BSPN2018-002678-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
CHRISTOPHER HARGETT
78485 HIGHWAY 111 UNIT 6
LA QUINTA, CA 9+2253
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DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
SPECIAL INSPECTION/
BSPN2018-0026
79485 HIGHWAY 111 STE 6
600020027
HARGETT/ NEW SPACE
LICENSED CONTRACTOR'S DECLARATION
I herebyaffirm 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: License No.:
Date
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. 7031.3, Business and Professlons 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 Ifcensed 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 Cade) 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 ane year of completion, the owner -builder wlII 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 Add
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/13/2018
Owner:
STAN BARON t
6780 ALTAWAR DR
LOS ANGELES, CA 90045 f'a J
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Contractor:
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Llc. No.:
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 work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 3700 or the Labor Code, for the performance of the work forwhich 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 totheworkers'
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:
Applicant:
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.
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
:onstruction, and hereby authorize representatives of this city to enter upon the
above -mentioned property for inspection purposes.
)ate: 13 / 2*Signature (Applicant or Agent): ��
Date: 9/13/2018
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
BSPN2018-0026
79485 HIGHWAY 111 STE 6
600020027
HARGETT / NEW SPACE
Applicant:
CHRISTOPHER HARGETT
78485 HIGHWAY 111 UNIT 6
LA QUINTA, CA 9+2253
Owner:
STAN BARON
6780 ALTAWAR DR
LOS ANGELES, CA 90045
Contractor:
Llc. No.:
----------------------------------------------------------------------------------------------
Detail: SPECIAL INSPECTION - NEVER OCCUPIED SPACE, FOR PILATES AND TRAINING. THIS PERMIT IS NOT FOR WORK. 2016 CALIFORNIA BUILDING CODE.
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT QTY
AMOUNT
SPECIAL INSPECTION
101-0000-42404 0
$78.02
Total Paid for COMPLIANCE SURVEY/SPECIAL INSPECTION:
$78.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00
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PERMIT #
PLAN LOCATION:
Project Address:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
Applicant Name: t� r
Address:
City, ST, Zip: L cn Q,u�nVp, L Z5
Telephone: -L 6i g, � 2 3
i
Email ka�,�n�n Cow\
Valuation of Project$
Contractor Name:
New SFD Construction:
Address:
Conditioned Space SF
City, St, Zip
Garage SF
Telephone:
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: City Bus Lic:
Arch/Eng Name: Construction. Type: Occupancy:.
Address: Grading:
City, St, Zip
Telephone: Bedrooms: Stories: # Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name: 1 av\ q,.,
New Commercial / Tenant Improvements:
Address: 7 Y
Total Building SF
City, ST, Zip l.ao �r `1 fr b�°�S
Construction Type: Occupancy:
Telephone: 3 a
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Req'd
Rec'd
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
—
- -I
— —_
HOA Approval
School Fees
Burrtec Debris Plan.
Planning approval
Public Works approval
Fire approval
City Business License