BRES2017-017278-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
c&Y' 4 4Quxfw
DESIGN & DEVELOPMENT DEPARTMENT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/7/2017
gOwner.
1
B` RTIMUS KAVA JAUGH FRICKLETO
150 OVERBROOK RD STE 200
JAW00D, KS 92253 7
Applicant: DESIGN AND DEVELOPMENT DEPARTME6I°ntractor:
GABRIEL RIOS BOB EDWARDS MNSTRUCTION INCORPORATED
49901 CINNABAR LN 51-455 DESERT CUB DRIVE
COACHELLA, CA 92236 LA QUINTA, CA 9?253
(760)777-8202•
Lic. No.: 684857
-------------------------------------------------- -- ----- ---------------- - - - - -- ---- --- -- - - - -
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.
Licensee Class:C2� 7 License No.: 68485
Date: 7(17 �' ContFactor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I art 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).:
(_) 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.).
(_) 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.).
(_) I am exempt under Sec. . B.&?.C. for this reason
Date:
Owner:
t 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 Name:
Lender's Address:
WORKER'S COMPENSA70N DECLARATION
I hereby affirm under penalty of perjury one o► the following declarations:
I have and will maintain a certificat-m of consent to self -insure for workers'
compensation, as provided for by Section 3700 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: ACE AMERICAN INSURANCE COMPAN' Policy Number: RWCC64339661
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, and agree that, if I should become subject to the
workers' compensation provisions of Section ?7 oft La or de, I shall forthwith
comply w' h ose provisions.
Date: � � (� Applicant:
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 ($100,00). 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 thi! 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 owns, 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 ssuance 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 city to a on the
above -me ion d property for inspection purposes.
4
Oa � Signature (A'pplicant or Agent):
�� �_. _ _
BUILDING PERMIT—
Application Number:
BRES2017-0172
Property Address:
80009 RIVIERA
D
APN:
762120003
Application Description:
BARTIMUS / DOOR/WINDOW CW
NG &0- T
AUG 01 '2017
Property Zoning:
Application Valuation:
$12,000.00
CITY OF LA QUINTA
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/7/2017
gOwner.
1
B` RTIMUS KAVA JAUGH FRICKLETO
150 OVERBROOK RD STE 200
JAW00D, KS 92253 7
Applicant: DESIGN AND DEVELOPMENT DEPARTME6I°ntractor:
GABRIEL RIOS BOB EDWARDS MNSTRUCTION INCORPORATED
49901 CINNABAR LN 51-455 DESERT CUB DRIVE
COACHELLA, CA 92236 LA QUINTA, CA 9?253
(760)777-8202•
Lic. No.: 684857
-------------------------------------------------- -- ----- ---------------- - - - - -- ---- --- -- - - - -
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.
Licensee Class:C2� 7 License No.: 68485
Date: 7(17 �' ContFactor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I art 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).:
(_) 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.).
(_) 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.).
(_) I am exempt under Sec. . B.&?.C. for this reason
Date:
Owner:
t 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 Name:
Lender's Address:
WORKER'S COMPENSA70N DECLARATION
I hereby affirm under penalty of perjury one o► the following declarations:
I have and will maintain a certificat-m of consent to self -insure for workers'
compensation, as provided for by Section 3700 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: ACE AMERICAN INSURANCE COMPAN' Policy Number: RWCC64339661
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, and agree that, if I should become subject to the
workers' compensation provisions of Section ?7 oft La or de, I shall forthwith
comply w' h ose provisions.
Date: � � (� Applicant:
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 ($100,00). 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 thi! 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 owns, 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 ssuance 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 city to a on the
above -me ion d property for inspection purposes.
4
Oa � Signature (A'pplicant or Agent):
�� �_. _ _
.
Date: 8/7/2017
Application Number:
BRES2017-0172
_ Owner:
Property Address:
80009 RIVIERA
BARTIMUS KAVANAUGH FRICKLETO
` APN:
762120003
11150 OVERBROOK RD STE 200
Application Description:
BARTIMUS / DOOR/WINDOW CHANGE OUT
LEAWOOD, KS 92253
Property Zoning:
Application Valuation:
$12,000.00
I
Applicant:
Contractor:
GABRIEL RIOS
BOB EDWARDS CONSTRUCTION INCORPORATED
49901 CINNABAR LN
51-455 DESERT CLUB DRIVE
COACHELLA, CA 92236
LA QUINTA, CA 92253
(760)777-8202
Llc. No.: 684857
---------------
-------------------------------------
-----------------------------------------
Detail:
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY AMOUNT
HOURLY CHARGE - ESGIL CIVIL ENGINEER
101-0000-42600 2 $210.00
Total Paid for BLDG CITY STAFF - PEF HOUR: $210.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$1.56
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $1.56
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DOOR/WINDOW, NEW/ALT, EAADDITION•1
101-0000-42400
0
$31.92
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DOOR/WINDOW, NEW/ALT, EA ADDITION 1 PC
101-0000-42600
0
$36.48
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DOOR/WINDOW, NEW/ALT, FIRST 1
101-0000-42400
0
$101.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DOOR/WINDOW, NEW/ALT, FIRST 1 PC
101-0000-42600 '
0
$115.52
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $285.25