BRES2017-027478--
y495 CALLE TAMPICO a"" VOICE (760) 777-7125
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LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011DESIGN & DEVELOPMENT.DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
�. Date: 1/19/2018 .
Permit Type/Subtype: BUILDING RESIDENTIAL/RE CLDE Owner:
Application Number: BRES2017-0274 RANDY ROWLEY
Property Address: 79515 MANDARINA 79515 MANDARINA
APN: 776191025 LA QUINTA, CA 92253
Application Description: ROWLEY / INTERIOR REM D L WITH WJ%WVJJA[BUJAj yUT
Property Zoning:
jjff
Application Valuation: $30,000.00 U0
DESIGN AND DEVELO Q NITTA
Applicant: DEPARTMENT OWNERtBUILDER
GABRIEL RIDS
49901 CINNABAR
COACHELLA, CA 92236 ,
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).:
(_) 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
r Date:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lendin g ncy for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
Llc. No.:
WORKER'S COMPENSATION 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 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 that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forth i h
comply with those provisions.
Date: ` / _/de Applican"/
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLA FU ,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP
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 building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date: / / C�. / Signatu A isr en )"G
Date: 1/19/2018
Application Number:
BRES2017-0274 -
Owner:
Property Address:
79515 MANDARINA
RANDY ROWLEY
APN:
776191025
79515 MANDARINA
Application Description:
ROWLEY / INTERIOR REMODEL WITH WINDOW CHANGEOUT .
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$30,000.00
Applicant:
Contractor:
GABRIEL RIOS
OWNER BUILDER
49901 CINNABAR
COACHELLA, CA 92236
---------------------------------------------------------------------------------------------
Llc. No.:
Detail: REMODEL TO LIVING ROOM, FAMILY ROOM, DINNING ROOM AND KITCHEN. REPLACEMENT
OF VARIOUS WINDOW & SLIDING GLASS DOORS.
CONSTRUCTION SHALL BE PER 2016 CRC
FINANCIAL
DESCRIPTION ACCOUNT QTY AMOUNT
HOURLY CHARGE - YES ADMINISTRATIVE STAFF
101-0000-42600 0.25 $10.00
DESCRIPTION
ACCOUNT QTY AMOUNT
HOURLY CHARGE - YES PRINCIPAL/STRUCTURAL ENGINEER
101-0000-42600 1.25 $187.50
Total Paid for BLDG CITY STAFF - PER HOUR: $197.50
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: $207.53
DESCRIPTION
ACCOUNT
QTY
AMOUNT
APPLIANCE REPAIR/ALTERATION
101-0000-42402
0
$13.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
APPLIANCE REPAIR/ALTERATION PC
101-0000-42600
0
$5.20
DESCRIPTION
ACCOUNT
QTY
AMOUNT
EXHAUST HOOD
101-0000-42402
0
$13.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
EXHAUST HOOD PC
101-0000-42600
0
$5.20
Total Paid for MECHANICAL: $36.40
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PLAN CHECK DEPOSIT - ADDITION/REMODEL
101-0000-42600
1
$125.00
Total Paid for PLAN CHECK DEPOSIT - ADDITION/REMODEL: $125.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$26.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$26.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$13.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$26.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
$13.00
DESCRIPTION
ACCOUNT'
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP PC
101-0000-42600
0
$13.00
Total Paid for PLUMBING FEES: $117.01
DESCRIPTION
ACCOUNTQTY
AMOUNT
RECORDS MANAGEMENT FEE - MAJOR
101-0000-42416
0
$20.00
Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $20.00;
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
.0
$23.41
DESCRIPTION
ACCOUNT
QTY
AMOUNT.
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$18.72
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: $240.30
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
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