BRES2017-0190Q.�iTw/ D � Qaba VOICE (760) 777-7125
78-495 CALLE TAMPICO
Twit FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/1/2017
Application Number: BRES2017-0190 Owner:
Property Address: 53700 AVENIDA OBREGON PDQ INVESTMENTS LLC
APN: 774115010 32392 SOUTH COAST HIGHWAY STE 150
Application Description: PDQ INVESTMENTS / STUCCO LAGUNA BEACH, CA 92651
Property Zoning:
Application Valuation: $5,000.00
Applicant. Contractor.
RM CONSTRUCTION RM CONSTRU7ION
P O BOX 406 PAUG U Y 2017 P O BOX 406
THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276
CITY OF LA QUINTA (760)275-549:
DESIGN AND DEVELOPMENT DEPARTMENT Llc. No.: 764761
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 Clas : B License No.: 764761
Date: Date: , Contrlr actor: .
OWNER -BUILDER DE ATION
I hereby affirm under penalty of perjury that I am x pt from the Contractor's State
License Law for the following reason (Sec. 7031. , Bu iness 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
Lender's Address:
WORKER'S COMPEN::ATION 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 3:00 of the Labor Code, for the performance
ofo k -for which this permit is issued.
( `- (have and will maintain workers'compensation insurance, as required by
Section 3 00 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: 9170351
_ 1 certify that in the performance cf the work for which this permit is issued, I
shall not employ any person in any manner to as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the
workers' comns@tion provisions of Section 3700 of the Lab ode, I shall forthwith
comply with t�ose brovisions. /1
Applicant'_
WARNING: FAILURE TO SECURE WORKERS' COMPYNSaTIONIfeOVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL'PEgALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100;300). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKMOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on t its 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, an the applicant, each agrees to, and shall
defend, indemnify and hold harmless the Cit+of La Quinta, its officers, agents, and
employees for any act or omission related tathe work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this appication becomes null and void if work is not
commenced within 180 days from date of isquance of such permit, or cessation of work
for 180 days will subject permit.to cancellation.
I certify that I have read this application and ;tate that the above information incorrect.
I agree to comply with all city and county ordinances and state laws rela ' g to building
construction, and hereby authorize represen_atives of this city to ente>on the above-
mentione¢ property for inspection purposes. /1 / /
Application Number:
BRES2017-0190
Property Address:
53700 AVENIDA OBREGON
APN:
774115010
Application Description:
PDQ INVESTMENTS / STUCCO
Property Zoning:
Application Valuation:
$5,000.00
Applicant:
RM CONSTRUCTION
P 0 BOX 406
THOUSAND PALMS, CA 92276
Date: 8/1/2017
Owner:
PDQ INVESTMENTS LLC
32392 SOUTF COAST HIGHWAY STE 150
LAGUNA BEA:H, CA 92651
Contractor:
RM CONSTRICTION
P 0 BOX 406
THOUSAND PALMS, CA 92276
(760)275-549V
Llc. No.: 764761
Detail: RE -STUCCO EXISITNG BUILDING. THIS PERMIT DOES NOT INCLUDE ANY OTHER WORK INCLUDING RE -ROOF TO THE BUILDING. PER 2016
CALIFONRIA BUILDING CODE.
W' a FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS 561473 FEE 101-0000-20306 0 $1:00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.65
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.65
DESCRIPTION
ACCOUNT
QTY
AMOUNT
STUCCO APPLICATION, EA ADDITIONAL 500 SF
101-0000-42404
0
$22.80
DESCRIPTION
ACCOUNT
QTY
AMOUNT
STUCCO APPLICATION, FIRST 500 SF
101-0000-42404
0
$25.84
DESCRIPTION
ACCOUNT
QTY
AMOUNT
STUCCO APPLICATION, FIRST 500 SF PC
101-0000-42600
0
$77.52
Total Paid for STUCCO APPLICATION: $126.16
DESCRIPTION .
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00