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BRES2017-018178-495 CALLE TAMPICO Tjh/ D *P Qa�GLJ LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRES2017-0181 Property Address: 53395 VIA STRADA APN: 777200001 Application Description: GLADNEY / ADD BATHROOM AT EXISTING OFFICE Property Zoning: Application Valuation: $25,000.00 Applicant: PD ANTON MARINKOVICH 550 5 OLEANDER RD AUG 0 2017 PALM SPRINGS, CA 92264 LD' DESIGN AND r:.:7r;.0; 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. C54 License No.: 655 Date: J2 (� Contractor: 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).: (_) 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 Na Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/8/2017 Owner: DAN AND DIANE GLADNEY 53395 VIA STRADA LA QUINTA, CA 92253 Contractor: GALATI ENTERPRISES INC 78050 CALLE CADIZ LA QUINTA, CA 92253 (760)777-9994 Llc. No.: 655861 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 37D0 of the Labor Code, for the performance of tAworkfor which this permit is issued. I have and will maintain workers' compensation Insurance, as required by Sects 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: BENCHMARK INSURANCE COMPANY Policy Number. CST5009259 _ I certifythat in the performance of the work for whirh 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 Sec "on 3700 of the Labor Code, 1 shall forthwith comply with those provisions. Date: 1) Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALLSUBJECT 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. (�y Date � � 1 Signature (Applicant or Agent): "�1 1' Date: 8/8/2017 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: ANTON MARINKOVICH 550 S OLEANDER RD PALM SPRINGS, CA 92264 BRES2017-0181 53395 VIA STRADA 777200001 GLADNEY / ADD BATHROOM AT EXISTING OFFICE $25,000.00 Owner: DAN AND DIANE GLADNEY 53395 VIA STRADA LA QUINTA, CA 92253 Contractor: GALATI ENTERPRISES INC 78050 CALLE CADIZ LA QUINTA, CA 92253 (760)777-9994 Llc. No.: 655861 Detail: GLADNEY / ADD BATHROOM TO EXISTING OFFICE RESULTING IN AN ADDITION OF 17 S.F OF CONDITIONED SPACE. SITE SPECIFIC ENGINEERING (B.G. STRUCTURAL ENGINEERING). WORK FULLY COMPLETED PRIOR TO PERMIT ISSUANCE --CONTRACTOR TO EXPOSE CONSTRUCTION FOR INSPECTION AS NECESSARY. 2016 CALIFORNIA BUILDING CODES. 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 ADDITION: $307.04 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 DEVICES, FIRST20 101-0000-42403 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $25.33 Total Paid for ELECTRICAL: $50.66 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: $17.74 DESCRIPTION ACCOUNT QTY 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 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: $101.36 DESCRIPTION ACCOUNT CITY AMOUNT REMODEL, FIRST 100 SF 101-0000-42400 0 $51.68 DESCRIPTION ACCOUNT CITY 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 $3.25 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $3.25 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 Bin # City Of La Q uin to BOdin g U Safety Division Permit # 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-70 ]2 Building Permit Application and Tracking Sheet Project Address: Owner's Name: p �� A_ P. Number: - Address: Legal Description- City, ST, Zip: Contractor: y Telephone: 7,'' v Address: 75—� Project Description:S ��7—• City, ST, Zip: Telephone: Y= < ; = State Lic. # : City Lie. #.-Q Arch., Engr., Designer: L Address: &A?106/Z rii 7ro City, ST, Zip: f Il Telephone:-10,,�0• -=<:=. Construction Type: Occupancy: State Lic. #: Project type (circle one): New dd'n Alter Repair Demo Name of Contact Person: I`�11l�ikUl�l4� Sq. Ft_: # Stories: # Units: Telephone # of Contact Person (oO _ `� • ` Estimated Value of Project: =--5— 0 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACIQNG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance Titic 24 Cal cs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd 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 resubmitted Grading 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 1' v } Total Permit •ees JUL 2 5 2017 'CITY OF L_ ; OUNTA COA►ltti UNITY CE E-0PMENT R Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) �398-1224 RECEV AUG 0 8 2017 This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMM/IND AMOUNT: DATE: RECEIPT: CHECK #: INITLALS CITY OF LA QUINTA COMMUNITY DEVELOPMENT CERTIFICATE OF COMPLIANCE (California Education Code 17620) Project Name: The Hideaway Owner's Name: Dan and Diane Gladney Project Address: 53-395 Via Estrada Project Description: Addition to Existing Dwelling APN: 777200001 Tract #: Type of Development: Residential XX Commercial Total Square Feet of Building Area: 17 sq. ft. Date: August 4, 2017 Phone No. 760-777-9994 Lot #'s: Industrial Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized to sign opb.2half of the owner/developeer. Dated: August 4, 2017 Signature: SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code Gov. Code 17620 65995 Number of Sq.Ft. 17 Amount per Sq.Ft. $0.00 Amount Collected $0.00 Project Agreement Existing Not Subject to Fee Approval Prior to 1/1/87 Requirement Building Permit Application Completed: Yes/No By: Elsa F. Esqueda, Director of Facilities and Maintenance Note: Pursuant to AB 181 any room additions or enclosures of 500 sq. ft. or less are exempt from developer fees. Any mobile homes being relocated within the same school district's jurisdiction are exempt from developer fees. Certificate issued by: Laurie Howard, Secretary Signature:AuA�� �(Z NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90-day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90-day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. ,iV:c'nr,�loc: ur�fca'crlili;::llc of �Innpiiancc Dour ur-;iai_ii ,-1007 11/2010