Andalusia TR 31681-3 (75 Series; Plans 21-23) 2013 Code UpdateTit,
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P.O. BOX 1504 APPLICATION ONLY
Address
Building N S Z I 2- Z- 3 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
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State Lic. City
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Arch., Engr., �( f_
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm 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.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
(Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct,
alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for
such permit to file a signed statement that he is licensed pursuant to the provisions of the Contrac-
tor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code, or that he 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).
01, 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 Profes-
sions Code: The Contractor's License Law does not apply to an owner of property who builds or
improves thereon and who does such work himself or through his own employees, provided that
such 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 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 Contractor's License Law does not apply
to an owner of property who builds or improves thereon, and who contracts for such projects with
a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's
Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑Copy is filed with the city. ❑Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less).
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 Workers' Compensation Laws of California.
Date Owner
NOTICE TO APPLICANT.' If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for
which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
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 the above -mentioned
property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
WHITE = BUILDING DEPARTMENT
A.P. Number
Legal Description
Project Description S Z'-1, Z Z-t - 3
1 1 A—
Sq. Ft. No.
Size Sto
No. Dw.
New Add ❑ Alter ❑ Repair ❑ Demolition ❑
I Estimate&"t q% gUINTA
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
CONTACT INFORMATION
NAME:
PHONE:
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line —
FINAL DATE
Issued by:
Validated by: —
Validation:
YELLOW = APPLICANT
INSPECTOR
Date Permit
PINK = FINANCE
EsGil Corporation
In (Partnership with Government for Buifding Safety
DATE: OCT. 14, 2014 ❑ APPLICANT
❑ JURIS.
JURISDICTION: LA QUINTA ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: 14-584 SET: IV
PROJECT ADDRESS: ANDALUSIA AT CORAL MOUNTAIN
PROJECT NAME: TRACT HOMES (PLANS #21, 22 & 23 FOR T.D. DESERT DEVELOP.)
❑ The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
® The plans transmitted on Sept. 30t' will substantially comply with the jurisdiction's building codes
when minor deficiencies identified below are resolved and checked by building department staff.
❑ The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
❑ The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
❑ The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
❑ The applicant's copy of the check list has been sent to:
® EsGil Corporation staff did not advise the applicant that the plan check has been completed.
❑ EsGil Corporation staff did advise the applicant that the plan check has been completed..
Person contacted: Telephone #:
Date contacted: (by: ) Email: Fax #:
Mail Telephone Fax In Person
❑ REMARKS: As per applicant City will review the site plans, City to verify.
[Each Model has a iv o-" version as well as reverse plans & two or more different elevations].
By: ALI SADRE, S.E. Carrrreda Rans me sent to the Otyan Sept 30n.
EsGil Corporation
❑ GA ❑ EJ ❑ MB ❑ PC LOG IN & OUT
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-106