BRES2017-017178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
„"i °Y V"Q"""w
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT'
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS. (760) 777-7153
78115 CALLE ESTADO, SUITE 105
LA QUINTA, CA 92253
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 t
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit bjects.the applicant to a civil penalty of not more than five hundred dollars
TTas owner of the property, or my employees with wages as their sole
& ensation, 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
withinhdre year of completion, the owner -builder will have the burden of proving that
e did not build or improve for the purpose of sale.).
(U I, as owner of t property, am exclusively contracting with licensed contractors
to construct the pro' (Sec. 7044, Business and. Pro ssions Code: The Contractors'
State License Law cls not apply to an owner of prop y who builds or improves
there ,and who tracts for the projects with�acLtractor(s) licensed pursuant to
t --actors' S e License Law.).
am exemp nder Sec. B.&P.C. fon
Oa�I"
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:
Llc. No.:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificcte of consent to self -insure for workers'
compensation, as provided for by Section 37 )0 of the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain workers' :ompensation 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 insurar ce caibecobject
umber are:
Carrier: Policy Number: _
I certify that in the performance cf theis permit is issued,
shall not employ any person in any manner so as tto the workers'
compensation laws of California, and agree t iat, isubject to the
workers' compensation provisions of Sectiorv3700e, I shall forthwith
comply those prov Bions.
/ V'T --
WARNING: FAILURE TO SECURE WORKERS' C.7MPENSATION 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 Ilhe Building Official for a permit subject to
the conditions and restrictions set forth on tFis 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 or issuance of such permit, or ceAation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and --tate that the above informs is correct.
I agree to comply with all city and county orcinances and state law to building
construction, and hereby authorize representatives of this city to ter the
above-mentioned property for inspection purposes.
Agent):
Date: 11/7/2017
Permit Type/Subtype:
Application Number:
BUILDING RESIDENTIAL/DWELLING -SIN
BRES2017-0171
FE AM Owner:
Q1 UL AND BRENDAWff
(�-'.J
Property Address:
78612 PEERLESS PL
.... 29 148TH ST ISSUED
APN:
770310017
f +`��•� �l 7 MONTON AE? CN T5Rlq-7
jL
Application Description:
Property Zoning:
TRADITION /JOHNSON / NEW SFD
L e � ��� "t
NOV J % 2017.
Application Valuation:
$604,284.30
OOMMUA4TYTYC)F4tULIAID
DE(
ELOPMEWDEPARRAENT
Applicant:
Contractor:
SOUTH WEST CONCEPTS, INC.
OWNER / BUILCER
78115 CALLE ESTADO, SUITE 105
LA QUINTA, CA 92253
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 t
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit bjects.the applicant to a civil penalty of not more than five hundred dollars
TTas owner of the property, or my employees with wages as their sole
& ensation, 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
withinhdre year of completion, the owner -builder will have the burden of proving that
e did not build or improve for the purpose of sale.).
(U I, as owner of t property, am exclusively contracting with licensed contractors
to construct the pro' (Sec. 7044, Business and. Pro ssions Code: The Contractors'
State License Law cls not apply to an owner of prop y who builds or improves
there ,and who tracts for the projects with�acLtractor(s) licensed pursuant to
t --actors' S e License Law.).
am exemp nder Sec. B.&P.C. fon
Oa�I"
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:
Llc. No.:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificcte of consent to self -insure for workers'
compensation, as provided for by Section 37 )0 of the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain workers' :ompensation 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 insurar ce caibecobject
umber are:
Carrier: Policy Number: _
I certify that in the performance cf theis permit is issued,
shall not employ any person in any manner so as tto the workers'
compensation laws of California, and agree t iat, isubject to the
workers' compensation provisions of Sectiorv3700e, I shall forthwith
comply those prov Bions.
/ V'T --
WARNING: FAILURE TO SECURE WORKERS' C.7MPENSATION 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 Ilhe Building Official for a permit subject to
the conditions and restrictions set forth on tFis 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 or issuance of such permit, or ceAation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and --tate that the above informs is correct.
I agree to comply with all city and county orcinances and state law to building
construction, and hereby authorize representatives of this city to ter the
above-mentioned property for inspection purposes.
Agent):
Date: 11/7/2017
Application Number: BRES2017-0171 Owner:
Property Address: 78612 PEERLESS PL PAUL AND BRENDA JOHNSON
APIC' 770310017 9429 148TH ST
Application Description: TRADITION /JOHNSON / NEW SFD EDMONTON AB, ZN T5R1A-7
Property Zoning:
Application Valuation: $604,284.30
Applicant: Contractor:
SOUTH WEST CONCEPTS, INC. OWNER / BUILDER
78115 CALLE ESTADO, SUITE 105
LA QUINTA, CA 92253;
Llc. No.:
---------------------------------------------------------------------------------------------
Detail: 6741 SF NEW DWELLING - LOT 27, [VB/RES-3/CLASS A-FR/13D] THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLCCK WALLS OR DRIVEWAY
APPROACH. 2016 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION
ACCOUNT CITY AMOUNT
ART IN PUBLIC PLACES - RESIDENTIAL
270-0000-43201 0 $1,010.71
Total Paid for ART IN PUBLIC PLACES- AIPP: $1,010.71
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$25.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $25.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DIF - CIVIC CENTER
252-0000-43200
0
$942.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DIF - COMMUNITY CENTERS
254-0000-43200
0
$129.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT.
DIF - FIRE PROTECTION
257-0000-43200
0
$433.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DIF - LIBRARIES
253-0000-43200
0
$344.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DIF - PARK MAINTENANCE
256-0000-43200
0
$40.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DIF - PARKS/REC
251-0000-43200
0
$2,048.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DIF - STREET MAINTENANCE
255-0000-43200
0
$116.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DIF - TRANSPORTATION
250-0000-43200
0
$2,842.00
Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SERVICES
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SERVICES PC
101-0000-42600
0
$12.67
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TEMP POWER SERVICE
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TEMP POWER SERVICE PC
101-0000-42600
0
$17.73
. Total Paid for ELECTRICAL: $81.06
i DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, EA ADDITION 1,000SF
101-0000-42403
0
$119.34
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, EA ADDITION 1,000SF, PC
101-0000-42600
0
$49.14
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, FIRST 1,000SF
101-0000-42403
0
$156.04
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, FIRST 1,OOOSF, PC
101-0000-42600
0
$51.49
Total Paid for ELECTRICAL - NEW CONSTRU --TION: $376.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT >7KSF
101-0000-42408
01
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT >7KSF PC
101-0000-42600
0
$190.00
Total Paid for GRADING: $228.00
DESCRIPTION
ACCOUNT
: QTY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402
0
$228.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$151.98
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
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FURNACE
101-0000-42402
0
$228.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FURNACE PC
101-0000-42600
0
$151.98
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN
101-0000-42402
0
$152.04
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN PC
101-0000-42600
0
$60.84
Total Paid for MECHANICAL: $990.58
DESCRIPTION
ACCOUNT
QTY
AMOUNT
..MULTI SPECIES RESIDENTIAL 0-8 UNITS - 2017 UPDATE
101-0000-20310
0
$1,245.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
MULTI -SPECIES RESIDENTIAL>14 UNITS - 2017 UPDATE
101-0000-20310
0
$17.00
Total Paid for MULTI -SPECIES RESIDENTIAL: $1,262.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NEW CONSTRUCTION PERMIT
101-0000-42400
0
$848.47
Total Paid for NEW CONSTRUCTION PERMIT: $848.47
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NEW CONSTRUCTION PLAN CHECK
101-0000-42600
0
$1,200.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
NEW CONSTRUCTION PLAN CHECK
101-0000-42600
0
$638:75
Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,838.75
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BACKFLOW DEVICE
101-0000-4240.1
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BACKFLOW DEVICE PC
101-0000-42600
0
$5.07
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BUILDING SEWER
101-0000-42401
0
$25.33
DESCRIPTION
ACCOUNT
:QTY
AMOUNT
BUILDING SEWER PC
101-0000-42600
0
$17.73
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$456.12
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
.0
$456.12
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 5+ OUTLETS
101-0000-42401
0
$39.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 5+ OUTLETS PC
101-0000-42600
0
$26.01
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
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT
101-0000-42401
0
$38.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT PC
101-0000-42600
0
$22.80
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
$12.67 .
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER SYSTEM INST/ALT/REP PC
101-0000-42600
0
$12.67
Total Paid for PLUMBING FEES: $1,149.55
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE - MAJOR
101-0000-42416
0
$20.00
Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $20.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$78.56
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $78.56
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMEINT FEE:. $5.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SINGLE FAMILY DETACHED
224-0000-20320
0
$1,837.44
Total Paid for TUMF - RESIDENTIAL: $1,837.44