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BDEM2018-000778-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: GALATI ENTERPRISES, INC 78050 CALLS CADIZ LA QUINTA, CA 92253 cewyl 4 4 Qumrcv DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT DEMOLITION/SINGLE FAMILY BDEM 2018-0007 53580 AVENIDA CORTEZ 774102004 HURWITZ / DEMO PERMIT $6,000.00 D OCT 0 12018 CITY OF LA QUINTA DESIGN & DEVELOPMENT DEPARTMENT 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 Class: B. C54 License No.: 65 861 Date: w ' (' (� Contractor: L`% OWNER -BUILDER DECLARATION 1 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. . BAP.C. for this reason 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 - VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/1/2018 Owner: DANIEL HURWITZ 54605 AVENIDA RAMIREZ LA QUINTA, CA 92253 Contractor: GALATI ENTERPRISES INC 78050 CALLE CADIZ LA QUINTA, CA 92253 (760)777-9994 Lic. 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 3700 of the Labor Code, for the performance of PIP y5A for which this permit is issued. I have and will malntaln workers' compensation insurance, as required by Sectior07D0 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: CST5011728 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 complyi with those provisions. Date: `� ' ' � D/7Applicant: 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 thi lty to enter upon the above -mentioned property for inspection purposes. ." 4( elx Date: [(3. `', Signature (Applicant or Agent). Lender's Add Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: GALATI ENTERPRISES, INC 78050 CALLE CADIZ LA QU I NTA, CA 92253 Detail BDEM2018-0007 53580 AVENIDA CORTEZ 774102004 HURWITZ/ DEMO PERMIT $6,000.00 Owner: DANIEL HURWITZ 54605 AVENIDA RAMIREZ LA QUINTA,CA 92253 Contractor: GALATI ENTERPRISES INC 78050 CALLE CADIZ LA QUINTA, CA 92253 (760)777-9994 Llc. No.: 655861 Date: 10/1/2018 FINANCIAL•• • DESCRIPTION ACCOUNT CITY AMOUNT Credit Card Fee 101-0000-43505 0 $2.85 Total Paid for Credit Card Fee: $2.85 DESCRIPTION ACCOUNT CITY AMOUNT DEMOLITION, INTERIOR 101-0000-42404 0 $39.01 DESCRIPTION ACCOUNT CITY AMOUNT DEMOLITION, INTERIOR PC 101-0000-42600 0 $104.55 Total Paid for DEMOLITION: $143.56 DESCRIPTION ACCOUNT CITY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 PERMIT # � -D C %1 ZDI � 0 (i • PLAN LOCATION: A Q Project Address: j 3 Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN #: Applicant Name: Address: City, ST, Zip: Telephone: -7 (�C) �( y Email: /1 i @ ct (q� •- �� i Valuation of Project $ C� d 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: e4r Construction Type: O Occupancy: Address: Grading: City, St, Zip Telephone: Bedrooms: Stories: #Units: Email: State Lic: City Bus Lic: Property Owner's Name: �q �(1 c L �(J / vJ \ t -Z., New Commercial / Tenant Improvements: Address: --I - 7 1� M 2 3 Total Building SF City, ST, Zip t n C Construction Type: Occupancy: Telephone: y S Email: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 OFFICE USE ONLY # Submittal Req'd J Req'd Plan Sets Structural Calcs Truss Calcs Title 24 Calcs Soils Report Grading Plan (PM10) Landscape Plan Subcontractor List Grant Deed HOA Approval School Fees Burrtec Debris Plan Planning approval Public Works approval Fire approval City Business License 9/19/18 To whom it may concern, authorize Galati Enterprises, Inc. to perform work ( including demolition work) on my property at 53580 Avenida Cortez, La Quinta, CA. 92253. Thank you, Daniel Hurwitz sk 500F Hurwitz Daniel J 53580 Avenida Cortez La Quinta, CA 92253 Riverside County APN-. 774-102-004 Built: 1998 Sq Ft: 1,476 Type: Residential / SFR Beds: 3 Baths: 2 Order Customer Service Cos:sFirst' Add is Farm List Report Name Actions Combined Report Edit I Run Property Profile Run Available Allowance 96 100 Transaction History Run 98 100 V