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BRES2019-010778-495 CALLE TAMPICO D� VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 4/11/2019 Permit Type/Subtype: BUILDING RESIDENTIAL/REMODEL Owner: Application Number: BRES2019-0107 HINCHMAN BRUCE M & HIROMI B Property Address: 81280 GOLF VIEW DR 81280 GOLF VIEW& APN: 762390014 LA QUINTA, CA 92UP Application Description: HINCHMEN / WATER DAMAGE REPLACE PORTION OF DRYWALL & G7 Property Zoning: INSULAT Application Valuation: b t'r -'C3 $6,000.00 Applicant: Contractor. MERRIMAN'S INCORPORATED MERRIMAN'S INCORED9TEDr--) P O BOX 547 P O BOX 547 dm; -4 a ::::3 CALIMESA, CA 92320 CAL}MESA, CA 92320M'y F U:5 {909}795-5301 � LIc. No.: 292346 rt 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, C47, D03, D41, C15. C39..0-8 License No.: 292346 Date: ( Contractor: 'u� tl�t�++s TW(i 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.). (_) 1, 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 Add 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 thew k for which this permit is issued. have and will maintain workers' compensation insurance, as required by Sec ' n 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:TS ATE QMPENSATION INSURANCE FUND Policy Number: 9228864 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: � • ( ( '�q Applicant: � cwLQ�L3� 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 aws relating to building construction, and hereby authorize representatives ofthi it to gn fup the above-mentioned property for inspection purposes. 7 j) rI Date: 4'0 -1 t Signature (Applicant or Agent. Date: 4/11/2019 Application Number: BRES2019-0107 Owner: Property Address: 81280 GOLF VIEW DR HINCHMAN BRUCE M & HIROMI B APN: 762390014 81280 GOLF VIEW DR Application Description: HINCHMEN / WATER DAMAGE REPLACE PORTION OF DRYWALL & INSULAT LA QUINTA, CA 92253 Property Zoning: Application Valuation: $6,000.00 Applicant: Contractor: MERRIMAN'S INCORPORATED MERRIMAN'S INCORPORATED P O BOX 547 P O BOX 547 CALIMESA, CA 92320 CALIMESA, CA 92320 (909)795-5301 Llc. No.: 292346 Detail: REPLACE DRYWALL AND INSULATION THROUGHOUT DWELLING, 2' FROM FLOOR. 2016 CALIFORNIA BUILDING CODE. I FINANrw INFCIRMATIn1U DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT QTY 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: $203.32 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 ta a�fra CA[ WORNIA Project Address: 13 ` z5) 6V APN #: RMIT# fr!6A` `1" 1 V Iew Lk, I Project Description: Applicant Name: S C Address: P-0, City, ST, Zip: L-AAC---SA, Telephone: ,pg - ►"c�s, S30 1 Email: KA.FY7 it -Lk A A. i �-. r r ! Contractor Name: INl1-ren 5C Address: PIC), ��- City, St, Zip Telephone: Email: State Lic:- c3 -, 3d( f City Bus Lic: Valuation of Project $ Co 001L:�) New SFD Construction: Conditioned Space SF Garage SF Patio/Porch SF Fire Sprinklers SF Property Owner's Name: Address: 14(,� City, ST, Zip E3(2g-C> 60LF VIv4F::1j �R Telephone: Zo 10 elgS!�, Email: New Commercial / Tenant Improvements: Total Building SF Construction Type: Occupancy: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 OFFICE USE ONLY # Submittal Required Received Plan Sets —Truss Structural Calcs 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 Owamk� 90l-Z?>D Ga -F VIC* DF- W,� Om&�, CA gaG3 C-2-04> Cold --105-5 IA- Lo Co ✓c -p— Ll��lh IoM GllW,-Si- 00K \,N0�-) .�.x sq1 4wmssI�, CA 12320 Cana) -1 g5 -553o1 77SI.Aa.I 7D V-tl-wtwl GID LIF q Ic-W D P,