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BRES2017-0192 Revision 278-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 'RSV ksI oN Permit Type/Subtype: Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: BROCKPAYTON 4490 JASMINE AVE CULVER CITY, CA `e4hr 4 1wRu4rw DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT BUILDING RESIDENTIAL/DWELLING - SINGLE FAMILY DETACHED BRES2017-0192 80957 VIA PESSARO 777390002 HICKS / 7,262SF DWELLING/VB/RES-3/CLASS A-FR/13D $648,112.90 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/24/2018 Owner: BRENT & 10RJA HICKS 5525 SE SCENIC LN #200 VANCOUVER, WA 98661 Contractor: PD DD MONARCH HOMES DESERT DIVISION INC DBA DA 49-950 JEFFERSON ST #130-134 SEP 24 2018 INDIO, CA 92201 CITY OF LA QUINTA (760)413-8863 DESIGN AND DEVE[OPMFNT DEPARTMENT Llc. No.: 457228 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 Cla s: B}License No.: 457228 Dater I Y Contractor: \ 64yq/L, 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 Name: Lender's Address: 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' compensatio s provided for by Section 3700 of the Labor Code, For the performance of the 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: STATE COMPENSATION INSURANCE FUND , Policy Number: 9045509 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 revisions. Date: ZtApplicant: 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 ($100,000). 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-m ntioned property for inspection purposes. Date: Signature (Applicant or Agent): Date: 9/24/2018 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: BROCK PAYTON 4490 JASMINE AVE CULVER CITY, CA BRES2017-0192 80957 VIA PESSARO 777390002 HICKS / 7,262SF DWELLING/VB/RES-3/CLASS A-FR/13D $648,112.90 Owner: BRENT & 1ORJA HICKS 5525 SE SCENIC LN #200 VANCOUVER, WA 98661 Contractor: MONARCH HOMES DESERT DIVISION INC DBA DA 49-950 JEFFERSON ST #130-134 INDIO, CA 92201 (760)413-8863 Llc. No.: 457228 Detail: 7,262SF SINGLE FAMILY DWELLING [VB/RES-3/CLASS A-FR/13D] THIS PERMIT DOES NOT INCLUDE POOL, SPA, WATER FEATURES, BLOCK WALLS OR DRIVEWAY APPROACH. DEFERRED SUBMITTAL OF PHOTOVOLTAIC SYSTEM APPROVED BY AOR. 2016 CALIFORNIA BUILDING CODES. INFORMATION DESCRIPTION ACCOUNT CITY AMOUNT ALTERNATE METHOD/MATERIAL REVIEW 101-0000-42600 0.5 $78.00 Total Paid for ADMINISTRATIVE: $78.00 DESCRIPTION ACCOUNT CITY AMOUNT ART IN PUBLIC PLACES - RESIDENTIAL 270-0000-43201 0 $1,120.28 Total Paid for ART IN PUBLIC PLACES - AIPP: $1,120.28 DESCRIPTION ACCOUNT CITY AMOUNT HOURLY CHARGE - CITY BUILDING STAFF 101-0000-42600 2.5 $390.00 Total Paid for BLDG CITY STAFF - PER HOUR: $390.00 DESCRIPTION ACCOUNT CITY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $26.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $26.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - CIVIC CENTER 252-0000-43200 0 $942.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - LIBRARIES 253-0000-43200 0 $344.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - PARKS/REC 251-0000-43200 0 $2,048.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 DESCRIPTION ACCOUNT CITY AMOUNT DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 DESCRIPTION ACCOUNT CITY AMOUNT TEMP POWER SERVICE 101-0000-42403 0 $25.33 DESCRIPTION ACCOUNT CITY AMOUNT TEMP POWER SERVICE PC 101-0000-42600 0 $17.73 Total Paid for ELECTRICAL: $43.06 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $106.08 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, EA ADDITION 1,000SF, PC 101-0000-42600 0 $43.68 DESCRIPTION ACCOUNT CITY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $156.04 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $51.49 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $357.29 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT >7KSF 101-0000-42408 0 $38.00 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL PRECISE GRADING - CUSTOM HOME LOT >7KSF PC 101-0000-42600 0 $190.00 Total Paid for GRADING: $228.00 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR 101-0000-42402 0 $190.00 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR PC 101-0000-42600 0 $126.65 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD 101-0000-42402 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD PC 101-0000-42600 0 $5.07 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE 101-0000-42402 0 $190.00 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE PC 101-0000-42600 0 $126.65 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN 101-0000-42402 0 $139.37 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN PC 101-0000-42600 0 $55.77 Total Paid for MECHANICAL: $846.18 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PERMIT 101-0000-42400 0 $874.43 Total Paid for NEW CONSTRUCTION PERMIT: $874.43 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $1,200.00 DESCRIPTION ACCOUNT QTY AMOUNT NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $698.15 Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,898.15 DESCRIPTION ACCOUNT QTY AMOUNT BACKFLOW DEVICE 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT BACKFLOW DEVICE PC 101-0000-42600 0 $5.07 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER 101-0000-42401 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER PC 101-0000-42600 0 $17.73 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $468.79 DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $468.79 DESCRIPTION ACCOUNT CITY AMOUNT GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $39.01 DESCRIPTION ACCOUNT CITY AMOUNT GAS SYSTEM, 5+ OUTLETS PC 101-0000-42600 0 $26.01 DESCRIPTION ACCOUNT CITY AMOUNT WATER HEATER/VENT 101-0000-42401 0 $25.34 DESCRIPTION ACCOUNT CITY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 $15.20 DESCRIPTION ACCOUNT CITY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT CITY AMOUNT WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.67 Total Paid for PLUMBING FEES: $1,129.28 DESCRIPTION ACCOUNT CITY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $84.25 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $84.25 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 DESCRIPTION ACCOUNT CITY AMOUNT SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 Total Paid for TUMF - RESIDENTIAL: $1,837.44 TOTALS: $15,811.36 �r P1�1�M1'I �i7%-01qaL PLAN LOCATION: Project Address: ko,. �6. 1, 4 S/�&" Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN #: T IL� fq 91�iv5bo GG L Applicant Name: Address: City, ST, Zip: U Telephone!? Z'43 Email; 6 60�j&vo �^1 i�.( aluationofPro ject$ Contractor Name: New SFD Construction: Address: Conditioned Space SF City, St, Zip Garage SF Telephone: Patio/Porch SF Email: Fire Sprinklers SF State Lie: t City Bus Lie: v v I I." ---/ , 1 Arch/Eng Name: Construction Type: Occupancy: Address: Grading: city, St, Zip Telephone: Bedrooms: Stories: # Units: 3mail: State Lie: City Bus Lie: 'roperty Owner's Name: 6464jr (w New Commercial / Tenant Improvements: kddress: o � �G� Total Building SF ity, ST, Zip v 1kf(-)1t CA . ZZP Construction Type: Occupancy: Telephone: :mail: 78495 CALLE TAMPICO LA QU I NTA, CA 92253 760-777-7000 O 'Do