BRES2019-006778-495 CALLE TAMPICO Tity/ D 4Q &
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: BUILDING RESIDENTIAL/REMODEL
Application Number: BRES2019-0067
Property Address: 53612 VIA DONA
APN: 777420010
Application Description: FLEENOR / OUTDOOR FIREPLACE
Property Zoning:
Application Valuation: $18,000.00
Applicant: ANTON MARINKOVICH D
550 S OLEANDER RD n
PALM SPRINGS, CA 92264 MAR 2 6 201J
CITY OF LA QUINTA 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: B License No.:1026894
Date: Can;rackbr
OWNER -BUILDER DECLARATI
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: 3/26/2019
Owner:
ALAN & AMI FLEENOR
53612 VIA DONA
LA QUINTA, CA 92253
Contractor:
MARIO A YANEZ CONSTRUCTION
PO BOX 580925
NORTH PALM SPRINGS, CA 92258
(760)285-1532
Llc. No.: 1026884
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
f th ark 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:
Cal'irieroNORGUARD INSLfflMCE COMPANY Policy Number: MAWC045971
I certify that in the performance of the work for which this permit is issued, I
s I no mploy any person in any manner so as to become subject to the workers'
mpensatloh -laws of California, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I all ro
comply with those provisions.
Date 3 r 6 r 70IAPPlicarit:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CO RAGE IS U WFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND ES 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 u above -
mentioned property for inspection purposes. _
rDate�Lf ► Signature (Applicant or Agen
Date: 3/26/2019
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
ANTON MARINKOVICH
550 5 OLEANDER RD
PALM SPRINGS, CA 92264
BRES2019-0067
53612 VIA DONA
777420010
FLEENOR / OUTDOOR FIREPLACE
$18,000.00
Owner:
ALAN & AMI FLEENOR
53612 VIA DONA
LA QUINTA, CA 92253
Contractor:
MARIO A YAN,EZ CONSTRUCTION
PO BOX 580925
NORTH PALM SPRINGS, CA 92258
(760)285-1532
Llc. No.: 1026884
Detail: OUTDOOR FIREPLACE AT REAR LOGGIA PATIO. OUTDOOR' FIREPLACE MUST B,�,$PA PHASE 2 APPROVED FIREPLACE. PER 2016 CALIFORNIA
BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
QTY
AMOUNT
101-0000-42600
($84.98)
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$84.98
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$16.42
Total Paid for PERMIT ISSUANCE: $16.42
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
($26.68)
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($13.34)
DESCRIPTION
ACCOUNT
CITY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$13.34
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
1 U
$26.68
Total Paid for PLUMBING FEES: $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE - MAJOR
101-0000-42416
0
$21.00
Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $21.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
ta 0"fra
Project Address: 2—
APN #: 777- %a - 0/0
Applicant Name:�'�G'
vi
Address: s'JQ S. �b
City, ST, Zip: 1:P19z:rt7
Telephone:
Email. -
Property Owner's Name:
Address:
City, ST, Zip
Telephone: 7Cif�
Email: _
PERMIT# '5f-ES'Z019 — QQ(o
PLAN LOCATION:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
104117�'/,
Valuation of Project $
New Commercial / Tenant Improvements:
Total Building SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA CIUINTA, CA 92253
760-777-7000