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BRES2018-030278-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: ROB PITCHFORD 77622 COUNTRY CLUB STE 0 PALM DESERT, CA 92211 ceitiv, 4 6420 Q" DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT BUILDING RESIDENTIAL/REMODEL BRES2018-0302 81040 GOLF VIEW DR 762280030 BETTENCOURT / FIREPLACE / BBQ ADDITON $7,500.00 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: TIM BETTENCOURT 2020 STANDIFORD AVE NO A MODESTO, CA 92253 D � a Contractor: MARIO A YANEZ CONSTRUCTION PO BOX 580925 FEB 0 6 2019 NORTH PALM SPRINGS, CA 92258 wyOF LAQUINTA (760)285-1532 DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 1026884 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed Zr provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Bus' and Professions Code, and my License is in full force and effect. License Class: B License No.:1026884 Date:-' G'/ Contractor Date: 2/6/2019 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: have and will maintain a certificate of consent to self -insure for workers' compens i , a roviclecl for by Section 3700 of the Labor Code, for the performance of th which this permit is issued. ave and will maintain workers' compensation insurance, as required by S. 00 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: OWNER -BUILDER DECLARATI Carrier: JQ—R,"AHQ.INSURAN�E CQMPANY Policy Number:MAWL990876 I hereby affirm under penalty of perjury that I am exempt from the Contractor's State _ I certify that in the performance of the work for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair any compensation laws of California, and agree that, if I should become subject to the structure, prior to its issuance, also requires the applicant for the permit to file a signed workers' compensation provisions of Section 3700 of the r I shall forthwith statement that he or she is licensed pursuant to the provisions of the Contractor's State comply with those provisions. 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 the basis for _ r 6 ZpI and the Date:Z Applicant, 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).: WARNING: FAILURE TO SECURE WORKERS' COMPENSATld%,COV! AGE IS UNLAWFUL, (_) I, as owner of the property, or my employees with wages as their sole AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO compensation, will do the work, and the structure is not intended or offered for sale. ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF (Sec, 7044, Business and Professions Code: The Contractors' State License Law does not COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, apply to an owner of property who builds or improves thereon, and who does the work INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT within one year of completion, the owner -builder will have the burden of proving that he IMPORTANT: Application is hereby made to the Building Official for a permit subject to or she did not build or improve for the purpose of sale.). the conditions and restrictions set forth on this application, (_) I, as owner of the property, am exclusively contracting with licensed contractors to 1. Each person upon whose behalf this application is made, each person at whose construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State request and for whose benefit work is performed under or pursuant to any permit issued License Law does not apply to an owner of property who builds or improves thereon, as a result of this application , the owner, and the applicant, each agrees to, and shall and who contracts for the projects with a contractor(s) licensed pursuant to the defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and Contractors' State License Law.). employees for any act or omission related to the work being performed under or (_) I am exempt under Sec. . B.&P.C. for this reason 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 Date: Owner: for 180 days will subject permit to cancellation. 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 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 relatin to building construction, and hereby authorize representatives of this city to enter the ove- mentioned property for inspection purposes. Date: - 2p Signature(ApplicantorAgent) Date: 2/6/2019 Application Number: BRES2018-0302 Property Address: 81040 GOLF VIEW DR APN: 762280030 Application Description: BETTENCOURT/ FIREPLACE / BBQ ADDITON Property Zoning: Application Valuation: $7,500.00 Applicant: ROB PITCHFORD 77622 COUNTRY CLUB STE 0 PALM DESERT, CA 92211 Detail: FIREPLACE AND BBQ REAR YARD UNDER EXISTING PATIO COVER. Owner: TIM BETTENCOURT 2020 STANDIFORD AVE NO A MODESTO, CA 92253 Contractor: MARIO A YANEZ CONSTRUCTION PO BOX 580925 NORTH PALM SPRINGS, CA 92258 (760)285-1532 Llc. No.: 1026884 DESCRIPTION ACCOUNT CITY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT CITY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $26.01 DESCRIPTION ACCOUNT CITY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $26.01 I Total Paid for ELECTRICAL: $52.02 DESCRIPTION ACCOUNT CITY AMOUNT FIREPLACE 101-0000-42400 0 $156.04 DESCRIPTION ACCOUNT CITY AMOUNT FIREPLACE PC 101-0000-42600 0 $234.06 i Total Paid for FIREPLACE: $390.10 DESCRIPTION ACCOUNT CITY AMOUNT 101-0000-42600 ($78.02) DESCRIPTION ACCOUNT CITY AMOUNT 101-0000-42600 ($7.97) DESCRIPTION ACCOUNT CITY AMOUNT PARTITION 101-0000-42400 0 $78.02 DESCRIPTION ACCOUNT CITY AMOUNT PARTITION PC 101-0000-42600 0 $7.97 DESCRIPTION ACCOUNT CITY AMOUNT PARTITION PC 101-0000-42600 0 $135.59 Total Paid for PARTITION: $135.59 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 CITY AMOUNT 101-0000-42600 ($13.00) DESCRIPTION ACCOUNT CITY AMOUNT 101-0000-42600 ($26.01) DESCRIPTION ACCOUNT CITY AMOUNT GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $13.00 DESCRIPTION ACCOUNT CITY AMOUNT GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $26.01 Total Paid for PLUMBING FEES: $0.00 DESCRIPTION ACCOUNT Cc AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $0.98 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.98 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE J 502-0000-43611 1 0 1 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 TOTALS:0• X.a-- 62"4WrC4-/ PERMIT # BALS Q r tJ PLAN LOCATION: Project Address: —� �OGV Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN #: 7 #0u Applicant Name: Address: City, ST, Zip( E-OT C,6 /227 Telephone: -760 T 46 Z Q Email: R 6Cr.,>G? / M AX m O Valuation of Project $-# 00 r� Contractor Name: New SFD Construction: Address: Conditioned Space 0 SF City, St, Zip Garage SF Telephone: Patio/Porch SF Email: Fire Sprinklers SF State Lic: City Bus Lic: V!cv 17/ .�Fcter-D Construction Type: Occupancy: Address: '1'7_ 6 Z Z GCEUT9* C 1.41t' Grading: City, St, Zip t j Telephone: -ILO �; 4,6 0162� Bedrooms: Stories: # Units: Email: f AIL . State Lic: City Bus Lic: if Property Owner's Name: 1-f( E New Commercial / Tenant Improvements: Address: '16 ` • (J`"r V j4w Total Building SF City, ST, Zip �"�' G� Construction Type: Occupancy: Telephone: Email: % ?% (2 � L� 78495 CALLS TAMPICO LA QU I NTA, 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 HOA Approval School Fees Burrtec Debris Plan Planning approval Public Works approval Fire approval City Business License