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BRES2017-002678-495 CALLE TAMPICO D �iNMCl/ LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT Application Number: BRES2017-0026 Property Address: 55870 PEBBLE BEACH APN: 775130018 Application Description: RIPPEE / REMODEL AND ADDITTION Property Zoning: Application Valuation: $132,562.40 Applicant: PACIFIC VIEW ESTATES, JEFF RIPPEE 55870 PEBBLE BEACH LA QUINTA, CA 92253 BUILDING PERMIT VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: PACIFIC VIEW ESTATES, INC. P.O. BOX 9080 ® RANCHO SANTA FE, CA 92067 Q PRAY1,52017o tra A: WN R UILDER DFSIGNglvOCII QI/IIVTq p�'ENrDEPgI�T�t�eNao.: 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).: ( ) 1, 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 contractors) licensed pursuant to Contractors' State License Law.). III am exempt under Sec. . B.&P.C. for this reason Date 5 10 Own A., CONSTR N 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: Date: 5/15/2017 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 37d0 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: Carr, Polity Number: _ I certify that in the performance of the work for which this permit is issued, I sha of 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. Date: 5 l 1_ ] 7 Applican : WARNING: FAILURE TO SECURE WORKERS COMPENSATION 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 ci o enter upon the above-mentioned property for inspection purposes. Date: 13 Signature (Applicant or Agen r Date: 5/15/2017 Application Number: BRES2017-0026 Owner: Property Address: 55810 PEBBLE BEACH PACIFIC VIEW ESTATES, INC. APN: 775130018 P.O. BOX 9080 Application Description: RIPPEE / REMODEL AND ADDITTION RANCHO SANTA FE, CA 92067 Property Zoning: Application Valuation: $132,562.40 Applicant: Contractor: PACIFIC VIEW ESTATES, JEFF RIPPEE OWNER BUILDER 55870 PEBBLE BEACH LA QUINTA, CA 92253 -------------------------------------------------------,-------------------------------------- LIC. No.: Detail: REMODEL ADDITION CONSTRUCTION WAS PERFORMED WITHOUT PERMITS. ADDITION OF OFFICE, NOOK, AND LIVINGROOM ADDITION. VISUAL EVALUATION WAS PERFORMED BY DENISE POELTER, P.E. FROM THE FLYING BUTTRESS. SITE INSPECTIONS WIILL BE REQUIRED FROM CITY BUILDING DEPT. r FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, EA ADDITIONAL 500 SF 101-0000-42400 0 $65.36 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $18.24 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, FIRST 100 SF 101-0000-42400 0 $127.68 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, FIRST 100 SF PC 101-0000-42600 0 $179.36 Total Paid for ADDITION: $390.64 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - CITY BUILDING STAFF 101-0000-42600 1.25 $190.00 Total Paid for BLDG CITY STAFF - PER HOUR: $190.00 DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $6.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $6.00 DESCRIPTION ACCOUNT 1 QTY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $152.00 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,OOOSF, PC 101=0000-42600 0 $50.16 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $202.16 DESCRIPTION ACCOUNT QTY AMOUNT APPLIANCE REPAIR/ALTERATION 101-0000-42402 0 $12.67. DESCRIPTION ACCOUNT QTY AMOUNT APPLIANCE REPAIR/ALTERATION PC 101-0000-42600 0 $5.07 Total Paid for MECHANICAL: $17.74 DESCRIPTION ACCOUNT , QTY AMOUNT GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.67 . DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT ROOF DRAIN 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT ROOF DRAIN PC 101-0000-42600 0 $12.67 Total Paid for PLUMBING FEES: $63.34 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $17.23 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $17.23 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00