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.
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