BDEM2019-000278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
MICHELE PACELLI
53785 AVENIDA RAMIREZ
LA QUINTA, CA 0
Twyl 464ti44(rw
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
DEMOLITION/SINGLE FAMILY
BDEM2019-0002
53785 AVENIDA RAMIREZ
774161016
PACELLI / DEMO GARAGE WALL CODE VIOLATION
n � U
V
JAN 16 2019
CITY OF LAQUINTA 0
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: _ 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. 7031.5, 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
an rafessions Code) or that he ar she is exempt therefrom and the basis for the
aile91N exemption. Any violation of Section 7031.5 by any applicant for a permit
s b the applicant to a civil penaltyof not more than five hundred dollars ($500).:
owner of the property, or my employees wlth wages as their sole
a pensation, 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
him If or herself through his or her own employeas, provided that the Improvements
are t intended or offered for sale. If, however, the building or improvement is sold
40,,S,tN,,Ucr,1
re year of completion, the owner -builder will have the burden of proving that he
not build or improve for the purpose of sale.).
owner of the property, am exclusively contracting with licensed contractors to
the project. (Sec. 7044, Business and Professions Code: The Contractors' State
U a Law does not apply to an owner of Property who builds or improves thereon,
an dwh6,contracts for the projects with a contractors) licensed pursuant to the
a t s' State License Law.).
am xempt under Sec. _ . B,&P.C. for this reason f _
Date: [ 1 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/16/2019
Owner:
MICHELE PACELLI
53785 AVENIDA RAMIREZ
LA QUINTA, CA 0
Contractor:
Llc. No.:
WORKER'S COMPENSATION DECLARATION
I herebyaffirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure forworkers'
compensation, as provided for by Section 3700 of the labor Code, for the performance
of the work for which this permit is issued.
L I have and will maintain workers' compensation insurance, as required by
Section 0 of the Labor Code, for the performance of the work for which this permit is
issued. workers' compensation insurance carrier and policy number are:
C i Policy Number:_
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 agre that, if I should bec subject to the
workers' compensation provisions of S t n 3 00 of the La , I shall forthwith
comp
lywi h th se rov' ' ns.
Date
: Applicant:
WARNING: FAILURE 0 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
he conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
-equest and for whose benefit work is performed under or pursuant to any permit issued
3s a result of this application , the owner, and the applicant, each agrees to, and shall
iefend, 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
allowing issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not
ommernced within 180 days from date of issuance of such permit, or cessation of work
Dr 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 ordinanmm�-
ng
construction, and hereby authorize representativv
mentioned prop rty for inspection purposes.
Date: Signature (Applicant or A
Date: " 1t16/2019
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
BDEM2019-0002
53785 AVENIDA RAMIREZ
774161016
PACELLI / DEMO GARAGE WALL CODE VIOLATION
Applicant:
MICHELE PACELLI
53785 AVENIDA RAMIREZ
LA QU I NTA, CA 0
Owner:
MICHELE PACELLI
53785 AVENIDA RAMIREZ
LA QUINTA, CA 0
Contractor:
,LIc. No.:
----------------------------------------------------------- --- -----------------------------
Detail: PACELLI DEMO UNPERMITTED WALL IN GARAGE. RETURN GARAGE TO PREVIOUS CONDITION. PER 2016 CALIFORNIA BUILDING CODES. DOES NOT
TTING IF DISCOVERED UPON INSPECTION.
INCLUDE ANY NEW INSTALLATIONS. ANY OTHER UNPERMITTED WORK WILL REQUIRE PERM3
DESCRIPTION
DEMOLITION, FULL
DESCRIPTION
DEMOLITION, FULL PC
DESCRIPTION
RECORDS MANAGEMENT FEE
DESCRIPTION
TECHNOLOGY ENHANCEMENT FEE
ACCOUNT CITY
AMOUNT
101-0000-42404 0
$27.22
ACCOUNT CITY
AMOUNT
101-0000-42600 0
$96.06
Total Paid for DEMOLITION:
$123.28
CITY
AMOUNT
EEACCOUNT
101-0000-42416 0
$10.00
Total Paid for RECORDS MANAGEMENT FEE:
$10.00
ACCOUNT CITY
AMOUNT
502-0000-43611 0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00
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PERMIT# Q ��
PLAN LOCATION:
Project Address: S� �5 �i�e
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
Applicant Name: ` _ ��O
Address:
City, ST, Zip: —D 0 —7
Telephone:
Email:
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:
Address:
Grading:
City, St, Zip
Bedrooms: Stories: # Units:
Telephone:
Email:
State Lie: City Bus Lie:
Property Owner's Name:
New Commercial / Tenant Improvements:
Address:
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
CITY OF LA QUINTA
BUILDING DIVISION
REVIEWED FOR
COMP DANCE
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