BRES2019-015078-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
D & T REMODELING INC
78365 HWY 111 #533
LA QUINTA, CA 92253
c&tw 4 la Qu4a
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BUILDING RESIDENTIAL/DWELLING - SINGLE FAMILY DETACHED
BRES2019-0150
79824 ARNOLD PALMER
775241075
BARRET / GAS OUTLET FOR FIREPIT AND INSTALL OF LED LIGHT
$27,000.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
BARRET H. & JOAN HORN
79824 ARNOLD PALMER
LA QUINTA, CA 92253
LJ Contractor:
D & T REMODELING INC
D78365 HWY 111 #533
MAY y 1' M9 LA QUINTA, CA 92253
!l�v�l 6 (760)902-3914
CIS OF Li (,-!J1 NIIA Llc. No.: 997936
DESIGN & 0EL VEUO', MF-NT DEL RAI PAEN I
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 fcommencing 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.: 997936 1
Date: S(!;R 9 Contractor:
iWak�1
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.).
() 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:
Date: 5/16/2019
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
ofk for which this permit is issued. @r.
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:
Carrier: EVEREST PREMIER INSURANCE COMPANY Policy Number:
7600017201191
1 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 Core, I shall forthwith
comply wit those rovisions.
hate: Applicant:
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 laws relating to building
construction, and hereby authorize representatives of this city to enter upon It
above•mentione property for inspection purposes.
Date,. SignatUre (AppliCant or Agent):
Date: �/16/2di9
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
D & T REMODELING INC
78365 HWY 111 #533
LA QUINTA, CA 92253
BRES2019-0150
79824 ARNOLD PALMER
775241075
BARRET / GAS OUTLET FOR FIREPIT AND INSTALL OF LED LIGHT
$27,000.00
Owner:
BARRET H. & JOAN HORN
79824 ARNOLD PALMER
LA QUINTA, CA 92253
Contractor:
D & T REMODELING INC
78365 HWY 111 #533
LA QUINTA, CA 92253
(760)902-3914
Llc. No.: 997936
Detail: NEW GAS LINE FOR FUTURE FIRE PIT, AND INSTALLATION OF NEW RECESSED LED LIGHT ABOVE BARBECUE AREA. PER 2016 CALIFORNIA BUILDING
CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
CITY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$26.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST20 PC
101-0000-42600
0
$26.68
Total Paid for ELECTRICAL: $53.36
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.40
Total Paid for PERMIT ISSUANCE: $101.40
DESCRIPTION
ACCOUNT
QTY
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
0
$26.68
Total Paid for PLUMBING FEES: $40.02
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
PERMIT #
W Qa�tra
c fItF()R\i ; ---
PL6N L A I
Project Address: -19 9 14
roject Description:
APN #: Ile; • 224 t . 01
Applicant Name,
Addres!Ep-qqM—tLU"
City, ST, Zip: Z '< 2
Telephone: d 2, 51.� 1`]` .� ` ll � tu,��
Email:
Contractor Name: r ` ►New SFD Construction:
Address: '� 6 ? , � � Conditioned Space SF
City, St, Zip Garage SF
Telephone: �. �2, , l Patio/Porch SF
Email:D NtOAa Fire Sprinklers SF
State Lic: CIG1 gbVity Bus Lic: Ol 223C7
Architect/Engineer Name: Construction Occupancy:
Address: Grading:
City, St, Zip
Telephone: Bedrooms: Stories: #Units:
Email:
State Lic: City Bus Lic: —T
Property Owner's Name: c w Commercial /Tenant Improvements:
Address:I"MU m Total Building SF
City, ST, Zip ?�Z.�j7j Construction Type: Occupancy:
Telephone: ,�)
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
# � Submittal j Required I Received
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