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BRES2018-037878-495 CALLE TAMPICO c 0 D � 4" LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Permit Type/Subtype: BUILDING RESIDENTIAL/REMODEL Application Number: BRES2018-0378 Property Address: 44185 CARMEN PL APN: 604151001 Application Description: CULLEN / REPAIR FIRE DAMAGE Property Zoning: Application Valuation: $80,000.00 Applicant: SCOTT BAKER /POWELL ASSOCIATES P 9980 INDIANA AVE RIVERSIDE, CA 92503 JAN 18 2019 CITY OF LAQUINTA 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 License No.: 936193 L ( Date: 7ss i 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 Name: Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/18/2019 Owner: JOHN CULLEN Contractor: A'S CONTRACTOR INC 1095 N MAIN ST UNIT ORANGE, CA 92867 (800)886-1594 Llc. No.: 936193 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 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 C MPEN ATION INSURANCE FUND Policy Number: 922898$-_ 1 _ K l 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 provisions. Date: ! ! Applicarit::-. 5 -— 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 -mentioned property for inspection purposes. � � J Date I q Signature (Applicant or Agent): f Application Number: BRES2018-0378 Property Address: 44185 CARMEN PL APN: 604151001 Application Description: CULLEN / REPAIR FIRE DAMAGE Property Zoning: Application Valuation: $80,000.00 Applicant: SCOTT BAKER /POWELL ASSOCIATES 9980 INDIANA AVE RIVERSIDE, CA 92503 Owner: JOHN CULLEN Contractor: A'S CONTRACTOR INC 1095 N MAIN ST UNIT T ORANGE, CA 92867 (800)886-1594 Llc. No.: 936193 Date: 1/18/2019 --------------------------------------------------------------------------------------------- Detail: 2635 SF FIRE DAMAGE REMODEL INCLUDING REPLACEMENT OF HVAC MECHANICAL EQUIPMENT, WATER HEATER, AND ELECTRICAL THROUGHOUT. 2016 CALIFORNIA BUILDING CODES. ACCOUNT QTY AMOUNT DESCRIPTION 0 $4.00 101-0000-20306 BSAS SB1473 FEE STANDARDS ADMINISTRATION BSA: $4.00 Total Paid for BUILDING ACCOUNT QTY AMOUNT DESCRIPTION 0 $27 22 101-0000-42403 RESIDENTIAL, EA ADDITION 1,000SF CITY AMOUNT ACCOUNT DESCRIPTION 0 $11.20 101-0000-42600 RESIDENTIAL, EA ADDITION 1,000SF, PC CITY AMOUNT ACCOUNT DESCRIPTION 0 $160.10 101-0000-42403 RESIDENTIAL, FIRST 1,000SF CITY AMOUNT ACCOUNT DESCRIPTION 0 $52.83 101-0000-42600 RESIDENTIAL, FIRST 1,000SF, PC CONSTRUCTION: $251.35 Total Paid for ELECTRICAL -NEW ACCOUNT QTY AMOUNT DESCRIPTION 0 $40.02 101-0000-42402 CONDENSER/COMPRESSOR QTY AMOUNT ACCOUNT DESCRIPTION 0 $26.68 101-0000-42600 CONDENSER/COMPRESSOR PC CITY AMOUNT ACCOUNT DESCRIPTION 0 $40.02 101-0000-42402 FURNACE ACCOUNT QTY AMOUNT DESCRIPTION 0 $26.68 101-0000-42600 FURNACE PC Total Paid for MECHANICAL: $133.40 ACCOUNT QTY AMOUNT DESCRIPTION 1 $125.00 PLAN CHECK DEPOSIT - ADDITION/REMODEL 101-0000-42600 $125.00 Total Paid for PLAN CHECK DEPOSIT - ADDITION/REMODEL: ACCOUNT QTY AMOUNT DESCRIPTION 0 $13.34 101-0000-42401 FIXTURE/TRAP QTY AMOUNT ACCOUNT DESCRIPTION 0 $13.34 101-0000-42600 FIXTURE/TRAP PC CITY AMOUNT ACCOUNT DESCRIPTION 0 $13.34 101-0000-42401 WATER HEATER/VENT QTY AMOUNT ACCOUNT DESCRIPTION 0 $8.00 101-0000-42600 WATER HEATER/VENT PC Total Paid for PLUMBING FEES: $48.02 ACCOUNT QTY AMOUNT DESCRIPTION ($125.00) 101-0000-42600 ACCOUNT QTY AMOUNT DESCRIPTION 0 $144.06 101-0000-42400 REMODEL, EA ADDITIONAL 500 SF CITY AMOUNT ACCOUNT DESCRIPTION 0 $115.26 101-0000-42600 REMODEL, EA ADDITIONAL 500 SF PC QTY AMOUNT ACCOUNT — DESCRIPTION REMODEL, FIRST 100 SF DESCRIPTION REMODEL, FIRST 500 SF PC DESCRIPTION REMODEL, FIRST 500 SF PC DESCRIPTION SMI - RESIDENTIAL DESCRIPTION TECHNOLOGY ENHANCEMENT FEE 101-0000-42400 0 $54.43 ACCOUNT QTY AMOUNT 101-0000-42600 0 $125.00 ACCOUNT QTY AMOUNT 101-0000-42600 0 $23.89 Total Paid for REMODEL: $337.64 ACCOUNT CITY AMOUNT 101-0000-20308 0 $10.40 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $10.40 ACCOUNT CITY AMOUNT 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 terra Qa KPERMIT GEM.fd5rDESERRTTL— PLAN LOCATION: Project Address: �f(� / I-1 / U � ` Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN #: r Applicant Name: n Address: ( ,vA City, ST, Zip: Tf( { Cie IQ 3 Telephone. d Emait:'- 14 to ow eOa1\4OS e2'-coM 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 Lie: City Bus Lie: Arch/Eng Name: Construction Type: Occupancy: Addres .��n� S3 Grading: City, St, zip Vff Telephon�_c::q� `-(—IS,� — Y"UQ? Bedrooms: Stories: # Units: Email: i t� IA��"� CtI�A FSS C� i'►1 [State Lic: City Bus Lie: Property Owner's Name: "-�eCC� �t1 New Commercial / Tenant Improvements: Address:. ` Total Building SF City, ST, Zil ( Construction Type: Occupancy: Telephone: '' Email: —+ 78495 CALLE TAMPICO LA QU I NTA, CA 92253 760-777-7000