BTTR2016-0001�4 arw
78-495 CALLE TAMPICO VOICE (760) 777-7125
• FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 4/12/2016
Application Number: BTTR2016-0001 Owner:
Property Address: 53370 ROSS AVE T STAR III LLC
APN: 767680011 2030 E FLAMINGO RD STE 290
Application Description: MADISON / LUCE / CONSTRUCTION .RA_ I.LFR LAS VEGAS, NV 89119
Property Zoning: D /1
Application Valuation: $2,000.00
Applicant: ntractor:
DISCOVERY BUILDERS CALIFORNIA INC DBA DB ' APR, 1.' 2 2C,'' D 3COVERY BUILD13RS CALIFORNIA INC DBA DB
14605 N 73RD STREET 1 605 N 73RD STREET
SCOTTSDALE, AZ 85260 CITY OFIAQUINTA S OTTSDALE, AZ 8_5260
COMMUNITY DEVELOPMENT DEPARTME 80)624-5200
Llc. No.: 915336
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.
License 1Class: B License No.: 915336
Dater "7 T7 L Contractor.
OWNER-BUILDE tECLARATION
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).:
( ) 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:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of tqe 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
ofthe��pr—k FQr which this permit is issued.
� ave and will maintain workers' cornpensation 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 subj ct to the
workers' compensation provisions of Section 37CO of the Labor Code, I all forthwith
comply with those provisions./J
Date: �+ Applicant:
WARNING: FAILURE TO SECURE WORKERS' OM DENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TOC MINA- PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000) IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR ILI 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 aoplication.
1. Each person upon whose behalf this applica*.ion is made, each person at whose
request and for whose benefit work is performec 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 applicat on becomes null and void if work is
not commenced within 180 days from date of isTuance 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 MAA
/ilding
construction, and hereby authorize representatives of this city to enter up n thS�`'1
above-mentioned property for inspection purposes. / M.
FINANCIAL INFORMATION
tr;. DESCRIPTION 4 QTY,
"i41V1OUNT
PAID DATE:'
tnACCOUNTF_
SPECIAL INSPECTION
101-0000-42404 0
$72.52
$0.00
PAID.BYF= . � '
'_ : METHOD `'� `
RECEIPT #
'CHECK #F
CLTD BY s
_rti
Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION:
$72.52
$0.00
TOTALS:•
00
Description: MADISON / LUCE / CONSTRUCTION TRAILER
Type: TEMPORARY TRA-ILER
Subtype: Status: APPROVED
Applied: 4/11/2016 SKH
Approved: 4/12/2016 SKH
Parcel No: 767680011 Site Address: 53370 ROSS AVE LA QUINTA,CA 92253
Subdivision: TR 33076-1
Block: Lot: 49
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled: -
Valuation: $2,000.00
Occupancy Type:. Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: TEMPORARY TRAILER. 2013 CALIFORNIA BUILDING CODES.
OWNER T STAR III LLC
i
'CONDITIONS
" Applied to Approved
Printed: Tuesday, April 12, 2016 9:14:50 AM 1 of 2
CRWIYSTEMS
FAX, EMAIL
NAME'TYPE _ _"' NAME ' rt
CONTACTS
3_ADDRESSI CITY " : -STATE
ZIP '.`;
PHONE'
APPLICANT DISCOVERY BUILDERS CALIFORNIA
INC DBA DB
14605 N 73RD STREET SCOTTSDALE AZ
85260
-SBIRDWELL@DISCOVE
RYLANDCO.COM
CONTRACTOR DISCOVERY BUILDERS CALIFORNIA
INC DBA DB
14605 N 73RD STREET SCOTTSDALE AZ
85260
SBIRDWELL@DISCOVE
RYLANDCO.COM
OWNER T STAR III LLC
i
2030 E FLAMINGO RD LAS VEGAS NV
I STE 290
89119
Printed: Tuesday, April 12, 2016 9:14:50 AM 1 of 2
CRWIYSTEMS
DESCRIPTION
ACCOUNT G
QTY
AMOUNT
PAID
PAID DATE
RECEIPT
CHECK #
METHOD
PAID BY P
CLTD
�..,.•
,#
BY
SPECIAL INSPECTION
101-0000-42404
0
$72.52
$0.00
Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION:
$72.52
$0.00
TOTAL
INSPECTIONS
PARENT PROJECTS
K° RETURNED STATUS REMARKS F NOTES
REVIEW TYPE REVIEWER SENT DATE DUE DATE DATE
aoND
IFwroAMATION
ATTACHMENTS
Printed: Tuesday, April 12, 2016 9:14:50 AM 2 of 2
SYSTEMS
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MiTek'
Re: Lot 31 A
MiTek USA, Inc.
7777 Greenback Lane
Suite 109
Citrus Heights, CA, 95610
Telephone 9161676-1900
Fax 91616x6-1909
The truss drawing(s) referenced below have been prepared by MiTek USA, Inc. under my d_rect supervision
based on the parameters provided by BMC -Indio, CA.
Pages or sheets covered by this seal: R46162042 thru R46162122
My license renewal date for the state of California is December 31, 2017.
Lumber design values are in accordance with ANSUTPI 1 section 6.3
These truss designs rely on lumber values established by others.
• Q?,pFESS/pN\
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SOON O9�F2
L C 074486 c
* ` EXP. 12-31-17
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t
`-� December 18,2015
Ong, Choo Soon
The seal on these drawings indicate acceptance of professional engineering responsibility solely for the
truss components shown. The suitability and use of this component for any particular building is the
responsibility of the building designer, per ANSVTPI 1.