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BRES2015-034078-495 CALLE TAMPICb � 0 D � VOICE (760) 777-7125. LA QUINTA, CALIFORNIA 92253 rr ,-:. FAX (760) 777-7011 COMMUNITY DEVELOPMENT D PAR)MEN� �Li\ v 1M�� CTIONS(760)'777-7153 BUILDING PERMI SCP 30 '-'015 Date: 9/30/2015 Application Number: BRE52015-0340 ._©caner..._....,,. Property Address: 52849 ROSS AVE APN: 767670017 COMMUNITY [ IALSP'AVR 407 Application Description: SUGARMAN / 105 SQ FT CLOSET ADDITION BE Property Zoning: Application Valuation: $30,000.00 Applicant: Contractor: HUGO CERVANTES DISCOVERY BUILDERS CALIFORNIA INC DBA DB 51825 AVENIDA VELASCO 14605 N 73RD STREET . LA QUINTA, CA 92253 SCOTTSDALE, AZ 85260 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: B License No.: 915336 tractor: OWNER -BUILDER DECLARATIO 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 th basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for 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.). ( ) 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 Name: Lender's Address: (480)624-5200 Llc. No.: 915336 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 w r0f'or 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: _ Policy Number: 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 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: ! J pplicantt✓ WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO OVERAGE 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 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 enter upon the above-mentioned property for inspection purposes. *��x �" , /J �heture (Applicant or Agent : ` DESCRIPTIONACCOUNT FINANCIAL • - • QTY:..AMOUNT .'PAIb, PAID DATE° ADDIT10A1 *AAODITIONAL 500 SF 101-0000-42400 0 $62.36 $0.00 ;PAID BY:' METHOD , •` ;RECEIPT# CHECK'# CLTD BY DESCRIPTION - `- ACCOUNT QTY AMOUNT PAID, PAID DATE ADDITION, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $17.40 $0.00 PAID,BY METHOD RECEIPT#,CHECK# �..`CLTD;BY DESCRIPTION ACCOUNT QTY':, .. AMOUNT: PAID PAID'DATE ADDITION, FIRST 100 SF 101-0000-42400 0 $120.83 $0.00 PAID„ BY METHOD; RECEIPT# CHECK #. " CLTD"BY . - 'DESCRIPTION' �:'-ACCOUNT , - " QTY`; AMOUNT ,PAID PAID DATE ADDITION, FIRST 100 SF PC 101-0000-42600 0 $171.14 $0.00 ' �PAIDBY METHOD �, " RECEIPT# CHECK # s GLTD BY. �. Total Paid for ADDITION: $371.73 $0.00 DESCRIPTION ACCOUNT ,,� QTY,- AMOUNT. . PAID ;PAID'DATE. HOURLY PLAN CHECK - YES 101-0000-42600 2 $140.00 $0.00 ,PAID BY, METHOD "RECEIPT # CHECK # :' CLTD BY Total Paid for BLDG CITY STAFF - PER HOUR: $140.00 $0.00 '.DESCRIPTION -ACCOUNT `: QTY ' AMOUNT'' PAID ` PAID DATE' BSAS SB1473 FEE 101-0000-20306 0 $2.00 $0.00 M PAID BY METHOD RECEIPT # - CHECK # ,' CLTD BY. Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 $0.00 DESCRIPTION ACCOUNT .. QTY _ , AMOUNT: , P.AID., " PAID DATE_;,.., DEVICES, FIRST 20 101-0000-42403 0 $24.17 $0.00 PAID, �-`METHOD=.' ::. RECEIPT ;CHECK#'CLTDBY"' BY DESCRIPTION ACCOUNT' ` QTY AMOUNT " PAID PAID DATE' DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 v ' ' PAID`BY MET HOD RECEIPT # `, CHECK # ; CLTD BY Total Paid for ELECTRICAL: $48.34 $0.00 DESCRIPTION . ACCOUNT, , '. " . QWL' AM PAID DATE T RESIDENTIAL, FIRST 1,000SF. 101-0000-42403 0 $145.03 $0.00 PAID BYWETHOD RECEIPT # _ CHECK #<:'`.CLTD BY; .y RESIDENTIAL', FIRST 1,000SF, PC 101 0000-42600 0 $47.86; $0 Oo " .1 .PAIDBY �z METHODi RECEIPT'# CHECK# CLTD.•BY ESCRIPTION-� ACO NTS CITY AMOU Ty 0. PAIb MPA- s CONDENSER/COMPRESSOR, 101-00,00-42402 0 $3636 $0 00., zuem.�en�-.'•:xa..;..m�.wc¢9:ibak'F6'x&k;nw>ti5ti.5Cb'via"i: iYii D3b&Y. 'E': r". Xa'.Z:S'SSbi'w.^iN.::SSfi'.TX�1°Y55GRY'+SY.!'(lkSS'.:" Y.ES'c=RX.� :�RRk�$�SAY.*'.`AZRv`w..42 f"KiS.RC'.r3.. - , CONDENSER/COMPRESSOR PC 101-0000-42600. 0 $24.17 $0 00 TotaL;Paid,for MECHANICAL:. $77 35':` , $0 00 ROOF. DRAIN 101;0000-42401 0`.' $12.09 ;$0.00 a PAID BY METHOQM, ' �RELIPT# CHECK,## y,` � yCU§BY ROOF,DRAIN'PC 101=0000=42600 0' : '$12.09 $0.00 . -- Total 'Paid. for ELECTRICAL - NEW'CONSTRUCTION:' $192.89 $0.00 MWAN DESCRIPTION ACCOUNT TY Q'y 1 . AMOUNTP,AID a . �PDDE '. DESCRIPTION ACCOUNT APPLIANCE REPAIR/ALTERATION '' i01-0000-42402 0 $12.09 ._ $0:00 " �, �s .71 D9off �M HOD RECEIPT .s� k CHECK#@LTD d e . BY , SMI - RESIDENTIAL - 101-0000=20308 0 $1.90 r fes. �� ;;, N AMOUNT P,A D PDATE CHECKS# APPLIANCE REPAIR/ALTERATION PC 101'0000-42600 0 $4.8 '., $0 0!0 . k. .1 .PAIDBY �z METHODi RECEIPT'# CHECK# CLTD.•BY ESCRIPTION-� ACO NTS CITY AMOU Ty 0. PAIb MPA- s CONDENSER/COMPRESSOR, 101-00,00-42402 0 $3636 $0 00., zuem.�en�-.'•:xa..;..m�.wc¢9:ibak'F6'x&k;nw>ti5ti.5Cb'via"i: iYii D3b&Y. 'E': r". Xa'.Z:S'SSbi'w.^iN.::SSfi'.TX�1°Y55GRY'+SY.!'(lkSS'.:" Y.ES'c=RX.� :�RRk�$�SAY.*'.`AZRv`w..42 f"KiS.RC'.r3.. - , CONDENSER/COMPRESSOR PC 101-0000-42600. 0 $24.17 $0 00 TotaL;Paid,for MECHANICAL:. $77 35':` , $0 00 ROOF. DRAIN 101;0000-42401 0`.' $12.09 ;$0.00 a PAID BY METHOQM, ' �RELIPT# CHECK,## y,` � yCU§BY ROOF,DRAIN'PC 101=0000=42600 0' : '$12.09 $0.00 . Total:Paid for PLUMBINGTEES:.:.. >$24.18 ,. $0.00 '. DESCRIPTION ACCOUNT CITY AMOUNT �PA� PAID DATE �, �s s�ev��u �� SMI - RESIDENTIAL - 101-0000=20308 0 $1.90 r ffPA D=.BAY f va 5M HO ' REC SPT# tp, CHECKS# CLQ Y ; . k. �. Total Paid for STRONG MOTION INSTRUMENTATION SMI:` $3.90 $0.00 m ��