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Telephone: f7G G
State Lie. #: 9 j15-6 /
City Lie #:
Arch, Engr., Designer:
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Address: 52'1'1S 2
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City, ST, Zip: V(��A 10
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Telephone: 17(6
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Construction Type:
Occupancy:
State Lie. #: Z
Proj. Type
New
Add'n
Alter Repair
Demo
Name of Contact: X.r'1
SgFt:
#Stories # Units:
Telephone of Contact: �)� r
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Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
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Submittal
Req'd
Req'd
TRACKING
PERMIT FEES
Plan Sets
i
Plan Check Submitted
Item
Amount
Structural Calcs
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
2nd Rev, Ready for corrections /
Electrical:
Subcontractor List
Called Contact Person
Plumbing:
Grant Deed
Plans Picked Up
S.M.I.
HOA Approval
Plans Resubmitted
Grading
IN-HOUSE
3rd Rev, Ready for corrections /
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Apps
Date of permit issue
School Fees
Total Permit Fees
EsGil Corporation
In Partnership with Government for Buifding Safety
DATE: October 4, 2017 ❑ APPLICANT
JURIS.
JURISDICTION: La Quinta ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: BRES2017-0218 SET: II
PROJECT ADDRESS: 78230 Lago Dr.
PROJECT NAME: Goddard SFR Roof Repair
® The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
❑ The plans transmitted herewith will substantially comply with the jurisdiction's building codes
when minor deficiencies identified below are resolved and checked by building department staff.
❑ The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
The check list transmitted herewith is for your information.
❑ The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
❑ The applicant's copy of the check list has been sent to:
® EsGil Corporation staff did not advise the applicant that the plan check has been completed.
❑ EsGil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: ie
Date contacted: (by-
Mail Telephone Fax In Person
® REMARKS: Structural -only review
By: Abe Doliente (for D.A.)
EsGil Corporation
❑GA ❑EJ ❑MB ❑PC
Telephone #:
Email:
9/27/17
Enclosures:
OCT 0 5 2017
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT