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BRES2017-0151VOICE (760) 777-7125 78-495 CALLE TAMPICO O�i � ,D LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 7774153 BUILDING PERMIT Date: 8/4/2017 Application Number: BRES2017-0151 Owner: Property Address: 55081 OAK HILL CHRIS & DEBRA WALT APN: 775141024 55081 OAK HILL . Application Description: WALT/ INTERIOR REMODEL LA QUINTA, CA 92253 Property Zoning: Application Valuation: $9,000.00 D A (, Applicant: AUG U 4 2017 Contractor: DAZ DAZ P 0 BOX 5083 COMMUNI CI OF(q Q -UJ — P 0 BOX 5083 LA QUINTA, CA 92253 - E�IIELOPh1EVTDEPgHTMENT LA QUINTA, CA 92253 (760)285-3793 Llc. No.: 944325 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 {commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: B License No.: 944325 Oe- G ntractor: 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.). (_1 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.). (T) 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 Lender's Ad 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: STATE COMPENSATION INSURANCE FUND Policy Number: 9168769 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 tha if I should become subject to the workers' compensation provisions of 5ection 3 of th r Code, I shall forthwith com ply with those pr visions. : d p icant: WARNING: FAILURE TO SECURE WORKERS' OMPENSATION 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 building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. D r 0 Signature (Applicant or Agen Date: 8/4/2017 Application Number: BRES2017-0151 Owner: Property Address: 55081 OAK HILL CHRIS & DEBRA WALT APN: 775141024 55081 OAK HILL Application Description: WALT / INTERIOR REMODEL LA QUINTA, CA 92253 Property Zoning: Application Valuation: $9,000.00 Applicant: Contractor: DAZ DAZ P 0 BOX 5083 P 0 BOX 5083 LA QUINTA, CA 92253 LA QUINTA, CA 92253 (760)285-3793 --------------------------------------------------------------------------------------------- Llc. No.: 944325 Detail: INTERIOR REMODEL. REMOVE EXISTING WALL'AND ADD BEAM TO CREATE OPENING AT KITCHEN. ADD LIGHTING, RECEPTACLES, SINK, AND RANGE/HOOD AT KITCHEN, AND ADD LIGHT AT WET BAR. THIS PERMIT DOES NOT INCLUDE OTHER ALTERATIONS TO IN-ERIOR OF DWELLING. 2016 CALIFORNIA BUILDING CODES. FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT BSA$ 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 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES/FIXTURES, ADDITIONAL 101-0000-42403 0 $10.12 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES/FIXTURES, ADDITIONAL PC 101-0000-42600 0 $2.52 Total Paid for ELECTRICAL: $63.30 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD 101-0000-42402 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD PC 101-0000-42600 0 $5.07 Total Paid for MECHANICAL: $17.74 DESCRIPTION •ACCOUNT QTY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $12.67 Total Paid for PLUMBING FEES: $25.34 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, EA ADDITIONAL 500 SF 101-0000-42400 0 $22.80 'DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $18.24 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, FIRST 100 SF 101-0000-42400 0 $51.68 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, FIRST 500 SF PC 101-0000-42600 0 $141.36 Total Paid for REMODEL: $234.08 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $1.17 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $1.17 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY. ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 • Bin # City of La Quilita Buitdin,Cr 8T Safety Division Permit # 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: �54rn Owner's Name: r"Ai u(i N 4 D±�i/A JAAJ-�_ A. P. Number: Address: Legal Description: City, ST, Zip: L,41- Contractor: Tele . hone: p Address: 3dX QProject Description: City, ST, Zip: mA ........... Tclephonc:q-(e0, ............ .......... .... State Lic. # City Lie. fl: P Arch., Engr., Designer: P �cl -eA^ Address: City, ST, Zip: Telephone: I -foo. ..... Con struction T . ype: I Occupancy: State Lic. 9. Project type (circle one): New Add'n Alter Repair. Demo. Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person-..._ Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE ti Submittal Rcqld Rcc'd TRACKfNG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural CaIcs. Reviewed, ready for corrections Plan Check Deposit Truss Caics. Called Contact Person Plan Check Balance Title 24 CaIcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'd Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Gran( Deed Plans picked up II.O.A. Approval Plans resubmitted Grading -IN HOUSE:- Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Pet -son A.I.P.P. Pub. 1Vks. Appr Da(e of permit issue School Fees, H17 V L_ Ptal Permit Fees o JUL 03 2017 CITY OF LA QUINTA - COMMUNuy DP,'/_r_'_.--')PMENT