BRES2018-033578-495 CALLE TAMPICO ' 0 D .. VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 1/18/2019
Permit Type/Subtype: BUILDING RESIDENTIAL/REMODEL Owner:
Application Number: BRES2018-0335 MELDMAN FAMILY LTD PARTNERSH
Property Address: 53525 HUMBOLDT BLVD 14605 N 73RD ST
APN: 767700018 SCOTTSDALE, AZ 0
Application Description: MELDMAN / 1053 SF GARAGE CONVERSION
Property Zoning:
Application Valuation: $25,000.00
Applicant: D Contractor:
MOX DESIGN DISCOVERY BUILDERS CALIFORNIA INC DBA DB
14605 N 73RD STREET
JA N 18 2019 SCOTTSDALE, AZ 85260
CITY OF iA QUINTA (480)624-5200
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 915336
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 Class: B License No.:.
Date: Contractor:' '
�aY
OWNER -BUILDER DEC TION
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
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'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of for which this permit is Issued.
i have and will malntain workers' compensation insurance, as required by
thSe 43700 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: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA 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 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: Applicant: [�
WARNING: FAILURE TO SECURE WORKERS' COMPEN ION 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.
Date:_—>/ = —
Signature(ApplicantorAgent 1��
Date: 1/18/2019
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
MOX DESIGN
BRES2018-0335
53525 HUMBOLDT BLVD
767700018
MELDMAN / 1053 SF GARAGE CONVERSION
$25,000.00
Owner:
MELDMAN FAMILY LTD PARTNERSH
14605 N 73RD ST
SCOTTSDALE, AZ 0
Contractor:
DISCOVERY BUILDERS CALIFORNIA INC DBA DB
14605 N 73RD STREET
SCOTTSDALE, AZ 85260
(480)624-5200
LIc. No.: 915336
Detail: 1053 SF REMODEL - CONVERSION OF EXISTING GARAGE TO TWO GUEST SUITES. THIS INCLUDES RELOCATION OF EXISTING MECHANICAL
EQUIPMENT, TWO NEW SPLIT HEAT PUMPS, RELOCATION OF TWO EXISITNG ELECTRICAL SUB PANELS, NEW ELECTRICAL, PLUMBING, AND
FENESTRATION AT REMODEL AREA. 2016 CALIFORNIA BUILDING CODES.
FINANCIAL
DESCRIPTION
INFORMATION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($125.00)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HOURLY CHARGE - INTERWEST STRUCTURAL PLAN REVIEW
101-0000-42600
0
$125.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HOURLY CHARGE - INTERWEST STRUCTURAL PLAN REVIEW
101-0000-42600
1 2
$125.00
Total Paid for BLDG CITY STAFF - PER HOUR: $125.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, FIRST 1,000SF
101-0000-42403
0
$160.10
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, FIRST 1,000SF, PC
101-0000-42600
0
$52.83
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $212.93
DESCRIPTION
ACCOUNT
QTY
AMOUNT
AIR HANDLER
101-0000-42402
0
$80.04
DESCRIPTION
ACCOUNT
CITY
AMOUNT
AIR HANDLER PC
101-0000-42600
0
$26.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402
0
$80.04
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$53.36
DESCRIPTION
ACCOUNT
QTY
AMOUNT
OTHER MECHANICAL EQUIPMENT
101-0000-42402
0
$80.04
DESCRIPTION
ACCOUNT
QTY
AMOUNT
OTHER MECHANICAL EQUIPMENT PC
101-0000-42600
0
$80.04
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN
101-0000-42402
0
$26.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
VENT FAN PC
101-0000-42600
0
$10.68
Total Paid for MECHANICAL: $437.56
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PLAN CHECK DEPOSIT - ADDITION/REMODEL
101-0000-42600
1
$125.00
Total Paid for PLAN CHECK DEPOSIT - ADDITION/REMODEL: $125.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$106.72
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$106.72
DESCRIPTION
ACCOUNT I
QTY I
AMOUNT
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$13.34
DESCRIPTION
ACCOUNT
CITY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$26.68
Total Paid for PLUMBING FEES: $253.46
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE - MAJOR
101-0000-42416
0
$21.00
Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $21.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$48.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$38.42
DESCRIPTION
ACCOUNT
CITY
AMOUNT
REMODEL, FIRST 100 SF
101-0000-42400
0
$54.43
DESCRIPTION
ACCOUNT
CITY
AMOUNT
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$148.89
Total Paid for REMODEL: $289.76
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$3.25
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $3.25
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS: $1,473.96
e
OC&
PERMIT #
PLAN LOCATION:
Project Address: ,yiJ �5 oLDr_VD
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
Q11Jx177 E GA
APN #:
Applicant Name: *1�
Address: *v 3 a(J/1.
City, ST, Zip: Q
Telephone: Q .
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:
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
OFFICE USE ONLY
w
u1mittal
Req'd
Ree'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
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City Business License