BRES2016-02334 QUM&78 495 CALLE TAMPICC.a �. 1 VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 V FAX (760) 777-7011
y DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 "
BUILDING PERMIT /
Date: 5/2/2017 ✓
Application Number: BRES2016-0233 Owner:
Property Address: 52935 P.VENIDA MENDOZA ANGEL GERARDO
APN: 773332023 '
Application Description: ANGEL GERARDO / REMODEL 92253
Property Zoning:
Application Valuation: $2,000.00, FL�
[l'Applicant: -7 Contractor:
ANGELGERARDO 201 ` OWNER BUILDER
52935 AVENIDA MENDOZA UINTALA QUINTA, CA 92253 NTDEPARTMENT w
Lic. No.: r!
---------------------------------------------------------------------------------------------
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
x($500).: --J
(_) 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
tle Contractors' State License Law.).
JpIrNr� am exempt under Sec. . B:&P.C. for this reason
Date:
-
Ow
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:
i
Lender's Address:
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 forthwith
comply with those provisions.
Da rte: f 2 Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINE 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 building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
�i
Date: Signature (Applicant or Agent):
- d
-
Applicant:
ANGELGERARDO
52935 AVENIDA MENDOZA
LA QUINTA, CA 92253
Owner:
ANGELGERARDO
92253
Contractor:
OWNER BUILDER
Date: 5/2%2017
Llc. No.:
-------------------------------------------------=-------------------------------------------
Detail: REMOVE 6X6'8" SLIDER IN MASTER BEDROOM AND ADD 2 30"X48" SINGLE HUNG WINDOWS. PER 2013 CRC & ENERGY CODES.
Application Number:
BRES2016-0233
Property Address:
'52935 AVENIDA MENDOZA
APN:
77:3332023
Application Description:
ANGEL GERARDO / REMODEL
Property Zoning:
Application Valuation:
$2,000.00
Applicant:
ANGELGERARDO
52935 AVENIDA MENDOZA
LA QUINTA, CA 92253
Owner:
ANGELGERARDO
92253
Contractor:
OWNER BUILDER
Date: 5/2%2017
Llc. No.:
-------------------------------------------------=-------------------------------------------
Detail: REMOVE 6X6'8" SLIDER IN MASTER BEDROOM AND ADD 2 30"X48" SINGLE HUNG WINDOWS. PER 2013 CRC & ENERGY CODES.
rz
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT' QTY 'AMOUNT
113SAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$25.33
Total Paid for ELECTRICAL: $50.66
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50
DESCRIPTION
ACCOUNT
QTY
AMOUNT
STUCCO APPLICATION, FIRST 500 SF
101-0000-42404
0
$25.84
Total Paid for STUCCO APPLICATION: $25.84
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
z Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DOOR/WINDOW, REPLACE FIRST 7
101-0000-42400
0
$60.91
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DOOR/WINDOW, REPLACE, FIRST 7 PC
101-0000-42600
0
$110.22
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $171.13