BSPN2018-000578-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
D & S ELECTRIC
29412 GILLETTE COURT
SUN CITY, CA 92586
4
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
SPECIAL INSPECTION/
BSPN2018-0005
53245 AVENIDA MARTIN, Z�
774061025
IID UTILITY RELEASE
VOICE (760) .777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/13/2018
Owner:
TWILLA OSKEY
92253
FEB 13 2018
CITY OF LA QUINTA
DESIGN AND DEVELOPMENT DEPARTMENT Contractor:
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.: ^ A
Date: 2 ^ / 3— / - Contractor:
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:
OWNER -BUILDER DECLARATION
Carrier: _ Policy Number: _
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, Improve, demolish, or repair
compensation laws of California, and agree that,. if I, should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 370 of the Labor Code, I shall fortpwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with those provisions.
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
Date: 2 "� (_ Applicant:
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
WARNING: FAILURE TO' SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(_) I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF.
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this application'is made, each person at whose
(_) I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , the owner, and the applicant, each agrees to, and -
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(_) I am exempt under Sec. B.&P.C. for this reason
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..
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 Na
Lender's Address:
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 C
above-mentioned property for inspection purpose's.
Date:,2 f K Signature (Applicant or Agent):
/r
Date: 2%13/2018
Application Number:
BSPN2018-0005
Owner:
Property Address:
53245 AVENIDA MARTINEZ
TWILLA OSKEY
APN:
774061025
Application Description:
IID UTILITY RELEASE
92253•
Property Zoning:
Application Valuation:
Applicant:
Contractor:
D & S ELECTRIC
29412 GILLETTE COURT
SUN CITY, CA 92586
----------------------------------------------------------
Llc. No.:
Detail:
--------------------------------
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
SPECIAL INSPECTION 101-0000-42404
0
$78.02
Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION: $78.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS:i
/+
G:C\T _........ ;.... :
PERMIT #
PLAN LOCATION:
Project Address:S
Project Description: Pool, Remodel, Add't, Elect, Plumb,Mech
APN #:
h'L Q
Patio/Porch' SF
Email:
Applicant Name: .Q
State Lic:e_,, 7 City Bus Lic:
Address: G LC c
State Lic: City Bus Lic:
City, ST, Zip: SU.✓ C c`E a �� �.
Telephone: S — 3 C� D y&
rEmail:
Valuation of Project $
e
Contractor Name:
'New SFD Construction:
Address: C ` C
Conditioned Space SF
City, St, Zipu ) S �,
Garage SF
Telephone: — _ 3 (n _y Cd�
Patio/Porch' SF
Email:
Fire Sprinklers SF
State Lic:e_,, 7 City Bus Lic:
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Construction Type: Occupancy:
Telephone:
Bedrooms:
Stories:
#Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name:
New Commercial / Tenant Improvements:
Address:
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
#
Submittal
`Req'd
•Rec'd
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM 10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License .