BRES2017-0078J
78-495 CALLE TAMPICO C` 0 D
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LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype:
BUILDING RESIDENTIAL/ADDITION
Application Number:
BRES2017-0078
Property Address:
79840 REMINGTON DR
APN:
766060039
Application Description:
ADAMS FAMILY TRUST / GARAGE & MEDIA ADD'T
Property Zoning:
�
Application Valuation:
$100,000.00 II 11 &
Applicant:
J A DOLAN GENERAL CONTRACTOR INC
74040 HIGHWAY 111 #L-226
PALM DESERT, CA 92260
lUL- ___.
GCT 31 2017
CIT•YOFrA QUINTA
COMMUNITYDEVELOPMEWpFpgRTMENT
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 Busi d Professions Code,
and my License is in full force and effect.
License Class: B License No.: 645369
PCrtractor.
OWNER -BUILD 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 forthe 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 Divisions
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).:
{_J 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.).
(_J 1, 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.).
U 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
.Date: -10/31/2017
Owner:
ADAMS FAMILY TRUST
79840 REMINGTCN DR
LA QUINTA, CA K253
Contractor:
J A DOLAN GENEFAL CONTRACTOR INC
74040 HIGHWAY Ill #L-226 _
PALM DESERT, CP 92260
(760)340-0905
Llc. No.: 645369
WORKER'S COMPENSAMON 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
Df 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 perfor nance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: NORGUARD INSURANCE COMPANY Policy Number: JAWC891475
I certify that in the performance of :he work for which this permit is issued, I
shall not employ any person in any manner so 3s to become subject to the workers'
compensation laws df California, and agree that, if I should become subject to the
workers' compensation provisions of Secti 00 o Code, I shall forthwith
comply with those provisions.
Date: 117 Ap Ip (17Xf_11.1V
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 ($100,00D). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOF_ 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 appli:ation 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 tae 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 ssuance of such permit, or cessation of
work for 180 days will subject permit to cancelation.
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 ordiiances and state laws relating to building
construction, and hereby authorize repre ativ s cit to enter upon the
above-mentioned property for inspecti n pu se
Date* - , - 2 tr Sign�at�,('' tic
Date: 10/31/2017
Application: Number: BRES2017-0078 Owner:.
Property Address: 79840 REMINGTON DR ADAMS FAMILY TRUST
APN: 766060039 79840 REMINGTCN DR
Application Description: ADAMS FAMILY TRUST / GARAGE & MEDIA ADD'T LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $100,000.00•
Applicant: Contractor:
J A DOLAN GENERAL CONTRACTOR INC 1 A DOLAN•GENERAL CONTRACTOR INC
74040 HIGHWAY 111 #L-226. 74040 HIGHWAY _11 #L-226
'PALM DESERT, CA 92260 PALM DESERT, CA 92260
(760)340-0905
Llc. No.: 645369
------------------------------------ ----------------------------------------------------------
Detail: GARAGE ADDITION 528 SF AND 462 SF MEDIA ROOM. PER 2016 CLAIFORNIABUILDING CODE "
i •
1
DESCRIPTION
ACCOUNT
QTY
AMOUNT
ADDITION, EA ADDITIONAL 500 SF
101-0000-42400
0
$65.36
DESCRIPTION
ACCOUNT
1QTY
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 ADDIrION: $390.64
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HOURLY CHARGE - YES STRUCTURAL PLAN REVIEW ENGINEER
101-0000-42600
3
$285.00
Total Paid for BLDG CITY STAFF - PER HOUR: $285.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$4.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $4.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
Credit Card Fee
101-0000-43505
0
$24.46
Total Paid for Credit Card Fee: $24.46
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, FIRST 1,O00SF
101-0000-42403
0
$152.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, FIRST 1,000SF, PC
101-0000-42600
0
$50.16
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $202.16
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402
0
$38.00 '
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FURNACE
101-0000-42402
0
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FURNACE PC
101-0000-42600
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN
101-0000-42402
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN PC
101-0000-42600
0
$5.07
Total Paid for MECHANICAL: _$144.40
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$38.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP PC,
101-0000-42600
0
$38.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT
101-0000-42401
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT PC
101-0000-42600
0
$7.60
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: $121.63
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: $193.04
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$13.00
Total Paid foe STRONG.MOTION INSTRUMENTATION SMI: $13.00 '
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $S.00
TOTALS: $1,383.33
L.
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