BRES2017-0179cu
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8 95_CALLE .TAM CO .
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BRES2017-0179
Property Address: 55389 RIVIERA
APN: 775153005.
Application Description: CANNON / KITCHEN REMODEL
Property Zoning:
Application Valuation: $40,000.00
Applicant:
BRIAN DIEBOLT DESIGN CONCEPTS
57445 29 PALMS HIGHWAY 304 AUG 8 2��7
YUCCA VALLEY, CA 92284
DD
CITY OF LA QUINTA
DESIGN AND DEVELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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: B License No.: 645369
Date: % Contractor: �'IJ6�A� 1 s Co,
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).:
U 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:
VOICE (760) 777-7125 .
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/18/2017
Owner:
ANTHONY AND VALERIE CANNON
55389 RIVIERA DR
LA QUINTA, CA 92253
Contractor:
J A DOLAN GENERAL CONTRACTOR INC
74040 HIGHWAY 111 #L-226
PALM DESERT, CA 92260
(760)340-0905
Llc. No.: 645369
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 3700 of the Labor Code, for the performance
of the wor r which this permit is issued.
1 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: NORGUARD INSURANCE COMPANY Policy Number: JAWC991475
_ I certify that in the performance of the 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, andagreeth s ecome subject to the
workers' compensation provisions of Sect' 70 f the La or Code, I shall forthwith
comply with those provisions. )
Date: lehedfl Applican -
WARNING: FAILURE TO SECURE W RS' 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 1 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 rel 'ng to building
construction, and hereby authorize representatives of this cit nt r up n the above-
mentioned property for inspection purposes:
Date: CJS II_�( Signature (Applicant or Agent)
Date: 8/18/2017
Application Number: BRES2017-0179
Owner:
Property'55389 RIVIERA
ANTHONY AND VALERIE CANNON
APN: 775153005
55389 RIVIERA DR
Application Description: CANNON / KITCHEN REMODEL
LA QUINTA, 0%92253.
Property Zoning:
Application Valuation: $40,000.00
Applicant:
Coritractor:
BRIAN DIEBOLT DESIGN CONCEPTS
J A DOLAN GENERAL CONTRACTOR INC
57445 29 PALMS HIGHWAY 304
74040 HIGHWAY 111 #L7226
YUCCA VALLEY, CA 92284
PALM DESERT, CA 92260
(760)340-0905
Llc. No.: 645369
Detail: INTERIOR KITCHEN REMODEL. REMOVE NON-BEARING PARTITIONS AND
REVISE LAYOUT. ADD ISLAND ANDNEW BAR COUNTER W/ SINK AT
BREAKFAST NOOK. REPLACE ALL KITCHEN LIGHTING AND VARIOUS RECEPTACLES. THIS APPROVAL DOES NOT INCL€JDE THE ALTERATION TO ANY LOAD
BEARING WALLS OR LATERAL RESISTING STRUCTURAL MEMBERS. 2016 CALIFORNIA BUILDING CODES.
DESCRIPTION
ACCOUNT QTY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $2.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
Credit Card Fee
101-0000-43505
0
$6.38
Total Paid for Credit Card Fee: $6.38
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES/FIXTURES, ADDITIONAL
101-0000-42403
0
$40.48
DESCRIPTION
ACCOUNT
QTY
AMOUNT •
DEVICES/FIXTURES, ADDITIONAL PC
101-0000-42600
0
$10.08
Total Paid for ELErTRICAL: $101.22
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PARTITION
101-0000-42400
0
$76.00
DESCRIPTION
ACCOUNT f
QTY
AMOUNT
PARTITION PC
101-0000-42600
0
$139.84
Total Paid for PARTITION: $215.84
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0.
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$12.67
Total Paid for PLUMBING FEES: $25.34
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$5.20
Total Paid for STRONG MOTION INSTRUMENTATDN SMI: $5.20
DESCRIPTION ACCOUNT QTY AMOUNT
TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
RA
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Bin #Ae
City *of La Quinta
Building &r Safety Division
78-495 Calle Tampico
La Quinta, CA 92253.- (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
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..Project Address:'rj S 8 /. \ V I tl=/{ Q (�
jOwner's Name: -0t il 6"A
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A. P. Number:
Address:
Legal Description: r
City, ST, Zip: LA v CA S
_ Cotractor: —
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P hone:
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ess: C�
-Project Description:
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City, ST, Zip:
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State Lic. # : ^ City Lic. #:
ch-Engr., Designer L---9
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,Address: 5 S 2 (A4, t,
Ctty, .ST, Zip: �.
.\Telephone:
Construction Type: Occupancy:
cY:
1
State Lic. #-
Project e n Alter Repair
J type (circle one): New Add' Demo
Name of Contact Person:
�Sq. Ft: �n
QJ
#Stories:
# Units:
Telephone # of Contact Person: x10 - 3G5 - Z A:Tstiimated
Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Chec t Deposit
Truss talcs.
Called Contact Person
Plan Chec.z Balance
Title 24 Cates.
Plans picked ap
Construction
Flood plain plan
Plans resubmitted
Mechanic<l
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A: Approval
Plans resubmittedGrading
-
IN HOUSE:-
'^' Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees