BRES2018-008878-495 CALLE TAMPICO-
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Prop erty"Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
ROWLAND GOMEZ
c&'&Y'4,�u'�wn�w
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BUILDING RESIDENTIAL loct"^^e'
BRES2018-0088
50800 CALLE QUITO
770102002
DELEON / REMODEL BA
$2,500.00
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 15 in full force and effect.
License Class: License No.::CONV:140528101254086939
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 all
.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 and r Sec. B.&P.C. for r son
17
DateOwn _
�
CONSTRU 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/19/2018
Owner:
BENNIE DELEON
50800 CALLE QUITO
LA QUINTA, 922E3
Contractor:
BENNIE DELEON
5080.0 CALLE QUI—O
LA QUINTA, 9223
(760)578-5196
Llc. No.::CONV:140528101254086939
WORKER'S COMPENSAT0N 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 370C 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 fie 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 3100 of t bor Code, I shall forthwith
comply wit hose p visions.
Dater Applicant -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL -;--
AND SHALL SUBJECT AN EMPLOYER TO CRIMIML'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 ordireinces and state laws elating to building
construction, and hereby authorize representatives of this city t er upon the
above-me�ioned pyoper y for inspection purposes.
r
Date: 3/19/2018
Application Number:.
BRES2018-0088
Owner:
Property Address:
50800 CALLE QUITO
BENNIE DELEON
APN:
770102002
50800 CALLE QUI -0
Application Description:
DELEON / REMODEL BATHROOMS
LA QUINTA, 92253
Property Zoning:
Application Valuation:
$2,500.00
Applicant:
Contractor:
ROWLAND GOMEZ
BENNIE DELEON
50800 CALLE QUI -0
LA QUINTA, 92253
(760)578-5196
------------------------------------------------------
Llc. No.::CONV:1r-0528101254086939
---------------------------------------
Detail: REMODEL [2] BATHROOMS
REMOVE/REPLACE [2] TUBS/SHOWERS. ADD [2] NEW
WINDOWS. REMOVE [1] WALL 10 REMOVE TUB. AND ADD [3]
LIGHTS AND [2] SWITCHES. PER 2016 CALIFORNIA BUILDING CODES
r
DESCRIPTION
BSAS SB1473 FEE
DESCRIPTION
DEVICES; FIRST 20
DESCRIPTION
DEVICES, FIRST 20 PC
DESCRIPTION
FIXTURE/TRAP
' DESCRIPTION
FIXTURE/TRAP PC
DESCRIPTION
WATER SYSTEM INST/ALT/REP
DESCRIPTION
WATER SYSTEM INST/ALT/REP PC
INFORMATIONFINANCIAL
ACCOUNT 'QTY AMOUNT
101-0000-20306 0 $1.00
D.TY
Total Paid for BUILDING STANDARDS ADMINISTRATION" BSA: $1.00
SMI - RESIDENTIAL
101-0000-20308
ACCOUNT
QTY
AMOUNT
101-0000-42403
0
$26:01
ACCOUNT
QTY
AMOUNT
101-0000-42600
•0
$26.01
Total Paid for ELECTF:ICAL: $52.02
ACCOUNT
QTY
AMOUNT
101-0000-42401
0
$26.00
ACCOUNT
QTY
AMOUNT
101-0000-42600
0
$26.00
ACCOUNT
CITY
AMOUNT
101-0000-42401
0
$26.00
ACCOUNT
CRTY
AMOUNT
101-0000-42600
Q
$26.00
Total Paid for PLUMBING FEES: $104.00
DESCRIPTION
ACCOUNT
D.TY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50
DESCRIPTION
ACCOUNT
-QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
S02-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
DESCRIPTION ACCOUNT QTY AMOUNT
DOOR/WINDOW, RETRO/REPAIR, FIRST 7 101-0000-42400. 0 $65.54
DESCRIPTION ACCOUNT QTY AMOUNT,
DOOR/WINDOW, RETRO/REPAIR, FIRST 7 PC 101-0000-42600 0 $63.98
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $129.52